What is a colonoscopy?
A colonoscopy is an examination of the entire length of your large intestine (colon). The physician uses a flexible tube called a colonoscope that has a small video camera attached to the tip. With this, the physician can view the interior of the colon and can remove colon polyps or suspicious tissue for further laboratory evaluation.
What is an EGD?
An EGD (upper endoscopy) is a procedure to examine your upper GI tract. The test involves an endoscope, a lighted camera on the end of the tube, which is passed down your throat to visualize your esophagus, stomach, and duodenum ( first portion of your small intestine).
What is flexible sigmoidoscopy?
A flexible sigmoidoscopy is an exam used to evaluate the lower part of the large intestine. During the exam, a thin flexible tube is inserted into the rectum. The doctor can view the inside of the rectum, the sigmoid colon and most of the descending colon, just under the last 2 feet of the large intestine.
This exam does not allow the doctor to see the entire colon. As a result, flexible sigmoidoscopy alone cannot detect cancer or small clumps of cells that could develop into cancer farther in the colon.
What is the difference between a “screening” and a “diagnostic” colonoscopy?
A “screening” colonoscopy will have no out-of-pocket costs for patients (such as co-pays or deductibles). A “diagnostic” colonoscopy is a colonoscopy that is done to investigate abnormal symptoms, tests, prior conditions, or family history. A “screening” colonoscopy turns into a “diagnostic” colonoscopy once tissue specimens are taken (polyp removal).
When do I get the results of the procedure?
You will be told about the preliminary results of the test before you leave to go home. You will also be given written information about these results as it is common not to remember all of what is said soon after the procedure. If biopsies are performed or polyps are removed during the procedure, you will receive a letter containing the results of the biopsies in 2 -3 weeks.
How many days do I need to take off work?
You will need to take off work the day of the procedure. Some patients, who work evenings, also take off work the day before the procedure to do the bowel prep.
How long does a colonoscopy take? How long will it take for me to recover?
The procedure itself usually takes about 20 minutes without any biopsy and /or polyp removal. You should plan on spending 1 ½ to 2 hours total to account for admission, pre op, waiting and recovery time.
Will I receive sedation for the exam? Will I be asleep?
You will receive sedation (usually propofol) for the exam. An intravenous line is placed, and medications are given intravenously. This is not general anesthesia; you will breathe on your own. Patients are asleep and comfortable during the procedure. Because of the sedation, you will need a driver to take you home.
Why do I need someone to drive me home?
You may feel sleepy, dizzy, and unsteady after the procedure. This is a result of the medications used for sedation. Your reflexes, coordination and judgement will be impaired. You may injure yourself or others if you try to drive or operate machinery.
What happens if I start drinking the preparation and I become nauseated or start vomiting?
Slow down and wait 30 minutes before beginning again. Try to drink 4 ounces every 15 – 20 minutes. Try to drink as much as you can as this will improve the quality of the preparation and the quality of the examination.
What happens if I drink the preparation and get no results?
If you don’t have frequent and progressively loose bowel movements within 3 hours of taking the preparation you may need something else to help it to work properly. Call US Digestive Health at (610) 644-6755. There is a physician on call after hours that will be able to assist you.
Can I still have a colonoscopy if I am menstruating?
Yes. The procedure can still be performed while you have your period. Tampons can be worn, and it will not interfere with the procedure.
If I take medication (diabetic, blood thinners), are there any risks?
Most medications do not interfere with this procedure. But, if you are on insulin, your dosage may need to be adjusted – or changed – for the preparation period and the day of the procedure.
If you take SGLT2 inhibitors (i.e. Jardiance, Synjardy, Farxiga) or GLP 1 agonists (i.e. Ozempic, Wegovy, Trulicity, Mounjaro), your medication will to be held before the procedure.
Anti-coagulant or blood-thinning medications will be held before the procedure to allow for biopsy and/or polyp removal.
Ask your physician about adjusting your medication(s).
I am taking the preparation and am having loose watery stools. Do I need to finish the prep?
Yes. You may have solid stool higher in the colon that needs to be eliminated.
My bottom is sore. What can I do?
When cleaning the area, avoid rubbing. Gently pat with a wet washcloth or moist baby wipes. You can apply Desitin, A&D Ointment, or Vaseline to the affected areas.
I am very thin. Do I still have to take all the preparation?
Yes. You must follow the preparation instructions provided to you. Your colon is approximately 6 feet long and must be completely emptied to help ensure an accurate and thorough examination.
I seem to be all “cleaned out” but haven’t finished my preparation. Do I need to finish it?
Yes. You must follow the preparation instructions provided to you to help ensure an accurate and thorough examination.
I am having an upper endoscopy. Will I have a sore throat after the procedure is over?
You should have little or no pain following your procedure. You may have a slight sore throat that can be relieved with warm liquids, throat lozenges or, if necessary, Tylenol.
What is an Advanced Directive? Do I need to have one before the procedure?
Advance directives are legal documents that provide instructions for medical care and only go into effect if you cannot communicate your own wishes. The state of Pennsylvania recognizes two types of advanced directives, durable power of attorney and living wills.
It is not necessary to have an advanced directive before your procedure. Upon request, the center can provide you with advanced directive forms, that can be filled out at a later date.
What should I wear to my procedure?
Patients should wear comfortable clothes and shoes. Bring ONLY what is necessary (ID card and insurance card). Leave all valuables and jewelry at home. You will be asked to change prior to the procedure. For an EGD (upper endoscopy), patients will remove all clothing from the waist up. For a colonoscopy, all clothing will be removed, underwear included. You will be given a patient gown and nonskid socks to wear. All personal items will be placed in a “patient belonging bag” and stowed underneath the stretcher to remain with you.
Will I be contacted by the physician or nurse after my procedure?
Patients are contacted by text message/ call the day after the procedure. If you are well, you do not need to respond to the text message/call. If you have any questions or concerns (abdominal pain, chest pain, fever, rectal bleeding), respond and you will be contacted by a nurse the same day.
Patients who have procedures on Friday will not receive follow up text messages/ calls until the following Monday. If you have any issues over the weekend (abdominal pain, chest pain, fever, rectal bleeding), an emergency contact number is included on all discharge instructions. There is a physician on call that will be able to assist you.
Who do I contact if there has been a change in my health history after I have scheduled a procedure?
If there has been a change in your health history (new diagnosis or new medication), contact US Digestive Health at (610) 644-6755 to update your information.
I am scheduled for a screening colonoscopy but was told I could incur costs. Why?
Screening colonoscopies are generally fully covered by insurance as preventive care. If a patient has had a positive result from a FIT test or Cologuard, their procedure shifts from screening to diagnostic. Diagnostic colonoscopies in these cases – aimed at investigating the positive test results – are covered by most insurance carriers as of May 31, 2022. Additionally, there are times during a screening colonoscopy when there are polyps found that need to be sent to pathology for further evaluation. In these cases, because of the need for pathology, it now becomes a diagnostic colonoscopy and there is a chance there could be costs to the patient. In all cases, it is very important for patients to check with their insurance carrier before having a procedure to confirm coverage and avoid any unexpected costs.
I received multiple billing statements following my procedure. Can you explain why?
The following is a summary of the billing process related to your procedure. You may receive statements from the following entities after your procedure:
- Regional Gastroenterology Associates of Lancaster, LTD-Physician Fee
- Main Line Endoscopy Center-Facility Fee
- RGAL Anesthesia Services, LLC-Anesthesia Fee
If a biopsy is necessary and/or polyp(s) are removal occurs, you may also receive a statement from one of the following providers:
- Regional Gastroenterology Associates of Lancaster, LTD -Pathologist Fee
- LabCorp or any other laboratory based on your insurance
If a second opinion is requested by the Pathologist, there may be an additional fee associated with the secondary lab service.