Preparation for endoscopy procedures:

• Upper Endoscopy
• Colonoscopy with Miralax Preparation
• Colonoscopy

Important Information about Sedation

Important Information regarding Blood Pressure Medication

Directions to each endoscopy center

Pre-registration telephone numbers

The other medications that may become a problem when taking laxatives in general are diuretics (such as lasix, furosemide, hydrocholorathiazide, and maxide). During the colonic laxative preparation, we would recommend not taking the diuretic unless your doctor feels they must be continued.

If you are taking HIV anti-viral therapy, you will need a special anesthetic sedation that requires advanced notice to set up.
 

Preparation for Endoscopy procedures:

Upper Endoscopy

Seven days before the procedure

1. Talk to your doctor if you are taking Coumadin, insulin or diabetic pills.
   
2. If you are having the procedure performed because of difficulty swallowing, Do not take aspirin and aspirin-containing products for 7 days. Tylenol is OK.
   

One day before the procedure

1. Pre-register by telephone.
   
2. Eat normally up until midnight.
   
3. You may drink clear liquids up until 4 hours prior to your arrival time. This includes black coffee (sugar is 0K), tea, and apple, grape, or cranberry juice).
   
4. You cannot drink milk or orange juice.
   
5. Do not drink any liquids including water 4 hours before the test.
   

Day of the procedure

1. Arrive at the Hospital at _______ on _________________.
   
2. If you have not pre-registered, then you have to stop at the outpatient desk 1/2 hour earlier than the normal arrival time.
   
3. You may not drive for the entire day. You may be dropped off and picked up by a responsible adult. The procedure will start approximately 1/2 to 1 hour later. The recovery time in the hospital is approximately 1 hour.
   

Colonoscopy with Miralax Preparation

1. Do not take aspirin, aspirin-containing pills or Plavix for 7 days. Do not take Advil, Motrin, Aleve-type medicine for 5 days. Vioxx, Celebrex and Bextra are Ok. Do not take iron for 7 days.
2. Call your primary care doctor if you are on Coumadin or are being treated for diabeter.
3. If possible, you should be off Coumadin for 3 days before the procedure.
4. You will need to purchase 64 oz. of a clear, non-carbonated beverage (recommend Gatorade to keep your electrolytes balanced), for (4) Dulcolax tablets that are over the counter, and fill the prescription from your doctor for the Miralax a 255-gram bottle. (This cost approximatedly $28.00 unless covered by insurance.)
   
    

Two days before the procedure

1. Take 2 Dulcolax pills before bedtime

One day before the procedure
 

1. For an entire day, in addition to the 64 oz of liquids for the laxatives to be mixed in, only have bouillon, broth, black coffee (sugar okay), tea, juice (apple, grape, cranberry), lemonade, any soda, water, Popsicles and plain Jell-O. clear candy and gum are okay. Drink as much as you can to prevent dehydration. Red Jell-O may cause red bowel movements.
2. Do not have solid food. You cannot have milk or orange juice.
3. At 2:00-3:00 pm you will take 2 Dulcolax tablets.
4. At 2:00-5:00 pm you will need to mix the 255-gram bottle of Miralax with 64oz of the liquid that you purchased. Make sure the Miralax is completely dissolved; you can do this ahead of time and chill. You will then drink an 8 oz glass every 10-15 minutes until solution is gone. If you are able to drink it earlier in the day, then you wil have less interrupted sleep.
5. Have nothing by mouth after midnight, including water (you may only take blood pressure and heart medication the morning of the procedure). ***

Day of the Procedure
 

1. You may not drive or work until the next day. You may be dropped off and picked up by a responsible person approximately 2 to 3 hours later. Taking a cab is not an option.
2. If you have any questions, please call (314) 997-0554, or see the web site at http://www.gidoctor.net/.

*** If your procedure is in the afternoon you may have clear liquids in the morning. Nothing up to 6 hours before the procedure.

Colonoscopy: Morning Procedure

Seven days before the procedure

1. Do not take aspirin or aspirin-containing pills for 7 days. Tylenol is OK to take. Do not take iron. (Do not take Advil, Motrin or similar drugs for 5 days).
   
2. Call your doctor if you are taking Coumadin or are being treated for diabetes. If possible you should stop Coumadin 4 days before the procedure.
   
3. Buy a 3-ounce bottle of Fleets phosphosoda oral liquid laxative and an ointment such as Anusol, Balmex or Borofax for anal discomfort (no prescriptions needed).

One day before the procedure

1. Pre-register by telephone.
   
2. For the entire day only have bouillon, broth, Gatorade, black coffee (sugar ok), tea, juice (apple, grape, cranberry), lemonade, any soda, water, Hi-C, Popsicle’s, plain Jell-O. Beer, wine, clear candy and gum are OK. Drink as much as you can to prevent dehydration. Red Jell-O may cause red bowel movements.
   
3. At 2:00 PM drink one half of the Fleets laxative mixed in a half glass (4 ounces) of ice cold lemonade or water. Drink two glasses of water. Stay close to the bathroom since the laxative is powerful but generally does not cause cramps.
   
4. At 6:00 PM drink the rest of the Fleets laxative mixed in a half glass (4 ounces) of ice cold lemonade or water. Drink two glasses of water. Drink at least 3 glasses of clear liquids before going to bed.
   
5. Have nothing by mouth after midnight including any liquids (take medications after procedure).
   

Day of the procedure

1. Arrive at the Hospital at _____ A.M. on ______________.
   
2. You may not drive or work for the entire day. You may be dropped off and picked up by a responsible adult.
   picked up. The procedure will start approximately 1/2 to 1 hour later. The procedure takes 1/2 to 1 hour; recovery time in the hospital is approximately 1 hour.

Colonoscopy: Late morning or afternoon procedure

Seven days before the procedure

1. Do not take aspirin or aspirin-containing pills for 7 days. Do not take Plavix for 5 days. Tylenol is OK to take. Do not take iron. (Do not take Advil, Motrin or similar drugs for 5 days.)
2. Call your doctor if you are taking Coumadin or are being treated for diabetes. If possible you should stop Coumadin 4 days before the procedure.
3. Buy a 3-ounce bottle of Fleets Phosphosoda oral liquid laxative and an ointment such as Anusol, Balmex or Borofax for anal discomfort (no prescriptions needed).

One day before the procedure

1. Pre-register by telephone. Call 362-1173 or (800) 292-3648. If you have not pre-registered, then you must stop at the registration desk on the first floor 1/2 hour earlier than the normal arrival time.
2. For the entire day only drink bouillon, broth, Gatorade, black coffee (sugar ok), tea, juice (apple, grape, cranberry), lemonade, any soda, water, Popsicle and plain Jell-O. Beer, wine, clear candy and gum are OK. Drink as much as you can to prevent dehydration. Red Jell-O may cause red bowel movements.
3. Do not eat solid food. You cannot have milk or orange juice.
4. At 2:00 P.M. drink one half of the Fleets oral laxative mixed in a half glass (4 ounces) of ice cold lemonade or water. Follow with two glasses of water. Stay close to the bathroom since the laxative is powerful but generally does not cause cramps.
5. At 6:00 P.M. drink the rest of the Fleets laxative mixed in 1/2 glass (4 ounces) of ice cold water or lemondade. Follow with two glasses of water.
6. Drink at least three glasses of water or clear liquids before going to bed.
7. Have nothing by mouth after midnight including any liquids. (Take your medications after the procedure.)
   

Day of the procedure

1. At 5:00 A.M. drink the rest of the Fleets oral laxative mixed in a half glass (4 ounces) of ice-cold juice or water. Follow with one glass of water. Stop drinking all liquids after this.
   
2. Arrive at the Hospital at ________ on _________________.
   
3. You may not drive or work for the entire day. You may be dropped off and picked up by a responsible adult. The procedure will start approximately 1/2 to 1 hour later. The procedure takes 1/2 to 1 hour; recovery time in the hospital is approximately 1 hour.
   

ERCP (Endoscopic Retrograde CholangiopancReatography)

Seven days before the procedure

1. Talk to your doctor if you are taking Coumadin, insulin or diabetic pills. If possible you should stop Coumadin 4 days before the procedure.
2. Stop aspirin and aspirin-containing products for 7 days. Tylenol is OK to take.

One day before the procedure

1. Pre-register by telephone.
2. Eat normally up until 8:00 PM.
3. You may drink clear liquids up until 4 hours prior to your arrival time. This Includes water, black coffee (sugar is 0K), tea, and apple, grape, or cranberry juice).
4. You cannot drink milk or orange juice.
5. Stop drinking all fluids including water within 4 hours of the exam.

Day of the procedure

1. Arrive at the Hospital at _________ on ________________.
2. You may not drive or work for the entire day. You may be dropped off and picked up by a responsible adult. The procedure will start approximately 2 hours later. The recovery time after the procedure is 4-6 hours. You may require admission.
    

Important Information about Sedation

Intravenous sedatives used for endoscopic procedures include Versed (similar to valium), Fentanyl, and/or Propofol. These medications provide amnesia and pain relief. You are breathing on your own – it is not general anesthesia. After the sedation wears off you may still be sleepy. This is why all endoscopy centers require that a responsible adult drive you home.

If you are taking DAILY narcotic pain medications, regular use of relaxers such as xanax, valium, ativan, librium, or sleeping pills (such as ambient, dalmane or restoril) you will need propofol and this may require advanced notice to set up. Similar concerns exist for HIV positive patients.

Important Information regarding Blood Pressure Medication

We would recommend not taking diuretics (such as lasix, furosemide, hydrocholorathiazide, and maxide) on the day of the laxatives are used unless your doctor feels they must be continued. You should take your other blood pressure pills the day before and the day of the procedure.

Directions to each endoscopy center:

Barnes-Jewish Center for Advanced Medicine
Traveling north on Kingshighway from Highway 40/I64: Take Exit 36B, which is Kingshighway north. Go 3 stoplights to Parkview Place. Turn right on Parkview Place. The parking garage is at the end of the block across Euclid Avenue.

Traveling north on Kingshighway from I44: Take Exit 287, which is Kingshighway. Drive 1.4 miles to Parkview Place. Turn right on Parkview Place. The parking garage is at the end of the block across Euclid Avenue.

Traveling south on Kingshighway: Turn left on Parkview Place. The parking garage is at the end of the block across Euclid Avenue.

Traveling east on Forest Park Avenue: Turn right on Euclid Avenue. The parking garage is on your left.

Traveling west on Forest Park Avenue: Turn left on Euclid Avenue. The parking garage is on your left.

Take the main elevators to the 10th floor.

Barnes-Jewish West County Hospital
The address is 12634 Olive Blvd and is 1 mile west of Highway 270. Go to the main entrance and check in at the registration desk in the lobby. From there you will be brought to endoscopy by our nursing staff.

Missouri Baptist Hospital
The Hospital is on Ballas Road just South and East of Highways 40 (64) and 270. Drive to the West entrance of the Hospital, park and go to the outpatient desk near Admitting office. From there you will be directed to endoscopy.

Pre-registration telephone numbers:

Call one day before the procedure
Barnes-Jewish Hospital, call 314-362-1173 or 1-800-292-3648.
Barnes-Jewish West County, call 314-996-8412.
Missouri Baptist Hospital, call 314-996-5152.