Dr Bassett Instructions for Colonoscopy 2010

Document Sample
Dr Bassett Instructions for Colonoscopy 2010 Powered By Docstoc
					Dr Mark Bassett                                                                                     161 Strickland Cres, Deakin ACT 2600
                                                                                                                       Ph: (02) 6162 1515

                                     These instructions also apply for colonoscopy and gastroscopy combined

  Your appointment is on ________________________ at _______ AM/PM at __________________________Hospital
     Please read both sides of this document well before the day of the appointment. If you CANNOT KEEP THE APPOINTMENT please advise at
        least 1 week before. If you have additional questions or need assistance or an interpreter to understand this document please advise us.

Brindabella Endoscopy Centre Ph 6282 7788 5 Dann Close, Garran (Cnr Hindmarsh Drive & Palmer St - off Yamba Drive)
Calvary John James Memorial Hospital Ph 6281 8100 Strickland Crescent, Deakin. Go to Day Surgery Unit.
Capital Day Surgical Centre Ph 6253 2514 Unit 2/9 Sydney Ave, Barton. Underground parking turn left off Sydney Ave, take lift to Level 1.
Mugga Wara Endoscopy Ph 6222 6655 National Capital Private Hospital, Hospital Road, Garran (near TCH Maternity)

                                                        (You should have received the kit with this form)

_______DAY 1 (2 days before test): LOW RESIDUE DIET - eat any food except fruit, vegetables, cereals, whole meal bread, nuts, fatty meat.
Between 5pm and 6pm: dissolve 1 SACHET OF PICOLAX in a glass of water and drink immediately. Drink at least 1 litre of clear liquid over the next
hour. This will partially clear the bowel. If this does not occur you must take a second SACHET OF PICOLAX at 10pm or 7am the next morning, made
up as before, followed by 1litre of clear liquid. If there is a history of constipation this will usually be essential for a good clearance.

_______DAY 2 (day before test): .You may have an early light breakfast before 8am. Thereafter drink LIQUIDS ONLY all day (about 2 litres) e.g.
strained soup, jelly, coffee, tea, lemonade, soft drinks, fruit juice, electrolyte drinks (e.g. ‘Powerade’). You may suck sweets. Make up as directed on
packet two (2) LITRES of COLONLYTELY and drink this between 5pm and 7pm until you have finished. The flavour is improved by adding cordial but
do not sweeten it. If you feel nauseated drink it more slowly. The bowel preparation will cause painless diarrhea and rarely may cause loss of bowel
control. If you have an afternoon colonoscopy appointment, an option is to take the 2nd litre of Colonlytely before 7 AM on the day of the test (Day 3).

_______DAY 3 (day of test): Drink only clear liquids until 6 HOURS before your appointment. Thereafter FAST, i.e. DO NOT EAT OR DRINK
ANYTHING. Come to the hospital at the above time, or at the time advised by the hospital.

MEDICATIONS. Continue your regular medications until the day before the test (i.e. last dose day before). Continue aspirin, cardiprin, cartia, astrix, and
arthritis (anti-inflammatory) tablets until the day before unless you have been advised differently. Please advise if you are taking CLOPIDOGREL
(Iscover, Plavix) or WARFARIN (blood thinning tablets) - these usually need to be ceased 3-4 days before if a surgical procedure such as polypectomy
is planned. Note that the oral contraceptive pill may be less effective during preparation for endoscopy. Please advise any allergies.

DIABETIC PATIENTS. If you are a DIABETIC on either insulin or tablets, the test is usually done in the morning and the morning insulin or tablet is not
given until AFTER the procedure. There are special instructions for diabetic patients – ensure that you obtain these.

OTHER HEALTH PROBLEMS. Please advise if you have other health problems, if we are not aware of these, e.g. heart disease, kidney diseases,
hypertension, strokes, blood clotting problems, bleeding problems. If you have a severe cold or ‘flu virus, or a flare up of lung disease (e.g. asthma,
chest infection), it may be necessary to postpone the appointment. Please advise if your health has changed since the appointment was made.

SEDATION. As you will have intravenous sedation, you MUST NOT DRIVE HOME. Please arrange transport. You must not drive, use machinery, or
make important legal decisions UNTIL THE NEXT DAY OR LONGER IF YOU FEEL UNWELL, UNSTEADY OR TIRED. You will be at the hospital
about 3 hours. Children will usually require a general anaesthetic and a longer admission.

AFTER THE PROCEDURE. If you feel unwell or notice anything unusual please contact me. If I am unavailable contact the hospital where the
procedure was performed or come to the Emergency Department at Canberra Hospital. Take the day of the procedure off work - inform the nursing
staff at the hospital if you need a certificate. It may be unwise to travel away from the Canberra region for 1 week after the test or longer if you have had
a surgical procedure. If you intend to travel please advise me.

REPORTS. Following the test you will be given a brief provisional report and a full report will be sent to the referring doctor. You may be asked to make
a follow-up appointment to discuss the results of the test including the results of any biopsies, and also to discuss treatment.

             If you have problems during the preparation contact Dr Bassett on 6162 1515 during hours or 0417 851166 after hours
The nature of the test, including possible side-effects and complications, will be discussed with you before the test. If you wish to have more
information please advise before the test.


To examine the lower gastrointestinal tract (colon or large bowel), to remove polyps (small benign growths) if these are found, inject bleeding blood
vessels, and to take samples of tissue (biopsies) for examination by a pathologist. Colonoscopy is the most reliable method of bowel examination but
small abnormalities including cancers may very occasionally be missed.


Prior to the procedure you will be given a bowel preparation kit with instructions. The bowel preparation cleans the colon. Without this it is not possible
to perform a full examination of the colon. Although the bowel preparation is unpleasant, it is very rare for it to be harmful. If you have had difficulties
with the preparation in the past, or if you have severe heart, lung, or kidney disease you should discuss this with the doctor.


A long, thin flexible tube is passed around the bowel from the anus. This takes about 30 minutes and is done under intravenous sedation (Midazolam,
Fentanyl, and Propofol). Reactions to these medications are rare. After the procedure you must not drive or use machinery until the next day, or longer
if you feel unwell, unsteady or tired the next day. If you object to the use of sedation please discuss. Some patients can tolerate the procedure without
sedation. Colonoscopies are done in a hospital setting, usually on a day case basis. In all private hospitals in the ACT another medical practitioner will
give the sedation.


Barium enema x-ray of the bowel and CT colonography will give similar information but are not usually as accurate, and do not allow biopsies or
removal of polyps. These alternatives do not require sedation or hospital admission and may be suitable for investigation of particular problems.


Complications of colonoscopy and polypectomy are very uncommon. Some complications include:
   Reaction or sensitivity to medication used for sedation (this may affect your breathing briefly)
   Perforation (puncture) of the lining of the bowel (about 1 patient in 2000-5000)
   Pain in the chest, abdomen or back
   Infection of the bowel, blood, abdominal cavity and other organs
   Bleeding - if blood vessels are injected or a polyp is removed (about 1 patient in 300-500)
   Lung infections due to vomiting and aspiration during the procedure
   Heart attacks, cardiac arrest, and breathing problems (very rare)
   Failure to confirm a diagnosis because an abnormality was missed
   There are other very rare complications - please advise if you wish to be given more details

Everything will be done to minimise the risk of these complications. There are ways of detecting these complications early and specific treatments are
available if they do arise. Very occasionally there may be a need for hospitalisation, major surgery, intravenous feeding, or blood transfusion. Although
death can result from complications of colonoscopy this is very rare. Complications may become apparent several days after the test. It is your
responsibility to advise if you are aware of anything unusual.

SPECIAL PRECAUTIONS may need to be taken for the following conditions and it is your responsibility to advise us of these conditions, if you:

     suspect or know you are pregnant or if you are breastfeeding
     have severe heart, lung, or kidney disease, or diabetes
     have cancer, lymphoma, leukaemia, or you are receiving chemotherapy
     if you have had heart valve disease, a pacemaker, aortic graft or other blood vessel graft, or a joint replacement
     bleed very easily or if you take blood thinning medication (e.g. warfarin, clopidogrel, heparin)
     if you are allergic or sensitive to any medication


You have the right to privacy, respect, confidentiality and dignity. You have the right to participate in the decisions relating to your care, to refuse
treatment, and to seek a second opinion. It is your responsibility to provide accurate and truthful information at all times, and to respect other patients
and staff. Please advise if you are unhappy with any aspect of our service.

Updated: 26 June 2010