Downloadable Procedure Instructions

Colonoscopy Prep Instructions (doc)

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EGD Procedure Instructions (doc)

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EGD/Colonoscopy Prep INSTRUCTIONS (doc)

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Instructions available on site

A driver must be present and sign a driver consent form prior to ALL procedures. 

Colonoscopy Instructions

  

**Please call if you have any questions regarding your procedure or preparation for your procedure**


1. You will need to purchase 2 bottles of magnesium citrate and the bowel preparation. (Prepare and refrigerate on the day before your procedure.)

2. Arrange transportation to and from the office the day of your procedure. You cannot drive, please let your driver know that they may not leave during your procedure.

3. Please note that additional charges may be incurred for testing of tissue taken during your procedure.

4. If you have a co-pay, it will be due at the time of your procedure. You may also want to check with your insurance company about a deductible. Should you need to cancel or reschedule, please give 48 hours notice. Failure to comply may result in a $50.00 fee.

5. Prior Authorization will be obtained by the office staff if required by the patients insurance company. The claims will be filed for the procedure within 48 hours of the patient having the procedure performed.

6. Please note that we use third party anesthesia companies, there is a possibility that you may be responsible for any additional fees that your insurance may not cover. 

Instructions for Colonoscopy:

· The day before your procedure, you cannot eat anything solid at any time of the day. You may drink all the clear liquids you want with no limit until midnight. Examples: Ginger-ale, tea, clear soda, clear juices such as apple juice and clear grape juice, popsicles, broth, Gatorade, and Jell-O. You may have coffee with sugar but NO CREAMER. NOTHING RED, ORANGE, OR PURPLE. It is important to drink plenty of fluids this day.

· **NOTHING BY MOUTH AFTER MIDNIGHT UNLESS OTHERWISE DIRECTED** 

· Please take your blood pressure medications the morning of your procedure.

· If you are taking Iron DISCONTINUE 1 WEEK BEFORE your procedure.

· If you are taking Coumadin, discuss this with your doctor. (It is usually stopped 5 days before)

· If you are taking Plavix, ASA (Aspirin) , Effient, Xarelto, other blood thinners, do not take for 3 days unless otherwise directed.

· If you are diabetic, do not take your p.m. or your a.m. dose of the oral medication. If you use insulin, take only ½ your normal dose of insulin all day and do not take any insulin the day of your procedure. Please check your blood sugar the morning of your procedure.

· If you use an inhaler, medications for chest pain, or medicines for anxiety, please bring them with you.

If you are drinking MoviPrep follow these instructions:

5:00pm: Drink 1st bottle of magnesium citrate.

7:00pm: Mix and drink 1st A&B packets.

9:00pm: Mix and drink 2nd A&B packets.

5:00am: Drink 2nd bottle of magnesium citrate. Must be completed by 5:30am.

If you are drinking Go-Lytely or Nu-Lytelty follow these instructions:

5:00pm Drink 1st bottle of magnesium citrate.

7:00pm: Begin drinking your bowel prep. Drink 8oz. every 15 minutes until completed within 4 hours.

5:00am: Drink 2nd bottle of magnesium citrate and have it completed by 5:30am.

If you are drinking Miralax follow these instructions:

5:00pm: 1st bottle of magnesium citrate.
7:00pm: 510g of Miralax or Glycolax (this is over the counter) mixed with 94-128oz. of any clear liquid that isn’t red, orange, or purple. This needs to be finished by 8:30pm.
5:00am: Drink 2nd bottle of magnesium citrate and have it completed by 5:30am.

 If you are taking Suprep Bowel Prep Kit follow these instructions:
5:00pm: Pour one(1) 6oz bottle of SUPREP liquid into the mixing container. Add cool drinking water to the 16oz line on the container and mix. Drink all the liquid in the container. You must drink two(2) more 16oz containers of water over the next hour.
7:00pm: Pour one(1) 6oz bottle of SUPREP liquid into the mixing container. Add cool drinking water to the 16oz line on the container and mix. Drink all the liquid in the container. You must drink two(2) more 16oz containers of water over the next hour.

9:30pm: Drink 1st bottle of magnesium citrate.

5:00am: Drink 2nd bottle of magnesium citrate only if stools are not liquid and clear. If you drink the this please finish by 5:30am.

 

**NOTHING BY MOUTH AFTER MIDNIGHT UNLESS OTHERWISE INSTRUCTED**

EGD Esophagogastroduodenoscopy (Upper Endoscopy)

  

**Please call if you have any questions regarding your procedure or preparation for your procedure**


1. Arrange for transportation to and from the office the day of your procedure. You cannot drive, please let your driver know that they may not leave during your procedure.

2. Please note that additional charges may be incurred for testing of tissue taken during your procedure.

3. If you have a co-pay, it will be due at the time of your procedure. You may also want to check with your insurance company about a deductible. Should you need to cancel or reschedule, please give 48 hour notice. Failure to comply will result in a $50.00 fee.

4. Prior Authorization will be obtained by the office staff if required by the patients insurance company. The claims will be filed for the procedure within 48 hours of the patient having the procedure performed.

5. Please note that we use third party anesthesia companies, there is a possibility that you may be responsible for any additional fees that your insurance may not cover. 

Instructions for Endoscopy:

· Please take your blood pressure medicine the day of your procedure.

· If you are diabetic, do not take your a.m. dose the day of procedure of the oral medication. If you use insulin, do not take your a.m. dose the day of your procedure. Please check your blood sugar the morning of your procedure.

· If you are taking Coumadin, discuss this with your doctor (usually stopped 5 days before).

· If you are taking Plavix, ASA, Effient, Xarelto, other blood thinners, continue until the day before the procedure.

· If you use an inhaler, medications for chest pain, or medicines for anxiety, please bring them with you.


NOTHING BY MOUTH AFTER MIDNIGHT UNLESS OTHERWISE INSTRUCTED

Combo Instructions (EGD/Colonoscopy)

  

**Please call if you have any questions regarding your procedure or preparation for your procedure.**


1. You will need to purchase 2 bottles of magnesium citrate and the bowel preparation. (Prepare and refrigerate on the day before your procedure.)

2. Arrange transportation to and from the office the day of your procedure. You cannot drive, please let your driver know that they may not leave during your procedure.

3. Please note that additional charges may be incurred for testing of tissue taken during your procedures.

4. If you have a co-pay, it will be due at the time of your procedure. You may also want to check with your insurance company about a deductible. Should you need to cancel or reschedule, please give 48 hours notice. Failure to comply will result in a $50.00 fee.

5. Prior Authorization will be obtained by the office staff if required by the patients insurance company. The claims will be filed for the procedure within 48 hours of the patient having the procedure performed.

6. Please note that we use third party anesthesia companies, there is a possibility that you may be responsible for any additional fees that your insurance may not cover. 

Instructions for Colonoscopy and Upper Endoscopy:

· The day before your procedure, you cannot eat anything solid at any time of the day. You may drink all the clear liquids you want with no limit until midnight. Examples: Ginger-ale, tea, clear soda, clear juices such as apple juice and clear grape juice, popsicles, broth, Gatorade, and Jell-o. You may have coffee with sugar but NO CREAMER. NOTHING RED, ORANGE, OR PURPLE. It is important to drink plenty of fluids this day. 

· **NOTHING BY MOUTH AFTER MIDNIGHT UNLESS OTHERWISE DIRECTED**

· Please take your blood pressure medications the morning of your procedure.

· If you are taking Iron DISCONTINUE 1 WEEK BEFORE your procedure.

· If you are taking Coumadin, discuss this with your doctor. (It is usually stopped 5 days before).

· If you are taking Plavix, ASA (Aspirin), Effient, Xarelto, other blood thinners, do not take for 3 days unless otherwise directed.

· If you are diabetic, do not take your p.m. or your a.m. dose of the oral medication. If you use insulin, take only ½ your normal dose of insulin the day before the procedure and do not take any insulin medications the day of your procedure. Please check your blood sugar the day of your procedure.

· If you use an inhaler, medications for chest pain, or medicines for anxiety, please bring them with you.

If you are drinking MoviPrep follow these instructions:

5:00pm: Drink 1st bottle of magnesium citrate.

7:00pm: Mix and drink 1st A&B packets.

9:00pm: Mix and drink 2nd A&B packets.

5:00am: Drink 2nd bottle of magnesium citrate. Must be completed by 5:30am

If you are drinking Go-Lytely or Nu-Lytelty follow these instructions:

5:00pm Drink 1st bottle of magnesium citrate.

7:00pm: Begin drinking your bowel prep. Drink 8oz. every 15 minutes until completed within 4 hours.

5:00am: Drink 2nd bottle of magnesium citrate and have it completed by 5:30am.

If you are drinking Miralax follow these instructions:

5:00pm: 1st bottle of magnesium citrate.
7:00pm: 510g of Miralax or Glycolax (this is over the counter) mixed with 94-128oz. of any clear liquid that isn’t red, orange, or purple. This needs to be finished by 8:30pm.
5:00am: 2nd bottle of magnesium citrate and have it completed by 5:30am.

 If you are taking Suprep Bowel Prep Kit follow these instructions:
5:00pm: Pour one(1) 6oz bottle of SUPREP liquid into the mixing container. Add cool drinking water to the 16oz line on the container and mix. Drink all the liquid in the container. You must drink two(2) more 16oz containers of water over the next hour.
7:00pm: Pour one(1) 6oz bottle of SUPREP liquid into the mixing container. Add cool drinking water to the 16oz line on the container and mix. Drink all the liquid in the container. You must drink two(2) more 16oz containers of water over the next hour.

9:30pm: Drink 1st bottle of magnesium citrate.

5:00am: Drink 2nd bottle of magnesium citrate only if stools are not liquid and clear. If you drink the this please finish by 5:30am.

 
 

 **NOTHING BY MOUTH AFTER MIDNIGHT UNLESS

OTHERWISE INSTRUCTED**

 

Flexible Sigmoidoscopy Instructions

  

**Please call if you have any questions regarding your procedure or preparation for your procedure. **


1. You will need to purchase 2 bottles of magnesium citrate and 2 fleet enemas. (Refrigerate the magnesium citrate on the day before your procedure.)

2. Arrange transportation to and from the office the day of your procedure. You cannot drive, please let your driver know that they may not leave during your procedure.

3. If you have a co-pay, it will be due at the time of your procedure. You may also want to check with your insurance company about a deductible. Should you need to cancel or reschedule, please give 48 hours notice. Failure to comply will result in a $50.00 fee. 

4. Prior Authorization will be obtained by the office staff if required by the patients insurance company. The claims will be filed for the procedure within 48 hours of the patient having the procedure performed.

5. Please note that we use third party anesthesia companies, there is a possibility that you may be responsible for any additional fees that your insurance may not cover. 

Instructions for Flexible Sigmoidoscopy:

· The day before your procedure, you cannot eat anything solid at any time of the day. You may drink all the clear liquids you want with no limit until midnight. Examples: Ginger-ale, tea, clear soda, clear juices such as apple juice and clear grape juice, popsicles, broth, Gatorade, and Jell-O. NOTHING RED, ORANGE, OR PURPLE. It is important to drink plenty of fluids this day.


· **NOTHING BY MOUTH AFTER MIDNIGHT UNLESS OTHERWISE DIRECTED**


· Please take your blood pressure medications the morning of your procedure.

· If you are taking Iron DISCONTINUE 1 WEEK BEFORE your procedure.

· If you are taking Coumadin, discuss this with your doctor. (It is usually stopped 5 days before).

· If you are taking Plavix, ASA, Effient, Xarelto, other blood thinners, do not take for 3 days unless otherwise directed.

· If you are diabetic, do not take your p.m. or your a.m. dose of oral medication. If you use insulin, take only ½ of your normal dose of insulin all day and do not take any insulin medications the day of your procedure. Please take your blood sugar the day of your procedure.

· If you use an inhaler, medications for chest pain, or medicines for anxiety, please bring them with you.


Prep instructions the day before your procedure:

6:00pm: Drink the 1st bottle of magnesium citrate.

8:00pm: Drink the 2nd bottle of magnesium citrate. 

Before you go to bed use 1st fleet enema.

2 hours before your procedure use 2nd fleet enema.