New Jersey Medical School

Frequently Asked Questions (F.A.Q.)

How do I prepare for an upper endoscopy (EGD)/ERCP/Upper EUS?

You should arrive with an empty stomach. You must be fasting for 6 hours prior to the time of your procedure. No food or drink is allowed during this time. If you have an afternoon procedure, consult with your physician whether it is acceptable to drink clear liquids on the morning of your procedure. You may eat or drink the evening prior to your test.
Avoid all aspirin or ibuprofen based products for at least one week prior to your procedure. If you are taking anticoagulants such as coumadin or if you have diabetes, consult your physician prior to your procedure to determine how to dose these medications prior to your test.
Finally, you will need to arrange for a responsible adult to accompany you home. You will not be able to drive until the following morning, so this adult must drive you home or accompany you in a taxi or on public transit. This person should be available by phone or present at the procedure so a timely discharge from the endoscopy unit is possible.

How do I prepare for a colonoscopy exam?
The standard preparation for colonoscopy begins the morning of the day before your test. After having a light breakfast, the rest of the day should consist only of a clear liquid diet. No solid food or milk products. Just tea, Jell-O, clear broth, and water. Most of our patients will be asked to use either the fleets phosphosoda or Golytely/Colyte preparations. You will take these preparations as instructed. You should not make plans for that evening, as you will likely be using the restroom for much of that time. Don't start your preparation too late, or you may spend much of the night going to the restroom. The remainder of the instructions regarding taking your medicine and arranging for a ride are the same as for the upper endoscopy (EGD) test.

What if I can't find a responsible adult to accompany me home?
If you cannot find anyone, you may have to reschedule your procedure. Contact your physician's office in advance if you think this will be a problem. They may be able to offer you some suggestions. Occasionally, a special transport service may possibly be arranged. Please note: It is not possible to go home via taxi or bus unless an adult accompanies you. You must be able to be accompanied by a friend, family member, or a transport service that specializes in medical transportation.

I lost my instructions on how to prepare for my procedure. How do I get another copy or figure out what to do?
You can print out the instructions again by going HERE. Select the procedure that you are having and a PDF version of the instructions will appear which you can read or print out. If you are unable to do this, please contact your physician's office.

Do I have to drink all 4 quarts of the laxative preparation solution?
If your doctor has prescribed this solution for your preparation, it is very important you drink all of it. The lone exception is if your stools are perfectly clear before you have finished all of the solution, which rarely occurs. Remember that you have several feet of digestive tract and it takes a fairly large volume to completely clean out the colon. To have an optimal and accurate exam, it is important that your preparation for the test is complete. If your colon is not well cleaned out, the procedure may have to be terminated and rescheduled for another day.

I can't get/keep the preparation down or I'm not "cleaned out" for my colonoscopy/sigmoidoscopy. Should I reschedule?
There are a few techniques available for taking the colonoscopy and sigmoidoscopy preparations. These include taking small amounts of the preparation at short intervals and mixing the prep with ice/clear liquids such as Sprite/7-Up/apple juice. If this does not work and you are not "prepped" i.e. your stools are not relatively clear and entirely liquid, you may need to reschedule your procedure to a later date or later on during the same day while you continue your preparation. It is important to remember that that a thorough exam is not possible without an adequate preparation.

Is it ok to take my medications on the morning of the procedure?
Typically, the answer is yes. However, you should confirm this with your physician if you have any questions. We recommend that you take your blood pressure, cardiac, anti-rejection, anti-seizure and other medications on the morning of your procedure, if this is when you usually take them. It is acceptable to take these pills with a sip of water, even though you are "NPO". However, unless notified by your physician, you should not eat or drink anything else on the day of your procedure until your exam is completed. For diabetics, typically taking 1/2 of your usual morning dose of oral medication or insulin is recommended. For patients on anti-clotting medications (coumadin, aspirin, and anti-platelet drugs) or NSAIDS (most commonly ibuprofen products such as Aleve, Nuprin, and Motrin), these medications are typically stopped 1 week prior to the procedure, if possible. If you are taking anti-clotting medications or NSAIDS, confirm with your physician exactly how to take your medications.

Will my procedure hurt? Will I be asleep? Do I need to have an IV?
Endoscopic procedures may occasionally cause mild discomfort, usually because of the gas instilled in the GI tract in order to obtain good visualization of the tissues. At times, advancing the colonoscope through the colon, especially the right side of the colon, may be associated with some discomfort. Patients undergoing an upper endoscopy typically will gag without sedation. As a result, we feel patients will have the best experience with some sedation, which is administered through an IV for the quickest and best results. The medications administered serve to relieve discomfort and provide some amnesia with respect to the procedure. However, patients typically do not receive general anesthesia, as they would during surgery. If you have concerns regarding your ability to be adequately sedated, please mention this to your physician. However, with sedation, most patients have a pain-free procedure and don't recall much, if any, of the procedure.

Why can't I drive after a procedure with sedation?
Despite how you may feel, your ability to concentrate and focus are not back to normal 1-2 hours after sedation, which is when patients typically leave the endoscopy unit. As a result, it is unsafe to drive at this time. Patients are not safe to drive until the day after the procedure. Your reflexes will be slower than usual and you will not be legally able to drive until the next day.

How will I feel after my test?
After your test, you may have a dry mouth or feel drowsy, bloated, or hungry. The dry mouth and drowsiness are from the sedation and will gradually wear off. The bloating results from the air that is inflated into the digestive tract during the procedure. This helps your doctor perform a thorough exam. Even though we try to remove most of the air after the procedure, some of it will have to pass naturally. Since fasting is part of the preparation, many patients feel hungry. Once you are awake, you may have some sips of liquids or some crackers. Once you go home, you may have a meal if you don't experience any nausea. Lastly, some patients will have a sore throat after the upper EUS procedure.

Why am I not having my normal bowel movement the day after my procedure?
This is a frequent complaint in patients undergoing colonoscopy. The reasons are many and include the effects of sedation (which slow down your bowels) and the fact that your bowels were empty at the time of the procedure and that you may not have eaten much on the day of your procedure. Most patients will resume normal bowel movements within 1-2 days of their procedure.

The above FAQ courtesy of UCSF Gastroenterology Division