Please read through carefully prioir to procedure. 

Your stomach should be empty.  This is important for both upper GI endoscopy and for colonoscopy, because vomiting during sedation may soil the lungs and cause pneumonia.  Your instructions will include the information you need to understand what you may eat or drink and when you should stop taking anything by mouth.

Blood thinners should not be used for several days before your exam.  The risk of bleeding complications is much greater if your blood does not clot normally.  This is especially important if there is reason to dilate (expand) a stricture (constricted narrowing), to remove a growth or polyp or to treat a possible source of bleeding.  Aspirin, even in low dose (81 mg) is commonly used to inhibit blood clotting, and in most cases it should not be taken for at least 5 days before the examination.  Commonly used prescription and non-prescription drugs used for pain, those called NSAIDs (ibuprofen, naproxen and prescription NSAID drugs), also effect blood clotting and should not be taken for up to 5 days before the exam.  Patients with a history of stroke or coronary artery stents may be taking Plavix (clopidogrel), and these patients should ask the prescribing physician about stopping this medication.  Some patients with a history of irregular heartbeat (atrial fibrillation), blood clots (deep vein thrombosis, pulmonary embolism) or stroke may be taking Coumadin (warfarin), and they should also talk with the doctor prescribing it before scheduling their procedure.  After the procedure, you may be advised to avoid these medications for one to three more weeks.

It is very important to clear the large intestine of stool before colonoscopy.  Any material left in the colon will interfere with the physician’s ability to see the entire lining (mucosa) of the large intestine.  It is also important to know that incomplete cleansing of the bowel will prolong the examination, and may result in more discomfort either during or after the procedure.  Your physician will prescribe the laxative (cathartic) preparation that is best suited to be effective with low risk of harmful effects.  It is important to avoid excessive fluid loss (dehydration) during the cleansing process, and your instructions will advise you if supplemental fluids are needed.

Although not necessary for most GI endoscopy procedures, antibiotic treatment before the examination may be recommended.  Patients who have serious heart valve disease or a history of endocarditis may be at risk for infection during certain GI endoscopy procedures.  It is important to advise us in advance of any heart murmur or other risk factors for endocarditis.  It is generally recommended you avoid some GI endoscopy procedures if you have had artificial joint replacement surgery in recent months, or to arrange for antibiotic treatment before the procedure if it cannot be delayed.

You must arrange for transportation, you will not be allowed to drive after your procedure.  Because these examinations can be uncomfortable, sedation will be given to minimize your discomfort.  The sedative medications will significantly limit your ability to recall the examination and its associated discomfort.  It will also have the effect of impairing your judgment, alertness and coordination for the rest of the day.  You must not drive, operate machinery, fly an airplane, make important decisions or engage in risky activities for the remainder of the day and evening after this sedation.