ABOUT YOUR DOCTOR Dr Michael Merrett COLONOSCOPY Dr Michael Merrett is a Consultant Physician and Gastroenterologist who All enquiries: 9781 6990 (Afternoon Procedure) specialises in advanced gastrointestinal endoscopic techniques. Dr Merrett studied Medicine at Monash University (1977-1982), graduating Frankston Private Day Surgery with honours. This was followed by four years post-graduate training in Level 2, 24-28 Frankston Flinders Road, Frankston Internal Medicine and then three years specialist training in *Admission Time – Please telephone the Frankston Private Day Surgery Gastroenterology at Prince Henry’s and St.Vincent’s hospitals in Melbourne. on 9781 6900 after 3pm on the working day prior to your procedure to This was followed by a two year appointment at Oxford University as a confirm your arrival time. Senior Research Fellow in Gastroenterology. This included research in advanced endoscopic techniques and Inflammatory Bowel Disease. He has Chesterville Day Hospital been in private practice as a Gastroenterologist for 18 years and has 28 Chesterville Road, Cheltenham authored scientific publications in both Australian and International *Admission time – Please telephone our office on 9781 6990 at 2pm medical journals. He is currently a principal investigator in clinical trials, on the working day prior to your procedure to your procedure to confirm researching new therapies in Crohns disease and Ulcerative Colitis. your arrival time. Dr Merrett’s specialist interests include: Como Private Hospital 152 Como Parade West, Parkdale 1. Colonoscopy and bowel cancer screening *Admission time – Como Private Hospital will telephone you prior to your procedure to confirm your arrival time. 2. Inflammatory Bowel Disease – Crohns Disease, ulcerative colitis and coeliac disease 3. ERCP (Endoscopy of the bile duct/liver and pancreas) Procedure Information and Patient Instructions 4. Endoscopic intervention in cancer, including stents throughout the GI Date………………………………………………………………………… tract, NdYAG laser, APC therapy and gastrostomy tubes Please note that on the day of your colonoscopy: 5. Endoscopic mucosal resection particularly for Barrett’s oesophagus You must not drive or operate machinery for the rest of the day. 6. Gastric Balloons for management of obesity Wear loose, comfortable clothes. 7. Gastroesophageal reflux, including medical and endoscopic therapies Do not bring valuables with you. Please bring your Private Health Insurance details, Medicare card, current 8. Routine gastroscopy Pension/Health Care card, a current list of medications and your referral 9. Capsule endoscopy (“pillcam”) letter with you. Arrange for someone to drive you home 10. Jaundice and liver disease (excluding viral hepatitis) Taxis are only permitted if you are accompanied. Please have someone with you for six hours after your procedure. This information has been prepared to assist you in understanding what happens during a colonoscopy. If you have any questions please discuss them with your doctor. PREPARATION FOR COLONOSCOPY (Afternoon Procedure) What is a Colonoscopy? The bowel must be well prepared to ensure accurate views. Please follow our A colonoscopy is a medical procedure that allows the large bowel to be examined in instructions carefully (please disregard any instructions on the packaging). its entirety by directly looking at the wall of the bowel. This provides more accurate IF YOU HAVE ANY QUESTIONS REGARDING YOUR PREPARATION details than a CT scan or “virtual colonoscopy”. In certain cases, treatment can be PLEASE CONTACT OUR OFFICE ON 9781 6990. performed through the colonoscope during the procedure, thereby avoiding the need THREE DAYS PRIOR for a surgical operation. Please avoid eating cereal grains (e.g. muesli), multigrain breads, tomatoes, passionfruit, poppy seeds, nuts or other seed fruits for What happens during the examination? three days prior to your colonoscopy. Prior to the examination you will be given an intravenous sedation that will make you drowsy and comfortable. It is likely that you will remember little or nothing about the DAY BEFORE COLONOSCOPY examination. You may have a light breakfast and then drink *clear fluids only all The colonoscope is a thin, flexible tube that is passed through the anus and into the day. Please do not eat any food after breakfast. large bowel. It contains optical fibres that allow high resolution imaging of the No solid foods, milk or orange juice are to be taken after breakfast. bowel. The examination usually takes approximately 15 minutes to complete. Additional *clear fluids must be taken in conjunction with the preparations to avoid dehydration. Is the colonoscopy painful? *Clear fluids: Lemonade, soda water, mineral water, apple/blackcurrant fruit Most patients have no memory of the procedure. If there are a lot of loops in the juice, sports drinks (Gatorade), Lucozade, jelly, Bonox, clear soups, water, black bowel there can be some discomfort, although appropriate measures such as (no milk) tea/coffee. Sugar is permitted in your tea/coffee. additional medication can be utilised to avoid excessive pain. 3pm Take 3 Coloxyl with Senna (laxative tablets). Are there any risks? All tests, especially those requiring sedation are associated with some risk. If a polyp Dissolve 1 sachet of GLYCOPREP C and 1 sachet of PICOPREP into ONE (growth) needs to be removed, colonoscopy is the safest way of removing it. As litre of warm water and put in refrigerator. polyps are at risk of becoming cancerous, we recommend that they be removed. The time before the medication takes effect varies from patient to Polyp removal has a slight risk of bleeding or perforation (making a hole in the bowel patient. wall). Depending on the severity, these complications may require surgery. Other complications are rare and death is a remote possibility. Please ask us prior to the 6pm Commence drinking GLYCOPREP C and PICOPREP bowel preparation (1 procedure if you would like full details of rare complications. litre). (Suggestion: Drink a large glass of prep, followed by a few mouthfuls of your PLEASE INFORM OUR OFFICE IMMEDIATELY IF: chosen *clear fluid at approximately 15-20 minute intervals until completed) Breast Feeding – Our office can provide instructions regarding breast feeding before and after anaesthetic. One Maxolon tablet is included for nausea. This is only to be taken if required. Taking blood thinning medication – (e.g. Aspirin, Warfarin etc) some of these After you have finished drinking the first litre of bowel preparation, please medications may need to be ceased prior to the colonoscopy. prepare the second litre using the method above. Diabetic – Please inform reception if you are diabetic, as your medications may need to be adjusted prior to the colonoscopy. DAY OF COLONOSCOPY: Iron tablets – These must be ceased 7 days prior to the colonoscopy. Take any usual medications with a sip of water. You have a lap band - Different fasting instructions apply to patients with a lap band. Commence drinking second litre of bowel preparation. Please ask our office for more information. 4 hours prior to admission time – Cease any additional fluids (including You have a pacemaker – Please contact our office if you have a pacemaker, as special water). arrangements may need to be made. 2 hours prior to admission time – Dissolve 1 sachet of PICOPREP into 250ml (one cup) of warm water and commence drinking PICOPREP. Please maintain a complete fast (nothing to drink) after this time.