How do I know if I am covered for my colonoscopy?
There are many reasons to have a colonoscopy, from average risk screening, surveillance (for polyps or family history), or a diagnostic indication (such as bleeding, change in bowels, abnormal imaging, etc.) The scope will be ordered by your primary care physician, gastroenterologist, or suggested by another physician overseeing your care. However, before you have your colonoscopy, we advise you to call your insurance company and make sure you are covered for the procedure. Please ask about costs associated with the procedure itself, the facility fee, anesthesia fees, and potential pathology fees. Different insurance companies cover these fees at different rates, so our office will not know the specifics for your insurance.
Can I have a colonoscopy if I am on a blood thinner?
If you are on a blood thinner such as plavix, effient, brilinta, coumadin, xarelto, eliquis, pradaxa, heparin, or lovenox, please let us know well ahead of your procedure so we can make sure you have a plan for holding your medication prior to the procedure. This will allow us to provide therapeutic interventions such as polyp removal and reduce the risk of bleeding. Each drug is held for a different length of time depending on the medication, indication, and even kidney function. Because of the complexity of this decision, we will likely ask for a recommendation from the prescribing physician.
What dietary changes are necessary for a colonoscopy?
While the main bowel prep starts the day before the procedure, we ask that you eat a low residue diet starting 5 days prior to the procedure. This will ensure a successful and easier bowel prep. A low residue diet includes: white bread without nuts and seeds, white rice, plain white pasta, crackers, refined hot cereals (such as Cream of Wheat) or cold cereals with less than 1 gram of fiber per serving, pancakes or waffles made from white refined flour, most canned or well-cooked vegetables and fruits without skins or seeds, fruit and vegetable juice with little or no pulp, fruit-flavored drinks, flavored waters, tender meat, poultry, fish, eggs and tofu, milk and foods made from milk — such as yogurt, pudding, ice cream, cheeses and sour cream — if tolerated, butter, margarine, oils and salad dressings without seeds. Please avoid high fiber diet for 5 days before the procedure, this includes: whole-wheat or whole-grain breads, whole grain cereals, whole grain pastas; brown or wild rice and other whole grains, such as oats, kasha, barley and quinoa, dried fruits and prune juice; raw fruit, including those with seeds, skin or membranes; Raw or undercooked vegetables, especially corn; Dried beans, peas and lentils; Seeds and nuts and foods containing them, and popcorn.
One day prior to your colonoscopy, you can continue the low residue diet for breakfast, however for lunch and the remainder of the day, including dinner, you will be on a clear liquid diet. This includes: Water, mineral or flavored water, clear fruit juices without pulp (apple, white grape, white cranberry, lemonade, etc), Clear soft drinks, Clear sports drinks, Broth (chicken, beef, vegetable, or bone broth), Popsicles or gelatin (such as Jell-O), Coffee or tea (without milk), Ensure clear or other clear meal-replacement drinks. Please avoid reds if possible (red jello, red popsicles, and red drinks).
What else do I need to prepare for the colonoscopy?
In anticipation of your bowel prep: make sure you have a working toilet, adequate toilet paper, and all your bowel prep supplies. Stock up on clear liquids. You can fill your bowel prep prescription well in advance, and keep the prep for weeks/months if needed. You will need a driver for your procedure, so be sure to arrange this with a family member or friend. You will not be able to drive, drink alcohol, or make important decisions for the entire day after anesthesia so plan ahead for that as well. Many people will take the entire procedure day off of work, but will be able to work the following day.
When do I start my colonoscopy prep? What if I’m not clear?
Your bowel prep will start on the day prior to your colonoscopy. If you are chronically constipated, please let us know, as your may require an extended bowel prep to ensure you are cleared out for the procedure. Each bowel prep is different, but the premise is similar. You will drink half the bowel prep on the evening prior to the procedure, around 7 pm, and the other half of the bowel prep about 6 hours prior to the procedure start time. This may even be in the middle of the night, so plan accordingly. The expectation is that you will be passing clear, possibly yellow colored, liquid from below. If you are still passing stool just before your colonoscopy, you may be asked to reschedule your colonoscopy. A colonoscopy with a poor bowel prep will increase the risk of complication, and will be incomplete due to poor visualization.
When do I arrive for my procedure?
You should receive a phone call from the endoscopy center or endoscopy unit of the hospital 1-2 business days before your procedure. They may ask you questions regarding your medical history, including medications, so please be prepared. They will instruct you regarding arrival time, which is often 1-2 hours before the procedure start time. The scheduled start time provided to you by our office staff is tentative, and can change up until the day before the procedure. The final start time will be provided by the endoscopy staff.
What will happen when I arrive to the endoscopy center/unit?
Upon arrival to the endoscopy center or unit. You will check in, provide your ID and insurance cards, and be asked to sign paperwork including consent for the procedure and anesthesia. Bathrooms will be available. You will be asked to change into a gown and keep your belongings in a provided bag. You can bring your cell phone if you’d like.
Will I be under anesthesia for the procedure?
You will meet the anesthesiologist prior to the procedure. This is a good time to ask any questions and address any concerns related to anesthesia. An IV will be placed so you can receive IV fluids and anesthetic medication. The anesthesia is provided through the IV by a certified registered nurse anesthetist (CRNA), who you will also meet prior to the procedure. The anesthetic that is often used is rapid acting and with a short duration of action. There is no fixed dose, you will receive the amount that you need to maintain your comfort and ensure your safety. Many people report positive feelings with the anesthesia, though of course, there are risks with going under anesthesia.
Will I meet the gastroenterologist before the procedure?
Yes, you will see the gastroenterologist prior to the procedure. We will discuss potential risks of the procedure. We will go over your medical history one more time. We will ask about blood thinners and your bowel prep. This is a good time to ask questions or have concerns regarding the procedure itself addressed.
What happens in the procedure room?
When it’s time for your procedure, you will be taken to the procedure room. You will be introduced to the room nurse and tech. There may be music playing, and if this makes you uncomfortable, please let us know. A pre-procedure time-out will be performed, ensuring that we have the right patient and performing the right procedure. You will be asked to lay on your left hip and shoulder. Anesthetic will be provided and the procedure will be performed. If you are scheduled for an EGD and colonoscopy together, the upper scope is generally performed first. The colonoscopy can take as little as 15-30 minutes, or up to 1-2 hours depending on the complexity of the case.
What happens after the procedure?
After the procedure, you will be wheeled to the post-op area. The anesthesia will wear off and you will wake up from the procedure. We have transitioned to using CO2 to inflate your colon, which dissolves 40x faster than air, reducing discomfort after the procedure. You may still wake up with some gas and bloating, at which point you’ll be asked to pass the gas naturally. You will be offered a snack and beverage. Your gastroenterologist will talk to you about your results, and inform your driver/family member of results as well. The results will also be summarized in your discharge paperwork.
How do I get the results of my procedure?
If biopsies are taken or a polyp is removed, it will be sent to pathology, and take 1-2 weeks for results. I encourage you to sign up for our patient portal, to expedite your results and keep them available for your records. Click here to access the portal or use the tab above.
What can I expect when I go home and the following days?
Again, because of anesthesia, we ask that you avoid alcohol, driving, and any major decisions for the entire day. You will be provided instructions regarding diet, blood thinners, other medications, further testing, and follow up. Most patients will go out to eat or go home and nap after their procedure. You should be able to return to work and regular activity on the following day. A number will be provided to you in case of emergencies or adverse events. You will also receive a follow up call from the endoscopy center/unit.