Colonoscopy is an examination of the large intestine through a scope placed into the body at the rectum. It is performed routinely every 10 years beginning at age 50 unless symptoms require the study be done earlier. Upper gastrointestinal endoscopy is an examination of the esophagus, stomach and small intestine. It is done to evaluate symptoms only. Combining the two procedures allows them to be done with one dose of anesthesia, which is safer.
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Preparing for a Colonoscopy and Endoscopy
Obtain authorization for payment. This is the first matter of business once a decision to do an endoscopy and colonoscopy has been made by you and your physician. The physician's office staff will start this process. Take you insurance card, preauthorization papers and your driver's license or state-issued ID card with you to the procedure. Consult your pharmacist to see which of your medications and supplements must be stopped before surgery. Ask a friend or relative to drive you home, or if there is no one who can do this, the office staff will call for a cab.
Drink only clear liquids starting one to three days before your procedure unless told otherwise. Try alternating hot and cold liquids and drink enough to avoid hunger. Have some drinks with salt, such as fat-free broth, and some with sugar such as a sports drink.
Take the recommended laxative the day before your procedure to clear out the majority of the remaining material from the colon. Follow the instructions carefully and do not exceed the recommended dose as this can cause dangerous electrolyte imbalances.
Ask the pharmacist if your normal medications can be taken with laxatives. Many can not because they will be excreted too quickly to be absorbed, according to the Physician's Desk Reference.
Carry out an enema at home if instructed to do so by the physician. This will ensure all remaining material is out of the lower colon to allow a clear view. Mix the contents as instructed by the doctor's staff, or in accord with the label instructions using warm, not hot, water. Allow the solutions to flow out of the tubing into the toilet to remove air in the tubing, and then close the clamp. Hang the enema bag on a hanger over a door handle near the toilet.
Apply lubricant to the enema tip and insert the tip through your anus as far into the rectum as it will pass comfortably. Taking deep, slow breaths open the clamp and allow the liquid to pass into the colon. Keep the enema bag 15 to 18 inches above the enema tip. After the fluid is gone, or when you experience fairly strong cramping, clamp the tube and slowly remove the enema tip from the rectum, and then try to retain the fluid for a few minutes to make the enema more effective. When necessary expel the enema in the toilet.
Drink nothing at all after midnight the day of your procedure, unless told otherwise by your physician, because an Upper Gastric Endoscopy is scheduled. On the day of the procedure take warm socks and a sweater as the facilities are often air-conditioned. When performing a colonoscopy faster is not better. A study published in the April 2010 issue of the "Journal of Clinical Gastroenterology" reported that a procedure time of greater than six minutes is considered optimal for the detection of cancer and other abnormalities in the colon. Ask your physician what his withdrawal time normally is for colonoscopy. The doctor's answer should be, "No less than six minutes and as long as it takes to inspect the entire colon."
The total time for these two procedures is about 45 minutes and you will need to stay at the center for about two hours after they are complete. Plan to rest the remainder of the day.