The following questions and answers are provided for general information only and may not be completely accurate in every circumstance, do not intend to be medical advice, and are not to be used in diagnosis or treatment of diseases. Questions involving interpretation of the answers should be addressed by your physician.
What is an endoscopy, esophagogastroduodenoscopy or EGD?
All three terms refer to a procedure in which a physician uses an endoscope to examine the esophagus, stomach, and duodenum. The endoscope is a small, thin, flexible tube that houses a light and a video camera. After the patient receives a small sedative and solution to numb the throat, the endoscope is gently inserted into the mouth and down the esophagus into stomach or further into the duodenum or small intestine. The endoscope is used to diagnose the cause of problems such as abdominal pain, anemia, bleeding in the upper GI tract, nausea and vomiting, problems swallowing, unexplained weight loss, or an abnormality found on X-rays, CT-scan, or MRI. Tools may be passed through the endoscope to remove polyps, perform a biopsy, or stop bleeding through electrical cauderization.
The procedure is performed by a gastroenterologist, surgeon, or other trained health care provider performs the procedure.
How long does an endoscopy take?
After sedation, the average time for an endoscopy is between 5 and 10 minutes but may take as long as 60 minutes depending on whether biopsies are done.
How do I prepare for an endoscopy
The upper GI tract empties itself and requires no flushing. After a 6 hour fast period, you may only drink clear liquids and take your medication up until 3 hours before your procedure. However, you should follow your physician's instructions regarding all medication. See below for more information on permitted medications.
Is endoscopy painful?
No. You won't remember anything due to the sedation and a topical anesthetic is used to numb your throat and reduce the gag reflex. After the sedation and anesthetic wear off, your throat may feel scratchy or sore for a day or two but that's all.
What is a colonoscopy?
A colonoscopy is a procedure to examine the inside of the colon, large intestine, or large bowel. The colonoscope is a is a four foot long, thin, flexible tube that houses a light and a video camera. After the patient is sedated, the colonoscope is inserted into anus and advanced gently into the rectum and through the colon. The colonoscope is used to diagnose the cause of blood in the stool, abdominal pain, diarrhea, a change in bowel habit, or an abnormality found on colonic X-rays or a CT-scan. Individuals who have a family history of polyps or colon cancer may be recommended to have routine colonoscopies every 3 years as a matter of prevention and detection. With no family history as mentioned, an individual should undergo a colonoscopy every 10 years after 50. Tools may be passed through the endoscope remove polyps, perform a biopsy, or stop bleeding through electrical cauderization or medical application. The procedure is performed by a gastroenterologist.
How long does a colonoscopy take?
After sedation, the average time for an endoscopy is between 20 to 30 minutes but may take as long as 60 minutes depending on whether biopsies are done.
Is colonoscopy painful?
No. You won't remember anything due ot the sedation administered before and during the procedure. You may experience slight cramping due to the small amount of air pumped into the colon to help the doctor see more clearly. This is typically relieved through flatulence.
What are polyps?
Colon polyps are a small clump of cells which can be flat or have a stalk. Most polyps are harmless and do not cause symptoms. Some polyps may produce bleeding, mucous discharge, alteration in bowel function, or in rare cases, abdominal pain. Over time, polyps can develop into cancer. This is why regular examination of the rectum and colon are necessary for people over 50, those overweight, those who smoke, or for those with a family history of colon cancer.
What happens if I have polyps?
There is no way of predicting whether or not a polyp will become malignant (cancerous). Therefore, total removal of the polyp is advised. Most polyps can be removed with a colonoscope by snaring them or cauderizing them with a small electrical current. Large polyps may require more than one treatment and those that cannot be removed due to their size and position may require surgery.
I had some polyps removed. Can these polyps recur?
After a polyp is removed, its recurrence is unusual. But remember that the same factors which caused the polyp to form are still present. New polyps may occur in at least 30% of the people who have previously had polyps.
How do I prepare for a colonoscopy??
You will receive written instructions from your physician prior to the procedure. These instructions indicate when to start the prep and when to finish the prep based on your appointment time. Most patient are instructed to take up to four laxative (stool softener) pills followed by 64 ounces of a clear laxative liquid. The liquid usually comes in powdered form and is mixed at home with water. The preparation will cause bowel-cleansing diarrhea so it is wise to conduct this at home. You should purchase some kind of medicated wipes, Vaseline, or Desitin and apply it to your bottom as this will help to reduce any chafing or irritation caused by the prep. It is normal to visit the bathroom every 5 to 10 minutes while you are consuming the liquid as directed. Also, do not eat or drink anything the day before or the day of your procedure which contains blue, red, or purple food dyes as this can confuse the results of your colonoscopy.
Can I work the day before the colonoscopy?
Yes, most people work the day before their procedure. However, you should be drinking lots of fluids with calories to properly hydrate your body and deliver the nutrition it needs. Once you start the bowel preparation, you will want to be at home or at least near a bathroom.
What if I'm not cleaned out?
After undergoing the prep, your output should be clear or yellow liquid. It is ok if it is not clear or yellow as long as no solid stool is present.
What if I vomitted during the prep and cannot keep it down?
If you were able to keep the prep down for 20 minutes then this should be enough time for it to pass beyond the stomach. As long as your output is relatively clear with no stool, then the procedure may continue as planned. If you typcially become nauseated when taking medication or ingesting prep, you should let your phsycian known so that an anti emetic may be prescribed.
What clear liquids are recommended during the prep?
People commonly drink gatorade, water, apple juice, white cranberry juice (not red). Do not drink any liquids 2 hours prior to your scheduled procedure.
What if I am not feeling well or come down with some illness days before the procedure?
Please call and speak with the nurse or phsyician. The procedure will be canceled if you are running fever. Otherwise, the decision is yours to reschedule or continue with the appointment.
What if I am having my period the week of the procedure?
This will not interfere with the procedure at all. If you feel uncomfortable, however, you may reschedule your procedure.
I ate nuts and/or seeds with a few days of the colonoscopy. Can the procedure still be done?
Yes, the procedure can still be done. Nuts are not usually problematic as they are too big to block channels in the scope. Berry seeds, however, are very small and can block channels. In this case, drink plenty of fluids to flush out any seeds or nuts.
What happens when I arrive at the endoscopy center?
Upon your arrival, you will be greeted by our receptionist and escorted to the prep area. You will then change into a gown in a private area and an intravenous line will be started. A certified Nurse Anesthetist will provide your anesthesia, which is a fact acting intravenous sedative that creates a completely relaxed and pain free deep sleep throuhout the procedure.
Is general anesthesia used for a colonoscopy?
No. The anesthesia used produces a conscious sedation or "twilight". It is fact acting and tolerated by most people and doesn't require breathing assistance. You will awaken immediately after the procedure and will not experience any lingering effects. However, you will require a driver to take you home and should avoid operating heavy machinery for several hours after.
What types of sedation are current available?
There are two types of sedation commonly used for a colonoscopy: Propophol and Fentanyl. If you are usually nauseated by narcotics, please let the nursing staff known ahead of time so that they can give you medication through the IV to counteract nausea.
What medication(s) should I take before my procedure?
Always follow your physicians individual instructions. You should discuss all medications with your physician prior to your procedure. If you are a diabetic, taking blood thinners, or taking blood pressure medication, please contact the physician if you haven't already done so.
If I am diabetic, should I check my blood sugar before comming in for the procedure?
Yes. It is important for the physician's staff to have a baseline for your blood glucose. You should check it at home and let the nurse know the result when checking in.
If I didn't stop my aspirin (NSAIDs) 3 days before the procedure, can I still have the procedure?
Yes, however, there might be a slight increased risk of bleeding should biospies be taken or polyps removed. If you have any concers or questions, please call to speak with the nurse or the physician.
If I have had any orthopedic replacement surgery, do I need an antibiotic prior to my colonoscopy?
You should contact your physician because of new guidlines concerning antibiotic therapy.
Since I take antibiotics for dental procedures, should I also take them before a colonoscopy?
Antibiotics are not required for endoscopy/colonoscopy procedures. If you are concerned about this, please speak with your physician when scheduling your procedure.
Is it ok to take pain pills (narcotics) for pain management?
Yes, it is ok to take these on the days prior to the procedure. For any other questions, you need to speak with your physician.
Since I feel fine and alert, can I drive myself home after the procedure?
No. Even though you may have tolerated the anesthesia well and feel alert, your reflexes have been subtley altered. It is a legal requirement that you have a responsible person drive you home and esort you into your house. You should not drive or operate heavy machinery for the rest of the day. Without a designated driver, the procedure will be rescheduled (no exceptions). Your safety is important to us!
What happens when the procedure is finished?
Within 15 to 30 mintues after the procedure, you will be escorted to a private consultation room where you can be joined by your family member or friend if you choose. The physician will discuss the procedural findings and recommendations, and arrange any follow up procedures, office visits, and/or tests if needed.
Can I be alone after the procedure?
Since you are under the influence of a narcotic/sedative, you should have some supervision to make sure you comply with discharge instructions. If someone cannot be with you, ask a neighbor if they can check in on you now and then.
Will I be able to eat after the procedure?
Yes. After an EGD or colonoscopy, you may resume a normal diet immediately. However, if your esophagus required dilation, then a soft diet is recommended for the next 24 hours. Your physician will indicate in the discharge instructions.
Are there any restrictions on the day after the procedure?
There are generally no restrictions on the day after a procedure. If restrictions are necessary, then your physician will discuss with you.