Dr Michael Merrett COLONOSCOPY

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Dr Michael Merrett COLONOSCOPY Powered By Docstoc
					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.