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Frequently Asked Questions

Before Your Procedure

Why is it recommended to avoid seeds and nuts for several days prior to colonoscopy?

The dense components of very high roughage foods such as seeds and some skins tend to layer out at the bottom of intestinal segments and thus may be more resistant to being flushed out by laxatives.  In most cases the preparation fluids will flush out the material anyway but an extra measure of assurance of obtaining an optimal preparation comes from avoiding these foods a few days.

We recognize that it is likely that many will inadvertently eat some of these items and that’s okay.  We would put a priority on avoiding the smallest densest seeds such those in tomatoes, kiwi fruit, blackberries, and raspberries.

Why avoid iron supplements prior to colonoscopy?

Iron supplements in many people have a constipating effect, making it more difficult for the laxative to clean out the colon. In addition, retained iron frequently stains the walls of the colon or the fluid, limiting the clarity of views.

Why is avoiding red or purple drinks or Jell-O advised?

Even after an excellent preparation for colonoscopy a certain amount of fluid and mucous is retained adhering to the walls of the colon.  These will be tinted red or purple by natural and artificial dies in beets, fruit punches (Hawaiian Punch, e.g.), and jello, which can give an appearance similar to blood, which increases the difficulty in reaching clear conclusions during the procedure.

What should I do on the day of my prep?

Obtain the clear liquids that appeal the most to you in the days leading up to the formal preparation day and have them well chilled (as appropriate).  Most people find that they are much less hungry than they expected during the preparation day.

Take the formal laxative at home as the time to its taking effect (kicking in) varies greatly, from 30 minutes to 4 hours. Extra fluids are encouraged. Plan to do light activities such as reading, watching videos, or simple chores at home.

What do I do about hypoglycemia?

I can’t skip meals.  The sugar and protein containing fluids (including Jell-O) can sustain blood sugar very well for most people.  Again in many cases patients who have had some trouble with hypoglycemia in the past find that their preparation for the procedure goes better than expected as the increased fluid intake that one hopes to achieve during colonoscopy preparation and a restful day (without fluctuations in activity or meals) avoids the circumstances that usually bring on their symptoms.  On very rare occasions where the above advice doesn’t work for a patient we’ve been able to in virtually every case design a customized eating plan at an office appointment to get through a successful colonoscopy preparation.

Are beer or wine clear liquids?

Beer and white wine are indeed qualifying clear liquids and therefore can be taken during a colonoscopy prep in medically prudent amounts (1-2 servings). Please note that they will dehydrate and so it is not recommended.

I take warfarin (Coumadin), will I need to stop it?

Advice about stopping and restarting oral anti-coagulants (warfarin/Coumadin) is individualized and needs to come directly from our office.  In most cases an office appointment will be scheduled to review the specifics of your medical history before making the final plan.

What should I do about the clopadogrel (Plavix) or aspirin I take because of a heart or other circulation problem?

Patients on these medications to treat a specific medical problem will need to have their history reviewed either by our scheduling coordinator or during an office appointment to get a specific plan tailored to their individual circumstance.  After review sometimes these medications are continued.

Will my chronic constipation allow me to be adequately prepared for colonoscopy?

If you believe you have significant constipation or have been told that your preparation for prior colonoscopy wasn’t optimal, an enhanced preparation may be advisable.  Please review your history with our scheduling coordinator, nurse, or with the provider at your office appointment.

May I take my medicines before an endoscopy or colonoscopy?

In most cases, yes, routine medications can be taken with a glass of water up to three hours prior to an endoscopic procedure.  This will often mean waking up a little early and taking medications with clear liquids such as water, non-red juices/purple (no pulp), tea, black coffee.

For those with very early procedures an alternate plan is to bring your medication bottles to the endoscopy suite to be taken after the procedure.

May I have fluids after midnight?

Yes, you may continue to have water, soda ,non-red/purple juices, tea, and even black coffee up to 3 hours prior to the procedure.

What meals should I eat the day prior to an Upper Endoscopy?

You may consume a  small to moderate evening meal completing it prior to 9pm.  The traditional NPO (nothing per os) after midnight works in most cases but sometimes a large rich meal consumed at 10pm or 11pm at night will still be partially present in the morning interfering with the exam.

Once the small to moderate solid meal has been digested, clear liquids such as water, non-red/purple juice, soda, tea, and black coffee to satisfy thirst are fine.

Do the sedative medications have any drug interactions?

In general the sedatives used do not have any effect the body’s handling (metabolism) of maintenance medications for most chronic medications.  If you are taking sleeping , anti-anxiety, or psychiatric medications your system may be some what more resistant to the sedatives which can usually be handled by raising the dose.  The dose of maintenance medication and other categories (blood pressure, diabetes, gout, arthritis) need not be changed after an endoscopic procedure has been completed.  Blood thinning medications such as Warfarin, Coumadin, clopidogrel bisulfate (Plavix), or aspirin are a special category and specific individualized advice is always needed and is usually covered in the post procedure discharge instructions.

During Your Procedure

What happens on the day of endoscopy/colonoscopy?

After you arrive at the facility (be sure to check whether you are going to Surgicare or the hospital) you’ll register, review your history with a nurse who will then start an intravenous line.  You’ll have an opportunity to ask questions or review any new developments with your doctor. Your blood pressure, pulse and breathing are monitored via a typical blood pressure cuff and an oximeter (finger cap).  You receive initial doses of the sedative to make sure you are quite calm before the actual procedure begins.  The level of sedation can be varied in most cases to suit your preference.

Will my procedure cause discomfort or hurt?

In the vast majority of cases the answer is no.  While most patients naturally fear their first endoscopic procedure, in practice the sedative medications are quite effective, safe and allow us a great deal of flexibility in keeping your comfort a priority.  Patient comfort is a high priority for our doctors and nursing staff such that most patients that need a subsequent procedure down the line, face it with much less anxiety.

After Your Procedure

Why is it advised to not travel out of the country for the month after the colonoscopy?

It needs to be remembered that during endoscopic procedures (i.e. colonoscopy) besides diagnosing disease, therapy may be administered which has to be viewed as being a form of surgery preformed internally.  The most frequent example of this occurs during colonoscopy where after a polyp is seen it is removed via an electro-surgical technique burning away its attachment to the wall of the colon.  A burn (cautery mark) is left behind that will heal over a number of days (up to 14 to 18) and on rare occasions bleeding can occur from the edge of the healing burn and require follow up medical attention.  This is infrequent, though on average one patient per year from our practice will require hospital admission for observation (generally brief lasting 24 to 48 hours) as a consequence of their colonoscopy.  One patient every ten years may require an operation to fix some problem (for instance bleeding or infection, etc.) that comes on as a consequence of colonoscopy.  While this is a very infrequent event, for everyone’s peace of mind it makes sense to be able to obtain medical care the first few weeks after a colonoscopy.

The same principles apply towards planning for an upper endoscopy, however the risks are less, probably a quarter to a third of those of colonoscopy.  Thus the advice regarding travel and a planned endoscopic procedure is really against international travel (Canada and Western Europe are probably fine) but against traveling to out of the way places.

What are the medications used for endoscopy/colonoscopy?

Midazolam (Versed) is the most commonly used sedative.  It is excellent at relieving anxiety, suppressing the gag reflex and awareness of discomfort.  It induces amnesia, and interference with memory is probably the last effect of the drug to wear off, such that conversations after the procedure with the patient, who appears otherwise awake, may not be remembered.  In some upper endoscopies and most colonoscopies a small dose of a narcotic pain reliever such as meperidine (demerol) or morphine or fentanyl (trade name) is used.  The two agents together often work nicely to provide a synergistic effect allowing a smaller dose of each medicine to be used enhancing comfort and speeding recovery.  Because of uncertainty regarding the recovery of memory and reflexes following the use of these sedatives, it is required that patients not drive or use complex machinery (lawn mowers, chainsaws, etc.) for the rest of the day.  Similarly activities requiring precise balance on ladders, roofs, etc. need to be avoided.

Who can be my driver for an endoscopy/colonoscopy?

After undergoing a sedated procedure it is absolutely required that a person be driven home by another responsible adult.  In addition to driving, it’s helpful if that person can be present to hear the preliminary report of the endoscopic procedure (impression of the doctor) and discharge instructions.  As a consequence of the sedative the patient may very well not remember being given the instructions.  The impaired memory function the sedatives produce can be very subtle and last some hours after all other apparent recovery from the sedative has occurred.  It is not uncommon for someone not to remember conversations two or three hours after a procedure when they have been dressed, walking and engaging in apparently normal conversation.  Thus it’s helpful if the person chosen as a driver is a spouse, sibling, or other trusted relative, friend, or neighbor who can pass on the initial report.

What follow-up information will I receive?

You will be sent home with a discharge instruction sheet and plan that if findings were normal or minor may include the final follow-up plan such as seeing your regular doctor for his/her previous instructions.  The endoscopy nursing staff will contact you the next day at home or at another number you may wish to give.

Our office will contact you with the results of any biopsy or specimen reports in about a week.  If you have not heard about a biopsy (after ten days)or have any other concerns following your procedure, please call our office at (607) 272-5011.  5% to 10% of patients will have findings that warrant a follow-up discussion in the office at an appointment 4  to 5 working days after the procedure.  If a new medication treatment is started office follow up is usually deferred a number of weeks so as to access its affect prior to the appointment.

Can I take a taxi home from my endoscopy procedure?

Yes, you may, though we feel for a number of reasons that having a trusted family member, friend or neighbor bringing you home has numerous advantages.  These include hearing the initial medical report and reporting back to later when your memory may be more reliable, and giving you supportive TLC on your arrival home.  The post procedure observation period time prior to taking a taxi is extended to allow for these factors.

May I ride walk or bicycle home?

No, we require that a patient who has had an endoscopy be released to a responsible adult.  A released patient is not allowed to navigate his/her way on public roadways.

What should I eat after my procedure?

You should start with a light meal at home taking care to avoid a meal that is too large or high in fat or spice. Eating at a restaurant is not recommended since your system may not be ready to handle a large meal despite the hunger one may begin to feel once the procedure is done.  Additional restrictions may be required short term if there has been dilation of an esophageal stricture, treatment of an ulcer, or removal of a large polyp.

Prep Instructions

EGD Prep

Please call Express Check In 24-48 hours prior to the day of your procedure: (607) 274-4353
DEFINITION:
A small and flexible tube-like fiberoptic instrument is inserted through your mouth and into your stomach. Your doctor can then visually examine your esophagus, stomach, and opening to the small intestine.
PROCEDURE:
Before insertion of the scope, your throat may be sprayed with medication to numb your tongue and throat to prevent gagging. Intravenous medication will be administered to make you groggy. Mild discomfort may be experienced, but few people remember the procedure. The procedure itself will take approximately 5 to 20 minutes and you will remain in the Endoscopy Suite until you are more fully awake. Plan to be at the Hospital or Cayuga Endoscopy Center for 1-2 hours.
INSTRUCTIONS:
HAVE NO MEALS AFTER 8PM. NOTHING TO DRINK AFTER MIDNIGHT. SIPS OF WATER ARE ALLOWED UP TO 3 HOURS BEFORE THE PROCEDURE. (If you are also scheduled for a colonoscopy, on the same day as this procedure, and the colonoscopy calls for a morning laxative, you may take them as those liquids don’t interfere with a stomach exam.)
Take all prescription medication(s) up to 3 hours prior to the scheduled procedure starting time. Get specific instructions for any diabetic medications or Coumadin, Warfarin, Plavix, clopidogrel bisulfate (blood thinners) or if you have a mechanical heart valve.
Nothing by mouth 3 hours prior to the scheduled procedure starting time.
YOU MUST ARRANGE FOR A FAMILY MEMBER OR FRIEND to review the test results and discharge instructions with your physician and to DRIVE YOU HOME. If you do not have a driver, sedation will not be given.
AFTER THE PROCEDURE:
No driving, operating machinery, swimming, or climbing ladders for the rest of the day. You may eat as soon as your throat is no longer numb. Initially plan to eat lightly at home. Going to a restaurant is not recommended.
Should you have any questions or concerns after reviewing these instructions please contact our office at (607) 272-5011 and ask to speak with the scheduling coordinator.
PLEASE NOTE:
The above service may be considered as a surgical procedure by certain insurance companies. Please contact your insurance carrier for coverage information. Precertification may be required.
GASTROENTEROLOGY ASSOCIATES OF ITHACA, P.C.
2435 NORTH TRI
PHAMMER ROAD
Peter T. Brennan, M.D.
ITHACA, NEW YORK 14850
Steve A. Rogers, M.D.
Brent D. Lemberg, M.D.
TELEPHONE (607) 272-5011
Sarah E. Champion, FNP-C.
FAX NUMBER (607) 272-5861
IMPORTANT INFORMATION ABOUT HEALTH INSURANCE COVERAGE
Gastroenterology Associates of Ithaca, PC is a participating provider in many health plan networks. The following is a list of the plans in which we participate. In general, the major health plans we participate include:
  • Aetna Chickering Student Plans
  • Health Now
  • Aetna Managed Choice Plans
  • Martin’s Point Health Care
  • Excellus-Commercial Products
  • Medicare and Medicaid
  • Excellus-Medicare Blue PPO
  • MVP Commercial (Cigna PPO plans)
  • Empire Plan (NYS employees)
  • Total Care
  • Lifetime Benefit Solutions (RMSCO)
  • UnyHealth
This list is not a guarantee of coverage by your insurance carrier, nor does it imply that we participate with all coverage policies sponsored by a particular insurance carrier. It is meant for general information purposes only. Some health plans use smaller networks for certain products they offer so it is important to check whether we participate in the specific plan you are covered by. Please contact your insurance carrier to verify our participation with your individual coverage plan. IF YOUR PLAN IS NOT ON THE LIST WE DO NOT PARTICIPATE WITH THAT HEALTH PLAN AND YOUR CARE COULD BE CONSIDERED OUT OF NETWORK.
If you are having a procedure; it is also important to know that there will be separate charges for the hospital as well as the pathologist (should biopsies or specimens be taken). Please contact the hospital in which your procedure is scheduled to inquire about coverage of their services and to obtain the name and information of their contracted pathologist. We are affiliated with Cayuga Medical Center. You may request a written estimate of costs that will be submitted to your insurance on your behalf. Please be advised that these are just estimates and that the costs could increase due to unanticipated circumstances (i.e. a
polyp is found and removed by varying techniques). Upon request you will be provided a list of other physicians and facilities that may be involved in your care. You must contact them directly to discuss their participation with your insurance plan.

What is Upper GI Endoscopy?

Your doctor has recommended that you have a medical procedure called upper GI endoscopy to evaluate or treat your condition. This brochure will help you understand how upper GI endoscopy can benefit you and what you can expect before, during, and after this procedure.
What is Upper GI Endoscopy?
The term “endoscopy” refers to a special technique for looking inside a part of the body. “Upper GI” is the portion of the gastrointestinal tract, the digestive system, that includes the esophagus, the swallowing tube leading to the stomach, which is connected to the duodenum, the beginning of the small intestine. The esophagus carries food from the mouth for digestion in the stomach and duodenum. Upper GI endoscopy is a procedure performed by a gastroenterologist, a well-trained subspecialist who uses the endoscope to diagnose and, in some cases, treat problems of the upper digestive system.
The endoscope is a long, thin, flexible tube with a tiny video camera and light on the end. By adjusting the various controls on the endoscope, the gastroenterologist can safely guide the instrument to carefully examine the inside lining of the upper digestive system. The high quality picture from the endoscope is shown on a TV monitor; it gives a clear, detailed view. In many cases, upper GI endoscopy is a more precise examination than X-ray studies.
Upper GI endoscopy can be helpful in the evaluation or diagnosis of various problems, including difficult or painful swallowing, pain in the stomach or abdomen, and bleeding, ulcers, and tumors.
How Do I Prepare for the Procedure?
Regardless of the reason upper GI endoscopy has been recommended for you, there are important steps you can take to prepare for and participate in the procedure. First, be sure to give your doctor a complete list of all the medicines you are taking and any allergies you have to drugs or other substances.
Your medical team will also want to know if you have heart, lung, or other medical conditions that may need special attention before, during, or after upper GI endoscopy. You will be given instructions in advance that will outline what you should and should not do in preparation for the upper GI endoscopy. Be sure to read and follow these instructions.
One very important step in preparing for upper GI endoscopy is that you should not eat or drink within eight to ten hours of your procedure. Food in the stomach will block the view through the endoscope, and it could cause vomiting.
Upper GI endoscopy can be done in either a hospital or outpatient office. You’ll be asked to sign a form that verifies that you consent to having the procedure and that you understand what is involved. If there is anything you don’t understand, ask for more information!
What Can You Expect During an Upper GI Endoscopy?
During the procedure, everything will be done to help you be as comfortable as possible. Your blood pressure, pulse, and the oxygen level in your blood will be carefully monitored. Your doctor may give you a sedative medication; the drug will make you relaxed and drowsy, but you will remain awake enough to cooperate.
You may also have your throat sprayed or be asked to gargle with a local anesthetic to help keep you comfortable as the endoscope is passed. A supportive mouthpiece will be placed to help you keep your mouth open during the endoscopy. Once you are fully prepared, your doctor will gently maneuver the endoscope into position.
As the endoscope is slowly and carefully inserted, air is introduced through it to help your doctor see better. During the procedure, you should feel no pain and it will not interfere with your breathing. Your doctor will use the endoscope to look closely for any problems that may require evaluation, diagnosis, or treatment.
In some cases, it may be necessary to take a sample of tissue, called a biopsy, for later examination under the microscope. This, too, is a painless procedure. In other cases, this endoscope can be used to treat a problem such as active bleeding from an ulcer.
What are the Possible Complications From an Upper GI Endoscopy?
Years of experience have proved that upper GI endoscopy is a safe procedure. Typically, it takes only 15-20 minutes to perform.
Complications rarely occur. These include perforation – a puncture of the intestinal wall, which could require surgical repair, and bleeding, which could require transfusion. Again, these complications are unlikely. Be sure to discuss any specific concerns you may have with your doctor. When your endoscopy is completed you’ll be cared for in a recovery area until most of the effects of the medication have worn off.
Your doctor will inform you about the results of the procedure and provide any additional information you need to know.
What Can I Expect After My Upper GI Endoscopy?
You will be given instructions regarding how soon you c an eat and drink, plus other guidelines for resuming your normal activity.
Occasionally, minor problems may persist, such as mild sore throat, bloating, or cramping; these should disappear in 24 hours or less. By the time you’re ready to go home, you’ll feel stronger and more alert. Nevertheless, you should plan on resting for the remainder of the day. This means not driving, so you’ll need to have a family member or friend take you home.
In a few days, you will hear from your doctor with additional information such as results of the biopsy, or you may have questions you want to ask the doctor directly.

Liver Biopsy

The following instructions will prepare you for your procedure.
  1. No Aspirin or Ibuprofen type medications one week before your procedure.
  2. Nothing to eat or drink after midnight the night before your procedure.
  3. Report to the outpatient registration desk 15-20 minutes before your exam.
  4. The procedure will take place in the Radiology Department at Cayuga Medical Center.
  5. You should expect to be at the hospital for approximately 6 hours.
If you have any questions or need to reschedule this appointment please contact our
office at (607) 272-5011.

What is Liver Biopsy?

In a liver biopsy (BYE-op-see), the physician examines a small piece of tissue from
your liver for signs of damage or disease. A special needle is used to remove the tissue from the liver. The physician decides to do a liver biopsy after tests suggest that the liver does not work properly. For example, a blood test might show that your blood contains higher than normal levels of liver enzymes or too much iron or copper. An x ray could suggest that the liver is swollen. Looking at liver tissue itself is the best way to determine whether the liver is healthy or what is causing it to be damaged.
Preparation
Before scheduling your biopsy, the physician will take blood samples to make sure your blood clots properly. Be sure to mention any medications you take,
especially those that affect blood clotting, like blood thinners. One week before the
procedure, you will have to stop taking aspirin, ibuprofen, and anticoagulants.
You must not eat or drink anything for 8 hours before the biopsy, and you should plan to arrive at the hospital about an hour before the scheduled time of the procedure. Your physician will tell you whether to take your regular medications during the fasting period and may give you other special instructions. The digestive system
Procedure
Liver biopsy is considered minor surgery and so it is done at the hospital. F or the biopsy, you will lie on a hospital bed on your back with your right hand above your head. After marking the outline of your liver and injecting a local anesthetic to numb the area, the physician will make a small incision in your right side near your rib cage, then insert the biopsy needle and retrieve a sample of liver tissue. In some cases, the physician may use an ultrasound image of the liver to help guide the needle to a specific spot.
You will need to hold very still so that the physician does not nick the lung or gallbladder, which are close to the liver. The physician will ask you to hold your breath for 5 to 10 seconds while he or she puts the needle in your liver. You may feel pressure and a dull pain. The entire procedure takes about 20 minutes.
Two other methods of liver biopsy are also available. For a laparoscopic biopsy, the physician inserts a special tube called a laparoscope through an incision in the abdomen. The laparoscope sends images of the liver to a monitor. The physician watches the monitor and uses instruments in the laparoscope to remove tissue samples from one or more parts of the liver. Physicians use this type of biopsy when they need tissue samples from specific parts of the liver.
Transvenous biopsy involves inserting a tube called a catheter into a vein in the neck andguiding it to the liver. The physician puts a biopsy needle into the catheter and then into the liver. Physicians use this procedure when patients have blood clotting problems or fluid in the abdomen.
Recovery
After the biopsy, the physician will put a bandage over the incision and have you lie on your right side, pressed against a towel, for 1 to 2 hours. The nurse will monitor your vital signs and level of pain. You will need to arrange for someone to take
you home from the hospital since you will not be allowed to drive after having the sedative. You must go directly home and remain in bed (except to use the bathroom) for 8 to 12 hours, depending on your physician’s instructions. Also, avoid exertion for the next week so that the incision and liver can heal. You can expect a little soreness at the incision site and possibly some pain in you r right shoulder. This pain is caused by irritation of the diaphragm muscle (the pain usually radiates to the shoulder) and should disappear within a few hours or days. Your physician may recommend that you take Tylenol for pain, but you must not take aspirin or ibuprofen for the first week after surgery. These medicines decrease blood clotting, which is crucial for healing. Like any surgery, liver biopsy does have some risks, such as puncture of the lung or gallbladder, infection, bleeding, and pain, but these complications are rare.

Colyte Prep

You are scheduled to have a colonoscopy examination at , on , . You should arrive at
will perform the procedure. On average, you will be ready for discharge within 2 hours. Because you will receive sedation, you will need someone with you to drive you home. If you do not have arrangements for someone else to drive you home we will be unable to administer sedation for this procedure. It is best if the driver is someone you are comfortable with having hear the preliminary procedure report, as you may not remember it clearly. Take your usual medications at your usual time that morning with a sip of water. Read and follow the instructions below to prepare for your examination. If you have questions call the Scheduling Coordinator at 272-5011.
*To pre-register please call (607) 274-4353 24-48 hours prior to the day of your
procedure.
INSTRUCTIONS FOR YOUR BOWEL PREPARATION WITH COLYTE, GOLYTELY, NULYTELY, HALFLYTELY PREPARATION
FOR THE PROCEDURE:
  • Follow the preparation instructions given to you NOT THE ONES THAT COME WITH THE LAXATIVE (note: the more fluids you drink, the better the laxative works, and you will be less dehydrated.)
  • Eliminatehigh fiber and whole grain foods, nuts and seeds in your diet during the three days leading up to your colonoscopy. In addition, discontinue iron, and bulking agents like Metamucil, Citrucel, Psyllium, and FiberCon during those three days leading up to your colonoscopy.
  • If you are on Coumadin,Warfarin, Plavix, clopidogrel bisulfate (blood thinners), check with your physician regarding stopping medication prior to the procedure. Check with your physician before taking any over the counter medication that may contain aspirin.
  • Diabetics on insulin may get individualized instruction.
  • Other regular medications can be taken normally in the days leading to the procedure.
  • Because the sedative medications remaining in your system after the procedure can slow your reaction times, it is our policy that you must have someone else drive you home after the procedure. If the person driving you does not remain at the hospital, they must be within 15 minutes distance and the nurse will notify them when you are almost ready to leave. Plan ahead to make arrangements for your transportation. You will be asked not to drive for 12 hours after the sedation. Most people feel tired after being sedated, so rest is recommended. You will be able to eat normally after the colonoscopy. You may resume regular activity the next day.
PLEASE NOTE:
Certain insurance companies may consider the above service as a surgical procedure. For Screening colonoscopies: in the event of a finding, such as the removal of polyps, the procedure would no longer be considered a screening exam and your insurance coverage could change to diagnostic colonoscopy benefits. Please check with y our insurance carrier. If you were seen in our office for symptoms prior to the colonoscopy; this would not be considered a screening colonoscopy examination (even if you were due for a screening at this time). Precertification may be required.
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COLONOSCOPY PREP INSTRUCTIONS:
  • You will be given a prescription for COLYTE, GOLYTELY, NULYTELY, or HALFLYTELY to cleanse the bowel. Purchase it in advance. TWO DAYS

BEFORE THE PROCEDURE:

  • In the evening, mix the prep following package instructions and keep it in the refrigerator, as it is more palatable when served cold.
THE DAY BEFORE THE EXAM:
  • Drink only clear liquids for the entire day throughout the day; solid foods, milk or milk products are not allowed. Clear liquids include all of the following that are not colored red or purple: strained fruit juices without pulp (apple, white grape, lemonade), water, clear broth or bouillon (vegetable, chicken, beef), coffee or tea (without milk or nondairy creamer), Gatorade , carbonated and non-carbonated soft drinks, Kool-Aid (or other fruit flavored drinks), plain Jello (without added fruit or toppings), and ice Popsicles .
  • 3:00pm Start the COLYTE/GOLYTELY. Drink 2/3 of the Colyte/Golytely “PREP”. Drink an 8 oz glass every 20 minutes until gone. If you become nauseated or bloated while drinking the PREP stop the PREP for 30 minutes and then resume. (Place remaining solution in the refrigerator overnight.)Tea or clear juices can be taken with it for taste.
  • You may continue to drink clear liquids up to 2 hours before your procedure.
DAY OF THE PROCEDURE:
  • 3 HOURS BEFORE YOU LEAVE FOR YOUR EXAM: Take the remaining 1/3 of the Colyte/Golytely “PREP”, just as you did the evening before. Continue to drink clear liquids up to 2 hours before your procedure.
  • It is important to drink all of the prep to ensure a successful colonoscopy exam.
  • After completing the prep wait 30 minutes, then take your morning blood pressure orcardiac medications; bring your other usual morning medications to take after the procedure.
AFTER THE PROCEDURE:
  • Resume your regular diet unless otherwise instructed. Initially plan to eat lightly at home. Going to a restaurant is not recommended.
  • Resume your regular medications unless instructed otherwise.
  • No driving or operating machinery or making major decisions should be considered for the rest of that day.
  • If you had polyps removed, plan no trips outside the country or to remote locations for 14 days as continuing care may be needed. On average one patient per year requires hospital attention following colonoscopy.

MoviPrep

Because you will receive sedation, you will need someone with you to drive you home. If you do not have arrangements for someone else to drive you home we will be unable to administer sedation for this procedure. It is best if the driver is someone you are comfortable with having hear the preliminary procedure report, as you may not remember it clearly. Read and follow the instructions below to prepare for your examination. If you have questions call our Scheduling Department at 272- 5011
*To pre-register please call (607) 274-4353 24-48 hours prior to the day of your procedure.
PREPARATION FOR THE PROCEDURE:
  • Eliminate high fiber and whole grain foods, nuts and seeds in your diet during the three days leading up to your colonoscopy. In addition, discontinue iron, and bulking agents like Metamucil, Citrucel, Psyllium, and FiberCon during those three days leading up to your colonoscopy.
  • If you are on Coumadin,Warfarin, Plavix, clopidogrel bisulfate (blood thinners), check with your physician regarding stopping medication prior to the procedure. Check with your physician beforetaking any over the counter medication that may contain aspirin.
  • Diabetics on insulin will get individualized instruction.
  • Other regular medications can be taken normally in the days leading to the procedure.
THE DAY BEFORE THE EXAM:
Drink only clear liquids for the entire day including breakfast, lunch, and dinner, Solid foods, milk or milk products are not allowed. Clear liquids include all of the following that are not colored red or purple: strained fruit juices without pulp (apple, white grape, white cranberry, lemonade, etc), water, clear broth or bouillon
(vegetable, chicken, beef), coffee or tea (without milk or nondairy creamer), Gatorade , carbonated and non-carbonated soft drinks, Kool-Aid (or other fruit flavored drinks), plain Jell-O (without added fruit or toppings), and ice Popsicles .
PLEASE NOTE:
  • Certain insurance companies may consider the above service as a surgical procedure.
  • For Screening colonoscopies: in the event of a finding, such as the removal of polyps, the procedure would no longer be considered a screening exam and your insurance coverage could change to diagnostic colonoscopy benefits. Please check with your insurance carrier. If you were seen in our office for symptoms prior to the colonoscopy; this would not be considered a screening colonoscopy examination (even if you were due for a screening at this time). Precertification may be required. Please contact your insurance carrier for coverage information.
COLONOSCOPY PREP INSTRUCTIONS:
The MoviPrep carton contains 4 pouches and a disposable container for mixing.
You must complete the entire prep to ensure the most effective cleansing.
3:00 PM: Prepare the MoviPrep:
  • Empty 1 pouch A and 1 pouch B into the disposable container
  • Add luke warm drinking water to the top line of the container. Mix to dissolve. (can be made up ahead of time but should be used within 24 hours)
7:00 PM: First dose of MoviPrep:
  • The MoviPrep container is divided by 4 marks. Every 15 minutes, drink the solution down to the next mark, until the full liter is consumed.
  • Drink at least three (3) additional glasses of clear liquids in the next 2 hours. You are encouraged to drink additional clear liquids as desired.

9:00 PM: Prepare the morning dose of MoviPrep:

  • Empty 1 pouch A and 1 pouch B into the disposable container
  • Add luke warm drinking water to the top line of the container. Mix to dissolve. (can be made up ahead of time but should be used within 24 hours)
DAY OF COLONOSCOPY:
3 HOURS BEFORE YOU LEAVE FOR YOUR EXAM: Take your second dose of MoviPrep just as you did the evening before. (Follow the instructions above) Continue to drink clear liquids up to 2 hours before your procedure.
  • Take your morning blood pressure or cardiac medications and bring your other usual morning medications with you to be given after the procedure.
  • Because the sedative medications remaining in your system after the procedure can slow your reaction times, it is our policy that you must have someone else drive you home after the procedure. Plan ahead to make arrangements for your transportation. You will be asked not to drive for 12 hours after the sedation. Most people feel tired after being sedated, so rest is recommended. You will be able to eat normally after the colonoscopy. You may resume regular activity the next day.
AFTER THE PROCEDURE:
  • Resume your regular diet unless otherwise instructed. Initially plan to eat lightly at home. Going to a restaurant is not recommended.
  • Resume your regular medications unless instructed otherwise.
  • No driving, operating machinery or making major decisions for the rest of that day.
  • If you had polyps removed, plan no trips outside the country or to remote locations for 14 days as continuing care may be needed. On average one patient per year requires hospital attention following colonoscopy.

Miralax/Gatorade

Because you will receive sedation, you will need someone with you to drive you home. If you do not have arrangements for someone else to drive you home we will be unable to administer sedation for this procedure. It is best if the driver is someone you are comfortable with having heard the preliminary
procedure report, as you may not remember it clearly. At times it will be necessary for a follow-up office visit to discuss results and long term changes to your treatment. If you have questions call our Scheduling Department at 272-5011.
*To pre-register please call (607) 274-4353 24-48 hours prior to the day of your procedure.
PREPARATION FOR THE PROCEDURE:
  • Eliminate high fiber and whole grain foods, nuts and seeds in your diet during the three days leading up to your colonoscopy. In addition, discontinue iron, and bulking agents like Metamucil, Citrucel, Psyllium, and FiberCon during those three days leading up to your colonoscopy.
  • If you are on Coumadin,Warfarin, Plavix, clopidogrel bisulfate (blood thinners), check with your physician regarding stopping medication prior to the procedure. Check with your physician before taking any over the counter medication that may contain aspirin.
  • Diabetics on insulin will get individualized instruction.
  • Other regular medications can be taken normally in the days leading to the procedure. Because the sedative medications remaining in your system after the procedure can slow your reaction times, it is our policy that you must have someone else drive you home after the procedure. Plan ahead to make arrangements for your transportation. You will be asked not to drive for 12 hours after the sedation. Most people feel tired after being sedated, so rest is recommended. You will be able to eat normally after the colonoscopy. You may resume regular activity the next day.
ITEMS NEEDED:
  • TWO Dulcolax bisacodyl laxative tablets (not the stool softener or the suppository)
  • One 238 gram bottle of Miralax or generic equivalent
  • One 64 oz. bottle of Gatorade (no red or purple flavors). Please contact your insurance carrier for coverage information
COLONOSCOPY PREP INSTRUCTIONS
THE DAY BEFORE THE EXAM:
Drink only clear liquids for the entire day including breakfast, lunch, and dinner, Solid foods, milk or milk products are not allowed. Clear liquids include all of the following that are not colored red or purple: strained fruit juices without pulp (apple, white grape, white cranberry, lemonade, etc), water, clear broth or bouillon (vegetable, chicken, beef), coffee or tea (without milk or nondairy creamer), Gatorade , carbonated and non-carbonated soft drinks, Kool-Aid (or other fruit flavored drinks), plain Jello (without added fruit or toppings), and ice Popsicles .
  • 3:00pm, take 2 Dulcolax laxative tablets.
  • 5:00pm, mix the bottle of Miralax in 64 oz. of Gatorade using a separate container. Shake or stir the solution until the Miralax is dissolved.
  • Drink 2/3 of the Miralax/Gatorade solution. Drink an 8 oz glass every 20 minutes until 2/3 is consumed . If you become nauseated or bloated while drinking the Miralax prep stop the prep for 30 minutes and then resume. (Place remaining solution in the refrigerator overnight.)
  • You should continue to drink clear liquids (see definition above) until bedtime. You may feel fullness, cramping, or nausea after starting the laxatives. (Drinking a carbonated beverage may help you from becoming nauseated after drinking the laxative) Diarrhea usually begins in 1-2 hours and becomes clear of solid materials in 4-5 hours. You should continue to drink clear liquids up until 2 hours prior to your procedure at which time you should notconsume any additional clear liquids.
DAY OF THE PROCEDURE:
  • 3 HOURS BEFORE YOU LEAVE FOR YOUR EXAM: Take the remaining 1/3 of the Miralax/Gatorade solution just as you did the evening before. Continue to drink clear liquids up to 2 hours before your procedure.
  • After completing the prep wait 30 minutes, then take your morning blood pressure or cardiac medications; bring your other usual morning medications to take after the procedure.
AFTER THE PROCEDURE:
  • Resume your regular diet unless otherwise instructed. Initially plan to eat lightly at home. Going to a restaurant is not recommended.
  • Resume your regular medications unless instructed otherwise.
  • No driving or operating machinery or making major decisions for the rest of that day.
  • If you had polyps removed, plan no trips outside the country or to remote locations for 14 days as continuing care may be needed. On average one patient per year requires hospital attention following colonoscopy.
PLEASE NOTE:
Certain insurance companies may consider the above service as a surgical procedure. For Screening colonoscopies: in the event of a finding, such as the removal of polyps, the procedure would no longer be considered a screening exam and your insurance coverage could change to diagnostic colonoscopy benefits. Please check with your insurance carrier. If you were seen in our office for symptoms prior to the colonoscopy; this would not be considered a screening colonoscopy examination (even if you were due for a screening at this time). Precertification may be required.

Ducolax/Fleets Prep

SIGMOIDOSCOPY
PROCEDURE:
You will be positioned on your side on an examining table. The doctor will
then insert a small and flexible, tube-like instrument into your rectum so he can visually examine your intestine. Mild discomfort may be experienced, but the procedure lasts only a few minutes.
PURCHASE:
  • 4 ducolax tablets
  • 2 Fleet enemas
PREPARATION:
No meals after 6pm the evening before the procedure; take 4 ducolax tablets the evening before the procedure. Nothing by mouth after midnight on the night
before the exam.
Administer one Fleet’s enema two hours before the exam and another one, one
hour before the exam.
USE NO LAXATIVES!!!!!
Report to the outpatient registration desk 15 minutes early to register. If your procedure is scheduled to begin later in the morning, or after noon, you may consume clear liquids up to 3 hours prior to scheduled procedure starting time.
Take all prescription medication(s) up to 3 hours prior to scheduled procedure starting time.
Nothing by mouth for 3 hours prior to scheduled procedure-starting time.
PLEASE NOTE
Certain insurance companies may consider the above service as a surgical procedure. Please contact your insurance carrier for coverage information. Precertification may be required.
IMPORTANT INFORMATION ABOUT HEALTH INSURANCE COVERAGE
Gastroenterology Associates of Ithaca, PC is a participating provider in many health plan networks.
Please contact your insurance carrier to verify our participation with your individual coverage plan.
You may request a written estimate of costs that will be submitted to your insurance on your behalf. Please be advised that these are just estimates and that the costs could increase due to unanticipated circumstances (i.e. a polyp is found and
removed by varying techniques). Upon request you will be provided a list of other physicians and facilities that may be involved in your care. You must contact them directly to discuss their participation with your insurance plan.
About us

Proudly serving Ithaca and the surrounding area for over 40 years.

Contact Info

  Address: 2435 North Triphammer Road Ithaca, NY 14850

  Telephone: (607) 272-5011