GASTROENTEROLOGYCONSULTANTS, P.C.
BRIAN D. CLARKE, M.D. SUSAN A. WOLFE, FNP, C
You are scheduled for a colonoscopy on ______________________, ____________________ 201_ . Report to outpatient registration at _________ a.m./p.m. at
Community Hospital North at 7150 Clearvista Pkwy, Phone (317) 621-5193
Carmel Endoscopy Center at 13421 Old Meridian St, Phone(317) 706-1600
You need to be accompanied by a driver for this exam. (A taxi cab or bus is not acceptable.) YOU WILL NEED TO PURCHASE: SUPREP® Bowel Prep Kit (Prescription required) Follow package instructions for mixing. Dulcolax (Bisacodyl) (2 tablets) (No prescription required) – You may delete if you have intolerance or diarrhea MEDICATION RESTRICTIONS You may continue to take regular medications on day before procedure except medication that would prevent your colon from being cleaned out. Example: Anti-diarrheal medications, fiber supplements. Heart or blood pressure medications: Take these on the morning of the colon exam. Diabetics: Take half of your evening dose of insulin on the day before the procedure but do not take oral diabetes medication or insulin on the day of the colonoscopy until completed. (If any questions, please contact the doctor that prescribes your insulin.) Iron supplements (Ferrous sulfate): Stop 1 week before colonoscopy. Blood thinner: Please discontinue Coumadin (warfarin), Lovenox (heparin), Aspirin (>81 mg) 3 days before colonoscopy and Plavix (clopidogrel), Effient (prasugrel), Pradaxa (dabigatran),Persantine (dipyridamole), Pletal (cilostazol), Ticlid (ticlopidine) 5 days before the colonoscopy. Discuss with your prescribing physician for their approval before you stop any medicine that affects blood clotting. COLON PREP INSTRUCTIONS The Day Before Your Colonoscopy: 1. Clear Liquid Diet (see list below) beginning at breakfast. No solid food allowed. 2. 2:00 p.m.or immediately after work Take 2 bisacodyl delayed release tablets with water (do NOT chew or crush). First bowel movement should occur in about 1-4 hours after taking the laxative pills. (Helpful hint: Topical A&D ointment or Vaseline can reduce anal irritation from the resulting diarrhea) 3. Wait for a bowel movement (or maximum of 4 hours) then drink, 1 (6 oz) bottle of SUPREP® liquid into kit cup and fill with cool drinking water to the 16 oz. line. Drink ALL of the solution. 4. Drink two more cups of 16 oz. of clear liquids of your choice over next hour to ensure adequate hydration and an effective prep. You may experience some abdominal bloating and distention before the bowels move. The Morning of Your Colonoscopy: At least 3 1/2 hours before leaving home for procedure (You may need to set an alarm!) 5. Early morning Repeat step 3 and 4 by drinking 2nd bottle of SUPREP® solution mixed in 10 oz of water followed two more 16 ounce cups of clear liquids in an hour, DO NOT drink anything else after this. 6. If colonoscopy is in afternoon, clear liquids are encouraged up to 3 hours before your arrival time. CLEAR LIQUID DIET (No red or purple artificial colors) Jell-O® or gelatin (plain without fruit), coffee or tea, low-salt bouillon/broth, juices without pulp, popsicles, soda-pop, Crystal Light®, Kool-aid®, Gatorade® & hard candy. No milk products after lunch or fruit fiber. FINAL INSTRUCTIONS
Bring current medication list with dosages and a picture ID
**Please note: There is a $75.00 fee for procedures cancelled less than 48 hours (2 business days) before Frequently Asked Questions about Colonoscopy What is a colonoscopy? Colonoscopy is a procedure that allows your physician to examine the lining of the rectum and colon for signs of cancer, polyps, or other abnormalities. A flexible tube, about the thickness of an index finger is gently inserted into the anus and advanced through the length of the entire colon. This instrument called a “colonoscope” is equipped with a tiny video camera which sends pictures to a TV screen. What preparation is required? The rectum and colon must be completely emptied of stool for the procedure to be effectively performed. When scheduling for the procedure, our office will supply you with information regarding your prep and dietary restrictions. You will also be sedated for the procedure, so you will need to arrange to have some one drive you home afterwards. The sedation could impair your judgment and reflexes for the rest of the day, so you should not drive or operate machinery until the next day. Why is colonoscopy performed?
Colonoscopy is usually done as either part of a routine screening for cancer, in patients with known polyps or previous polyp removal, to evaluate a change in bowel habits or bleeding, or to evaluate inflammation in the lining of the colon. Colon cancer has become the second leading cause of cancer deaths in the country, killing nearly 60,000 people each year. The good news is that it is also one of the most preventable types of cancer. This is because the majority of colon cancers begin as a small noncancerous growth called a polyp. Polyps grow slowly and can eventually turn into cancer. This transformation can take as long as ten years, during which time you feel perfectly fine, showing no symptoms. Who should be screened? Colon cancer affects all races, men and women about equally. Current guidelines suggest screening for all average risk adults over the age of 50. If the exam is normal and there are no other risk factors, repeat examinations should be performed at ten year intervals. High risk individuals are screened more often. These would include those with symptoms, prior colon cancer or polyps, inflammatory bowel disease, and those with a family history of colon cancer or polyps. Will my insurance cover a screening colonoscopy? Since screening colonoscopy is considered routine care, the answer will depend on the insurance plan. Medicare recipients over the age of 50 are now covered for average risk screenings if they have not had a previous colonoscopy within the past ten years. The Medicare Part B deductible is waived in these cases. The State of Indiana passed a law in 2000 that requires most health insurance plans to cover colorectal cancer screening exams and lab tests in accordance with the latest American Cancer Society guidelines. You will need to contact your benefits representative for information specific to your plan. Will my benefits for routine procedures apply if a polyp is discovered during the course of a screening colonoscopy? Unfortunately, if a polyp or other abnormality is found during the course of a screening colonoscopy, most insurance companies will not consider the procedure to be a routine screening, but instead cover the service as a diagnostic procedure.
CliniCal Practice DeveloPment Louisa Stone People with advanced disease approaching the end of life require sensitive consideration with regard to infection control procedures. Strict adherence to infection control guidelines designed for the acute hospital setting may not always be appropriate for terminal y il patients. This article examines the management of meticillin (methicillin)-resis
Preventive Services Guidelines for Enrollees in HSA Plans Effective January 1, 2008 The following preventive services will be covered in full (plan pays 100%) when rendered by in-network providers and billed as routine preventive care. Age and frequency restrictions apply. Diagnostic tests performed to investigate existing symptoms or to monitor on-going conditions are not covered