Procedure Description: A flexible fiberoptic tube (colonoscope) is passed
What To Expect: After
any questions you have are answered, a medication will be given by
needle into your vein. This medication will make you feel sleepy and
relaxed.
You will be asked to turn on your left side and the room will be darkened.
The
doctor will then insert the flexible colonoscope tube into your rectum
and advance it through your colon, examining the lining thoroughly.
Many people fall asleep during the examination. You may feel some gas
or some abdominal cramping due to the air which the doctor will be
injecting into your colon. This is normal, but if you feel
uncomfortable, please tell the nurse. Fluoroscopy (x-ray) equipment may
be used to evaluate the scope?s position. This examination usually
takes about 20 minutes to an hour.
Preprocedure: In
order for the doctor to have a clear view of the colon, it is important
that the colon be completely free of stool. Therefore, you must
carefully follow the special instructions regarding diet, laxatives and
enemas which your doctor will give you. It is especially important to
stop using aspirin products, Metamucil, blood thinning medication, and
iron containing preparations for one week before the examination. If
you take daily medication, ask the doctor if you may take your morning
dose with just a swallow of water.
Be sure to let the doctor or G.I. nurse know if you are allergic to any drugs.
You will be asked to sign a consent form to authorize the doctor to perform the examination.
All dentures and contact lenses must be removed just prior to the start of the examination.
Postprocedure: After
the tube is removed, you will be moved to a quiet darkened room to
sleep or rest until the effect of the medication partially wears off
(usually one hour). You may feel some bloating from the air which the
doctor has put into the colon during this examination. You will feel
more comfortable if you expel this air. Before you leave the G.I. Unit,
the doctor will discuss his findings with you and your companion.
Unless the doctor or nurse instructs you otherwise, you may resume your
regular diet about four hours following the procedure.
Upper Endoscopy
Procedure Description: Upper Endoscopy
What To Expect: Upper
endoscopy enables the physician to look inside the esophagus, stomach
and duodenum (first part of the small intestine). The procedure might
be used to discover the reason for swallowing difficulties, nausea,
vomiting, reflux, bleeding, indigestion, abdominal pain, or chest pain.
Upper endoscopy is also called EGD, which stands for
esophagogastroduodenoscopy
(eh-SAH-fuh-goh-GAS-troh-doo-AH-duh-NAH-skuh-pee).
For
the procedure you will swallow a thin, flexible, lighted tube called an
endoscope (EN-doh-skope). Right before the procedure the physician will
spray your throat with a numbing agent that may help prevent gagging.
You may also receive pain medicine and a sedative to help you relax
during the exam. The endoscope transmits an image of the inside of the
esophagus, stomach and duodenum, so the physician can carefully examine
the lining of these organs. The scope also blows air into the stomach;
this expands the folds of tissue and makes it easier for the physician
to examine the stomach.
Preprocedure: Your
stomach and duodenum must be empty for the procedure to be thorough and
safe, so you will not be able to eat or drink anything for at least six
hours beforehand. Also, you must arrange for someone to take you
home--you will not be allowed to drive because of the sedatives. Your
physician may give you other special instructions.
Postprocedure: After
the endoscope is removed, you will be moved to a quiet darkened room to
sleep or rest until the effect of the medication partially wears off
(usually about 1 hour).
Before you leave the G.I. Unit, the doctor will discuss his findings with you and your companion.
Unless the doctor or nurse instructs you otherwise, you may resume your regular diet about 2 hours following the procedure.
6 Steps to Colon Cancer Prevention
1.
Get regular colorectal cancer screenings beginning at age 50. If you
have a personal or family history of colorectal cancer or colorectal
polyps, or a personal history of another cancer or inflammatory bowel
disease, talk to your doctor about earlier screening. 2. Eat between 25 to 30 grams of fiber each day from fruits, vegetables, whole grain bread and cereals, nuts and beans. 3. Eat a low-fat diet. 4. Eat foods with folate such as leafy green vegetables. 5.
If you use alcohol, drink only in moderation. Alcohol and tobacco in
combination are linked to colorectal cancer and other gastrointestinal
cancers. If you use tobacco, quit. If you don?t use tobacco, don?t
start. 6. Exercise for at least 20 minutes three to four days each
week. Moderate exer-cise such as walking, gardening, or climbing steps
may help reduce your risk.
March is National Colorectal Cancer
Awareness Month. Talk to your gastroenterologist or other healthcare
provider about colorectal cancer. Colorectal cancer is preventable, and
is easy to treat and often curable when detected early. Ask your
healthcare provider what kind of screening test you should have and
when. To learn more, visit the American Society of Colon and Rectal
Surgeons website at: www.fascrs.org or www.preventcancer.org/colorectal.htm or call 1-877-35-COLON.
Colorectal
Cancer Awareness Month was founded by the Cancer Research Foundation of
America in collaboration with the National Colorectal Cancer Roundtable
and the American Digestive Health Foundation. American Society of Colon and Rectal Surgeons
MIRALAX PREP
PURCHASE THESE ITEMS AHEAD OF TIME: 1. Two Dulcolax 5 mg tablets (does not need a prescription) 2. One 238-255-gram bottle of Miralax NOW OVER THE COUNTER! 3. One 64-ounce bottles of Gatorade (no red flavors)Note one could also buy 64 oz of snapple 4. Tuck's pads or Vaseline can be used to protect the anal area especially if you have hemorrhoids.
Three days prior to your colonoscopy: - Review and plan dietary needs for the next two days.
- Confirm your ride.
- If you have questions, please call us.(917) 721-8802
Two days prior to your colonoscopy: - Eat well-balanced meals but try to avoid nuts, popcorn, raw fruit, raw vegetables, and salads.
-
List any allergies and all prescription medications and
non-prescription products (over-the-counter, anti-inflammatory, herbal,
vitamins, etc.) you are taking. Bring these lists with you on the day
of the colonoscopy.
One day prior to your colonoscopy: - Start on a Clear Liquid Diet when you get up and continue all day.
Beverages: Tea, coffee (without cream/milk), Kool-Aid, carbonated beverages, Gatorade You may add sugar to coffee and tea but not milk or creamer (non-dairy creamers are okay).
Juices: Cranberry, apple, grape, strained lemonade, limeade, and orange drink Any juice that you can see through and has no pulp is acceptable.
Dessert: Italian ices, popsicles, Jell-O, and hard candy.
- Do not drink red colored beverages or eat red Jell-O.
- No solid food of any kind.
-
Throughout the day, make sure to drink at least eight glasses (two
quarts) of fluids such as Gatorade or a similar product, preferably not
only plain water.
- Take your usual prescription medications
(except iron). If you are on coumadin or other blood thinners, please
contact our office and your primary physician for specific instructions
at least one week prior to the colonoscopy.
- Diabetic Patients:
You may have your usual breakfast today and should take your diabetic
medications. Monitor your blood sugar at your usual times.
6:00 p.m. Take two Dulcolax tablets by mouth with 1 glass of water
7:00
p.m. Mix the 238-gram bottle of Miralax in 64-ounces of Gatorade. Shake
the solution until the Miralax is dissolved. Drink eight-ounces every
10-15 minutes until the entire solution is gone.
- Drink an additional 32-ounces of any clear liquid (without Miralax) over the next one to two hours.
Remember to remain close to toilet facilities!
-
You may continue to have clear liquids until midnight. After midnight,
do not eat or drink anything except the colonoscopy prep and you should
take your medications with sips of water.
Probiotic Paper
In Vivo. ;21 (3):507-12 17591361 Soy isoflavone intake and estrogen excretion patterns in young women: effect of probiotic administration. [My paper] Leonard A Cohen , Jeffrey S Crespin , Carla Wolper , Edith A Zang , Brian Pittman , Zhonglin Zhao , Peter R Holt
Colonoscopy versus CT colonography i.e. Virtual Co
March 9, 2008 Colonoscopy versus CT colonography i.e. Virtual Colonoscopy
In
the same week, two important gastroenterological organizations have
come out with different recommendations for screening for colon cancer.
The American College of Gastroenterology believes that traditional
colonoscopy is still the best test to screen for colon cancer. The
American Gastroenterology Association on the other hand feels that they
are equivocal. However, if they were just as good, why is CT
colonography recommended every 5 years while traditional colonoscopy is
recommended every 10 years.
Traditional colonoscopy still has
several advantages over CT colonography. Polyps, the precursors to
colon cancer, can be removed at the same time the exam is performed.
Small lesions that are under 5 mm can also be detected and removed
during the exam. While radiologists would argue that many of these
lesions are not advanced and will not advance to colon cancer, I have
seen first hand lesions such as these transform rapidly into advanced
neoplastic lesions. These small lesions are not reported on CT
colonography. For 96% of people, this is probably not a problem.
Unfortunately, the other 4% have lesions that likely could progress
undetected to colon cancer. Finally,the average radiation exposure of a
single CT colonography exam is the equivalent of about 100 chest X-rays.
For
myself as a physician and as a patient, I still think that traditional
colonoscopy is still the best test when performed by a properly trained
gastroenterologist. On the other hand, CT colonography is a better
option than no screening at all.
Jeffrey Crespin, MD
Gatorade Prep
Miralax-Gatorade Prep For A Colonoscopy (Keep Prep Sheet In Bathroom For Your Reading Pleasure, AND look this over a week before scheduled visit!) I
will look inside your entire five feet of colon . The procedure takes
fifteen to twenty minutes. You will be comfortably sleeping, under the
influence of IV Propofol and Versed, administered by a board-certified
anesthesiologist. You will not feel a thing! It is a very relaxing
sleep, from which you will awaken very quickly. (Bush had this
anesthesia, and Cheney was president for 5 minutes). You will be able
to leave within thirty minutes after the procedure, and you will be
able to eat, and go to work within an hour! You do not need anyone to
pick you up, and you will be allowed to drive four hours after the
procedure. Make a good effort to be well cleaned!! The prep is the
hard part. I can't see through a clouded lens! This 'tasty',
'pleasant', nearly enjoyable prep requires you to purchase 3
ingredients: 1. Four DULCOLAX LAXATIVE tablets from the pharmacy-- MUST BE THE LAXATIVE PILLS! (over-the-counter). 2. MIRALAX POWDER 238gm bottle (over-the-counter). 3. 64 oz. of Gatorade or Powerade. Diabetics may use diet soda, any flavor. Preparation
In detail: Please take all your normal medication. Do not take aspirin
for three days before the procedure, as it might increase the risk of
bleeding if a polyp is removed. If you take an anticoagulant, or if you
have inadvertently taken a few aspirin, call. In most cases, an aspirin
will not make a difference unless a large polyp is removed. Tylenol,
Aleve and Advil are okay. If you have an artificial valve or a very
serious significant heart murmur, please call. If you are pregnant or
breastfeeding, please call. You may have a LIGHT LUNCH the day
before the procedure. After lunch, drink only fluids - anything you can
read through. (Water, seltzer, black coffee, tea, vodka, Gatorade are
okay.) IT SHOULD BE EMPHASIZED THAT ALL FLUID INTAKE, INCLUDING WATER, SHOULD END SIX (6!) HOURS BEFORE THE PROCEDURE. In
order to prevent hunger, some patients drink liquid Sustacal or Ensure,
nutritional supplements available over-the-counter in pharmacies. You
can drink up to 4 cans up until midnight. (Sustacal and Ensure are not
clear, but are completely absorbed in the small bowel, and are okay.)
?OVER? Directions DIRECTIONS FOR DULCOLAX/MIRALAX/GATORADE PREP: Mix
the entire 238 gram bottle of Miralax with 2 quarts of Gatorade in a
large pitcher. Stir, chill, add ice, and let it breathe for at least a
few minutes in order to fully appreciate the flavor. At
approximately 4-7PM the evening before the procedure, take all four
Dulcolax tablets. It will probably take about 2-3 hours before the
action begins. If you are a frequent laxative user, please start with
double your USUAL effective Dulcolax dose (or call the office if
questions). Two hours after the Dulcolax, start drinking your
chilled Miralax cocktail. (We are entertaining creative names for this
cocktail, so please feel free to jot down your thoughts during your
private moments.) You should pace yourself to drink about eight 8 ounce
glasses (64oz.) over a 2-4 hour period, roughly one glass every 15-30
minutes, until finished. Expect to use the facilities at least
10-15 times. The stool should be clear, lemonade-like, not sludgy or
brown. Expect some cramps. If you have questions about success, call at
8 am, when the phones get turned on. We can improvise in the morning if
necessary. You can expect to leave approximately 45 minutes after
we start the procedure. Most people do not need anyone to pick them up,
as the anesthesia wears off very quickly. Most patients will want
to eat breakfast and are capable of being at work within an hour of
leaving the office. No driving a car or operating heavy machinery
(airplanes, backhoes, chainsaws, etc.) for 4 hours after anesthesia. It is a good idea to bring an extra pair of underwear. Menstrual
periods, viral syndromes, or urinary infections do not interfere with
the colonoscopy! Call if questions!!! Bring any Insurance or Referral
Forms.
Obesity
Halflytely Prep
HalfLytely PM Colonoscopy Prep The day before your procedure Fill your prescription for HalfLytely® bowel prep kit at your pharmacy. · The day before the test you may have a light breakfast · After 11:00 AM follow a clear liquid diet. (see below) · Prepare Halfylytely prep solution. (see instructions below) · At 6:00 PM take two (2) Bisacodyl® tablets. Note: Do not take Bisacodyl® within 1 hour of taking an Antacid . · At 8:00 PM take two (2) Bisacodyl® tablets. To prepare the Halflytely® prep solution · Add lukewarm drinking water to top of line on bottle. · Cap bottle and shake to dissolve the powder. ·
The reconstituted solution will be clear and colorless. Use within 48
hours. Do not add anything else, such as flavorings, to the solution. On the day of your procedure: ____________________________ Stay on a Clear Liquid diet until 4 hours prior to your procedure. Then nothing to eat or drink until after your procedure. · Begin to drink the HalfLytely® solution at 7:00 PM ·
Drink 1 (8 oz) glass every 10 minutes (about 8 glasses). Drink each
glass quickly rather than drinking small amounts continuously · Be
sure to drink ALL of the HalfLytely® solution· You may experience a
bloating sensation, but cramping or other discomfort is quite uncommon.
Many patients find it most convenient to drink the solution while in the bathroom ON __________________arrive at ______________________________ Hospital at ___________AM.
Please note the following: · Hospital policy requires transportation must be provided by a responsible person after your procedure. Failure to comply may result in the cancellation of your procedure. · No driving or operating machinery for 24 hours after procedure. · Do Not take any other medicines within 1 hour of starting to drink the prep solution. · If on Insulin, Plavix or Coumadin please adjust as follows: _________________________________ · If on arthritis medication or any new medications, check with physician for specific instructions. · Avoid drinking large amounts of water during or after taking the HalfLytely prep and after colonoscopy.
Clear Liquid Diet (Do not eat or drink anything red) Broth Sorbet (with no fruit pieces) Popsicles ® Jell-O ® Water Black Tea/Coffee (No milk or cream) Soda Crystal Light ® Hard Candy Fruit Juice without Pulp White Grape Juice Grapefruit Juice w/o pulp Apple Juice
And all foods or beverages listed above in Clear Liquids
DIABETES PREP FOR COLONOSCOPY / ENDOSCOPY ·
All efforts will be made to schedule your case in the early morning. If
not, consult your physician for specific instructions. · The clear liquid diet contains foods with sugar. It is OK to drink these liquids! ·
Continue your blood sugar testing before your procedure; perform a test
at home before leaving for your procedure and report the result to the
nurse upon your arrival at the hospital. · If you are taking
tablets that contain Metformin (Glucophage, Avandamet, Metaglip,
Glucovance or generic forms of Metformin), discontinue the day before
your procedure and resume the day after your procedure. · Other
tablets for diabetes (including Glyburide, Glipizide, Actos, Avandia,
Prandin, Starlix, Glyset, Precose) may be taken on the day and night
before your procedure, but not on the morning of your procedure. Resume
the tablets when you return home. · If you are taking long acting
insulin (Lantus), do not stop it. If your long acting insulin is NPH,
Lente or Ultralente, take your normal dose the evening before, but only
2/3 your usual dose on the morning of the procedure. · If you are
taking a rapid acting Insulin (Regular, Humalog, or Novolog) do not
take any on the morning of your procedure, unless your blood sugar is
above 200 mg/dL in which case you should take ½ your usual dose. · If your blood sugar is high before, during or after the procedure, you may receive extra shots of insulin. If you have any questions, please contact your primary care physician or diabetes physician.
Golytely Prep
Go Lytely Colonoscopy Prep
The day before your procedure · Fill your prescription for GoLytely® bowel prep kit at your pharmacy. · Have a light breakfast · After 11:00AM, follow a clear liquid diet. (see below) · Prepare Golytely prep solution. (see instructions below) · At 6:00 PM take two (2) Bisacodyl® tablets. Note: Do not take Bisacodyl® within 1 hour of taking an Antacid . · To prepare the Golytely® prep solution · Add lukewarm drinking water to top of line on bottle. · Cap bottle and shake to dissolve the powder. ·
The reconstituted solution will be clear and colorless. Use within 48
hours. Do not add anything else, such as flavorings, to the solution. On the day of your procedure: ____________________________ Stay on a Clear Liquid diet until 4 hours prior to your procedure. Then nothing to eat or drink until after your procedure. · Begin to drink the GoLytely® solution at 7:00 PM ·
Drink 1 (8 oz) glass every 10 minutes (about 8 glasses). Drink each
glass quickly rather than drinking small amounts continuously · Be sure to drink ALL of the GoLytely® solution · You may experience a bloating sensation, but cramping or other discomfort is quite uncommon. · Many patients find it most convenient to drink the solution while in the bathroom ON __________________arrive at ______________________________ Hospital at ___________AM.
Please note the following: · Hospital policy requires transportation must be provided by a responsible person after your procedure. Failure to comply may result in the cancellation of your procedure. · No driving or operating machinery for 24 hours after procedure. · Do Not take any other medicines within 1 hour of starting to drink the prep solution. · If on Insulin, Plavix or Coumadin please adjust as follows: _________________________________ · If on arthritis medication or any new medications, check with physician for specific instructions. · Avoid drinking large amounts of water during or after taking the GoLytely prep and after colonoscopy.
Clear Liquid Diet (Do not eat or drink anything red) Broth Sorbet (with no fruit pieces) Popsicles ® Jell-O ® Water Black Tea/Coffee (No milk or cream) Soda Crystal Light ® Hard Candy Fruit Juice without Pulp White Grape Juice Grapefruit Juice w/o pulp Apple Juice
And all foods or beverages listed above in Clear Liquids
DIABETES PREP FOR COLONOSCOPY / ENDOSCOPY ·
All efforts will be made to schedule your case in the early morning. If
not, consult your physician for specific instructions. · The clear liquid diet contains foods with sugar. It is OK to drink these liquids! ·
Continue your blood sugar testing before your procedure; perform a test
at home before leaving for your procedure and report the result to the
nurse upon your arrival at the hospital. · If you are taking
tablets that contain Metformin (Glucophage, Avandamet, Metaglip,
Glucovance or generic forms of Metformin), discontinue the day before
your procedure and resume the day after your procedure. · Other
tablets for diabetes (including Glyburide, Glipizide, Actos, Avandia,
Prandin, Starlix, Glyset, Precose) may be taken on the day and night
before your procedure, but not on the morning of your procedure. Resume
the tablets when you return home. · If you are taking long acting
insulin (Lantus), do not stop it. If your long acting insulin is NPH,
Lente or Ultralente, take your normal dose the evening before, but only
2/3 your usual dose on the morning of the procedure. · If you are
taking a rapid acting Insulin (Regular, Humalog, or Novolog) do not
take any on the morning of your procedure, unless your blood sugar is
above 200 mg/dL in which case you should take ½ your usual dose. · If your blood sugar is high before, during or after the procedure, you may receive extra shots of insulin. If you have any questions, please contact your primary care physician or diabetes physician.
Beth Israel Directions
DIRECTIONS TO BETH ISRAEL; Take
the 4 or 5 or N, R train to union square and the L train to 14th and
1st. Walk north to 16th and 1st. Take a left on 16th street. You will
enter through the emergency entrance marked on this map with an X. The
first set of elevators on your left go to the 8th floor of Dazian which
is where you will check in and where the colonoscopy will be performed.
If
you have any questions before the procedure, my toll free answering
service number is 1888 388-5334. I look forward to seeing you. STATE LAW AND BETH ISRAEL mandate that you be accompanied home from the hospital by a relative or friend upon discharge.
Lenox Hill Endoscopy is at 100 East 77th st between Lexington and Park. The endoscopy suite
is located on the second floor. Take the six train to 77th and
Lexington and walk 100 yards west to the main hospital entrance
