General points to remember

•  It is our aim for you to be seen and investigated as soon as possible after your arrival. However, the department is very busy and your investigation may be delayed. If emergencies occur, these patients will obviously be given priority over the less urgent cases. 
•  The hospital cannot accept any responsibility for the loss or damage to personal property during your time on these premises. 
•  If you are unable to keep your appointment please notify the endoscopy department as soon as possible. 
• Because you are having sedation, please arrange for someone to collect you. 
• If you have any problems with persistent abdominal pain or bleeding please contact the Endoscopy Helpline for advice. Contact details will be on your discharge letter.

Specific advice for people with diabetes

Treatment by diet alone

If you control your diabetes with diet alone, you simply need to follow the instructions given to you to prepare for your colonoscopy.

Treatment by tablets and/or insulin 

You should inform the endoscopy department about your diabetes and request an early morning appointment.

Preparation on first day 

As advised earlier in this Booklet there are two days of preparation before the examination. When following the low fibre diet on the first day try to make sure you eat your usual amounts of carbohydrate from the allowed list eg white bread, white rice, pasta etc. Continue to take your usual tablets and/or insulin and check your blood sugar levels as usual. 

Adjusting your diabetes medication to prevent hypoglycaemia 

You will need to reduce your treatment the day before and the morning of the procedure to prevent the risk of hypoglycaemia (low blood sugar level). As a result your blood sugar control may be a little higher than usual. This is only temporary to maintain your blood sugars through the procedure and you should be back to your usual level of control within 24 to 48 hours. 

If you have concerns about adjusting your dosage, please contact the Diabetes Nursing Team well in advance of the appointment, to discuss appropriate measures.

Carrying Glucose to treat Hypoglycaemia 

On the day before and day of the procedure carry glucose tablets in case of hypoglycaemia. As these are absorbed quickly through the tissues of the mouth, if sucked, they will not interfere with the procedure. Take three (3) tablets initially, followed by a further three (3) after 10 minutes if symptoms persist. If your medication has been adjusted this should not be a problem.

General points to remember

Please Note:

1. If you are a diabetic and receiving oral diabetic agents, please do not take these medications the day before and the day of your procedure. 

2. If you are diabetic and receiving insulin, please discuss this with our office at least seven (7) days prior to your colonoscopy/endoscopy. 

3. If you are taking Coumadin (warfarin), please discuss this with our office at least seven (7) days prior to your colonoscopy/endoscopy. 

4. If you are taking steroid medications (e.g. Prednisone, Decadron, Medrol), please discuss this with our office at least seven (7) days prior to your colonoscopy/endoscopy. 

5. If you have had a cardiac valve replacement or a history of endocarditis (infection or inflammation of a heart valve generally requiring prolonged intravenous antibiotic therapy), please discuss this with our office at least seven (7) days prior to your colonoscopy/endoscopy. 

6. Do not take the following medications for a period of seven (7) days prior to your colonoscopy/endoscopy: aspirin or aspirin-containing medications (e.g. Anacin, Bufferin, Alka-Seltzer), and iron (including multivitamins that contain iron). 

7. Do not take nonsteroidal anti-inflammatory drugs (NSAID’s, e.g., Motrin, Advil, Nuprin, Naprosyn, Voltaren, Vioxx, Celebrex, and others)for a period of three (3) days prior to your colonoscopy/endoscopy. 

8. All other medications including antiplatelet drugs [e.g. Plavix (clopidogrel), Ticlid (ticlopidine), Pletal (cilostazol)] may be continued without change and may be taken up to and including the day of your colonoscopy/endoscopy.

9. If you have a history of congestive heart failure, liver disease or kidney disease, please discuss your preparation instructions with our office at least seven (7) days prior to your colonoscopy/endoscopy. 

10. Since you will be given a sedative for this examination, you must have a responsible adult take you home and accompany you into your residence. As well, you must have a responsible adult stay with you for the next 24 hours. You should plan on limiting your activity and resting at home for the remainder of the day. You must not drive a motor vehicle or operate machinery for the next 24 hours. If there is a problem with these arrangements, please inform this office to allow for rescheduling of your procedure. Sedation for your procedure cannot be administered unless these arrangements are completed. 

11. If you have an insurance plan that requires a referral (MVP, CDPHP, Senior Blue, many others), please be sure our office has a referral from your primary care physician to cover this procedure. If your insurance requires pre-authorization, please be sure our office has obtained this

General points to remember

The hospital cannot accept any responsibility for the loss or damage to personal property during your time on these premises. 

If you have any problems with a persistent sore throat, chest or abdominal pain or bleeding please contact your GP immediately informing them that you have had an endoscopy.

If you are unable to contact or speak to your doctor, you must go immediately to the casualty department. If your symptoms persist or worsen, go immediately to casualty. 

It is our aim for you to be seen and investigated as soon as possible after your arrival. However, the department is very busy and your investigation may be delayed. If emergencies occur, these patients will obviously be given priority over less urgent cases.

The hospital cannot except any responsibility for the loss or damage to personal property during your time on these premises.

Dietary instructions for colonoscopy preparation

Low fibre diet 

Fibre is the indigestible part of cereals, fruit and vegetables. Please commence a low fibre diet 2 days before your procedure. 

Foods allowed 

Lean, tender lamb, beef, pork, chicken, turkey, offal, bacon, lean ham, fish, Yorkshire pudding, pancakes; bread sauce; clear and puréed soups; potato (no skins), boiled and mashed; tomato pulp (no skins or pips); fruit juice (if tolerated); pastry made with white flour, white bread, white flour, cornflakes, rice krispies, icing smooth biscuits, eg: Marie, Osborne; spaghetti and pasta; white rice, crisps; rosehip syrup, Ribena; sugar or glucose in small amounts; boiled sweets, toffees; plain or milk chocolate; shortcake, cream crackers, water biscuits; sponge cake, Madeira cake; ice cream, iced lollies; plain or flavoured yoghurt; jelly marmalade; honey, syrup; tea and coffee (without milk) and fizzy drinks. 

Foods to be avoided 

Wholemeal, wheatmeal, granary bread, wholemeal flour; bran biscuits, coconut biscuits; all cereals containing bran or whole wheat, eg; shredded wheat, bran flakes, bran buds, muesli; digestive biscuits; Ryvita, Vita Wheat, oat cakes, etc. 

To enable a more effective examination, we would be grateful if you would take a clear fluid only diet for the period of time stated on the attached appointment letter.

Fluids allowed 

Twenty-four hours before your examination you should take clear fluids only (no food): 

Tea (no milk), black coffee, water, strained fruit juice, strained tomato juice, fruit squash, soda water, tonic water, lemonade, oxo, Bovril, marmite (mixed into weak drinks with hot water), clear soups and broths, consommé.

 In addition 

You may eat clear jellies You may suck clear boiled sweets and clear mints. You may add sugar or glucose to your drinks. 

Fluids not allowed 

Drinks or soups thickened with flour or other thickening agents