Pre-procedure Instructions

• Upper Endoscopy
• Small Bowel Enteroscopy
• Upper Endoscopic Ultrasound (EUS)
• Treatment of Barrett's Esophagus
• Percutaneous Endoscopic Gastrosomy (PEG) Feeding Tube Placement
• Colonoscopy
• Illeoscopy
• Lower Endoscopic Ultrasound (EUS) and Flexible Sigmoidoscopy
• Liver Biopsy
• Endoscopic Retrograde Cholangiopancreatography (ERCP)
• Esophageal Manometry
• 24-hour Ambulatory pH Monitoring

Upper Endoscopy (EGD/Esophagogastroduodenoscopy),
Small Bowel Enteroscopy
Upper Endoscopic Ultrasound (EUS)
Treatment of Barrett's Esophagus
Percutaneous Endoscopic Gastrostomy (PEG) Feeding Tube Placement

To prepare for your procedure, please follow these instructions carefully:

1. If your procedure is in the morning, do not eat or drink anything after midnight on the day of the procedure.
2. If your procedure is in the afternoon, do not eat anything after midnight on the day of the procedure. You may have only CLEAR LIQUIDS until 6 hours prior to your scheduled procedure time. Clear liquids include clear apple/white grape/white pear juice, clear broths, coffee and tea without creamer/milk, Gatorade, Crystal Lite, pop, Jello, and water. AVOID all red and purple juices and Jellos.
3. Taking your usual medication with small sips of water on the morning of the procedure will be OK. If you are taking diabetes or blood-thinning medications, you should follow the individualized instructions that will be given to you prior to the procedure.
4. You will need to arrange for someone to drive you home as you will be medicated for this procedure. You must have somemone at the faciity to release you after your procedure. For your own safety, you WILL NOT be able to walk home or to take a taxi/bus home.
5. Please call 541 868-9500 with any questions regarding these instructions, or, in case of emergency to reschedule your procedure. Urgent concerns outside of the office hours should be directed to the on-call physician at 541 868-9500 (toll free 877 484-4501).

Colonoscopy
Ileoscopy

There are different bowel preparations available for your procedure. If you have specific questions regarding which bowel prep would be best for you, please discuss this with your physician.

Prior to your colonoscopy: Ideally, please avoid foods with seeds and nuts 3 days before your procedure. Items such as yogurts or jams with strawberries or blackberries, and breads with seeds should be avoided. However, if you do forget DO NOT cancel your procedure.

Take your usual medications with a small sip of water the morning of your exam. If you are taking medications for diabetes you will be asked to withhold oral medications the evening prior and morning of your procedure. If you are taking insulin you will be given guidelines at the time of scheduling your procedure or you may phone your doctor who prescribed your insulin. Unless you are directed at the time your procedure is scheduled, it is not necessary for you to discontinue taking aspirin. If you are taking Coumadin, Jantoven or Warfarin you will be given individualized instructions at the time your procedure is scheduled. Ideally, do not take multivitamins with iron or iron supplements for 5 days before your exam. If you forget and do take your vitamins do not cancel your procedure.

The day prior to your procedure: begin a clear liquid diet as soon as you wake up. This means no solid food, no milk products, and no alcoholic beverages. Suggested liquids include: apple juice, white grape juice, clear broths, coffee and tea without creamer, Gatorade, Crystal Light, soda pop, Jell-O and water. Avoid all red or purple juices and Jell-O.

What to expect during your bowel prep: The first few glasses of the bowel prep you may feel bloated or “full.” You will begin passing watery stool within a few hours after consuming your bowel prep. You may wish to apply a liberal amount of Vaseline to the rectal area to prevent irritation. You may also use Preparation H, Anusol or Tucks medicated pads for comfort.

Arrange for someone to drive you home as you will be medicated for this procedure. You must have somemone at the faciity to release you after your procedure.You may NOT take a taxi or a bus home.

BOWEL PREPARATIONS

PEG-3350
SODIUM CHLORIDE, SODIUM BICARBONATE POTASSIUM CHLORIDE
(common names: NuLytely; TriLyte; CoLyte; GoLytely)

Begin drinking the PEG-3350 at 12 noon, frequently stirring the solution. It is important to drink all of the PEG-3350. While drinking the PEG-3350 you may have sugar free drinks only such as diet soda and sugar free Jell-O. You may continue to have broths, coffee or tea.

Hints on drinking PEG-3350 bowel prep: On the morning of your bowel prep, mix Crystal Light sugar-free lemonade (NOT raspberry) directly into the gallon of bowel prep. The bowel prep comes with flavor packs but they are not enough to flavor the bowel prep so put those aside. Crystal Light seems to work the best. Fill container to line with lukewarm water, shake well and place in your refrigerator. At noon, shake container well, begin drinking the bowel prep slowly. When you pour yourself a glass of PEG-3350 with the Crystal Light you may want to use a small amount of the flavor packets that came with the bowel prep as an added flavor to the prep. This way you will have an assortment of flavors while drinking the bowel prep instead of having just one flavor. Drink the bowel prep slowly, there is no time limit as to when you need to finish it however you do need to drink the entire gallon. Take breaks from drinking it and drink a cup of warm tea, coffee, broth or any other clear liquid. Shake prep well every time you pour a glass. The prep is designed to go directly to your colon and because it is refrigerated you may/will get chills. THIS IS NORMAL it just means the prep is working. You may drink the bowel prep at room temperature if you find it more comfortable for you. Most people finish the prep in 6-8 hours however if it takes you longer that is fine. You must finish the entire gallon of prep. You may have clear liquids up to 6 hours prior to your procedure. You are to discontinue clear liquids, including water, 4 hours prior to your procedure. If you need to take medications during the 4 hour period you may take them with a very small sip of water.

Lower Endoscopic Ultrasound (EUS) and Flexible Sigmoidoscopy

To prepare for your procedure, please follow these instructions carefully:

1. Purchase 2 Fleet enemas and one 10oz bottle of magnesium citrate from your pharmacy. These are non-prescription items but your pharmacist can assist you in locating them.
   1. Take by mouth the 10oz bottle of magnesium citrate at 6:00 PM the evening before your exam. Do not overeat, but you may eat your regular diet on this day.
   2. On the day of your exam, administer the first Fleet enema 2 ½ hours before you need to leave to check in for your appointment. Follow the package instructions. Lying on your left side is a relatively comfortable position and the most effective. It is important to retain the enema solution for at least 5 minutes before expelling the solution into the toilet.
   3. Administer the second Fleet enema 1 ½ hours before you need to leave to check in for your appointment, again holding the enema solution for at least 5 minutes or longer. If there are still bits of stool being passed from the bowel with completion of the second enema, please fill the empty enema bottle with warm water and administer a third enema. Continue warm water enemas until the expelled water is clear.
2. If your procedure is in the morning, do not eat or drink anything after midnight on the day of the procedure.
3. If your procedure is in the afternoon, do not eat anything after midnight on the day of the procedure. You may have only CLEAR LIQUIDS until 4 hours prior to your scheduled procedure time. Clear liquids include clear apple/white grape/white pear juice, clear broths, coffee and tea without creamer/milk, Gatorade, Crystal Lite, pop, Jello, and water. AVOID all red and purple juices and Jellos.
4. Taking your usual medication with small sips of water on the morning of the procedure will be OK. If you are taking diabetes or blood-thinning medications, you should follow the individualized instructions that will be given to you prior to the procedure.
5. You will need to arrange for someone to drive you home as you may be medicated for this procedure. You must have somemone at the faciity to release you after your procedure. For your own safety, you WILL NOT be able to walk home or to take a taxi/bus home.
6. Please call 541 868-9500 with any questions regarding these instructions, or, in case of emergency to reschedule your procedure. Urgent concerns outside of the office hours should be directed to the on-call physician at 541 868-9500 (toll free 877 484-4501).

Liver Biopsy

To prepare for your procedure, please follow these instructions carefully:

1. If your procedure is in the morning, do not eat or drink anything after midnight on the day of the procedure.
2. If your procedure is in the afternoon, do not eat anything after midnight on the day of the procedure. You may have only CLEAR LIQUIDS until 6 hours prior to your scheduled procedure time. Clear liquids include clear apple/white grape/white pear juice, clear broths, coffee and tea without creamer/milk, Gatorade, Crystal Lite, pop, Jello, and water. AVOID all red and purple juices and Jellos.
3. Taking your usual medication with small sips of water on the morning of the procedure will be OK. If you are taking diabetes or blood-thinning medications, you should follow the individualized instructions that will be given to you prior to the procedure. Avoid asprin, NSAIDS and ibuprophin 5 days prior to procedure. If you forget and take an aprin product, please contact us imediately as we will need to reschedule your procedure.
4. You will need to arrange for someone to drive you home as you will be medicated for this procedure. You must have somemone at the faciity to release you after your procedure. For your own safety, you WILL NOT be able to walk home or to take a taxi/bus home.
5. Please call 541 868-9500 with any questions regarding these instructions, or, in case of emergency to reschedule your procedure. Urgent concerns outside of the office hours should be directed to the on-call physician at 541 868-9500 (toll free 877 484-4501).

Endoscopic Retrograde Cholangiopancreatography (ERCP)

To prepare for your procedure, please follow these instructions carefully:

1. If your procedure is in the morning, do not eat or drink anything after midnight on the day of the procedure.
2. If your procedure is in the afternoon, do not eat anything after midnight on the day of the procedure. You may have only CLEAR LIQUIDS until 6 hours prior to your scheduled procedure time. Clear liquids include clear apple/white grape/white pear juice, clear broths, coffee and tea without creamer/milk, Gatorade, Crystal Lite, pop, Jello, and water. AVOID all red and purple juices and Jellos.
3. Taking your usual medication with small sips of water on the morning of the procedure will be OK. If you are taking diabetes or blood-thinning medications, you should follow the individualized instructions that will be given to you prior to the procedure.
4. You will need to arrange for someone to drive you home as you will be medicated for this procedure. You must have somemone at the faciity to release you after your procedure. For your own safety, you WILL NOT be able to walk home or to take a taxi/bus home.
5. Please call 541 868-9500 with any questions regarding these instructions, or, in case of emergency to reschedule your procedure. Urgent concerns outside of the office hours should be directed to the on-call physician at 541 868-9500 (toll free 877 484-4501).

Esophageal Manometry

To prepare for your procedure, please follow these instructions carefully:

1. Do not eat or drink anything after midnight on the day of the procedure.
2. Taking your usual medication with small sips of water on the morning of the procedure will be OK. If you are taking diabetes or blood-thinning medications, you should follow the individualized instructions that will be given to you prior to the procedure.
3. If you are taking Reglan, you will be instructed when to stop these as necessary.
4. You will NOT be sedated with these examinations and may drive yourself to and from your appointment. However, if you are also having an upper endoscopy, you will receive sedative medications and MAY NOT drive yourself home. If this is the case, please see instructions for “Upper Endoscopy".
5. Please call 541 868-9500 with any questions regarding these instructions, or, in case of emergency to reschedule your procedure. Urgent concerns outside of the office hours should be directed to the on-call physician at 541 868-9500 (toll free 877 484-4501).

24-hour Ambulatory pH Monitoring

To prepare for your procedure, please follow these instructions carefully:

1. Do not eat or drink anything 4 hours prior to the procedure.
2. Taking your usual medication with small sips of water on the morning of the procedure will be OK. If you are taking diabetes or blood-thinning medications, you should follow the individualized instructions that will be given to you prior to the procedure.
3. If you are taking any anti-acid medications, you will be instructed when to stop these as necessary.
4. You will NOT be sedated with these examinations and may drive yourself to and from your appointment. However, if you are also having an upper endoscopy, you will receive sedative medications and MAY NOT drive yourself home. If this is the case, please see instructions for “Upper Endoscopy".
5. Please call 541 868-9500 with any questions regarding these instructions, or, in case of emergency to reschedule your procedure. Urgent concerns outside of the office hours should be directed to the on-call physician at 541 868-9500 (toll free 877 484-4501).

Note: the information in this section is provided as a supplement to information discussed with your healthcare provider. It is not intended to serve as a complete description of a particular topic or substitute for a clinic visit.