FREQUENTLY ASKED QUESTIONS

Appointments
Medical Records
Procedures
Virtual colonoscopy
Transportation
Medications
Preparations
Colonoscopy vs. Sigmoidoscopy
Camera in a Pill

Appointments

Q. Why do I have to fill out papers and come to your office one-half hour early for my first appointment?

A. There are several forms that need to be completed, some related to insurance and some related to your medical history. Completion of the medical history form helps your doctor to better diagnose and manage your problem.

Q. Why can't you get records from my other doctors?

A. The records that come from other doctors' offices are the property of that physician's office and only you can give authority to have those records transferred. You must first sign a release form (available at your referring physicians' office or ours) and ask that those records be sent to us. The best way to ensure that your office visit is the most productive is to bring your old records with you to your first visit with us.

Q. Will I feel pain during the procedure?

A. The majority of patients who undergo procedures, especially colonoscopy, feel little to no discomfort.
Moreover, the medications used create a temporary amnesia so most patients do not even remember the procedure. Still, the physician administering the medication has to balance patient comfort with safety during conscious sedation and, on occasion, there may be recollection of the procedure.

Q. Why can't I drive myself home if I'm awake when the procedure is over?

A. The medication that is administered during the procedure can have lingering effects for several hours after the procedure. For your safety, our policy is to prohibit patients from driving for at least 12 hours after the procedure. Someone must drive the patient home.

Q. Can I stay a few extra hours after my procedure and then drive myself home?

A. You cannot drive any vehicle until the day after the procedure since the medication can linger in the system and can affect your driving abilities. Someone must drive the patient home.

Q. When will I get the results of the test?

A. Your doctor will be able to give you preliminary results immediately following the procedure. If biopsies were taken, it may take up to two weeks for the results. It is recommended that if you do not get biopsy results within two weeks of the test that you call the office for the results. If, however, biopsy results arrive sooner, you will receive a letter in the mail with the biopsy results and subsequent recommendations.

Q. What is virtual colonoscopy and can I get that instead?

A. Virtual colonoscopy is a new technique designed to reconstruct three-dimensional images of the colon using CAT scan. This is not readily available at most hospitals and is not yet perfected at any institution. Studies have suggested that this technique might miss a significant percentage of smaller polyps that can be found with colonoscopy. Like traditional colonoscopy, virtual colonoscopy requires you to be cleansed just as if you are having a colonoscopy. Furthermore, if polyps were detected by virtual colonoscopy, you would still need a traditional colonoscopy to remove these polyps, thus resulting in two procedures. At this time, Gastrointestinal Associates cannot endorse virtual colonoscopy as an adequate screening test.

A detailed description of all colonoscopy preparations can be found on the drop-down menu at the following link: http://www.gastropa.com/procedures.htm

Q. Why did my doctor choose one colonoscopy preparation over another?

A. There are currently three commonly used preparations. The choice of a preparation is based on a number of factors including the physician's experience with previous patients, patient preference, and the potential side-effects of some of the preparations. The phosphasoda prep is the most frequently-prescribed preparation but, some physicians prefer the Colyte preparation and, yet others, may prefer the Visicol preparation. It is important to note that some medical conditions might warrant one type of preparation instead of another. Please ask your doctor if you have any further questions about this.

Q. If the procedure is scheduled late in the day, is the starting time of the liquid diet any different on the day before?

A. Yes. This is outlined in the preparation sheet that is provided for the procedure. It is recommended that you drink liquids until four hours prior to the procedure. After that time please do not drink or eat anything or we may not be able to perform the procedure.

Q. Can I take the new "pill" (Visicol) for my colonoscopy preparation?

A. A new preparation is available for colonoscopy. This product consists of pills instead of the liquid used for other preparations. This product (Visicol) is available, but may not be appropriate for every patient. Please discuss this with your doctor at the time of your visit.

Q. Why can I have cranberry juice but not red Jell-o or Kool Aid during a preparation?

A. Jell-0 and Kool Aid have artificial colors that may discolor the fluid in the colon and give the appearance of blood in the colon. Cranberry juice doesn't have artificial coloring so it won't discolor the preparation. Other fruit juices that are not red or other types of Jello are acceptable to take on the day of the preparation.

Q. Should I take my Metamucil or Citrucel prior to the colonoscopy?

A. It is recommended that you hold Metamucil, Citrucel and other fiber products for one week prior to the procedure. This will allow for a better result from the preparation.

Q. What medications need to be stopped prior to the procedures?

A. Any herbal medications, especially St. John's Wort and Ginkgo Biloba, need to be stopped for two weeks prior to the procedure. Aspirin does not need to be stopped. If you are on Coumadin (a blood thinner), please inform the office staff. Coumadin cannot be taken at the time of the procedure. Also inform the office if you are taking any medications for diabetes or weight loss medications such as Meridia.

Q. What is the difference between having a flexible sigmoidoscopy and having a colonoscopy?

A. A sigmoidoscopy is a shorter test that requires less preparation, but is less thorough. A colonoscopy requires greater preparation the day before and sedation for the procedure, but provides a more extensive examination of the colon. It has been shown that up to 50% of polyps and other findings can be missed with a sigmoidoscopy; hence there has been a trend towards performing a coIonoscopy rather than sigmoidoscopy. Please discuss this further with the physician performing the procedure if you have any additional questions.

Q. Why should I bother to have a sigmoidoscopy if it only looks at part of the colon?

A. In the following situations, a sigmoidoscopy may be more appropriate than a colonoscopy: 1) If the symptoms suggest that the problem might be found in the lower part of the colon, a sigmoidoscopy might render an answer faster and with less preparation than a colonoscopy. 2) If a process of active inflammation is suspected, it is often recommended to start with a sigmoidoscopy to evaluate the extent of the inflammation and to "chart the waters" because a colonoscopy in this situation may be riskier. 3) In certain cases such as diarrhea due to infection, a sigmoidoscopy might be more desirable. Consult with the doctor at Gastrointestinal Associates if you have further questions.

Q. I heard about a new capsule that has a camera built into it. Will that replace the need for colonoscopy?

A. Gastrointestinal Associates currently has an ingestible capsule that has been developed with a miniature camera to film the gastrointestinal tract as it passes through the intestine. This capsule may be helpful for some small intestinal conditions but does not replace colonoscopy for conditions in the colon (the large intestine). It does not allow removal of polyps or the ability to biopsy the colon. At your office visit, your doctor will offer further recommendations about this if it is determined you would benefit from the test.