After Your Procedure
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Questions:

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Why is it advised to not travel out of the country for the month after the colonoscopy?

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What are the medications used for endoscopy/colonoscopy?

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Who can be my driver for an endoscopy/colonoscopy?

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What follow-up information will I receive?

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Can I take a taxi home from my endoscopy procedure?

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May I ride walk or bicycle home?

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What should I eat after my procedure?

 

Why is it advised to not travel out of the country for the month after the colonoscopy?

It needs to be remembered that during endoscopic procedures

(i.e. colonoscopy) besides diagnosing disease, therapy may be administered which has to be viewed as being a form of surgery preformed internally.  The most frequent example of this occurs during colonoscopy where after a polyp is seen it is removed via an electro-surgical technique burning away its attachment to the wall of the colon.  A burn (cautery mark) is left behind that will heal over a number of days (up to 14 to 18) and on rare occasions bleeding can occur from the edge of the healing burn and require follow up medical attention.  This is infrequent, though on

average one patient per year from our practice will require hospital admission for observation (generally brief lasting 24 to 48 hours) as a consequence of their colonoscopy.  One patient every ten years may require an operation to fix some problem (for instance bleeding or infection, etc.) that comes on as a consequence of colonoscopy.  While this is a very infrequent event, for everyoneís peace of mind it makes sense to be able to obtain medical care the first few weeks after a colonoscopy. 

The same principles apply towards planning for an upper endoscopy, however the risks are less, probably a quarter to a third of those of colonoscopy.  Thus the advice regarding travel and a planned endoscopic procedure is really against international travel (Canada and Western Europe are probably fine) but against traveling to out of the way places.

What are the medications used for endoscopy/colonoscopy?

Midazolam (Versed) is the most commonly used sedative.  It is excellent at relieving anxiety, suppressing the gag reflex and awareness of discomfort.  It induces amnesia, and interference with memory is probably the last effect of the drug to wear off, such that conversations after the procedure with the patient,

who appears otherwise awake, may not be remembered.  In

some upper endoscopies and most colonoscopies a small dose of

a narcotic pain reliever such as meperidine (demerol) or

morphine or fentanyl (trade name) is used.  The two agents together often work nicely to provide a synergistic effect

allowing a smaller dose of each medicine to be used enhancing comfort and speeding recovery.  Because of uncertainty

regarding the recovery of memory and reflexes following the use of these sedatives, it is required that patients not drive or use complex machinery (lawn mowers, chainsaws, etc.) for the rest

of the day.  Similarly activities requiring precise balance on ladders, roofs, etc. need to be avoided. 

Who can be my driver for an endoscopy/colonoscopy?

After undergoing a sedated procedure it is absolutely required

that a person be driven home by another responsible adult.  In addition to driving, itís helpful if that person can be present to hear the preliminary report of the endoscopic procedure (impression of the doctor) and discharge instructions.  As a consequence of the sedative the patient may very well not remember being given the instructions.  The impaired memory function the sedatives produce can be very subtle and last some hours after all other apparent recovery from the sedative has occurred.  It is not uncommon for someone not to remember conversations two or three hours after a procedure when they have been dressed, walking and engaging in apparently normal conversation.  Thus itís helpful if the person chosen as a driver is a spouse, sibling, or other trusted relative, friend, or neighbor

who can pass on the initial report. 

What follow-up information will I receive?

You will be sent home with a discharge instruction sheet and plan that if findings were normal or minor may include the final follow-up plan such as seeing your regular doctor fper his/her previous instructions.  The endoscopy nursing staff will contact you the

next day at home or at another number you may wish to give.

Our office will contact you with the results of any biopsy or specimen reports in about a week.  If you have not heard about

a biopsy (after ten days)or have any other concerns following

your procedure, please call our office at (607) 272-5011.  5% to 10% of patients will have findings that warrant a follow-up discussion

in the office at an appointment 4  to 5 working days after the procedure.  If a new medication treatment is started office

follow up is usually deferred a number of weeks so as to access

its affect prior to the appointment. 

Can I take a taxi home from my endoscopy procedure?

Yes, you may, though we feel for a number of reasons that

having a trusted family member, friend or neighbor bringing you home has numerous advantages.  These include hearing the

initial medical report and reporting back to later when your memory may be more reliable, and giving you supportive TLC on your arrival home.  The post procedure observation period time prior to taking a taxi is extended to allow for these factors.

May I ride walk or bicycle home?

No, we require that a patient who has had an endoscopy be released to a responsible adult.  A released patient is not allowed to navigate his/her way on public roadways.

What should I eat after my procedure?

You should start with a light meal at home taking care to avoid a meal that is too large or high in fat or spice. Eating at a

restaurant is not recommended since your system may not be

ready to handle a large meal dispite the hunger one may begin to feel once the procedure is done.  Additional restrictions may be required short term if there has been dilation of an esophageal stricture, treatment of an ulcer, or removal of a large polyp.

 

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This site was last updated 02/28/06