Before the Procedure Prep Related Questions

Q. What time should I start my prep?

A.You will need to be on a clear liquid diet the entire day before your procedure; however, you won’t need to start your prep until sometime between 12:00 noon and 6:00 PM in the day.You will need to use the bathroom frequently once you start the prep, so you might want to be at home before starting.

Q. Is there anyway I can make this taste better?

A. You can try sucking on hard candy, or you can rinse your mouth with water, mouthwash or any other beverage listed on the Clear Liquid Diet.

Q. Why should I avoid red liquids?

A. The red color can stay in the colon and potentially look like blood.

Q.  One of the medications I was instructed to take the morning of my procedure is red, is it OK to take it?

A. Yes. Medications for blood pressure, heart medications and seizures should be taken the morning of your procedure regardless of their color.

Q. I feel like vomiting and don’t think I can drink any more.What should I do?

A. Without a clean bowel, the doctor will not be able to see the inside of your colon to complete the examination.   Walking and other activities usually decrease nausea. Some patients prefer to remove the prep from the refrigerator a half-hour before they are scheduled to start drinking it.   If you do vomit or feel nauseated, wait 45 minutes and begin drinking the solution again.   If not improved, please call us.

Q. I drank most of the solution but have not gone to the bathroom yet.What should I do?

A. Most people have a bowel movement after an hour some patients take 2 hours or longer. If you feel bloated or nauseated, wait 30-45 minutes and resume drinking the solution.  If you still have not had a bowel movement after drinking all of the solution, please call us for further instructions.

Q. Is the Prep the only liquid I need to drink prior to the procedure?

A. No, please drink an additional 4 to 8 glasses of liquids so you do not become dehydrated.   The colon prep liquid is to clean out the colon; not to replace fluid loss.

Q. I am taking the prep and now have loose, watery stools. Do I still need to take the rest of the prep?

A. Yes, you may have solid stool higher in the colon that needs to be eliminated as well.

Q. I already have diarrhea before taking the prep, do I still have to take the laxative?

A. Yes, you must take the prep as directed by your doctor.  Your colon is approximately 6 feet long, and your entire colon must be emptied for your physician to see it clearly.

Q. I see yellow color in the toilet bowl and a few flecks.What do I do?

A. If you drank the entire solution or if your last bowel movement was clear enough to see the bottom of the toilet, you should be fine.  It is OK if you have some flecks of material. The yellow color is the result of bile that normally colors the feces.This shouldn’t interfere with the examination.

Q. My bottom is very sore. What can I do?

A. To clean the area, avoid rubbing, but gently pat with a wet washcloth. Apply Vaseline ™, Prepartion H ™, or Desitin liberally.

Q. Is it OK to drink alcoholic beverages?

A. We strongly suggest you do not drink any alcoholic beverages prior to your procedure since they can cause dehydration, and some wines may thin your blood.

Q. Can I drink any nutritional supplements?

A. You may have any supplement as long as it does not contain milk or diary.

Q. Can I chew gum or suck candy?

A. Yes, but no hard candy with soft centers or anything with red colors.

Q. Can I brush my teeth?

A. Yes.

Q. Can I wear my dentures?

A. Yes, you may wear your dentures to the Endoscopy suite. However, you may be asked to remove them prior to the procedure.

Q. I have been instructed not to take anti-inflammatory or blood thinner medications several days before the procedure.  What can I take for headaches and pain relief?

A. You may take Tylenol as directed.

Q. Can I have chicken soup?

A. You may have the broth, but no chicken, noodles or vegetables are allowed.

Procedure Related Questions

Q. What is the difference between a colonoscopy and a sigmoidoscopy?

A. A sigmoidoscopy views the lower third of your colon, up to 60 centimeters, and is usually performed in the office without sedation. A colonoscopy views the entire large intestine (colon). A colonoscopy is performed with sedation and requires monitoring of your breathing and blood pressure. You will need to take a laxative prep for either procedure.

Q. Can I schedule a sigmoidoscopy or colonoscopy without a physician referral?

A.  Only if you are over 50 and are due for a screening colonoscopy.When you call to schedule this appointment, you will be asked to come into our office for a brief, no-charge pre-procedure visit where a nurse will review your medical history and medications, and explain the prep.If, however, you are having digestive issues, you will need to see a Physician or Physician Assistant for a consultative appointment.   The Physician will then recommend the appropriate procedure to help diagnose your problem.

Q. How long will my procedure take?

A. Patients should allow 1 to 2 hours from the time they arrive until they leave the facility. Each patient responds differently to the medications and this means that some patients may take slightly longer to recover.

Q. How long will I have to wait for the results of my procedure?

A. The doctor will generally speak with you or a family member or provide you with written preliminary results before you go home. If biopsies were taken or polyps removed, it will take 5 to 7 days to receive the results from the lab. Once the office has received the results and they have been reviewed, the doctor will send information to your referring doctor and send you a letter with the results, along with any recommendations for follow up.  If you do not receive results or hear from us with 2 weeks after your procedure please contact us.

Q. Will the procedure hurt?

A. You will be given I.V. medication by your doctor and a CRNA (Certified Registered Nurse Anesthetist) to keep you comfortable during the procedure. Propofol (a hypnotic agent) is the most common drug currently used for sedation, but Fentanyl (a narcotic pain medication) and Midazolam (a sedative) may be used.
The medication takes effect quickly promoting relaxation, drowsiness and forgetfulness. You may feel bloating when air is injected to improve visibility, cramps when the colonoscope is rounding a turn, and/or a hand pressing your abdomen to straighten the colonoscope. While you may experience some discomfort, our goal is to keep you as comfortable as possible. Many patients have no recollection of their procedure afterward because of the effects of the IV Sedation you are given.

Q. Is it necessary that I have a driver for a sedated procedure?

A. Yes. It is essential that you have an adult driver (18 or older) that remains with you during the procedure. You will be sedated and should not operate any machinery including an automobile. The effects of the sedation will affect your memory for a short time; therefore, the physician will speak with your driver about the results of your procedure and to explain any necessary follow-up. We will not perform your procedure if you arrive without an adult driver. You do not need a driver if you are scheduled for a sigmoidoscopy.

Q.  Is it OK to have the colonoscopy during my menstrual cycle?

A. Yes, the procedure can still be performed. You may use a Tampon during the procedure.

Q. How can I find out when I am due for a follow-up procedure?

A. You will receive a reminder notice from our office 1-2 months prior to the time you should have your screening procedure. The notice will ask you to call our office to schedule the needed procedure. If you do not receive a notice when you feel you should or have any questions, it is always best to call the office and ask to speak to a Procedure Scheduler.

Office Questions

Q. What are your office hours and phone number?

A. Our office hours are 8:00 a.m. – 5:00 p.m. Monday through Friday. Our phone number is (336) 768-6211. For billing information, please call (336) 765-4090 between the hours of 9:00 a.m. and 4:00 p.m. Please feel free to use voice mail as a means of communicating with our scheduling and clinical staff, as they are frequently away from their desk or assisting patients on other calls. Please leave a complete message that includes your name and phone number so we can access your medical record and be prepared to respond to your questions when your call is returned.

Q. Do I need a referral to be seen?

A. If you are a patient insured through a managed care plan (HMO, PPO, Point of Service), you will generally need a referral. Please check with your primary care doctor before scheduling the appointment. If you are insured with a plan that does not require a referral and have a gastrointestinal disorder, you do not need to have a referral from your primary care doctor. Please contact our billing office (336-765-4090) if you have any questions about your particular insurance carrier.

Q. Who should I ask for when calling the office?

A. There are over 50 staff members in our office, so it is helpful if you know which department you need to speak with. The following are some guidelines that will assist us in processing your call promptly:

• Ask for Scheduling – to make or cancel an appointment, questions about the time or location of your appointment.
• Ask for the Billing department for questions about your billing statement or referral.
• Ask for Medical Records  for copies or records requests.Please call 5 days in advance if you are picking up records.   If leaving a voice mail, please spell name and leave date of birth and phone number.
• Ask for the Triage Nurse – if you have questions about test results, procedure preparation, or other clinical issues.

Nurse Questions

Q.What should I do if I have a medical question between appointments?

A. If your question relates to an emergency, please call 911. If your question is of a less urgent nature, please contact our office and ask for the Triage Nurse. You will be directed to the Triage voice mail; please leave a message with your full name and phone number and your question. The Triage nurse will call you back as quickly as possible mails left after 3:30 may not be returned until the following business day.

Q. What should I do if I need a refill on a prescription and don’t have an office visit scheduled?

A. Please call your pharmacy for all prescription refill requests.   They will call or fax your request to our office.  Refill requests from the pharmacy will be called or faxed back to the pharmacy within 24-48 hours.  If prior authorization is required by your insurance plan, refill requests can take up to a week to complete. Please note that we are unable to authorize refill requests for medications prescribed by us if you have not been seen in our office in the last 12 months.  If you have not been seen in the past 12 months, please call our office to schedule an appointment or contact your primary care physician regarding refill of the medication.Prescription refill requests should be made at least a week before your supply is gone.