If you are having an

ABDOMINAL SONOGRAM

PELVIC SONOGRAM

LACTOSE MALABSORPTION TEST

LACTOSE HYDROGEN BREATH TEST

FLEXIBLE SIGMOIDOSCOPY OR INFRA RED COAGULATION OF HAEMORRHOIDS

UPPER ENDOSCOPY

COLONOSCOPY

ABDOMINAL SONOGRAM

- Nothing by mouth for 6-8 hours.

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PELVIC SONOGRAM

- 2 hours prior to test empty bladder
- drink 24-28 oz. within an hour after emptying blander.

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LACTOSE MALABSORPTION TEST

- Do not eat any slow digesting foods like beans, bran or other high fiber cereals the day before the test is performed.
- You must fast for 8 hours, with no food only water to drink before the test.
- Do not smoke, sleep, or exercise vigorously for at least 1/2 an hour before test.
- Drink 6 to 8 oz. of Milk three hours before the office visit.

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LACTOSE HYDROGEN BREATH TEST

You have been scheduled for a gastrointestinal diagnostic physiology test called a lactose hydrogen breath test.

Why am I having this test?

Your doctor has arranged this test to evaluate for lactose maldigestion which leads to poor tolerance of milk products.

What occurs during the examination?

You will be asked to report to the center fasting, not having eating for 12 hours. You will blow into an instrument and your breath will be analyzed for hydrogen gas. Then, you will be asked to drink a cup of lactose (which is the sugar in milk) dissolved in water. Then breath test results will be obtained two, three and four hours later.

Are there any possible complications?

If you have the lactose maldigestion condition, your symptoms may be reproduced. Occasionally, others have their usual abdominal discomfort unrelated to lactose.

After the procedure:

Some of your usual gas, bloating, or abdominal discomfort may occur.

General Instructions:

1. Do not eat or drink anything after midnight before the procedure.
2. No escort is required because this test doesn’t use anesthesia.
3. Do not dress elegantly. This way, we won’t have any problems with stains. Leave earrings and other jewelry at home.
4. If you have any questions, please contact your doctor’s office.

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FLEXIBLE SIGMOIDOSCOPY OR
INFRA RED COAGULATION OF HAEMORRHOIDS

INSTRUCTIONS FOR FLEXIBLE SIGMOIDOSCOPY

1. You may have clear liquids for dinner only on the day before your procedure.
2. Take one Fleet enema 2 hours before bedtime the day before the procedure.
3. No breakfast the day of your procedure.
4. Take another Fleet enema 1 hour before your appointment.
5. Try to hold each enema for 10 minutes.
6. You may take your regular medications with a small amount of water, unless otherwise directed by the physician, except insulin which may be taken after the procedure with food.

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UPPER ENDOSCOPY

WHAT IS UPPER ENDOSCOPY?

Upper GI endoscopy (also called EGD or esophagogastroduodenoscopy) is a procedure that allows your doctor to examine the lining of the esophagus (food pipe), stomach and duodenum (first part of the small intestine). Using a thin, flexible tube with its own lens and light source, the doctor can view the upper intestinal tract in order to indentify any abnormalities.

HOW DO I PREPARE FOR THE EXAM?

It is important not to eat or drink anything for atleast 6 hours before the exam. Be sure to discuss with you doctor whether you should use any of your usual medications before the procedure and whether you have any drug allergies. It is also important to mention other major diseases, such as heart or lung condition, that might require special attention during the procedure. You will be asked to sign a consent form authorizing the physician to perform the procedure.

WHAT HAPPENS DURING UPPER ENDOSCOPY?

Upper GI endoscopy is usually performed on an outpatient basis. All dentures, eyeglasses and contact may be anesthetized by a spray or liquid. A needle for intravenous (IV) medication will be placed in a vein in your arm prior to the procedure. Medicine will be injected through this needle that will make you sleepy and relaxed. As you lie on your side, the doctor will insert a small mouthpiece.

You can breathe easily throughout this exam. The doctor will examine the lining of your esophagus, stomach and duodenum. A biopsy (tiny bit of tissue) may be taken for microscopic analysis. You will not feel any discomfort when the discomfort when the biopsy is performed. The procedure takes 5-8 minutes. Many people do not recall any of the procedure.

WHAT CAN I EXPECT AFTER THE EXAM?

INSTRUCTIONS FOR UPPER ENDOSCOPY

1. Do not take anti-coagulants, aspirin or any anti-inflammatory medication (such as Motrin or Advil) for one week before the procedure. You may use Tylenol if needed.
2. If you take anticoagulants (blood thinners), have a heart murmur, or have been advised to take antibiotics before dental work, please call for special instructions at least 5 days before your appointment.
3. Do not eat or drink anything after midnight the day of the procedure.
4. You may take your regular medications before the procedure with a sip of water except for insulin or other diabetic medications which may be taken after the procedure.

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COLONOSCOPY

WHAT IS COLONSCOPY?

Colonscopy is the visual examination of the lining of the large intestine (colon) and rectum. The purpose of the exam is to identify any abnormalities by inserting a flexible fibre-optic tube into the anus. The tube, which is about the thickness of your finger, is slowly passed into the rectum and colon.

The results obtained from colonscopy are useful in diagnosing and treating a variety of symptoms and diseases.
The colon must be thoroughly clean in order for the exam to be accurate and complete. Usually, this consists of drinking a large volume of a solution that flushes the colon clean. Your physician will provide you with information about cleansing instructions.

HOW DO I PREPARE FOR THE EXAM?

The colon must be thoroughly clean in order for the exam to be accurate and complete. Usually, this consists of drinking a large volume of a solution that flushes the colon clean. Your physician will provide you with information about cleansing instructions.

WHAT HAPPENS DURING COLONOSCOPY?

A needle will be placed in your arm vein through which medication will be injected to help you feel relaxed and sleepy. While you are lying on your left side, the flexible colonoscope will be inserted, and the tube will be moved through the colon.

If there is an abnormal growth (polyp), it will be removed by applying electrical heat (electrocautery) through the colonoscope. A small tissue specimen (biopsy) may be taken from the lining of the colon for microscopic analysis. Neither test will cause you any discomfort.

WHAT CAN I EXPECT AFTER THE EXAM?

Due to the medication, you will probably feel drowsy for a period of time. You will not be allowed to drive an automobile or use potentially dangerous machinery until the next morning.

Your doctor will discuss the findings of the exam and provide you with instructions to follow when you return home. Ask the doctor or nurse if you have any questions.

INSTRUCTIONS FOR COLONOSCOPY & PREP

Read carefully. Do not exceed recommended dosage as serious side effects may occur. Please read all instructions at least two days before your colonoscopy. Your physician may adjust your dosage schedule.

· Do not take anti-coagulants, Coumadin, aspirin or any anti- inflammatory medication (such as Motrin or Advil) for one week before the procedure. You may use Tylenol if needed.
· If you take anticoagulants (blood thinners), have a heart murmur, or have been advised to take antibiotics before dental work, please call for special instructions at least 5 days before your appointment.
· You may take your regular medications before the procedure with a sip of water except for insulin or other diabetic medications which may be taken after the procedure.
· If a polyp is removed, do not take anticoagulants (Coumadin), aspirin or any anti-inflammatory medication for one week after the procedure.

ESCORT: It is likely that sedating medication will be given for your colonoscopy, and you may be drowsy for quite a while. For your safety, we cannot perform the examination unless someone is here to accompany you home afterwards.

2 DAYS BEFORE EXAMINATION:

You will need to obtain two (2) 1½ fl.oz. bottles of Fleet Phospho -Soda at any pharmacy. Also, buy 1 Fleet enema.

NOTE: Individual responses to laxatives do vary. This prep may cause multiple bowel movements. Often works within 30 minutes, but may take as long as 3 hours.

DAY BEFORE EXAMINATION:

Stay on clear liquids by mouth. (Nothing after midnight except medications). Clear liquids include: strained fruit juices without pulp (apple, white grape, and lemonade), water, clear broth or bouillon, coffee or tea (without milk or non-dairy creamer). All of the following that NOT colored red or purple: Gatorade, carbonated and non-carbonated soft drinks, Jello (without added fruits or toppings), and ice popsicles.

At 7:00 PM, take the 1½ fl. oz. of Fleet Phospho-Soda with 3 glasses of water. It may be added to Gatorade.

DAY OF EXAMINATION:

Nothing after midnight by mouth except medications.

At 6:00 AM, or at least 3 hours before your test, take another 1 ½ fl. oz. of Fleet Phospho - Soda with 3 glasses of water and one Fleet enema per rectum.

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