Questions About Medications

  • Do I need to stop my Coumadin?
    • If you take blood thinners (Coumadin, Plavix, Pradaxa, Lovenox, etc.) we recommend you continue unless you have specifically been asked to stop by the GI physician performing your exam. Please contact the prescribing provider of the medication if you have any questions.
  • I had a knee replacement 3 years ago; do I need to take antibiotics?
    • 2015 ASGE guidelines do not recommend periprocedural antibiotic prophylaxis for the prevention of septic arthritis in a patient population with prosthetic joints for any endoscopic procedure.
  • I had a valve replaced should I take antibiotics?
    • AHA states that administration of antibiotics solely to prevent endocarditis is no longer recommended for patients undergoing GI endoscopy but may recommend antibiotics for cardiac patients who may be at high risk. Please check with your cardiologist with any specific questions.
  • Can I continue my vitamins?
    • You should stop taking iron supplements, vitamins and liquid antacids 5 days before your colonoscopy.
  • Do I take my oral diabetes medications?
    • Contact your primary care doctor or diabetes doctor for recommendations on adjustments to your oral diabetes medications.
  • Should I take my insulin?
    • Contact your primary care doctor or diabetes doctor for recommendations on adjustments to your insulin doses.
  • Should I take my anti-hypertensive and anxiety medications?
    • You should contact your prescribing provider regarding taking any medication prior to the procedure. In general, we advocate for you to stay on your regular medication regimen when possible

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Questions About your Prep

  • I don’t have a prescription in my packet, what do I do?
    • Please note that your prescription will be sent electronically to your pharmacy so you should not expect to see a paper copy in your packet. If your pharmacy does not have the prescription, please call GI Associates for prescription or send Patient Gateway message. Only send a gateway message if your procedure is greater than one week away.
  • My pharmacy hasn’t received the prescription yet, what do I do?
    • Call GI Associates for prescription or send Patient Gateway message. Only send a gateway message if your procedure is in greater than one week away.
  • I was given for a prep Peg, is it the same as golytely?
    • Yes, the generic name is PEG-3350 with Electolytes (polyethylene glycol electrolyte solution). Brand names include GoLytely, NuLytely, CoLyte, TriLyte or GaviLyte.
      Do I really have to do half the prep tonight and half tomorrow?
    • We recommend drinking half the prep the evening prior to your procedure and half the morning of your procedure as this timing produces better cleansing results and makes it easier for your doctor to fully examine your colon.
  • Do I really have to get up at 3am to finish the prep?
    • You should finish drinking the prep 4-5 hours before your scheduled arrival time. This may require you to awaken very early in the morning in order to complete the prep. Although inconvenient, the correct timing of drinking the prep is critical to obtaining a good colon preparation.
  • Can I drink all the prep the night before?
    • Following the correct timing of drinking the prep is important. Drinking the second dose closer to the time of your procedure rather than drinking the whole preparation the night before produces better results and a cleaner colon for your procedure.
  • What do I do when I have to go to the bathroom in the morning on the way, I have a two hour drive?
    • You may need to wake up earlier to drink the second half of the preparation. We recommend drinking the second half 4-5 hours before your scheduled arrival time. If you have a 2 hour drive, you may want to start the second half 6-7 hours before your scheduled arrival time to minimize the chance that you will still need to be using the bathroom frequently on your drive to MGH.
  • What are the gas tabs?
    • The gas tabs are chewable simethicone tablets. They are available over the counter at your pharmacy. Some brand names include Gas-X, Maalox Anti-Gas, Mylicon, and Mylanta Gas. Ask your pharmacist if you are having difficulty locating them.
  • Do I really have to take the gas tabs?
    • Yes, you should take the gas tabs as part of the bowel preparation.
  • I can’t stomach the prep, what can I do to make it go down easier?
    • Many patients say that the preparation is easier to drink when cold so put it in the fridge after mixing. Using a straw to drink the prep can be helpful. Chewing gum or sucking on lemons or hard candy in between cups can help mask the taste. If you are nauseous, take a break for 30 minutes and then resume the prep with longer intervals between cups.
    • It is common to feel nausea during the preparation for colonoscopy and sigmoidoscopy. You may try to add some fruit juice, crystal lite, or ice to improve the flavor (nothing red or purple). If you vomit, rest for 30 minutes and try to resume drinking the preparation. The goal of the preparation is to clean out your bowels completely. If you do not have clear stools during the preparation, your doctor will find it difficult to complete the exam.
    • If you feel volume of prep has been a problem for you in the past or anticipate it to be a problem, please discuss this with your primary care provider. There are options for smaller volumes of prep however they are not appropriate for all patients.
  • Can I have a different prep, a friend of mine said they had something that was easier?
    • Our gastroenterologists prefer our patients to use this prep prior to their colonoscopy.
    • Discussion with patient can include concerns about prep or previous experiences and messages relayed to provider if a different prep may be needed.
  • I took the mag citrate the last time, can I do that this time?
    • We no longer recommend Mag Citrate as a bowel prep for our patients. Other preparations produce a better cleansing effect with fewer risks and side effects.
  • I haven’t gone to the bathroom yet and I already took the first half of the prep, what should I do?
    • Continue to drink the second half of the prep until you begin to have bowel movements. Make sure you are adequately hydrating with other clear liquids as well. Drink what is remaining in the morning at the start time of the second dose.
  • I am severely constipated and do not feel the prep was adequate last time OR I feel I will not be cleaned out with the prep, what do I do?
    • Please contact your GI provider atleast two weeks prior to your procedure to discuss the most appropriate prep and diet for you. There are adjustments that can be made if you have a diagnosed motility disorder or overall concern.

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Questions About your Diet

  • Can I eat canned peaches and applesauce?
    • You can eat canned or well-cooked fruit without skin, seeds or peel.
  • Can I eat steamed veggies?
    • You can eat canned or well-cooked vegetables without skin, seeds or peel.
  • I ate a salad yesterday, should I cancel the procedure?
    • No, do not cancel. Try another dose of mag citrate and if not clear with your regular prep, you can add milk of magnesia. If you have specific concerns about not being “clear” please call your provider’s office.
  • I ate breakfast this morning and realized I was not supposed to, should I cancel?
    • Yes, your exam will need to be canceled and rescheduled. You may not have solid food for at least 8 hours prior to your EGD and 24 hours prior to your colonoscopy.
  • I’m a vegetarian, what can I eat?
    • You can have tofu, eggs, creamy (smooth) peanut or almond butter, breads and grains made with refined white flour, white rice, low-fiber cereal (including puffed rice, cream of wheat, corn flakes), canned or well-cooked fruit and vegetables without skin, seeds or peel, dairy products. Avoid legumes (peas, beans, lentils), nuts, seeds and any uncooked fruit and vegetables.
  • Can I drink protein drinks?
    • If the protein drinks are low in fiber or fiber free then it is ok to continue taking. Any protein drinks on the day before colonoscopy should follow guidelines for clear liquids.
  • I “juice” my food, can I continue to drink them?
    • You should stop drinking these 5 days prior to your scheduled colonoscopy.

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Questions about your Escort

  • In general, how long will I spend in the endoscopy unit and what time should I be picked up?
    • You should expect to spend approximately 3 hours in the Endoscopy Unit. Your escort does not need to be in our waiting room during this whole time but should be available to pick you up within 30 minutes of being called.
  • How long is my procedure?
    • The length of the procedure depends on the type of procedure that you will have and the care that is required during the procedure.
      Please remember that procedure times can vary based on the needs of each individual.
      • Colonoscopy - 30 minutes
      • Flexible Sigmoidoscopy - 15 minutes
      • Endoscopic Ultrasound - 1.5 hours
      • ERCP 1.5 hours
      • Liver Biopsy - 15 minutes
  • Why do I need an escort?
    • You will need an escort after the procedure because it is not safe to travel alone or drive after receiving conscious sedation. This rule is strictly enforced to ensure the safety of our patients. If your escort does not accompany you to the procedure, you must provide his/her name and phone number so we can verify that he/she will accompany you from the unit and provide transportation. Your procedure will be cancelled and rescheduled if we can not confirm that you have an escort prior to the procedure.

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Pre-Procedure Questions

  • Why do I need to arrive at the GI Endoscopy unit 45 minutes before my test?
    • In order for you to be properly prepared for your test, we need to have you change into a gown and have an intravenous placed. Some paperwork will also need to be completed. If you come late to the unit, this will not only delay you but other patients.
  • What is conscious sedation? Will I be going to sleep?
    • It is combination of sedatives and narcotics. Our goal is not for you to go to sleep but for you to feel comfortable during the exam. You will feel the effects of the medications for a couple hours after the procedure. Therefore, you can not drive for 12 hours after the procedure.
  • What are the common complications that arise from colonoscopy or endoscopy?
    • The common complication from these procedures is related to conscious sedation. Many patients feel sleepy and tired after the procedures. After colonoscopy, bloating and cramps is common. The more serious complications include bleeding or perforation. Bleeding may occur after a polyp is removed. With significant bleeding, you will see fresh, red blood in your stool. A perforation of your bowel will cause severe abdominal pain and fever. For these serious complications, it is important for you to be evaluated quickly in the MGH emergency department or a one closer to you.

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Post-Procedure Questions

  • What if I haven't received my results from my procedure after 14 days?
    • Please contact your doctor’s office via telephone or patient gateway.
  • What if I am still having pain after my procedure?
    • Some mild gas pain may be expected following your colonoscopy. Walking can be helpful. If pain is persistent and accompanied by fever, chills, blood in stools, hard abdomen, abdominal swelling or inability to pass gas, you should seek urgent medical attention.
  • What is a biopsy and how to I get the report?
    • A biopsy is a sample of tissue taken during a procedure. Biopsies are often taken of ulcers, tumors, polyps, and abnormal tissue in order to examine the samples with a microscope. The reports are usually available in 10-14 days. After your procedure, we will provide instructions for obtaining the report.
  • Will I see my physician after the procedure?
    • Since you will be receiving sedatives for your procedures, you may not remember much of the test or the discussions afterwards. Many physicians ask that the patients be informed of the results of the procedure with a written statement. This will help you remember what was found during the procedure. All reports are sent to the referring physician(s) after the procedure.

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Interventional Procedure Questions

  • What is an ERCP?
    • ERCP (endoscopic retrograde cholangio-pancreatography) is a term for a procedure in which the bile and pancreatic ducts are examined with an endoscope. X-ray dye is injected into the ducts and x-ray pictures are taken. If there is a blockage, a stent will be placed to unblock the duct.
  • What is an EUS?
    • EUS or endoscopic ultrasound is an endoscopic exam using an endoscope with an ultrasound probe on the tip of the scope. This type of exam is often performed to evaluate patients with abnormalities in the pancreas and tumors in the esophagus and stomach.

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