Procedures & Prep

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Upper Endoscopy Piedmont Fayette Hospital(printable version)When you are scheduled for a upper endoscopy, please report to Piedmont Fayette Hospital registration desk- West Entrance at your designated time. Someone must be with you while you have the procedure and to drive you home. If your driver is not in our waiting room, your procedure will not be performed. Procedures cancelled less than 72 hours of the appointment may be subject to a charge of $100.00. These charges will be billed to the patient and not their insurance carrier. If you have any questions or need to cancel your procedure scheduled at Piedmont Fayette Hospital please call: Drs. Khandelwal, Kanji, Gryboski: 770-460-3100 Joanne Drs. Burney, Woods: 770-719-0922 Lisa Dr. Rudolph: 678-326-4812 Tracy Dr. Strain: 678-817-6550 x 1430 Amanda In order to pre-cert the procedure we must have your current insurance card. Our staff will contact the insurance company to pre-certify the procedure. Pre-cert is not a guarantee of payment. For benefit information, contact your insurance company. Please bring your insurance card, picture ID and a list of medication to the facility on the day of your procedure. If you have special needs, please notify the staff prior to your procedure. If you are having your procedure in the outpatient lab of Piedmont Fayette Hospital and you have sleep apnea, you must bring your CPAP machine. Important Information for your Upper Endoscopy If you vary from these instructions in any way, this includes drinking any fluids, your procedure will be delayed or cancelled.   You may have nothing to eat or drink after midnight the morning of the procedure except for the medications listed below. No gum, hard candy or ice chips the day of the procedure. Two weeks before a procedure, stop taking any herbal products, including Olestra products. (Olestra is found in fat free chips and snack products.) One week before your procedure, TAKE NO ASPIRIN. Read all “over the counter” labels and take no medications that contains aspirin. Take no Ibuprofen (Advil, Aleve, etc.), no BC or Goody’s Powders, no arthritis medications or anti-inflammatory medications. You may take Tylenol. Do not take Vitamin E, Iron, multi vitamins or fish oil. All of these medications have a blood thinning effect and could cause unnecessary bleeding. Your doctor will advise you to stop Plavix, Coumadin, Pradaxa or Xarelto1, 2, 3, 4, or 5 days before the procedure. The morning of the procedure: when you wake up, take heart medications, breathing medications, blood pressure medications or seizure medications with a sip of water. If you have any doubt about whether you should take your medications prior to your procedure, simply bring them with you. If you are diabetic, read and follow the special diabetic instructions. Please do not consume alcoholic beverages 24 hours before your exam. Wear comfortable clothes that are easy to remove. Jewelry should be left at home with exception of wedding bands. Remove any tongue, lip, nose and cheek piercings prior to the procedure.Upper Endoscopy at Summit Endoscopy Center(printable version)When you are scheduled for a upper endoscopy, please report to Summit Endoscopy Center Suite 401- Inside Piedmont Fayette Hospital- East Entrance (4th floor) at your designated time. Someone must be with you while you have the procedure and to drive you home. If your driver is not in our waiting room, your procedure will not be performed.   Procedures cancelled less than 72 hours of the appointment may be subject to a charge of $100.00. These charges will be billed to the patient and not their insurance carrier.   If you have any questions or need to cancel your procedure call: Summit Endoscopy Center: 678-817-6505 Option 1, 2 or 3   In order to pre-cert the procedure we must have your current insurance card. Our staff will contact the insurance company to pre-certify the procedure. Pre-cert is not a guarantee of payment. For benefit information, contact your insurance company. Please bring your insurance card, picture ID and a list of medication to the facility on the day of your procedure.   If you have special needs, please notify the staff prior to your procedure. If you are having your procedure in the outpatient lab of Piedmont Fayette Hospital and you have sleep apnea, you must bring your CPAP machine. Important Information for your Upper Endoscopy If you vary from these instructions in any way, this includes drinking any fluids, your procedure will be delayed or cancelled.   You may have nothing to eat or drink after midnight the morning of the procedure except for the medications listed below.   No gum, hard candy or ice chips the day of the procedure.   Two weeks before a procedure, stop taking any herbal products, including Olestra products. (Olestra is found in fat free chips and snack products.)   One week before your procedure, TAKE NO ASPIRIN. Read all “over the counter” labels and take no medications that contains aspirin. Take no Ibuprofen (Advil, Aleve, etc.), no BC or Goody’s Powders, no arthritis medications or anti-inflammatory medications.   You may take Tylenol. Do not take Vitamin E, Iron, multi vitamins or fish oil. All of these medications have a blood thinning effect and could cause unnecessary bleeding. Your doctor will advise you to stop Plavix, Coumadin, Pradaxa or Xarelto1, 2, 3, 4, or 5 days before the procedure.   The morning of the procedure: when you wake up, take heart medications, breathing medications, blood pressure medications or seizure medications with a sip of water. If you have any doubt about whether you should take your medications prior to your procedure, simply bring them with you.   If you are diabetic, read and follow the special diabetic instructions.   Please do not consume alcoholic beverages 24 hours before your exam.   Wear comfortable clothes that are easy to remove. Jewelry should be left at home with exception of wedding bands. Remove any tongue, lip, nose and cheek piercings prior to the procedure.Diabetic Diet(printable version)OUTPATIENT TESTING INSTRUCTIONS FOR PATIENTS WITH DIABETES It is important to keep your blood glucose controlled when you are having an outpatient procedure. The following directions will guide you in managing your diabetes medications before and after your test or procedure.  The evening before your test or procedure 
  1. Continue usual diabetes medication until midnight. (If on Lantus insulin at night, see exceptions below under #6).
  2. Follow all directions your doctor gives you for test preparation. If a clear liquid diet has been prescribed, follow the diet below. It is OK to take liquids containing sugar as listen in the sample diet.
SAMPLE DIET:   May substitute equivalent clear liquids 8 oz. Diet Soft Drink 8 oz. Regular Jell-O (no red or purple flavors) 1 Regular Popsicle (no red or purple flavors) 8 oz. Apple Juice Broth **The more you can drink, the better the prep will work. The liquids help to cleanse the colon. Those liquids should be diet or calorie free.
  1. Nothing to eat or drink after midnight except for #3 below and your morning dose of laxative if ordered by your doctor.
The morning of the test or procedure 
  1. Nothing to eat or drink.
  2. Check blood sugar first thing this morning (and at 12 noon if you are not at the hospital) and write down the results. Bring these results and your blood sugar log book with you to the hospital.
  3. If your blood sugar is less than 60, take one of the following before your arrival at hospital: 3 glucose tablets or 4 oz. Juice (prefer clear juice such as apple or white grape only. NO Orange Juice.)
  4. If blood glucose is equal or greater than 250 call your doctor
  5. DO NOT TAKE your diabetes pill this morning.
  6. If you take Insulin:
    1. NPH, Lente, Ultra Lente: Take 1/2 your morning dose the day of the procedure.
    2. 70/30, 75/25, 50/50: Take 1/3 your morning dose the day of the procedure.
    3. Take NO short acting insulin: Novolog, Humalog, Regular
Example 1: Your usual morning dose is 15 units NPH and 8 units Regular, you would take 7 units NPH and NO regular the morning of your procedure. Example 2: Your usual morning dose is 27 units of 70/30 insulin, you would take 9 units of 70/30 the morning of your procedure. Lantus Insulin:
  1. If you take Lantus insulin at night and your procedure is scheduled early in the morning, take your usual night time dose, but no morning insulin.
  2. If you take Lantus insulin at night and your procedure is scheduled late morning or early afternoon, take 2/3 of your evening dose and no morning insulin. 
When you arrive at the Summit Procedure Lab:  
  1. Check in for your test or procedure as directed by your doctor.
  2. Tell the nurse:
    1. You have diabetes
    2. What your blood sugar was this morning
    3. If you take insulin, how much insulin you took this morning
After the procedure
  1. Go back to your usual meal plan
  2. Take your diabetes pill
  3. Resume your usual insulin dose at the next scheduled time
  4. If your blood glucose is higher than 250, call the doctor who treats your diabetes.
If you have any questions about these instructions for your diabetes management, call the Summit Endoscopy Center at 678-817-6505
Movi Prep Instructions(printable version)

General Procedure Information

Please read these instructions two weeks before

-Arrange to have a driver to come with you and remain in our waiting room during your test.

Laxative Prep Method

*Follow these instructions. Do NOT follow instructions on the box MOVI Prep – Split dose Supplies to purchase
  1. Movi- Prep Kit (fill prescription)
  2. Clear liquid beverages/product

General Instructions

2 weeks before procedure
  • Stop taking herbal products
  • Stop eating snack containing olestra (found in “light” snacks)
1 week before procedure
  • Stop multivitamins, vitamin E, iron and fish oil supplements
  • Stop taking aspirin, NSAIDs and blood thinners 3, 4, or 5 days or as approved by your prescribing physician. You may take Tylenol  (acetaminophen
Days before your procedure
  • Purchase supplies
  • Read through these directions
  • Expect call from anesthesia department to discuss your medical history.
If you are diabetic, read and follow the special diabetic instructions. Questions? Please see frequently asked questions first. If you still have questions, please call

Day Before Procedure

DIET INSTRUCTIONS

  • You may only have CLEAR LIQUIDS the entire day before your procedure
  • NO SOLID FOODS should be eaten on this day
  • Examples of CLEAR LIQUIDS: strained fruit juices (apple, white grape, white cranberry). Limeade, lemonade, coffee, tea (no creamer), Coke, Pepsi, Diet soda, non-red soft drinks, chicken or beef broth, gelatin desserts without added fruit or whipped topping
  • AVOID RED and PURPLE liquids, including food dye
  • AVOID MILK and ALCOHOLIC beverages

LAXATIVE PREP INSTRUCTIONS

*Solution may be mixed and refrigerated up to 24 hours in advance
  • Morning: empty 1 pouch A and 1 pouch B into the disposable container; add lukewarm water or Minute Maid lemonade without pulp to the top line of the container and mix to dissolve, then refrigerate.
  • Evening: Begin drinking your prep solution at 5 PM. The Movi-Prep container is divided by 4 marks. Every 15 mins, drink the solution down to the next mark until ALL of the solution is consumed.
  • Drink 16 oz of clear liquid of your choice, and continue to take clear liquids until bedtime.
  • Prepare the second container of Movi-Prep the same way and refrigerate.

Day of Procedure

LAXATIVE PREP INSTRUCTIONS

  • 6 hours before leaving for the procedure drink the second container of Movi-Prep until ALL of the solution is consumed. You should complete it in about 1 hour.
  • Drink 16 oz of a clear liquid of your choice over the next 15 minutes
  • Put nothing else in your mouth except a small sip of water with your heart, blood pressure or seizure medication.
  • You must have NOTHING in your mouth 4 hours prior to your procedure. (This means NO water, ice chips, gum, candy, cough drops, etc.)
**Any contents in your stomach could come up, getting into your lungs while under anesthesia.

GENERAL INSTRUCTIONS

  • You may brush your teeth and gargle prior to your test.
  • DO NOT wear body LOTION or body JEWELRY. Please remove all piercings (tongue, cheek, nose rings, etc) prior to arrival.
  • Someone must be with you while you have the procedure and to drive you home. If your driver is NOT in our waiting room, your procedure will NOT be performed.
  • Failure to follow these instructions may cause your procedure to be delayed or cancelled
SUPREP Instructions(printable version)

General Procedure Information

Please read these instructions two weeks before

  • Arrange to have a driver to come with you and remain in our waiting room during your test.

Laxative Prep Method

*Follow these instructions. Do NOT follow instructions on the box SUPREP – Split dose Supplies to purchase
  1. SUPREP kit (fill prescription)
  2. Clear liquid beverages/product

 General Instructions

2 weeks before procedure
  • Stop taking herbal products
  • Stop eating snack containing olestra (found in “light” snacks)
 1 week before procedure
  • Stop taking aspirin, NSAIDs and blood Thinners 3, 4, or 5 days or as approved by your prescribing physician. You may take Tylenol (acetaminophen)
  • Stop multivitamins, vitamin E, iron and fish oil supplements

 Days before your procedure

  • Purchase supplies
  • Read through these directions
  • If your procedure is at Summit Endoscopy Center, expect call from anesthesia department to discuss your medical history.
If you are diabetic, read and follow the special diabetic instructions. Questions? Please see frequently asked questions first. If you still have questions, please call.

 Day Before Procedure

DIET INSTRUCTIONS

  • You may only have CLEAR LIQUIDS the entire day before your procedure
  • NO SOLID FOODS should be eaten on this day
  • Examples of CLEAR LIQUIDS: strained fruit juices (apple, white grape, white cranberry). Limeade, lemonade, coffee, tea (no creamer), Coke, Pepsi, Diet soda, non-red soft drinks, chicken or beef broth, gelatin desserts without added fruit or whipped topping
  • AVOID RED and PURPLE liquids, including food dye
  • AVOID MILK and ALCOHOLIC beverages

 LAXATIVE PREP INSTRUCTIONS

  • At 5 PM, Pour one 6 ounce bottle of SUPREP liquid into the mixing container. Add cool drinking water to the 16 ounce line on the container.
  • Drink ALL the liquid in the container over a 30 minute period.
  • Immediately follow with 32 ounces of clear liquids over the next hour.
  • Continue to drink clear liquids until bedtime.

Day of Procedure

LAXATIVE PREP INSTRUCTIONS

6 hours before leaving for the procedure
  • Pour one 6 ounce bottle of SUPREP liquid into the mixing container. Add cool drinking water to the 16 ounce line on the container.
  • Drink ALL the liquid in the container over a 30 minute period.
  • Immediately follow with 32 ounces of clear liquids over the next hour.
  • Put nothing else in your mouth except a small sip of water with your heart, blood pressure or seizure medication.
  • You must have NOTHING in your mouth 4 hours prior to your procedure. (This means NO water, ice chips, gum, candy, cough drops, etc.)
**Any contents in your stomach could come up, getting into your lungs while under anesthesia.

GENERAL INSTRUCTIONS

  • You may brush your teeth and gargle prior to your test.
  • DO NOT wear body LOTION or body JEWELRY.
  • Please remove all piercings (tongue, cheek, nose rings, etc) prior to arrival.
  • Someone must be with you while you have the procedure and to drive you home. If your driver is NOT in our waiting room, your procedure will NOT be performed.
  • Failure to follow these instructions may cause your procedure to be delayed or cancelled.
Prepopik Instructions(printable version)

General Procedure Information

Please read these instructions two weeks before

  •  Arrange to have a driver to come with you and remain in our waiting room during your test.

Laxative Prep Method

*Follow these instructions. Do NOT follow instructions on the box

Prepopik Prep – Split dose

Supplies to purchase
  1. Prepopik Prep Kit (fill prescription)
  2. Clear liquid beverages/product
 

General Instructions

2 weeks before procedure
  • Stop taking herbal products
  • Stop eating snack containing olestra (found in “light” snacks)
1 week before procedure
  • Stop taking aspirin, NSAIDs and blood thinners 3, 4, or 5 days or as approved by your prescribing physician. You may take Tylenol  (acetaminophen)
  • Stop multivitamins, vitamin E, iron and fish oil supplements
Days before your procedure
  • Purchase supplies
  • Read through these directions
  • Expect call from anesthesia department to discuss your medical history.
If you are diabetic, read and follow the special diabetic instructions. Questions? Please see frequently asked questions first. If you still have questions, please call.  

Day Before Procedure

 

DIET INSTRUCTIONS

  • You may only have CLEAR LIQUIDS the entire day before your procedure
  • NO SOLID FOODS should be eaten on this day
  • Examples of CLEAR LIQUIDS: strained fruit juices (apple, white grape, white cranberry). Limeade, lemonade, coffee, tea (no creamer), Coke, Pepsi, Diet soda, non-red soft drinks, chicken or beef broth, gelatin desserts without added fruit or whipped topping
  • AVOID RED and PURPLE liquids, including food dye
  • AVOID MILK and ALCOHOLIC beverages
 

LAXATIVE PREP INSTRUCTIONS

  • At 5 pm: Fill the dosing cup provided with cold water up to the lower (5 ounce)line on the cup.
  • Pour in the contents of ONE (1) packet and stir for 2-3 minutes until dissolved.
  • Drink the entire contents.
  • Follow with at least FIVE (5) 8-ounce drinks of clear liquid, taken at your own pace with in the next 5 hours, before bed.
 

Day of Procedure

LAXATIVE PREP INSTRUCTIONS

  • 6 hours before leaving for the procedure Fill the dosing cup provided with cold water up to the lower (5 ounce)line on the cup.
  • Pour in the contents of ONE (1) packet and stir for 2-3 minutes until dissolved.
  • Drink the entire contents.
  • Immediately follow with THREE (3) 8-ounce drinks of clear liquid within 1 hour.
  • Put nothing else in your mouth except a small sip of water with your heart, blood pressure or seizure medication.
  • You must have NOTHING in your mouth 4 hours prior to your procedure. (This means NO water, ice chips, gum, candy, cough drops, etc.)
**Any contents in your stomach could come up, getting into your lungs while under anesthesia.

GENERAL INSTRUCTIONS

  • You may brush your teeth and gargle prior to your test.
  • DO NOT wear body LOTION or body JEWELRY.
  • Please remove all piercings (tongue, cheek, nose rings, etc) prior to arrival.
  • Someone must be with you while you have the procedure and to drive you home. If your driver is NOT in our waiting room, your procedure will NOT be performed.
  • Failure to follow these instructions may cause your procedure to be delayed or cancelled.
Colyte/Nulytely Prep(printable version)

Someone must be with you while you have the procedure and to drive you home. If your driver is not in our waiting room, your procedure will not be performed.

 If you must cancel your procedure time, please do so 7 days in advance. If you have any questions or need to cancel your procedure, here is the number to call:
  • Summit Endoscopy Center:   678-817-6505 Option 1 or 2
  • www.summitendoscopycenter.com
  • Piedmont Fayette Hospital:   770-460-3100 Dianna
In order to pre-cert the procedure we must have your current insurance card. Our staff will contact the insurance company to pre-certify the procedure. Pre-cert is not a guarantee of payment. For benefit information, contact your insurance company. Please bring your insurance card, picture ID and a list of medication to the facility on the day of your procedure. If you have special needs, please notify the staff prior to your procedure. If you have sleep apnea, you may need to bring your CPAP machine.

Important Information for your Colonoscopy

If you become extremely nauseated and begin to vomit after taking the laxative, call your physician’s office and ask to speak with his nurse. The number is listed at the top of your instruction sheet. If you are able to keep the laxative down for 30 minutes, it will achieve its desired effect. Two weeks before a procedure, stop taking any herbal products, including Olestra products. (Olestra is found in no fat chips and snack products.) One week before your procedure, TAKE NO ASPIRIN. Read all “over the counter” labels and take no medications that contain aspirin. Take no Ibuprofren (Advil, Aleve, etc.), no BC or Goody’s Powders, no arthritis medications or anti-inflammatory medications. Do not take Vitamin E, Iron, multi vitamins or fish oil. Your doctor will advise you to stop Plavix or Coumadin 3, 4, or 5 days before the procedure. All of these medications have a blood thinning effect and could cause unnecessary bleeding. You may take Tylenol. The morning of the procedure: when you wake up, take heart medications, breathing medications, blood pressure medications or seizure medications with a sip of water. If you have any doubt about whether you should take your medications prior to your procedure, simply bring them with you. If you are diabetic, read and follow the special diabetic instructions. Please do not consume alcoholic beverages 24 hours before your exam. It is extremely important that you take all of the laxative as instructed. The desired effect of the colon prep is to leave the colon very clean. You can expect the results to be clear, yellow, or light green. Wear comfortable clothes that are easy to remove. Jewelry should be left at home with exception of wedding bands. Remove any tongue, lip, nose and cheek piercings prior to the procedure.

Preparation for your Colon Examination

Colyte/Nulytely Prep

It is very important that you follow these instructions. The success of your exam depends on it. Purchase:       Prescription for Colyte/Nulytely

One day before your exam:

  • Begin a clear liquid diet in the morning:
  • Clear liquid diet includes:
    • Water
    • Strained fruit juice, apple, white grape and lemonade.
    • No orange juice
    • Clear broth or bouillon
    • Coffee without milk or non-dairy products
    • Coke, Diet Coke, Pepsi, clear non-red soft drinks
    • Tea, Gatorade, Crystal Light or other similar drinks
    • Jello and popsicles: Avoid red or purple flavors
  • In the morning, prepare the Colyte/Nulytely by following the instructions on the package. You may use the cherry flavoring offered, as there is no red dye in it.
  • Place in refrigerator.
Between 3 to 5 PM:
  • Drink 64 ounces of the solution over two hours.
  • Continue drinking clear liquids until ready for bed.

 On exam day:

Six hours before leaving to come for the procedure:
  • Drink the remaining 64 ounces of solution over two hours.
*Then you may have nothing else until after the procedure. This includes ice chips, gum and hard candy. (The only exception is medications previously discussed on the information page.) If you vary from these instructions in any way, this includes drinking any fluids, your procedure may be delayed or cancelled.
Movi Prep and Colonoscopy Preparation Instructions(printable version)

What is a colonoscopy?

A colonoscopy is the most accurate test for detecting colon polyps and colon cancer, and the only test where polyps can be removed. During this procedure, a doctor examines the lining of your large intestine and rectum through a flexible tube called a colonoscope. The colonoscope is inserted into the anus and advanced slowly through the colon. If polyps or other abnormalities are found, the doctor may remove them for further examination or biopsy.

The bowel prep is the most important factor in ensuring you get the most thorough and complete exam during your colonoscopy. Small polyps can be missed if they are covered with retained stool. If your bowel prep is incomplete, your exam may need to be repeated on another day or you may need to return sooner for your next colonoscopy. Studies have clearly shown that the best preps are obtained when half of the prep is taken the night before your colonoscopy and the other half is taken the morning of the colonoscopy. This is called a split dose prep. The American College of Gastroenterology recommends a split dose prep for all patients. This regimen allows you to drink roughly half the total volume of liquid as compared to the 4 liter preps like Golytely that are completed the night before.

The preps used for split dose preps are Moviprep, Osmoprep Tablets, Prepopik, and Suprep. Osmoprep tablets and Suprep should not be used if you have heart or kidney problems. The Moviprep is safe for all patients. Please ignore the instructions on the back of the Moviprep box which states you can take all of the prep the night before the procedure. It simply does not work well enough if taken the night before. Please see the attached sheet with specific information. If you don’t think you can get up early to do the second half of the prep, please be sure to schedule your colonoscopy for later in the day. The liquid usually passes through the bowel much faster in the morning than in the evening so don’t panic if it takes awhile for the prep to start working in the evening.

PRE-PROCEDURE CHECKLIST

If you have diabetes, ask your regular doctor for diet and medication restrictions. Do not take your oral diabetes medicine on the day of your procedure.  If you take metformin, stop taking it the day before your colonoscopy. Also, please bring your Insulin and Insulin syringes with you to your procedure; we will check your blood sugar before and after the procedure.

If you take a medication to thin your blood

  • Do NOT stop taking your daily Aspirin or NSAIDs. If you are taking a daily Aspirin or NSAIDS we want you to continue to take your medication. On the day of your procedure you can make your gastroenterologist aware of the medication you are taking and the amount you are taking.
  • If you take a medication to thin your blood (such as Coumadin, Plavix, Pradaxa, Lovenox, Xarelto, Eliquis, Brilinta, Effient, Ticlid, Disgren, Pletal...) you must be seen in our office (can be seen by nurse practitioner or physician assistant) prior to your procedure. At the time of your office visit a plan will be made in conjunction with your prescribing physician about use of your blood thinner.

If you currently are taking other prescription medications, you may continue to take all other medications as instructed by the prescribing physician.

If you are or may be pregnant, please discuss the risks and benefits of this procedure with your doctor.

You MUST arrange for a ride for the day of your exam. If you fail to arrange transportation with a responsible adult, your procedure will need to be cancelled and rescheduled. Your driver must check in with you and stay in our office the entire time that you are there. We cannot start your procedure if you do not have a driver present. In addition to this, you may not take a taxi or ride the bus by yourself. This is for your safety.

If you must cancel or reschedule your appointment, please call 404-355-3200 for Atlanta or 706-253-7340 for Jasper at least three days prior to your procedure to avoid any late cancellation fees.

If you have any special needs, such as a pacemaker, internal defibrillator, latex allergy, need for an interpreter, or if you are allergic to eggs, nuts or soy, please contact our office immediately.  Your procedure may need to be rescheduled.

Remember your prep is a split dose. You will be taking the prep the day before the procedure as well as the day of the procedure. You can start your split prep 5 hours before the procedure.

Remember even while taking split prep you cannot have any liquids, ice chips, water or food two hours before your procedure. If you do, the procedure may be delayed.

STOP AND READ:

  • If you do not follow these instructions your procedure may be delayed or cancelled.
  • Please note that you cannot have any solid foods starting the day before your procedure.
  • The day of the procedure you may not have gum, mints, ice chips, hard candies or cigarettes.
  • You may have clear liquids up to two and a half hours before your procedure. This includes the prep solution.
  • You cannot have anything in your mouth (gum, mint, cough drop, ice chips etc.) two and a half hours before your procedure.

PREPARATION

To ensure a successful exam, please follow all instructions carefully. Failure to accurately and completely prepare for your exam may result in the need for an additional procedure and both procedures will be billed to your insurance.

The day before your exam:

The day of your exam:

  • You may take your usual medications with up to 4 oz. of water at least 2.5 hours prior to your procedure. Be sure to wear comfortable clothes and shoes that will remain on your feet (preferably tennis shoes) to your procedure. Please do NOT wear flip flops, sandals, or backless shoes.
  • Please remove ALL jewelry including earrings, rings, bracelets, anklets, necklaces, and watches prior to the procedure, and be sure to leave any and all valuables at home. DHEC will not be responsible for any lost valuables (including eyeglasses and dentures).
  • Plan to spend up to two hours at the endoscopy center the day of your procedure. The exam itself takes about 25 minutes to complete.

Before the exam:

  • You will change into a gown and robe.
  • Your medical history will be reviewed with you and you will be given a consent form to sign.
  • A nurse will insert an intravenous (IV) line into your hand or arm.

During the exam:

  • Medicine will be given through the IV line to sedate you.
  • Your heart rate and oxygen levels will be monitored. If your blood pressure is low, you may be given fluids through the IV line.
  • The doctor will insert a flexible tube - called a colonoscope - into your anus and will advance it slowly through the rectum and colon, looking for abnormal tissue or polyps.
  • If abnormal tissue or polyps are found, the doctor may remove them through the colonoscope for closer examination or biopsy. Tissue removal is painless.

What happens after the exam?

  • The doctor will talk with you about the initial results of your exam.
  • The doctor will prepare a full report for the physician who referred you for the colonoscopy.
  • You may feel bloated after the procedure. This is normal.
  • Medication given during the exam will prohibit you from driving for the rest of the day.
  • Following the exam, you may resume your normal diet. Avoid alcohol until the next day.
  • You may resume your regular activities the day after the procedure.
  • A nurse will provide you with complete discharge instructions before you leave the endoscopy center. Be sure to ask the nurse for specific instructions if you take blood thinners such as aspirin, Coumadin or Plavix.
  • Any tissue samples or polyps removed during the exam will be sent to a lab for evaluation. It may take 5-7 working days for you to be notified of the results.

Are there possible complications from a colonoscopy?

Although serious complications are rare, any medical procedure has the potential for risks. A nurse will review all potential warning signs with you before you leave the endoscopy center. Risks include:

  • Perforation, or a tear, of the lining of the colon.
  • Bleeding from the biopsy or polypectomy site if tissue was removed.
  • Reaction to medications used during the procedure.

Additional information:

Your procedure has been scheduled at one of the GI labs listed below. Please check your paperwork to make sure you arrive on time to the correct location:

DIGESTIVE HEALTHCARE ENDOSCOPY LAB is located at 95 Collier Road NW, Suite 4075. Enter the Piedmont Hospital complex at the Collier Road entrance. Park in the “South” parking deck. Take the elevator to the “Orange Level”. Cross over the glassed in covered bridge. You are now in the 95 building. You do not have to check in at the hospital. Go up to the 4th floor and look for Suite 4075. You and your driver may sign in at the window. If someone is sitting at the window, let them know you have arrived.

THE PIEDMONT HOSPITAL ENDSCOPY LAB is located on the first floor of the 77 building. It is most convenient to park in the North parking deck.  Take the elevator to the bridge level (BR).  You will need to go to the 77 building registration office to register for your procedure. After getting off at the bridge level you will walk through a glassed-in bridge and go straight. You will pass the 77 building (D) elevator, which will be located on your left.  The registration office is located in the next hallway on your left.  Once inside, a member of the registration staff will help you complete some additional paperwork, and then escort you to the GI Lab for your procedure. This should take approximately 15 minutes.

  • Bring a list of all of your current medications, including any allergy or over-the-counter medications.
  • Bring a photo ID as well as up-to-date insurance information, such as your insurance card and any referral forms that might be required by your payer.
  • If you have any special needs please notify the staff prior to your procedure (pacemaker, internal defibrillator, latex allergy, need interpreter).
  • Wear comfortable clothes to your procedure. Please wear shoes that will remain on your feet (i.e. no flip flops, sandals or backless shoes).
  • Attention: Your driver must check in and wait for you in the Endoscopy waiting room. It generally takes 1½ - 2 hours for a procedure to be completed.

Co-pays are required on the day of your appointment. If you have any questions about pre-certification, please call our business office at 404-603-3543.

If your insurance does not cover this procedure, for example you are a self-paying patient or you have been notified by our office that you owe a copay or coinsurance, please bring a credit card (Visa, MasterCard and AMEX), check or cash.

You may receive several statements from this procedure; your physician’s fee, a facility fee for the Endoscopy Center (supplies and nursing care), a statement for anesthesia (Propofol) and for pathology if tissue is removed during the procedure.

Digestive Healthcare of Georgia Endoscopy Center is co-owned and operated by the Physicians of Digestive Healthcare and Piedmont Hospital.

Prepopik and Colonoscopy Preparation Instructions(printable version)

What is a colonoscopy?

A colonoscopy is the most accurate test for detecting colon polyps and colon cancer, and the only test where polyps can be removed. During this procedure, a doctor examines the lining of your large intestine and rectum through a flexible tube called a colonoscope. The colonoscope is inserted into the anus and advanced slowly through the colon. If polyps or other abnormalities are found, the doctor may remove them for further examination or biopsy.

The bowel prep is the most important factor in ensuring you get the most thorough and complete exam during your colonoscopy. Small polyps can be missed if they are covered with retained stool. If your bowel prep is incomplete, your exam may need to be repeated on another day or you may need to return sooner for your next colonoscopy. Studies have clearly shown that the best preps are obtained when half of the prep is taken the night before your colonoscopy and the other half is taken the morning of the colonoscopy. This is called a split dose prep. The American College of Gastroenterology recommends a split dose prep for all patients. This regimen allows you to drink roughly half the total volume of liquid as compared to the 4 liter preps like Golytely that are completed the night before.

The preps used for split dose preps are Moviprep, Osmoprep Tablets, Prepopik, and Suprep. Osmoprep tablets and Suprep should not be used if you have heart or kidney problems. The Moviprep is safe for all patients. Please ignore the instructions on the back of the Moviprep box which states you can take all of the prep the night before the procedure. It simply does not work well enough if taken the night before. Please see the attached sheet with specific information. If you don’t think you can get up early to do the second half of the prep, please be sure to schedule your colonoscopy for later in the day. The liquid usually passes through the bowel much faster in the morning than in the evening so don’t panic if it takes awhile for the prep to start working in the evening.

PRE-PROCEDURE CHECKLIST

If you have diabetes, ask your regular doctor for diet and medication restrictions. Do not take your oral diabetes medicine on the day of your procedure. If you take metformin, stop taking it the day before your colonoscopy. Also, please bring your Insulin and Insulin syringes with you to your procedure; we will check your blood sugar before and after the procedure.

If you take a medication to thin your blood

  • Do NOT stop taking your daily Aspirin or NSAIDs. If you are taking a daily Aspirin or NSAIDS we want you to continue to take your medication. On the day of your procedure you can make your gastroenterologist aware of the medication you are taking and the amount you are taking.
  • If you take a medication to thin your blood (such as Coumadin, Plavix, Pradaxa, Lovenox, Xarelto, Eliquis, Brilinta, Effient, Ticlid, Disgren, Pletal...) you must be seen in our office (can be seen by nurse practitioner or physician assistant) prior to your procedure. At the time of your office visit a plan will be made in conjunction with your prescribing physician about use of your blood thinner.

If you currently are taking other prescription medications, you may continue to take all other medications as instructed by the prescribing physician.

If you are or may be pregnant, please discuss the risks and benefits of this procedure with your doctor.

You MUST arrange for a ride for the day of your exam. If you fail to arrange transportation with a responsible adult, your procedure will need to be cancelled and rescheduled. Your driver must check in with you and stay in our office the entire time that you are there. We cannot start your procedure if you do not have a driver present. In addition to this, you may not take a taxi or ride the bus by yourself. This is for your safety.

If you must cancel or reschedule your appointment, please call 404-355-3200 for Atlanta or 706-253-7340 for Jasper at least three days prior to your procedure to avoid any late cancellation fees.

If you have any special needs, such as a pacemaker, internal defibrillator, latex allergy, need for an interpreter, or if you are allergic to eggs, nuts or soy, please contact our office immediately. Your procedure may need to be rescheduled.

Remember your prep is a split dose. You will be taking the prep the day before the procedure as well as the day of the procedure. You can start your split prep 5 hours before the procedure.

Remember even while taking split prep you cannot have any liquids, ice chips, water or food two hours before your procedure. If you do, the procedure may be delayed.

STOP AND READ:

  • If you do not follow these instructions your procedure may be delayed or cancelled.
  • Please note that you cannot have any solid foods starting the day before your procedure.
  • The day of the procedure you may not have gum, mints, ice chips, hard candies or cigarettes.
  • You may have clear liquids up to two and a half hours before your procedure. This includes the prep solution.
  • You cannot have anything in your mouth (gum, mint, cough drop, ice chips etc.) two and a half hours before your procedure.

PREPARATION

To ensure a successful exam, please follow all instructions carefully. Failure to accurately and completely prepare for your exam may result in the need for an additional procedure and both procedures will be billed to your insurance.

The day before your exam:

The day of your exam:

  • You may take your usual medications with up to 4 oz. of water at least 2.5 hours prior to your procedure. Be sure to wear comfortable clothes and shoes that will remain on your feet (preferably tennis shoes) to your procedure. Please do NOT wear flip flops, sandals, or backless shoes.
  • Please remove ALL jewelry including earrings, rings, bracelets, anklets, necklaces, and watches prior to the procedure, and be sure to leave any and all valuables at home. DHEC will not be responsible for any lost valuables (including eyeglasses and dentures).
  • Plan to spend up to two hours at the endoscopy center the day of your procedure. The exam itself takes about 25 minutes to complete.

Before the exam:

  • You will change into a gown and robe.
  • Your medical history will be reviewed with you and you will be given a consent form to sign.
  • A nurse will insert an intravenous (IV) line into your hand or arm.

During the exam:

  • Medicine will be given through the IV line to sedate you.
  • Your heart rate and oxygen levels will be monitored. If your blood pressure is low, you may be given fluids through the IV line.
  • The doctor will insert a flexible tube - called a colonoscope - into your anus and will advance it slowly through the rectum and colon, looking for abnormal tissue or polyps.
  • If abnormal tissue or polyps are found, the doctor may remove them through the colonoscope for closer examination or biopsy. Tissue removal is painless.

What happens after the exam?

  • The doctor will talk with you about the initial results of your exam.
  • The doctor will prepare a full report for the physician who referred you for the colonoscopy.
  • You may feel bloated after the procedure. This is normal.
  • Medication given during the exam will prohibit you from driving for the rest of the day.
  • Following the exam, you may resume your normal diet. Avoid alcohol until the next day.
  • You may resume your regular activities the day after the procedure.
  • A nurse will provide you with complete discharge instructions before you leave the endoscopy center. Be sure to ask the nurse for specific instructions if you take blood thinners such as aspirin, Coumadin or Plavix.
  • Any tissue samples or polyps removed during the exam will be sent to a lab for evaluation. It may take 5-7 working days for you to be notified of the results.

Are there possible complications from a colonoscopy?

Although serious complications are rare, any medical procedure has the potential for risks. A nurse will review all potential warning signs with you before you leave the endoscopy center. Risks include:

  • Perforation, or a tear, of the lining of the colon.
  • Bleeding from the biopsy or polypectomy site if tissue was removed.
  • Reaction to medications used during the procedure.

Additional information:

Your procedure has been scheduled at one of the GI labs listed below. Please check your paperwork to make sure you arrive on time to the correct location:

DIGESTIVE HEALTHCARE ENDOSCOPY LAB is located at 95 Collier Road NW, Suite 4075. Enter the Piedmont Hospital complex at the Collier Road entrance. Park in the “South” parking deck. Take the elevator to the “Orange Level”. Cross over the glassed in covered bridge. You are now in the 95 building. You do not have to check in at the hospital. Go up to the 4th floor and look for Suite 4075. You and your driver may sign in at the window. If someone is sitting at the window, let them know you have arrived.

THE PIEDMONT HOSPITAL ENDSCOPY LAB is located on the first floor of the 77 building. It is most convenient to park in the North parking deck. Take the elevator to the bridge level (BR). You will need to go to the 77 building registration office to register for your procedure. After getting off at the bridge level you will walk through a glassed-in bridge and go straight. You will pass the 77 building (D) elevator, which will be located on your left. The registration office is located in the next hallway on your left. Once inside, a member of the registration staff will help you complete some additional paperwork, and then escort you to the GI Lab for your procedure. This should take approximately 15 minutes.

  • Bring a list of all of your current medications, including any allergy or over-the-counter medications.
  • Bring a photo ID as well as up-to-date insurance information, such as your insurance card and any referral forms that might be required by your payer.
  • If you have any special needs please notify the staff prior to your procedure (pacemaker, internal defibrillator, latex allergy, need interpreter).
  • Wear comfortable clothes to your procedure. Please wear shoes that will remain on your feet (i.e. no flip flops, sandals or backless shoes).
  • Attention: Your driver must check in and wait for you in the Endoscopy waiting room. It generally takes 1 ½ - 2 hours for a procedure to be completed.

Co-pays are required on the day of your appointment. If you have any questions about pre-certification, please call our business office at 404-603-3543.

If your insurance does not cover this procedure, for example you are a self-paying patient or you have been notified by our office that you owe a copay or coinsurance, please bring a credit card (Visa, MasterCard and AMEX), check or cash.

You may receive several statements from this procedure; your physician’s fee, a facility fee for the Endoscopy Center (supplies and nursing care), a statement for anesthesia (Propofol) and for pathology if tissue is removed during the procedure.

Digestive Healthcare of Georgia Endoscopy Center is co-owned and operated by the Physicians of Digestive Healthcare and Piedmont Hospital.

Suprep for Colonoscopy Instructions(printable version)

What is a colonoscopy?

A colonoscopy is the most accurate test for detecting colon polyps and colon cancer, and the only test where polyps can be removed. During this procedure, a doctor examines the lining of your large intestine and rectum through a flexible tube called a colonoscope. The colonoscope is inserted into the anus and advanced slowly through the colon. If polyps or other abnormalities are found, the doctor may remove them for further examination or biopsy.

The bowel prep is the most important factor in ensuring you get the most thorough and complete exam during your colonoscopy. Small polyps can be missed if they are covered with retained stool. If your bowel prep is incomplete, your exam may need to be repeated on another day or you may need to return sooner for your next colonoscopy. Studies have clearly shown that the best preps are obtained when half of the prep is taken the night before your colonoscopy and the other half is taken the morning of the colonoscopy. This is called a split dose prep. The American College of Gastroenterology recommends a split dose prep for all patients. This regimen allows you to drink roughly half the total volume of liquid as compared to the 4 liter preps like Golytely that are completed the night before.

The preps used for split dose preps are Moviprep, Osmoprep Tablets, Prepopik, and Suprep. Osmoprep tablets and Suprep should not be used if you have heart or kidney problems. The Moviprep is safe for all patients. Please ignore the instructions on the back of the Moviprep box which states you can take all of the prep the night before the procedure. It simply does not work well enough if taken the night before. Please see the attached sheet with specific information. If you don’t think you can get up early to do the second half of the prep, please be sure to schedule your colonoscopy for later in the day. The liquid usually passes through the bowel much faster in the morning than in the evening so don’t panic if it takes awhile for the prep to start working in the evening.

PRE-PROCEDURE CHECKLIST

If you have diabetes, ask your regular doctor for diet and medication restrictions. Do not take your oral diabetes medicine on the day of your procedure.  If you take metformin, stop taking it the day before your colonoscopy. Also, please bring your Insulin and Insulin syringes with you to your procedure; we will check your blood sugar before and after the procedure.

If you take a medication to thin your blood

  • Do NOT stop taking your daily Aspirin or NSAIDs. If you are taking a daily Aspirin or NSAIDS we want you to continue to take your medication. On the day of your procedure you can make your gastroenterologist aware of the medication you are taking and the amount you are taking.
  • If you take a medication to thin your blood (such as Coumadin, Plavix, Pradaxa, Lovenox, Xarelto, Eliquis, Brilinta, Effient, Ticlid, Disgren, Pletal...) you must be seen in our office (can be seen by nurse practitioner or physician assistant) prior to your procedure. At the time of your office visit a plan will be made in conjunction with your prescribing physician about use of your blood thinner.

If you currently are taking other prescription medications, you may continue to take all other medications as instructed by the prescribing physician.

If you are or may be pregnant, please discuss the risks and benefits of this procedure with your doctor.

You MUST arrange for a ride for the day of your exam. If you fail to arrange transportation with a responsible adult, your procedure will need to be cancelled and rescheduled. Your driver must check in with you and stay in our office the entire time that you are there. We cannot start your procedure if you do not have a driver present. In addition to this, you may not take a taxi or ride the bus by yourself. This is for your safety.

If you must cancel or reschedule your appointment, please call 404-355-3200 for Atlanta or 706-253-7340 for Jasper at least three days prior to your procedure to avoid any late cancellation fees.

If you have any special needs, such as a pacemaker, internal defibrillator, latex allergy, need for an interpreter, or if you are allergic to eggs, nuts or soy, please contact our office immediately.  Your procedure may need to be rescheduled.

Remember your prep is a split dose. You will be taking the prep the day before the procedure as well as the day of the procedure. You can start your split prep 5 hours before the procedure.

Remember even while taking split prep you cannot have any liquids, ice chips, water or food two hours before your procedure. If you do, the procedure may be delayed.

STOP AND READ:

  • If you do not follow these instructions your procedure may be delayed or cancelled.
  • Please note that you cannot have any solid foods starting the day before your procedure.
  • The day of the procedure you may not have gum, mints, ice chips, hard candies or cigarettes.
  • You may have clear liquids up to two and a half hours before your procedure. This includes the prep solution.
  • You cannot have anything in your mouth (gum, mint, cough drop, ice chips etc.) two and a half hours before your procedure.
Suprep Instructions Day Prior to Procedure: Begin clear liquid diet
  • Water, strained fruit juices (without pulp) including apple, orange, white grape or white cranberry; limeade or lemonade; coffee or tea (DO NOT use any dairy or non-dairy creamer); chicken broth, gelatin desserts without added fruits or toppings (NO RED OR PURPLE).
  • DO NOT DRINK MILK OR ALCHOHOLIC BEVERAGES; DO NOT EAT OR DRINK ANYTHING COLORED RED OR PURPLE.
  • Instructions: Starting at 5:30 p.m. the day before the procedure.
 STEP 1 Pour ONE (1) 6-ounce bottle of SUPREP liquid into the mixing container.
STEP 2 Add cool drinking water to the 16-ounce line on the container and mix.
STEP 3 Drink ALL the liquid in the container.
STEP 4 You MUST drink two (2) more 16-ounce containers of clear liquid of your choice over the next 1 hour
Starting 4 - 5 hours prior to your procedure time, repeat steps 1 through 4 using the other 6 ounce bottle of SUPREP. MUST BE COMPLETED 2 6 HOURS BEFORE YOUR PROCEDURE NOTHING MAY BE TAKEN BY MOUTH 2 6 HOURS BEFORE YOUR PROCEDURE

The day of your exam:

  • You may take your usual medications with up to 4 oz. of water at least 2.5 hours prior to your procedure. Be sure to wear comfortable clothes and shoes that will remain on your feet (preferably tennis shoes) to your procedure. Please do NOT wear flip flops, sandals, or backless shoes.
  • Please remove ALL jewelry including earrings, rings, bracelets, anklets, necklaces, and watches prior to the procedure, and be sure to leave any and all valuables at home. DHEC will not be responsible for any lost valuables (including eyeglasses and dentures).
  • Plan to spend up to two hours at the endoscopy center the day of your procedure. The exam itself takes about 25 minutes to complete.

Before the exam:

  • You will change into a gown and robe.
  • Your medical history will be reviewed with you and you will be given a consent form to sign.
  • A nurse will insert an intravenous (IV) line into your hand or arm.

During the exam:

  • Medicine will be given through the IV line to sedate you.
  • Your heart rate and oxygen levels will be monitored. If your blood pressure is low, you may be given fluids through the IV line.
  • The doctor will insert a flexible tube - called a colonoscope - into your anus and will advance it slowly through the rectum and colon, looking for abnormal tissue or polyps.
  • If abnormal tissue or polyps are found, the doctor may remove them through the colonoscope for closer examination or biopsy. Tissue removal is painless.

What happens after the exam?

  • The doctor will talk with you about the initial results of your exam.
  • The doctor will prepare a full report for the physician who referred you for the colonoscopy.
  • You may feel bloated after the procedure. This is normal.
  • Medication given during the exam will prohibit you from driving for the rest of the day.
  • Following the exam, you may resume your normal diet. Avoid alcohol until the next day.
  • You may resume your regular activities the day after the procedure.
  • A nurse will provide you with complete discharge instructions before you leave the endoscopy center. Be sure to ask the nurse for specific instructions if you take blood thinners such as aspirin, Coumadin or Plavix.
  • Any tissue samples or polyps removed during the exam will be sent to a lab for evaluation. It may take 5-7 working days for you to be notified of the results.

Are there possible complications from a colonoscopy?

Although serious complications are rare, any medical procedure has the potential for risks. A nurse will review all potential warning signs with you before you leave the endoscopy center. Risks include:

  • Perforation, or a tear, of the lining of the colon.
  • Bleeding from the biopsy or polypectomy site if tissue was removed.
  • Reaction to medications used during the procedure.

Additional information:

Your procedure has been scheduled at one of the GI labs listed below. Please check your paperwork to make sure you arrive on time to the correct location:

DIGESTIVE HEALTHCARE ENDOSCOPY LAB is located at 95 Collier Road NW, Suite 4075. Enter the Piedmont Hospital complex at the Collier Road entrance. Park in the “South” parking deck. Take the elevator to the “Orange Level”. Cross over the glassed in covered bridge. You are now in the 95 building. You do not have to check in at the hospital. Go up to the 4th floor and look for Suite 4075. You and your driver may sign in at the window. If someone is sitting at the window, let them know you have arrived.

THE PIEDMONT HOSPITAL ENDSCOPY LAB is located on the first floor of the 77 building. It is most convenient to park in the North parking deck.  Take the elevator to the bridge level (BR).  You will need to go to the 77 building registration office to register for your procedure. After getting off at the bridge level you will walk through a glassed-in bridge and go straight. You will pass the 77 building (D) elevator, which will be located on your left.  The registration office is located in the next hallway on your left.  Once inside, a member of the registration staff will help you complete some additional paperwork, and then escort you to the GI Lab for your procedure. This should take approximately 15 minutes.

  • Bring a list of all of your current medications, including any allergy or over-the-counter medications.
  • Bring a photo ID as well as up-to-date insurance information, such as your insurance card and any referral forms that might be required by your payer.
  • If you have any special needs please notify the staff prior to your procedure (pacemaker, internal defibrillator, latex allergy, need interpreter).
  • Wear comfortable clothes to your procedure. Please wear shoes that will remain on your feet (i.e. no flip flops, sandals or backless shoes).
  • Attention: Your driver must check in and wait for you in the Endoscopy waiting room. It generally takes 1½ - 2 hours for a procedure to be completed.

Co-pays are required on the day of your appointment. If you have any questions about pre-certification, please call our business office at 404-603-3543.

If your insurance does not cover this procedure, for example you are a self-paying patient or you have been notified by our office that you owe a copay or coinsurance, please bring a credit card (Visa, MasterCard and AMEX), check or cash.

You may receive several statements from this procedure; your physician’s fee, a facility fee for the Endoscopy Center (supplies and nursing care), a statement for anesthesia (Propofol) and for pathology if tissue is removed during the procedure.

Digestive Healthcare of Georgia Endoscopy Center is co-owned and operated by the Physicians of Digestive Healthcare and Piedmont Hospital.

Miralax Prep for Colonoscopy(printable version)

Items Needed:

Four Dulcolax tablets Purchase from pharmacy one 255 gram bottle of Miralax or generic equivalent Purchase one 64oz. bottle of Gatorade.  (NO RED FLAVORS)

One week prior to procedure:

  • Do NOT stop taking your daily Aspirin or NSAIDs. If you are taking a daily Aspirin or NSAIDS we want you to continue to take your medication. On the day of your procedure you can make your gastroenterologist aware of the medication you are taking and the amount you are taking.
  • If you take a medication to thin your blood (such as Coumadin, Plavix, Pradaxa, Lovenox, Xarelto, Eliquis, Brilinta, Effient, Ticlid, Disgren, Pletal...) you must be seen in our office (can be seen by nurse practitioner or physician assistant) prior to your procedure. At the time of your office visit a plan will be made in conjunction with your prescribing physician about use of your blood thinner.
  Stop taking iron and vitamins with iron 5 days before the colonoscopy. Read and familiarize yourself with the preparation instructions below.

Three days prior to Procedure:

Stop taking any anti-inflammatory such as Ibuprofen, Aleve, Motrin and Advil. Discontinue fiber supplements, such as Metamucil, Citrucel, Benefiber, fiber-con, etc.  You may continue to eat fiber-containing foods.

One day before procedure:

Start on a clear liquid diet all day!  Do not eat solid food of any kind. Take you usual prescription medications (except iron).  If you have Diabetes:  You should take your diabetic medications at one half the usual dose.  Monitor your blood sugar at your usual times. Sometime between 12 Noon and 6:00pm take the 2 Dulcolax tablets.  Please keep in mind that the cleansing process will take 4 to 8 hours or longer so plan your schedule accordingly. Two hours after taking Dulcolax tablets mix the 255 gram bottle of Miralax in 64 oz of Gatorade.  Shake the solution until the Miralax is dissolved.  Drink 8 oz. every 15-30 minutes until the entire solution is gone.  Continue to drink clear liquids until bedtime.  If you become nauseated during the ingestion of the Miralax pre; stop the prep for 45 minutes then resume. 8pm take 2 Dulcolax tablets Nothing to eat or drink after midnight.

On the day of the procedure:

If you take heart or blood pressure medications, please take it early in the morning of your procedure with a small amount of water.  If you are diabetic, please DO NOT take your diabetic medication on the day of your procedure (and check with your PCP or endocrinologist regarding diabetic medication). You will be sedated for the procedure.You must have someone drive you home after the procedure or it will not be performed. This is for your safety. You may not take a taxi by yourself or ride the bus.

PLEASE NOTE:

  • Attention Patients scheduled in Digestive Healthcare’s Endoscopy Lab: Your driver must check in and wait for you in the Endoscopy waiting room. It generally takes 1 ½ - 2 hours for a procedure to be completed.
  • Bring your insurance cards and picture ID with you.
  • Bring a list of your medications.
  • Leave your car keys and parking ticket with your driver.
  • If you have any special needs please notify the staff prior to your procedure (Pacemaker, internal defibrillator, latex allergy, need interpreter).
  • Wear comfortable clothes to your procedure. Please wear shoes that will remain on your feet (i.e. No flip flops, sandals or backless shoes)*

If you cannot keep your appointment you must call and cancel the appointment 72 hours prior to the appointment to avoid being charged a cancellation or no show fee of $150.00.

When you receive your statement from this procedure, there will be an invoice for the doctor’s fee, an invoice for the endoscopy center (supplies and nursing care), anesthesia invoice for Propofol and you may receive a separate bill from the Pathology laboratory if biopsies are obtained. If you have any questions regarding insurance or pre-certification, please call our billing office at 404-603-3543. **If your insurance does not cover this procedure and you have been notified that there is a deductible or Coinsurance that you need to pay, please bring a credit card (VISA, MC or AMEX only) or a check. ***Digestive Healthcare of Georgia Endoscopy Center is Co-Owned by the physicians of Digestive Healthcare and Piedmont Hospital. ***
Large Volume Bowel Prep and Colonoscopy Preparation Instructions(printable version)

What is a colonoscopy?

A colonoscopy is the most accurate test for detecting colon polyps and colon cancer, and the only test where polyps can be removed. During this procedure, a doctor examines the lining of your large intestine and rectum through a flexible tube called a colonoscope. The colonoscope is inserted into the anus and advanced slowly through the colon. If polyps or other abnormalities are found, the doctor may remove them for further examination or biopsy.

The bowel prep is the most important factor in ensuring you get the most thorough and complete exam during your colonoscopy. Small polyps can be missed if they are covered with retained stool. If your bowel prep is incomplete, your exam may need to be repeated on another day or you may need to return sooner for your next colonoscopy.

PRE-PROCEDURE CHECKLIST

If you have diabetes, ask your regular doctor for diet and medication restrictions. Do not take your oral diabetes medicine on the day of your procedure. If you take metformin, stop taking it the day before your colonoscopy. Also, please bring your Insulin and Insulin syringes with you to your procedure; we will check your blood sugar before and after the procedure.

If you take a medication to thin your blood

  • Do NOT stop taking your daily Aspirin or NSAIDs. If you are taking a daily Aspirin or NSAIDS we want you to continue to take your medication. On the day of your procedure you can make your gastroenterologist aware of the medication you are taking and the amount you are taking.
  • If you take a medication to thin your blood (such as Coumadin, Plavix, Pradaxa, Lovenox, Xarelto, Eliquis, Brilinta, Effient, Ticlid, Disgren, Pletal...) you must be seen in our office (can be seen by nurse practitioner or physician assistant) prior to your procedure. At the time of your office visit a plan will be made in conjunction with your prescribing physician about use of your blood thinner.

If you currently are taking other prescription medications, you may continue to take all other medications as instructed by the prescribing physician.

If you are or may be pregnant, please discuss the risks and benefits of this procedure with your doctor.

You MUST arrange for a ride for the day of your exam. If you fail to arrange transportation with a responsible adult, your procedure will need to be cancelled and rescheduled. Your driver must check in with you and stay in our office the entire time that you are there. We cannot start your procedure if you do not have a driver present. In addition to this, you may not take a taxi or ride the bus by yourself. This is for your safety.

If you must cancel or reschedule your appointment, please call 404-355-3200 for Atlanta or 706-253-7340 for Jasper at least three days prior to your procedure to avoid any late cancellation fees.

If you have any special needs, such as a pacemaker, internal defibrillator, latex allergy, need for an interpreter, or if you are allergic to eggs, nuts or soy, please contact our office immediately. Your procedure may need to be rescheduled.

Remember even while taking split prep you cannot have any liquids, ice chips, water or food two hours before your procedure. If you do, the procedure may be delayed.

STOP AND READ:

  • If you do not follow these instructions your procedure may be delayed or cancelled.
  • Please note that you cannot have any solid foods starting the day before your procedure.
  • The day of the procedure you may not have gum, mints, ice chips, hard candies or cigarettes.
  • You may have clear liquids up to two and a half hours before your procedure. This includes the prep solution.
  • You cannot have anything in your mouth (gum, mint, cough drop, ice chips etc.) two and a half hours before your procedure.

PREPARATION

To ensure a successful exam, please follow all instructions carefully. Failure to accurately and completely prepare for your exam may result in the need for an additional procedure and both procedures will be billed to your insurance.

The day before your exam:

  • On the day before your procedure begin a clear liquid diet. You may have beverages such as tea, coffee, carbonated drinks, strained fruit juices, Popsicles (NOT RED) Jell-O (NOT RED), broth or bouillon. No creamed soups or milk products. You may have clear liquids up until midnight the day before your procedure.
  • Your doctor gave you a prescription for one of the following: Colyte, Golytely or Nulytely. Solutions are the same, just different bands. This is the liquid laxative that will cleanse the colon for your procedure. Prepare and chill the Nulytely the morning before the procedure. When taking this prep please stay close to home (bathroom).
    • 1:00 pm – Take Ducolax (4) tablets. {IF YOU PLAN ON BEING AT WORK THAT DAY TAKE DULCOLAX AT 8pm}.
    • 3:30 PM – Take Reglan (1) 10mg this will help with the nausea and bloating.
    • 4:00 pm to 8:00 pm – Start drinking the Nulytely solution. Drink an 8 oz glass every 15-20 minutes until ALL has been consumed and the returns are clear. {You can take clear sugar free lemon drops, mints etc. in between each of the Nulytely prep}. Clear results are clear, yellow or green colored water. You may have sandy sediment that sinks to the bottom of the toilet. This is okay. If you are note able to drink the laxative and or begin vomiting please call 404-355-3200. You should begin having results within 1-3 hours. Should you feel full and nauseated while drinking, stop drinking for 30 minutes then resume.
  • Do not drink red liquids or alcoholic beverages.

The day of your exam:

  • You may take your usual medications with up to 4 oz. of water at least 2.5 hours prior to your procedure. Be sure to wear comfortable clothes and shoes that will remain on your feet (preferably tennis shoes) to your procedure. Please do NOT wear flip flops, sandals, or backless shoes.
  • Please remove ALL jewelry including earrings, rings, bracelets, anklets, necklaces, and watches prior to the procedure, and be sure to leave any and all valuables at home. DHEC will not be responsible for any lost valuables (including eyeglasses and dentures).
  • Plan to spend up to two hours at the endoscopy center the day of your procedure. The exam itself takes about 25 minutes to complete.

Before the exam:

  • You will change into a gown and robe.
  • Your medical history will be reviewed with you and you will be given a consent form to sign.
  • A nurse will insert an intravenous (IV) line into your hand or arm.

During the exam:

  • Medicine will be given through the IV line to sedate you.
  • Your heart rate and oxygen levels will be monitored. If your blood pressure is low, you may be given fluids through the IV line.
  • The doctor will insert a flexible tube - called a colonoscope - into your anus and will advance it slowly through the rectum and colon, looking for abnormal tissue or polyps.
  • If abnormal tissue or polyps are found, the doctor may remove them through the colonoscope for closer examination or biopsy. Tissue removal is painless.

What happens after the exam?

  • The doctor will talk with you about the initial results of your exam.
  • The doctor will prepare a full report for the physician who referred you for the colonoscopy.
  • You may feel bloated after the procedure. This is normal.
  • Medication given during the exam will prohibit you from driving for the rest of the day.
  • Following the exam, you may resume your normal diet. Avoid alcohol until the next day.
  • You may resume your regular activities the day after the procedure.
  • A nurse will provide you with complete discharge instructions before you leave the endoscopy center. Be sure to ask the nurse for specific instructions if you take blood thinners such as aspirin, Coumadin or Plavix.
  • Any tissue samples or polyps removed during the exam will be sent to a lab for evaluation. It may take 5-7 working days for you to be notified of the results.

Are there possible complications from a colonoscopy?

Although serious complications are rare, any medical procedure has the potential for risks. A nurse will review all potential warning signs with you before you leave the endoscopy center. Risks include:

  • Perforation, or a tear, of the lining of the colon.
  • Bleeding from the biopsy or polypectomy site if tissue was removed.
  • Reaction to medications used during the procedure.

Additional information:

Your procedure has been scheduled at one of the GI labs listed below. Please check your paperwork to make sure you arrive on time to the correct location:

DIGESTIVE HEALTHCARE ENDOSCOPY LAB is located at 95 Collier Road NW, Suite 4075. Enter the Piedmont Hospital complex at the Collier Road entrance. Park in the “South” parking deck. Take the elevator to the “Orange Level”. Cross over the glassed in covered bridge. You are now in the 95 building. You do not have to check in at the hospital. Go up to the 4th floor and look for Suite 4075. You and your driver may sign in at the window. If someone is sitting at the window, let them know you have arrived.

THE PIEDMONT HOSPITAL ENDSCOPY LAB is located on the first floor of the 77 building. It is most convenient to park in the North parking deck. Take the elevator to the bridge level (BR). You will need to go to the 77 building registration office to register for your procedure. After getting off at the bridge level you will walk through a glassed-in bridge and go straight. You will pass the 77 building (D) elevator, which will be located on your left. The registration office is located in the next hallway on your left. Once inside, a member of the registration staff will help you complete some additional paperwork, and then escort you to the GI Lab for your procedure. This should take approximately 15 minutes.

  • Bring a list of all of your current medications, including any allergy or over-the-counter medications.
  • Bring a photo ID as well as up-to-date insurance information, such as your insurance card and any referral forms that might be required by your payer.
  • If you have any special needs please notify the staff prior to your procedure (pacemaker, internal defibrillator, latex allergy, need interpreter).
  • Wear comfortable clothes to your procedure. Please wear shoes that will remain on your feet (i.e. no flip flops, sandals or backless shoes).
  • Attention: Your driver must check in and wait for you in the Endoscopy waiting room. It generally takes 1 ½ - 2 hours for a procedure to be completed.

Co-pays are required on the day of your appointment. If you have any questions about pre-certification, please call our business office at 404-603-3543.

If your insurance does not cover this procedure, for example you are a self-paying patient or you have been notified by our office that you owe a copay or coinsurance, please bring a credit card (Visa, MasterCard and AMEX), check or cash.

You may receive several statements from this procedure; your physician’s fee, a facility fee for the Endoscopy Center (supplies and nursing care), a statement for anesthesia (Propofol) and for pathology if tissue is removed during the procedure.

Digestive Healthcare of Georgia Endoscopy Center is co-owned and operated by the Physicians of Digestive Healthcare and Piedmont Hospital.

Sigmoidoscopy Preparation Instructions(printable version)

You will need to buy 2 Fleet Enemas (in the green and white box). These can be bought over the counter at the drug store. Have nothing to eat or drink from midnight the night before the procedure.

One (1) hour prior to the exam, take the 2 Fleet Enemas rectally. In order to cleanse the bowel properly, the contents of the bottle should be held in the rectum as long as possible (usually 5-7 minutes). Take them consecutively (one after the other).

If you have any questions, please call our office at 404-355-3200.

If your procedure is scheduled after 2:00pm, you may have a light breakfast before 9:00am.

This should NOT CONTAIN any fats or dairy products. After your breakfast follow the prep as stated above.

Upper Endoscopy at Digestive Healthcare Endoscopy Center Instructions(printable version)

What is an upper endoscopy?

An upper endoscopy is a test performed to evaluate symptoms of persistent upper abdominal pain, bleeding, nausea, vomiting or difficulty swallowing. During the procedure, a doctor examines the lining of your esophagus, stomach and the first part of your small intestine through a thin, flexible tube called an endoscope. If growths or other abnormalities are found during the procedure, the doctor may remove the abnormal tissue for further examination, or biopsy. An upper endoscopy may also be used to treat various conditions of the upper gastrointestinal (GI) tract, such as narrowing, abnormal growths or bleeding.

PRE-PROCEDURE CHECKLIST

If you have diabetes, ask your regular doctor for diet and medication restrictions. Do not take your oral diabetes medicine on the day of your procedure. If you take metformin, stop taking it the day before your colonoscopy. Also, please bring your Insulin and Insulin syringes with you to your procedure; we will check your blood sugar before and after the procedure.

If you take a medication to thin your blood (such as Coumadin, Plavix, Pradaxia or Lovenox) be sure to discuss this with the doctor performing your procedure. You must get your prescribing doctor's permission if you need to stop these medications.

If you currently are taking other prescription medications, you may continue to take all other medications as instructed by the prescribing physician.

If you are or may be pregnant, please discuss the risks and benefits of this procedure with your doctor.

You MUST arrange for a ride for the day of your exam. If you fail to arrange transportation with a responsible adult, your procedure will need to be cancelled and rescheduled. Your driver must check in with you and stay in our office the entire time that you are there. We cannot start your procedure if you do not have a driver present. In addition to this, you may not take a taxi or ride the bus by yourself. This is for your safety.

If you must cancel or reschedule your appointment, please call 404-355-3200 at least three days prior to your procedure to avoid a late cancellation fee of $150.00.

If you have any special needs, such as a pacemaker, internal defibrillator, latex allergy, need for an interpreter, or if you are allergic to eggs, nuts or soy, please contact our office immediately. Your procedure may need to be rescheduled.

STOP AND READ:

  • If you do not follow these instructions your procedure may be delayed or cancelled.
  • Please note that you cannot have any solid foods after midnight the night before your procedure. This includes gum, mints, ice chips and cigarettes.
  • You may have clear liquids up to two and a half hours before your procedure.
  • You may take your medicines with clear liquids.
  • You cannot have anything in your mouth (gum, mint, cough drop, ice chips etc.) two and a half hours before your procedure.

PREPARATION

To ensure a successful exam, please follow all instructions carefully. Failure to accurately and completely prepare for your exam may result in the need for an additional procedure and both procedures will be billed to your insurance.

The day before your exam:

  • Stop eating solid foods at midnight.
  • Clear liquids are okay to drink (examples: water, Gatorade, clear broth, black coffee and apple juice).
  • Do not drink red liquids or alcoholic beverages.

The day of your exam:

  • Pre-menopausal women will be asked to give a urine sample for a pregnancy test.
  • You may take your usual medications (exceptions noted above) with up to 4 oz. of water at least 2.5 hours prior to your procedure. Be sure to wear comfortable clothes and shoes that will remain on your feet (preferably tennis shoes) to your procedure. Please do NOT wear flip flops, sandals, or backless shoes.
  • Please remove ALL jewelry including earrings, rings, bracelets, anklets, necklaces, and watches prior to the procedure, and be sure to leave any and all valuables at home. DHEC will not be responsible for any lost valuables (including eyeglasses and dentures).
  • Plan to spend up to two hours at the endoscopy center the day of your procedure. The exam itself takes about 25 minutes to complete.

Before the exam:

  • You will change into a gown and robe.
  • Your medical history will be reviewed with you and you will be given a consent form to sign.
  • A nurse will insert an intravenous (IV) line into your hand or arm.

During the exam:

  • Medicine will be given through the IV line to sedate you.
  • Your heart rate and oxygen levels will be monitored. If your blood pressure is low, you may be given fluids through the IV line.
  • The doctor will insert a flexible, hollow tube - called an endoscope - into your mouth and will advance it slowly through the esophagus, stomach and duodenum (the first part of your small intestine).
  • If you have difficulty swallowing, and the doctor finds a narrowing in your esophagus, it may be possible for the area to be expanded during the exam.
  • If abnormal tissue is found, the doctor may remove it through the endoscope for closer examination, or biopsy. Tissue removal is painless.

What happens after the exam?

  • The doctor will talk with you about the initial results of your exam.
  • The doctor will prepare a full report for the physician who referred you for the upper endoscopy.
  • You may feel bloated after the procedure. This is normal.
  • Your throat may feel sore for a short time.
  • Medication given during the exam will prohibit you from driving for the rest of the day.
  • Following the exam, you may resume your normal diet. Avoid alcohol until the next day.
  • You may resume your regular activities the day after the procedure.
  • A nurse will provide you with complete discharge instructions before you leave the endoscopy center. Be sure to ask the nurse for specific instructions if you take blood thinners such as aspirin, Coumadin or Plavix.
  • Any tissue samples removed during the exam will be sent to a lab for evaluation. It may take 5-7 working days for you to be notified of the results.

Are there possible complications from an upper endoscopy?

Although serious complications are rare, any medical procedure has the potential for risks. A nurse will review all potential warning signs with you before you leave the endoscopy center. Risks include:

  • Perforation, or a tear, of the lining of the stomach or esophagus.
  • Bleeding from the biopsy site if tissue was removed.
  • Reaction to medications used during the procedure.

Additional information:

DIGESTIVE HEALTHCARE ENDOSCOPY LAB is located at 95 Collier Road NW, Suite 4075. Enter the Piedmont Hospital complex at the Collier Road entrance. Park in the “South” parking deck. Take the elevator to the “Orange Level”. Cross over the glassed in covered bridge. You are now in the 95 building. You do not have to check in at the hospital. Go up to the 4th floor and look for Suite 4075. You and your driver may sign in at the window. If someone is sitting at the window, let them know you have arrived.
  • Bring a list of all of your current medications, including any allergy or over-the-counter medications.
  • Bring a photo ID as well as up-to-date insurance information, such as your insurance card and any referral forms that might be required by your payer.
  • Co-pays are required on the day of your appointment. If you have any questions about pre-certification, please call our business office at 404-603-3543.
  • If your insurance does not cover this procedure, for example you are a self-paying patient or you have been notified by our office that you owe a copay or coinsurance, please bring a credit card (Visa, MasterCard and AMEX), check or cash.
  • You may receive several statements from this procedure; your physician’s fee, a facility fee for the Endoscopy Center (supplies and nursing care), a statement for anesthesia (Propofol) and for pathology if tissue is removed during the procedure.
Liver Biopsy Prep(printable version)

Do not take any aspirin, Motrin or similar medication ten days before and three days after the procedure.

Do not eat or drink anything after midnight the night before the procedure.

Please report to the main ER admitting office at the day of the procedure.

You may need to have blood work drawn two days prior to the procedure. Please call our office to see if this will be necessary.

If you are unable to keep your scheduled appointment please contact our office in advance so that we may cancel and reschedule the appointment if necessary.

Upper Endoscopy at Piedmont Hospital Instructions(printable version)

What is an upper endoscopy?

An upper endoscopy is a test performed to evaluate symptoms of persistent upper abdominal pain, bleeding, nausea, vomiting or difficulty swallowing. During the procedure, a doctor examines the lining of your esophagus, stomach and the first part of your small intestine through a thin, flexible tube called an endoscope. If growths or other abnormalities are found during the procedure, the doctor may remove the abnormal tissue for further examination, or biopsy. An upper endoscopy may also be used to treat various conditions of the upper gastrointestinal (GI) tract, such as narrowing, abnormal growths or bleeding.

PRE-PROCEDURE CHECKLIST

If you have diabetes, ask your regular doctor for diet and medication restrictions. Do not take your oral diabetes medicine on the day of your procedure. If you take metformin, stop taking it the day before your endoscopy. Also, please bring your Insulin and Insulin syringes with you to your procedure; we will check your blood sugar before and after the procedure.

If you take a medication to thin your blood (such as Coumadin, Plavix, Pradaxia or Lovenox) be sure to discuss this with the doctor performing your procedure. You must get your prescribing doctor's permission if you need to stop these medications.

If you currently are taking other prescription medications, you may continue to take all other medications as instructed by the prescribing physician.

If you are or may be pregnant, please discuss the risks and benefits of this procedure with your doctor.

You MUST arrange for a ride for the day of your exam. If you fail to arrange transportation with a responsible adult, your procedure will need to be cancelled and rescheduled. Your driver must check in with you and stay in our office the entire time that you are there. We cannot start your procedure if you do not have a driver present. In addition to this, you may not take a taxi or ride the bus by yourself. This is for your safety.

If you must cancel or reschedule your appointment, please call 404-355-3200 at least three days prior to your procedure to avoid any late cancellation fees.

If you have any special needs, please notify the admitting nurse prior to your procedure (i.e. a pacemaker, internal defibrillator, latex allergy, need for an interpreter, or are allergic to eggs, nuts, or soy).

Please be certain to have all of the following items with you:

  • Your completed pink Pre-Anesthesia Evaluation, which was included in your procedure packet.
  • A list of all your current prescription medications and all your over the counter medications.
  • A photo ID.
  • All your up-to-date insurance information, such as your insurance card or required referral forms.

DAY OF EXAMINATION

The Piedmont Hospital GI lab is located on the first floor of the 77 building. It is most convenient to park in the North parking deck. Take the elevator to the bridge level (BR). You will need to go to the 77 building registration office to register for your procedure. After getting off at the bridge level you will walk through a glassed-in bridge and go straight. You will pass the 77 building (D) elevator, which will be located on your left. The registration office is located in the next hallway on your left. Once inside, a member of the registration staff will help you complete some additional paperwork, and then escort you to the GI Lab for your procedure. This should take approximately 15 minutes.

STOP AND READ:

  • If you do not follow these instructions your procedure may be delayed or cancelled.
  • Please note that you cannot have any solid foods after midnight the night before your procedure. This includes gum, mints, ice chips and cigarettes.
  • You may have clear liquids up to two and a half hours before your procedure.
  • You may take your medicines with clear liquids.
  • You cannot have anything in your mouth (gum, mint, cough drop, ice chips etc.) two and a half hours before your procedure.

PREPARATION

To ensure a successful exam, please follow all instructions carefully. Failure to accurately and completely prepare for your exam may result in the need for an additional procedure and both procedures will be billed to your insurance.

  • Stop eating solid foods at midnight the night before your procedure.
  • Clear liquids are okay to drink (examples: water, Gatorade, clear broth, black coffee and apple juice).
  • Do not drink red liquids or alcoholic beverages.
  • You may take your usual medications (exceptions noted above) with up to 4 oz. of water at least 2.5 hours prior to your procedure. Be sure to wear comfortable clothes and shoes that will remain on your feet (preferably tennis shoes) to your procedure. Please do NOT wear flip flops, sandals, or backless shoes.
  • Please remove ALL jewelry including earrings, rings, bracelets, anklets, necklaces, and watches prior to the procedure, and be sure to leave any and all valuables at home.
  • Plan to spend up to two hours at the endoscopy center the day of your procedure. The exam itself takes about 25 minutes to complete.

Before the exam:

  • You will change into a gown and robe.
  • Your medical history will be reviewed with you.
  • You will be given a consent form to sign.
  • A nurse will insert an intravenous (IV) line into your hand or arm.
  • Pre-menopausal women will be asked to give a urine sample for a pregnancy test.

During the exam:

  • Medicine will be given through the IV line to sedate you.
  • Your heart rate and oxygen levels will be monitored. If your blood pressure is low, you may be given fluids through the IV line.
  • The doctor will insert a flexible, hollow tube - called an endoscope - into your mouth and will advance it slowly through the esophagus, stomach and duodenum (the first part of your small intestine).
  • If you have difficulty swallowing, and the doctor finds a narrowing in your esophagus, it may be possible for the area to be expanded during the exam.
  • If abnormal tissue is found, the doctor may remove it through the endoscope for closer examination, or biopsy. Tissue removal is painless.

What happens after the exam?

  • The doctor will talk with you about the initial results of your exam.
  • The doctor will prepare a full report for the physician who referred you for the endoscopy.
  • You may feel bloated after the procedure. This is normal.
  • Medication given during the exam will prohibit you from driving for the rest of the day.
  • Following the exam, you may resume your normal diet. Avoid alcohol until the next day.
  • You may resume your regular activities the day after the procedure.
  • A nurse will provide you with complete discharge instructions before you leave the endoscopy center. Be sure to ask the nurse for specific instructions if you take blood thinners such as aspirin, Coumadin or Plavix.
  • Any tissue samples removed during the exam will be sent to a lab for evaluation. It may take 5-7 working days for you to be notified of the results.
Upper Endoscopy (BRAVO) at Piedmont Hospital Instructions(printable version)

What is an upper endoscopy?

An upper endoscopy is a test performed to evaluate symptoms of persistent upper abdominal pain, bleeding, nausea, vomiting or difficulty swallowing. During the procedure, a doctor examines the lining of your esophagus, stomach and the first part of your small intestine through a thin, flexible tube called an endoscope. If growths or other abnormalities are found during the procedure, the doctor may remove the abnormal tissue for further examination, or biopsy. An upper endoscopy may also be used to treat various conditions of the upper gastrointestinal (GI) tract, such as narrowing, abnormal growths or bleeding.

What is the Bravo pH monitoring system?

The Bravo system is a pH test to help your doctor determine if you have acid reflux. A pH test measures the degree of acidity in your esophagus. The test period usually lasts 48 hours, and measures acidity in two ways:

  • How often stomach acid flows into the lower esophagus
  • Degree of acidity during the test period

Information from the pH test helps your doctor diagnose GERD (gastroesophageal reflux disease) and plan your treatment. Bravo system consists of a capsule, approximately the size of a gel cap that is temporarily attached to the wall of your esophagus. The capsule measures pH levels in your esophagus and transmits this information wirelessly to a portable receiver you wear on your waistband.

PRE-PROCEDURE CHECKLIST

If you have diabetes, ask your regular doctor for diet and medication restrictions. Do not take your oral diabetes medicine on the day of your procedure. If you take metformin, stop taking it the day before your endoscopy. Also, please bring your Insulin and Insulin syringes with you to your procedure; we will check your blood sugar before and after the procedure.

If you take a medication to thin your blood (such as Coumadin, Plavix, Pradaxia or Lovenox) be sure to discuss this with the doctor performing your procedure. You must get your prescribing doctor's permission if you need to stop these medications.

If you currently are taking other prescription medications, you may continue to take all other medications as instructed by the prescribing physician.

If you are or may be pregnant, please discuss the risks and benefits of this procedure with your doctor.

You MUST arrange for a ride for the day of your exam. If you fail to arrange transportation with a responsible adult, your procedure will need to be cancelled and rescheduled. Your driver must check in with you and stay in our office the entire time that you are there. We cannot start your procedure if you do not have a driver present. In addition to this, you may not take a taxi or ride the bus by yourself. This is for your safety.

If you must cancel or reschedule your appointment, please call 404-355-3200 at least three days prior to your procedure to avoid a late cancellation fee of $150.00.

If you have any special needs, such as a pacemaker, internal defibrillator, latex allergy, need for an interpreter, or if you are allergic to eggs, nuts or soy, please contact our office immediately. Your procedure may need to be rescheduled.

Please be certain to have all of the following items with you:

  • Your completed pink Pre-Anesthesia Evaluation, which was included in your procedure packet.
  • A list of all your current prescription medications and all your over the counter medications.
  • A photo ID.
  • All your up-to-date insurance information, such as your insurance card or required referral forms.

If you currently are taking other prescription medications, you may continue to take all other medications as instructed by the prescribing physician. However, your doctor may want to do this study off of the following medications for 10 days: Aciphex® (rabeprazole), Nexium® (esomeprazole), Prevacid® (lansoprazole), Dexilant® (dexlansoprazole), Prilosec® (omeprazole), Protonix® (pantoprazole) or Zegerid® (omeprazole/ sodium bicarbonate). The following medications may not be taken for two days: Pepcid® (famotidine), Tagamet® (cimetidine), Zantac® (ranitidine), Axid® (nizatidine). Your doctor will let you know prior to the test if you should stop your medications or continue your medications.

DAY OF EXAMINATION

The Piedmont Hospital GI lab is located on the first floor of the 77 building. It is most convenient to park in the North parking deck. Take the elevator to the bridge level (BR). You will need to go to the 77 building registration office to register for your procedure. After getting off at the bridge level you will walk through a glassed-in bridge and go straight. You will pass the 77 building (D) elevator, which will be located on your left. The registration office is located in the next hallway on your left. Once inside, a member of the registration staff will help you complete some additional paperwork, and then escort you to the GI Lab for your procedure. This should take approximately 15 minutes.

STOP AND READ:

  • If you do not follow these instructions your procedure may be delayed or cancelled.
  • Please note that you cannot have any solid foods after midnight the night before your procedure. This includes gum, mints, ice chips and cigarettes.
  • You may have clear liquids up to two and a half hours before your procedure.
  • You may take your medicines with clear liquids.
  • You cannot have anything in your mouth (gum, mint, cough drop, ice chips etc.) two and a half hours before your procedure.

PREPARATION

To ensure a successful exam, please follow all instructions carefully. Failure to accurately and completely prepare for your exam may result in the need for an additional procedure and both procedures will be billed to your insurance.

  • Stop eating solid foods at midnight.
  • Clear liquids are okay to drink (examples: water, Gatorade, clear broth, black coffee and apple juice).
  • Do not drink red liquids or alcoholic beverages.
  • You may have nothing by mouth (no water, gum, mints, ice cubes, etc.) at least 4 hours before your exam.
  • You may take your usual medications (exceptions noted above) with up to 4 oz. of water at least 4 hours prior to your procedure. Be sure to wear comfortable clothes and shoes that will remain on your feet (preferably tennis shoes) to your procedure. Please do NOT wear flip flops, sandals, or backless shoes.
  • Please remove ALL jewelry including earrings, rings, bracelets, anklets, necklaces, and watches prior to the procedure, and be sure to leave any and all valuables at home.
  • Plan to spend up to two hours at the endoscopy center the day of your procedure. The exam itself takes about 10-15 minutes to complete.

Before the exam:

  • You will change into a gown and robe.
  • Your medical history will be reviewed with a nurse and an anesthesiologist.
  • You will be given a consent form to sign.
  • A nurse will insert an intravenous (IV) line into your hand or arm.
  • Pre-menopausal women will be asked to give a urine sample for a pregnancy test.

During the exam:

  • Medicine will be given through the IV line to sedate you.
  • Your heart rate and oxygen levels will be monitored. If your blood pressure is low, you may be given fluids through the IV line.
  • The doctor will insert a flexible, hollow tube - called an endoscope - into your mouth and will advance it slowly through the esophagus, stomach and duodenum (the first part of your small intestine).
  • If abnormal tissue is found, the doctor may remove it through the endoscope for closer examination, or biopsy. Tissue removal is painless.
  • The doctor will pass the Bravo capsule into the esophagus. After the capsule is in place, suction is applied. This draws a small amount of tissue into the capsule to allow for the attachment.

What happens after the exam?

  • The doctor will talk with you about the initial results of your exam.
  • The doctor will prepare a full report for the physician who referred you for the upper endoscopy.
  • You may feel bloated after the procedure. This is normal.
  • Your throat may feel sore for a short time.
  • Medication given during the exam will prohibit you from driving for the rest of the day.
  • Following the exam, you may resume your normal diet. Avoid alcohol until the next day.
  • You may resume your regular activities the day after the procedure.
  • A nurse will provide you with complete discharge instructions before you leave the endoscopy center. Be sure to ask the nurse for specific instructions if you take blood thinners such as aspirin, Coumadin or Plavix.
  • Any tissue samples removed during the exam will be sent to a lab for evaluation. It may take 5-7 working days for you to be notified of the results.

As soon as the capsule is attached, it begins measuring the pH levels in your esophagus. The capsule transmits these measurements wirelessly to a small receiver you wear on your waistband or belt. As long as the capsule and receiver are within 3 feet of each other, the system will measure and record your pH levels. This means you can place the receiver nearby when bathing or sleeping without interrupting the test.

The receiver is about the size of a standard pager, and has three symptom buttons. You will be instructed to press the appropriate button during the study when you experience heartburn, regurgitation, or chest pain. The Bravo Receiver is designed to prevent you from turning it off during the test period.

You will also be asked to record periods of eating and sleeping in a diary throughout the test. You can go about your daily routine without any restrictions.

Some people say they have a vague sensation that "something" is in their esophagus. Others say they feel the capsule when they eat or when food passes the capsule. Chewing food carefully and drinking liquids may minimize this sensation.

Please note: The capsule contains a tiny magnet, and you should not undergo an MRI study within 30 days of using the Bravo system.

When the pH study is complete, you will return the receiver and diary to your doctor's office. The information stored in the receiver will be uploaded to a computer. Your doctor will analyze your results to determine if you have acid reflux and plan the best treatment for your heartburn symptoms.

The disposable capsule will spontaneously detach and pass through your digestive system a few days after the test period. Only a small area of esophageal tissue is affected by the capsule. Please do not take any over the counter antacids during the study period, such as Tums®, Rolaids®, Maalox®, Mylanta®, Gaviscon or Carafate® (sucralfate).

What are the possible complications of Bravo?

If you have a bleeding tendency, narrowing of the esophagus, severe irritation of the esophagus, varices, obstructions, a pacemaker, or an implantable cardiac defibrillator, you should not undergo a Bravo pH test. Additionally, because the capsule contains a small magnet, you should not have an MRI study within 30 days of undergoing the Bravo pH test.

Rare complications from using the Bravo pH Monitoring System include the following events: The capsule could detach from the esophagus before the test is complete, tears in the lining of the esophagus, causing bleeding and requiring possible medical intervention, and perforation.

Upper Endoscopy (BOTOX) at Piedmont Hospital(printable version)

What is an upper endoscopy?

An upper endoscopy is a test performed to evaluate symptoms of persistent upper abdominal pain, bleeding, nausea, vomiting or difficulty swallowing. During the procedure, a doctor examines the lining of your esophagus, stomach and the first part of your small intestine through a thin, flexible tube called an endoscope. If growths or other abnormalities are found during the procedure, the doctor may remove the abnormal tissue for further examination, or biopsy. An upper endoscopy may also be used to treat various conditions of the upper gastrointestinal (GI) tract, such as narrowing, abnormal growths or bleeding.

PRE-PROCEDURE CHECKLIST

If you have diabetes, ask your regular doctor for diet and medication restrictions. Do not take your oral diabetes medicine on the day of your procedure. If you take metformin, stop taking it the day before your endoscopy. Also, please bring your Insulin and Insulin syringes with you to your procedure; we will check your blood sugar before and after the procedure.

If you take a medication to thin your blood (such as Coumadin, Plavix, Pradaxia or Lovenox) be sure to discuss this with the doctor performing your procedure. You must get your prescribing doctor's permission if you need to stop these medications.

If you currently are taking other prescription medications, you may continue to take all other medications as instructed by the prescribing physician.

If you are or may be pregnant, please discuss the risks and benefits of this procedure with your doctor.

You MUST arrange for a ride for the day of your exam. If you fail to arrange transportation with a responsible adult, your procedure will need to be cancelled and rescheduled. Your driver must check in with you and stay in our office the entire time that you are there. We cannot start your procedure if you do not have a driver present. In addition to this, you may not take a taxi or ride the bus by yourself. This is for your safety.

If you must cancel or reschedule your appointment, please call 404-355-3200 at least three days prior to your procedure to avoid any late cancellation fees.

If you have any special needs, please notify the admitting nurse prior to your procedure (i.e. a pacemaker, internal defibrillator, latex allergy, need for an interpreter, or are allergic to eggs, nuts, or soy).

Please be certain to have all of the following items with you:

  • Your completed pink Pre-Anesthesia Evaluation, which was included in your procedure packet.
  • A list of all your current prescription medications and all your over the counter medications.
  • A photo ID.
  • All your up-to-date insurance information, such as your insurance card or required referral forms.

DAY OF EXAMINATION

The Piedmont Hospital GI lab is located on the first floor of the 77 building. It is most convenient to park in the North parking deck. Take the elevator to the bridge level (BR). You will need to go to the 77 building registration office to register for your procedure. After getting off at the bridge level you will walk through a glassed-in bridge and go straight. You will pass the 77 building (D) elevator, which will be located on your left. The registration office is located in the next hallway on your left. Once inside, a member of the registration staff will help you complete some additional paperwork, and then escort you to the GI Lab for your procedure. This should take approximately 15 minutes.

STOP AND READ:

  • If you do not follow these instructions your procedure may be delayed or cancelled.
  • Please note that you cannot have any solid foods starting the day before your procedure.
  • The day of the procedure you may not have gum, mints, ice chips, hard candies or cigarettes.
  • You cannot have anything in your mouth (gum, mint, cough drop, ice chips etc.) two and a half hours before your procedure.

PREPARATION

To ensure a successful exam, please follow all instructions carefully. Failure to accurately and completely prepare for your exam may result in the need for an additional procedure and both procedures will be billed to your insurance.

  • Stop eating solid foods 24 hours before the procedure.
  • All liquids are okay to drink.
  • Do not drink red liquids or alcoholic beverages.
  • You may take your usual medications (exceptions noted above) with up to 4 oz. of water at least 4 hours prior to your procedure. Be sure to wear comfortable clothes and shoes that will remain on your feet (preferably tennis shoes) to your procedure. Please do NOT wear flip flops, sandals, or backless shoes.
  • Please remove ALL jewelry including earrings, rings, bracelets, anklets, necklaces, and watches prior to the procedure, and be sure to leave any and all valuables at home.
  • Plan to spend up to two hours at the endoscopy center the day of your procedure. The exam itself takes about 10-15 minutes to complete.

Before the exam:

  • You will change into a gown and robe.
  • Your medical history will be reviewed with a nurse and an anesthesiologist.
  • You will be given a consent form to sign.
  • A nurse will insert an intravenous (IV) line into your hand or arm.
  • Pre-menopausal women will be asked to give a urine sample for a pregnancy test.

During the exam:

  • Medicine will be given through the IV line to help you relax and feel drowsy.
  • Your heart rate and oxygen levels will be monitored. If your blood pressure is low, you may be given fluids through the IV line.
  • The doctor will insert a flexible, hollow tube - called an endoscope - into your mouth and will advance it slowly through the esophagus, stomach and duodenum (the first part of your small intestine).
  • The doctor may inject Botox into your esophagus during the exam.
  • If abnormal tissue is found, the doctor may remove it through the endoscope for closer examination, or biopsy. Tissue removal is painless.

What happens after the exam?

  • The doctor will talk with you about the initial results of your exam.
  • The doctor will prepare a full report for you and the physician who referred you for the upper endoscopy.
  • You may feel bloated after the procedure. This is normal.
  • Your throat may feel sore for a short time.
  • Medication given during the exam will prohibit you from driving for the rest of the day.
  • Following the exam, you may resume your normal diet. Avoid alcohol until the next day.
  • You may resume your regular activities the day after the procedure.
  • A nurse will provide you with complete discharge instructions before you leave the endoscopy center. Be sure to ask the nurse for specific instructions if you take blood thinners such as aspirin, Coumadin or Plavix.
  • Any tissue samples removed during the exam will be sent to a lab for evaluation. It may take 5-7 working days for you to be notified of the results.
Upper Endoscopy (Achalasia) at Piedmont Hospital Instructions(printable version)

What is an upper endoscopy?

An upper endoscopy is a test performed to evaluate symptoms of persistent upper abdominal pain, bleeding, nausea, vomiting or difficulty swallowing. During the procedure, a doctor examines the lining of your esophagus, stomach and the first part of your small intestine through a thin, flexible tube called an endoscope. If growths or other abnormalities are found during the procedure, the doctor may remove the abnormal tissue for further examination, or biopsy. An upper endoscopy may also be used to treat various conditions of the upper gastrointestinal (GI) tract, such as narrowing, abnormal growths or bleeding.

PRE-PROCEDURE CHECKLIST

If you have diabetes, ask your regular doctor for diet and medication restrictions. Do not take your oral diabetes medicine on the day of your procedure. If you take metformin, stop taking it the day before your endoscopy. Also, please bring your Insulin and Insulin syringes with you to your procedure; we will check your blood sugar before and after the procedure.

If you take a medication to thin your blood (such as Coumadin, Plavix, Pradaxia or Lovenox) be sure to discuss this with the doctor performing your procedure. You must get your prescribing doctor's permission if you need to stop these medications.

If you currently are taking other prescription medications, you may continue to take all other medications as instructed by the prescribing physician.

If you are or may be pregnant, please discuss the risks and benefits of this procedure with your doctor.

You MUST arrange for a ride for the day of your exam. If you fail to arrange transportation with a responsible adult, your procedure will need to be cancelled and rescheduled. Your driver must check in with you and stay in our office the entire time that you are there. We cannot start your procedure if you do not have a driver present. In addition to this, you may not take a taxi or ride the bus by yourself. This is for your safety.

If you must cancel or reschedule your appointment, please call 404-355-3200 at least three days prior to your procedure to avoid any late cancellation fees.

If you have any special needs, please notify the admitting nurse prior to your procedure (i.e. a pacemaker, internal defibrillator, latex allergy, need an interpreter, or are allergic to eggs, nuts, or soy).

Please be certain to have all of the following items with you:

  • Your completed pink Pre-Anesthesia Evaluation, which was included in your procedure packet.
  • A list of all your current prescription medications and all your over the counter medications.
  • A photo ID.
  • All your up-to-date insurance information, such as your insurance card or required referral forms.

DAY OF EXAMINATION

The Piedmont Hospital GI lab is located on the first floor of the 77 building. It is most convenient to park in the North parking deck. Take the elevator to the bridge level (BR). You will need to go to the 77 building registration office to register for your procedure. After getting off at the bridge level you will walk through a glassed-in bridge and go straight. You will pass the 77 building (D) elevator, which will be located on your left. The registration office is located in the next hallway on your left. Once inside, a member of the registration staff will help you complete some additional paperwork, and then escort you to the GI Lab for your procedure. This should take approximately 15 minutes.

STOP AND READ:

  • If you do not follow these instructions your procedure may be delayed or cancelled.
  • Please note that you cannot have any solid foods starting the day before your procedure.
  • The day of the procedure you may not have gum, mints, ice chips, hard candies or cigarettes.
  • You cannot have anything in your mouth (gum, mint, cough drop, ice chips etc.) two and a half hours before your procedure.

PREPARATION

To ensure a successful exam, please follow all instructions carefully. Failure to accurately and completely prepare for your exam may result in the need for an additional procedure and both procedures will be billed to your insurance.

  • Stop eating solid foods 24 hours before the procedure.
  • All liquids are okay to drink.
  • Do not drink red liquids or alcoholic beverages.
  • You may take your usual medications (exceptions noted above) with up to 4 oz. of water at least 4 hours prior to your procedure. Be sure to wear comfortable clothes and shoes that will remain on your feet (preferably tennis shoes) to your procedure. Please do NOT wear flip flops, sandals, or backless shoes.
  • Please remove ALL jewelry including earrings, rings, bracelets, anklets, necklaces, and watches prior to the procedure, and be sure to leave any and all valuables at home.
  • Plan to spend up to two hours at the endoscopy center the day of your procedure. The exam itself takes about 10-15 minutes to complete.

Before the exam:

  • You will change into a gown and robe.
  • Your medical history will be reviewed with a nurse and an anesthesiologist.
  • You will be given a consent form to sign.
  • A nurse will insert an intravenous (IV) line into your hand or arm.
  • Pre-menopausal women will be asked to give a urine sample for a pregnancy test.

During the exam:

  • Medicine will be given through the IV line to sedate you.
  • Your heart rate and oxygen levels will be monitored. If your blood pressure is low, you may be given fluids through the IV line.
  • The doctor will insert a flexible, hollow tube - called an endoscope - into your mouth and will advance it slowly through the esophagus, stomach and duodenum (the first part of your small intestine).
  • The doctor may expand your esophagus with a large balloon during the exam.
  • If abnormal tissue is found, the doctor may remove it through the endoscope for closer examination, or biopsy. Tissue removal is painless.

What happens after the exam?

  • The doctor will talk with you about the initial results of your exam.
  • You will get an x-ray before discharge to make certain that there has not been a complication. There are complications with this procedure about 1% of the time. If there is a complication, you will be admitted to the hospital and may have surgery.
  • The doctor will prepare a full report for you and the physician who referred you for the upper endoscopy.
  • You may feel bloated after the procedure. This is normal.
  • Your throat may feel sore for a short time.
  • Medication given during the exam will prohibit you from driving for the rest of the day.
  • Following the exam, you may resume your normal diet. Avoid alcohol until the next day.
  • You may resume your regular activities the day after the procedure.
  • A nurse will provide you with complete discharge instructions before you leave the endoscopy center. Be sure to ask the nurse for specific instructions if you take blood thinners such as aspirin, Coumadin or Plavix.
  • Any tissue samples removed during the exam will be sent to a lab for evaluation. It may take 5-7 working days for you to be notified of the results.
 
Halo (BARRX) at Piedmont Hospital(printable version)

What is a Halo "BARRX" procedure?

Halo is a procedure that uses radio frequency (RF) energy delivered to a specific area in the esophagus where Barrett’s esophagus exists. Barrett's esophagus is a condition in which the esophagus changes so that some of the esophageal lining is replaced by a type of tissue similar to that normally found in the intestine. This change can sometimes lead to cancer of the esophagus.

During the Halo procedure, RF energy will destroy the Barrett’s cells without destroying the normal tissue in the deeper layers of the esophagus. The esophagus is expanded by a balloon and the RF energy heats the Barrett's cells and destroys them allowing healthy new tissue to grow in place.

Most people need three to four Halo treatment sessions to achieve a cure. Some people will need more, some less. Halo treatment sessions are usually performed every two to three months until there is no more visible Barrett's esophagus. Your doctor will then take biopsy samples of your esophagus, similar to previous surveillance endoscopies you may have had to monitor your Barrett's esophagus. This is to confirm that your Barrett's esophagus is gone. In the peer-reviewed medical literature, published cure rates of Barrett's esophagus are roughly 80% with radio frequency ablation.

PRE-PROCEDURE CHECKLIST

If you have diabetes, ask your regular doctor for diet and medication restrictions. Do not take your oral diabetes medicine on the day of your procedure. If you take metformin, stop taking it the day before your endoscopy. Please bring your Insulin and Insulin syringes with you to your procedure; we will check your blood sugar before and after the procedure.

If you take a medication to thin your blood (such as Coumadin, Plavix, Pradaxia or Lovenox) be sure to discuss this with the doctor performing your procedure. You must get your prescribing doctor's permission if you need to stop these medications.

If you currently are taking other prescription medications, you may continue to take all other medications as instructed by the prescribing physician.

If you are or may be pregnant, please discuss the risks and benefits of this procedure with your doctor.

You MUST arrange for a ride for the day of your exam. If you fail to arrange transportation with a responsible adult, your procedure will need to be cancelled and rescheduled. Your driver must check in with you and stay in our office the entire time that you are there. We cannot start your procedure if you do not have a driver present. In addition to this, you may not take a taxi or ride the bus by yourself. This is for your safety.

If you must cancel or reschedule your appointment, please call 404-355-3200 at least three days prior to your procedure to avoid any late cancellation fees.

If you have any special needs,, please notify the admitting nurse prior to your procedure (i.e. a pacemaker, internal defibrillator, latex allergy, need for an interpreter, or are allergic to eggs, nuts, or soy).

Please be certain to have all of the following items with you:

  • Your completed pink Pre-Anesthesia Evaluation, which was included in your procedure packet.
  • A list of all your current prescription medications and all your over the counter medications.
  • A photo ID.
  • All your up-to-date insurance information, such as your insurance card or required referral forms.

DAY OF EXAMINATION

The Piedmont Hospital GI lab is located on the first floor of the 77 building. It is most convenient to park in the North parking deck. Take the elevator to the bridge level (BR). You will need to go to the 77 building registration office to register for your procedure. After getting off at the bridge level you will walk through a glassed-in bridge and go straight. You will pass the 77 building (D) elevator, which will be located on your left. The registration office is located in the next hallway on your left. Once inside, a member of the registration staff will help you complete some additional paperwork, and then escort you to the GI Lab for your procedure. This should take approximately 15 minutes.

STOP AND READ:

  • If you do not follow these instructions your procedure may be delayed or cancelled.
  • Please note that you cannot have any solid foods starting the day before your procedure.
  • The day of the procedure you may not have gum, mints, ice chips, hard candies or cigarettes.
  • You cannot have anything in your mouth (gum, mint, cough drop, ice chips etc.) two and a half hours before your procedure.

PREPARATION

To ensure a successful exam, please follow all instructions carefully. Failure to accurately and completely prepare for your exam may result in the need for an additional procedure and both procedures will be billed to your insurance.

  • Stop eating solid foods at midnight.
  • Clear liquids are okay to drink (examples: water, Gatorade, clear broth, black coffee and apple juice).
  • Do not drink red liquids or alcoholic beverages.
  • You may have nothing by mouth (no water, gum, mints, ice cubes, etc.) at least 4 hours before your exam.
  • You may take your usual medications (exceptions noted above) with up to 4 oz. of water at least 4 hours prior to your procedure. Be sure to wear comfortable clothes and shoes that will remain on your feet (preferably tennis shoes) to your procedure. Please do NOT wear flip flops, sandals, or backless shoes.
  • Please remove ALL jewelry including earrings, rings, bracelets, anklets, necklaces, and watches prior to the procedure, and be sure to leave any and all valuables at home.
  • Plan to spend up to two hours at the endoscopy center the day of your procedure. The exam itself takes about 30-60 minutes to complete.

Before the exam:

  • You will change into a gown and robe.
  • Your medical history will be reviewed with a nurse and an anesthesiologist.
  • You will be given a consent form to sign.
  • A nurse will insert an intravenous (IV) line into your hand or arm.
  • Pre-menopausal women will be asked to give a urine sample for a pregnancy test.

During the exam:

  • Medicine will be given through the IV line to help you relax and feel drowsy.
  • Your heart rate and oxygen levels will be monitored.
  • The doctor will insert a flexible, hollow tube - called an endoscope - into your mouth and will advance it slowly through the esophagus, stomach and duodenum (the first part of your small intestine).

What should I expect after the procedure?

  • You will rest for 30 to 60 minutes after the procedure.
  • The doctor will talk with you about the results of your Halo procedure before you leave the endoscopy center.
  • A nurse will provide you with complete discharge instructions before you leave the endoscopy center. Be sure to ask the nurse for specific instructions if you take blood thinners such as aspirin, Coumadin or Plavix.
  • Your throat may feel sore, and it may be painful to swallow.
  • You may experience mild chest pain or nausea for two to three days. This is normal.
  • Medication or anesthesia given during the procedure will prohibit you from driving for the rest of the day.
  • Diet instruction will be discussed with you before you leave the endoscopy center. A liquid diet may be recommended for one or two days following therapy.
  • You should avoid sharp-edged foods (such as chips, nuts, popcorn, croutons, etc.) during this period.
  • You may resume your regular activities the day after the procedure.
  • A follow-up endoscopy exam is necessary two to three months after treatment to make certain that all abnormal cells have been eliminated.

Are there possible complications from a Halo procedure?

Although serious complications are rare, any medical procedure has the potential for risks. A nurse will review all potential warning signs with you before you leave the endoscopy center. Risks include:

  • Perforation, or a tear, of the lining of the lining of the stomach or esophagus.
  • Bleeding from the biopsy site, if any tissue was removed.
  • Reaction to medications used during the procedure.
 
ERCP at Piedmont Hospital Instructions(printable version)

What is an ERCP?

ERCP Is a specialized technique used to study the ducts (drainage routes) of the liver, gallbladder, and pancreas (the drainage channels from the liver are called bile ducts or biliary ducts). When performed by physicians with special training in this procedure, ERCP can be accomplished in 90-95% of patients. ERCP is a valuable tool that is used for diagnosis and treatment of many diseases of the pancreas, bile ducts, liver, and gallbladder. Structural abnormalities such as gallstones, tumors, or strictures (obstructing scar tissue) can be shown in detail and biopsies of abnormal tissue can be obtained if necessary. In some cases ERCP can be used to determine whether or not surgery is necessary and may be helpful in providing the anatomic detail the surgeon needs to plan an operation when surgery is necessary. Several conditions of the biliary or pancreatic ducts can be treated (cured or improved) by therapeutic ERCP techniques that can open the end of the bile duct, remove stones, and place stents (plastic drainage tubes) across obstructed ducts to improve their drainage.

PRE-PROCEDURE CHECKLIST

If you have diabetes, ask your regular doctor for diet and medication restrictions. Do not take your oral diabetes medicine on the day of your procedure. If you take metformin, stop taking it the day before your colonoscopy. Also, please bring your Insulin and Insulin syringes with you to your procedure; we will check your blood sugar before and after the procedure.

If you take a medication to thin your blood (such as Coumadin, Plavix, Pradaxia or Lovenox) be sure to discuss this with the doctor performing your procedure. You must get your prescribing doctor's permission if you need to stop these medications.

If you currently are taking other prescription medications, you may continue to take all other medications as instructed by the prescribing physician.

If you are or may be pregnant, please discuss the risks and benefits of this procedure with your doctor.

You MUST arrange for a ride for the day of your exam. If you fail to arrange transportation with a responsible adult, your procedure will need to be cancelled and rescheduled. Your driver must check in with you and stay in our office the entire time that you are there. We cannot start your procedure if you do not have a driver present. In addition to this, you may not take a taxi or ride the bus by yourself. This is for your safety.

If you must cancel or reschedule your appointment, please call 404-355-3200 at least three days prior to your procedure to avoid any late cancellation fees.

If you have any special needs,, please notify the admitting nurse prior to your procedure (i.e. a pacemaker, internal defibrillator, latex allergy, need for an interpreter, or are allergic to eggs, nuts, or soy).

Please be certain to have all of the following items with you:

  • Your completed pink Pre-Anesthesia Evaluation, which was included in your procedure packet.
  • A list of all your current prescription medications and all your over the counter medications.
  • A photo ID.
  • All your up-to-date insurance information, such as your insurance card or required referral forms.

DAY OF EXAMINATION

The Piedmont Hospital GI lab is located on the first floor of the 77 building. It is most convenient to park in the North parking deck. Take the elevator to the bridge level (BR). You will need to go to the 77 building registration office to register for your procedure. After getting off at the bridge level you will walk through a glassed-in bridge and go straight. You will pass the 77 building (D) elevator, which will be located on your left. The registration office is located in the next hallway on your left. Once inside, a member of the registration staff will help you complete some additional paperwork, and then escort you to the GI Lab for your procedure. This should take approximately 15 minutes.

PREPARATION

To ensure a successful exam, please follow all instructions carefully. Failure to accurately and completely prepare for your exam may result in the need for an additional procedure and both procedures will be billed to your insurance.

  • Stop eating solid foods at midnight.
  • Clear liquids are okay to drink (examples: water, Gatorade, clear broth, black coffee and apple juice).
  • Do not drink red liquids or alcoholic beverages.
  • You may have nothing by mouth (no water, gum, mints, ice cubes, etc.) at least 4 hours before your exam.
  • You may take your usual medications (exceptions noted above) with up to 4 oz. of water at least 4 hours prior to your procedure. Be sure to wear comfortable clothes and shoes that will remain on your feet (preferably tennis shoes) to your procedure. Please do NOT wear flip flops, sandals, or backless shoes.
  • Please remove ALL jewelry including earrings, rings, bracelets, anklets, necklaces, and watches prior to the procedure, and be sure to leave any and all valuables at home.
  • Plan to spend up to two hours at the endoscopy center the day of your procedure. The exam itself takes about 30-60 minutes to complete.

Before the exam:

  • You will change into a gown and robe.
  • Your medical history will be reviewed with a nurse and an anesthesiologist.
  • You will be given a consent form to sign.
  • A nurse will insert an intravenous (IV) line into your hand or arm.
  • Menstruating women under the age of 50 will be asked to give a urine sample for a pregnancy test.

During the exam:

  • Medicine will be given through the IV line to help you relax and feel drowsy.
  • Your heart rate and oxygen levels will be monitored. If your blood pressure is low, you may be given fluids through the IV line.
  • The doctor will insert a flexible, hollow tube - called an endoscope - into your mouth and will advance it slowly through the esophagus, stomach and duodenum (the first part of your small intestine). After the opening to the ducts is visually identified, a catheter (narrow plastic tube) is passed through the endoscope into the ducts. Contrast material ("dye") is then injected gently into the ducts (pancreatic or biliary) and x-rays are taken.
  • If abnormal tissue is found, the doctor may remove it through the endoscope for closer examination, or biopsy. Tissue removal is painless.

What happens after the exam?

  • The doctor will talk with you about the initial results of your exam.
  • The doctor will prepare a full report for you and the physician who referred you for the upper endoscopy.
  • You may feel bloated after the procedure. This is normal.
  • Your throat may feel sore for a short time.
  • Medication given during the exam will prohibit you from driving for the rest of the day.
  • Following the exam, you may resume your normal diet. Avoid alcohol until the next day.
  • You may resume your regular activities the day after the procedure.
  • A nurse will provide you with complete discharge instructions before you leave the endoscopy center. Be sure to ask the nurse for specific instructions if you take blood thinners such as aspirin, Coumadin or Plavix.
  • Any tissue samples removed during the exam will be sent to a lab for evaluation. It may take 5-7 working days for you to be notified of the results.

Are there possible complications from ERCP?

ERCP is generally a well-tolerated procedure when performed by physicians who have had special training and experience in this technique. However all procedures carry some risk. In ERCP, intravenous (IV) sedation is used, and localized irritation of the vein into which medications were given may cause a tender lump that may last days to weeks. The application of heat packs or hot moist towels to the area may ease the discomfort. An adverse reaction to the sedative may occur, including allergic reactions and changes in breathing, blood pressure, and heart rate.

Additional complications specific to ERCP can occur, including pancreatitis, infection, bowel perforation (a small hole in the digestive tract), and bleeding. The risks of the procedure vary with the indications for the test, what is found during the procedure, what therapeutic intervention is undertaken, and the presence of other major medical problems, such as heart or lung diseases. Published studies show the risk of pancreatitis is 5-10%, and the risk of infection, bleeding, and perforations are all less than 1%. If a complication does occur, it may result in hospitalization, blood transfusion, repeat procedure, or occasionally corrective surgery. Your physician will discuss the likelihood of complications with you before undergoing the test.

Capsule Endoscopy (Pill Cam) Instructions(printable version)

PREPARATION

To ensure the best results for your PillCam capsule endoscopy of the small bowel, follow your doctor’s instructions carefully and completely.

Day Before Capsule Endoscopy:

  • Start the prescribed liquid diet after lunch.
  • Do not eat or drink except for necessary medication with a sip of water, 10 hours before your capsule endoscopy.

Day of Capsule Endoscopy:

  • Do not take any medication 2 hours before having the exam.
  • Do not apply body lotion or powder to your abdomen.
  • Wear loose fitting, two piece clothing. Your upper clothing should be opaque, not sheer.
  • Arrive for your appointment at the scheduled time.

After swallowing the PillCam SB Capsule:

The capsule endoscopy procedure will last approximately 12 hours. Contact your doctor’s office immediately if you suffer from any abdominal pain, nausea or vomiting during your procedure.

  • You may drink colorless liquids starting 2 hours after swallowing the PillCam. Do no drink any red liquids.
  • You may have food 8 hours after ingestion. After the examination is completed, you may return to your normal diet.
  • Check the blue flashing DataRecorder light every 15 minutes to be sure it is blinking twice per second. If it stops blinking or changing color, note the time and contact your doctor.
  • Use the supplied Capsule Endoscopy Event Form to note the time of any event such as eating, drinking or a change in your activity. Return the complete Event Form to your doctor at the time you return the equipment.
  • Avoid strong electromagnetic fields such as MRI devices or ham radios after swallowing the capsule and until you pass it in a bowel movement.
  • Do not disconnect the equipment or completely remove the DataRecorder at any time during the procedure.
  • Treat the DataRecorder carefully. Avoid sudden movements and banging of the DataRecorder.
  • Avoid direct exposure to bright sunlight.
Colonoscopy with Lytely Prep(printable version)

Location: Piedmont Hospital GI Lab

(Circle one)  Report directly to the hospital GI Lab in 77 building on _________________ at _____________ am/pm.

Enter at Collier Road entrance. Park in the “North” parking deck. Take elevator to the bridge level (BR). Sign will say “Bridge to Hospital”. Get off at the bridge level.

Walk over the glassed in covered bridge. Turn right and then left. Look for sign to GI Lab. Check in at the window when you enter the GI Lab. You will be registered there.

OR

Location: Digestive Healthcare Endoscopy Lab (Our Office)

(Building 95, Suite 4075) Report to the office on _____________at ___________ am/pm.

Enter at the Collier Road entrance. Park in the “South” parking deck. Take the elevator to the “Orange Level”. Cross over the glassed in covered bridge.

You are now in the 95 building. You do not have to check in at the hospital. Go up to the 4th floor and look for Suite 4075. Sign in at the window.

If someone is sitting at the window, let them know you have arrived.

 

One Week Prior to Procedure

  • Do NOT stop taking your daily Aspirin or NSAIDs. If you are taking a daily Aspirin or NSAIDS we want you to continue to take your medication. On the day of your procedure you can make your gastroenterologist aware of the medication you are taking and the amount you are taking.
  • If you take a medication to thin your blood (such as Coumadin, Plavix, Pradaxa, Lovenox, Xarelto, Eliquis, Brilinta, Effient, Ticlid, Disgren, Pletal...) you must be seen in our office (can be seen by nurse practitioner or physician assistant) prior to your procedure. At the time of your office visit a plan will be made in conjunction with your prescribing physician about use of your blood thinner.
 

You may continue to take celebrex and vioxx up until your procedure.

Procedure Preparations

On the day before your procedure begin a clear liquid diet. You may have beverages such as tea, coffee, carbonated drinks, strained fruit juices, Popsicles (NOT RED) Jell-O (NO RED JELLO), broth or bouillon. No creamed soups or milk products. You may have clear liquids up until midnight the day before your procedure.

You will receive a prescription for ONE of the following: Colyte, Golytely or Nulytely. Solutions are the same, just different brands. This is the liquid laxative that will cleanse the colon for your procedure. Prepare and chill the Nulytely the morning before the procedure. When taking this prep please stay close to home (bathroom).

1:00 pm - Take Dulcolax (4) tablets. {IF YOU PLAN ON BEING AT WORK THAT DAY TAKE DULCOLAX AT 8 PM}

3:30 pm - Take Reglan (1) 10mg this will help with the nausea and bloating.

4:00 pm to 8:00 pm - Start drinking the Nulytely solution Drink an 8 oz glass every 15 – 20 minutes until ALL has been consumed and the returns are clear.  {You can take clear sugar free lemon drops, mints etc. in between each of the “Nulytely” prep} Clear results are clear, yellow or green colored water. You may have sandy sediment that sinks to the bottom of the toilet.

This is okay. If you are not able to drink the laxative and or begin vomiting, please call 404-355-1690. You should begin having results within 1-3 hours. Should you feel full and nauseated while drinking, stop drinking for 30 minutes then resume.

NOTHING TO EAT OR DRINK AFTER MIDNIGHT BEFORE YOUR PROCEDURE.  If your arrival time is noon or later, you may have 8 oz of a clear liquid before 7am and then nothing by mouth until after your procedure. (***However may take your BLOOD PRESSURE medication with a SIP of water on the day of the procedure***)

You must have someone drive you home after the procedure or it will not be preformed. This is for safety. You may not take a taxi by yourself or ride the bus. You may have a friend/family pick you up at the designated pick up area. If you give us a phone number when you are being admitted, we will be happy to speak with the person driving you home and call them and arrange a time to meet them.

If you have any questions or need to cancel, please call 404-355-3200. PLEASE GIVE US AT LEAST 72 HOURS IF YOU NEED TO CANCEL.

PLEASE NOTE:

  • Bring your insurance cards and credit card or check with you.
  • Bring a list of your Medications.
  • Leave your car keys and parking ticket with your driver.
  • If you have any special needs Please notify the staff prior to your procedure (Pacemaker, Internal Defribullator, Latex Allergy, need interpreter…).
  • Our Center closes at 5 pm. Please have a phone number available to contact your ride to pick you up prior to this time. Wear comfortable clothes to your procedure.
  • Colonoscopy patients plan to be with us for at least 2 ½ hours from arrival time. Endoscopy patients plan to be here at least 2 hours from arrival time.

When you receive your statement from this procedure, there will be an invoice for the doctor’s fee, an invoice for the endoscopy center (supplies and nursing care) and you may receive a separate bill from the Pathology laboratory if biopsies are obtained.

If you have any questions regarding insurance or pre-certification, please call our billing office at 404-603-3543.

**If your insurance does not cover this procedure and you have been notified that there is a deductible you need to pay, please bring a credit card (VISA, MC and AMEX only) or a check.

***Digestive Healthcare of Georgia Endoscopy center is co-owned and operated by The Physicians of Digestive Healthcare and Piedmont Hospital.***

Hemorrhoid Banding(printable version)

Hemorrhoids are swollen veins in the lower rectum or anus. By Age 50, about half of the population will have experienced this sometimes painful condition, which results from an increase in pressure inside the veins of the rectum. Common causes include constipation, pregnancy, childbirth, obesity, heavy lifting, sitting for long periods and diarrhea.

Although a frequently neglected area of healthcare, more than 50% of the population is afflicted with hemorrhoids and while the signs and symptoms may come and go, it is best to treat the underlying source to prevent the condition from worsening. This disposable hemorrhoid removal procedure is safe, painless and takes less than 5 minutes; most patients return to normal activities the same day. Patients typically require 3 treatments at two week intervals, and 99% of patients are able to avoid surgery using this technology.

We have been utilizing rubber band ligation for some time, but have now started to offer treatment using the patented CRH-O’Regan System TM new technology that makes the procedure quicker and more comfortable for our patients.

The O’Regan method uses a small rubber band to strangle the base of the swollen venin, which cuts off the blood supply to the hemorrhoid. This causes the banded tissue to shrink and fall off along with the rubber band. Typically, this happens within a few days after your appointment during a routine trip to the toilet and you may not even notice when this happens.

The band placement is relatively painless due to this refined technique and does not require anesthesia or other numbing agents. You may experience a dull ache or sense of fullness in the rectum within the first 24 hours, but this can generally be relieved by over-the-counter pain medication. Most patients can return to work the same day.

Endoscopic Ultrasound (EUS) Instructions(printable version)

What is an endoscopic ultrasound?

Endoscopic ultrasound (EUS) allows your doctor to examine the lining and the walls of your upper (GI) tract. The upper tract is the esophagus, stomach and duodenum. EUS is also used to study internal organs that lie next to the gastrointestinal tract, such as the gall bladder and pancreas.

Your doctor will use a thin, flexible tube called an endoscope that he or she will pass through your mouth or anus to the area to be examined. Your doctor then will turn on the ultrasound component to produce sound waves that create visual images of the digestive tract. The actual examination generally takes between 30 -60 minutes. If abnormal tissue is found, the doctor may remove it through the endoscope for closer examination or biopsy. Fine needle biopsy can also be performed to evaluate abnormalities directly adjacent to the upper GI tract.

EUS provides detailed pictures of your digestive tract anatomy. EUS may be used to diagnose the cause of conditions such as abdominal pain or abnormal weight loss. EUS is also used to evaluate an abnormality, such as a growth, that was detected at a prior endoscopy or by x-ray. In addition, EUS can be used to diagnose diseases of the pancreas, bile duct and gallbladder when other tests are inconclusive.

PRE-PROCEDURE CHECKLIST

If you have diabetes, ask your regular doctor for diet and medication restrictions. Do not take your oral diabetes medicine on the day of your procedure. If you take metformin, stop taking it the day before your endoscopy. Please bring your Insulin and Insulin syringes with you to your procedure; we will check your blood sugar before and after the procedure.

If you take a medication to thin your blood (such as Coumadin, Plavix, Pradaxia or Lovenox) be sure to discuss this with the doctor performing your procedure. You must get your prescribing doctor's permission if you need to stop these medications.

If you currently are taking other prescription medications, you may continue to take all other medications as instructed by the prescribing physician.

If you are or may be pregnant, please discuss the risks and benefits of this procedure with your doctor.

You MUST arrange for a ride for the day of your exam. If you fail to arrange transportation with a responsible adult, your procedure will need to be cancelled and rescheduled. Your driver must check in with you and stay in our office the entire time that you are there. We cannot start your procedure if you do not have a driver present. In addition to this, you may not take a taxi or ride the bus by yourself. This is for your safety.

If you must cancel or reschedule your appointment, please call 404-355-3200 at least three days prior to your procedure to avoid any late cancellation fees.

If you have any special needs, please notify the admitting nurse prior to your procedure (i.e. a pacemaker, internal defibrillator, latex allergy, need for an interpreter, or are allergic to eggs, nuts, or soy).

Please be certain to have all of the following items with you:

  • Your completed pink Pre-Anesthesia Evaluation, which was included in your procedure packet.
  • A list of all your current prescription medications and all your over the counter medications.
  • A photo ID.
  • All your up-to-date insurance information, such as your insurance card or required referral forms.

DAY OF EXAMINATION

The Piedmont Hospital GI lab is located on the first floor of the 77 building. It is most convenient to park in the North parking deck. Take the elevator to the bridge level (BR). You will need to go to the 77 building registration office to register for your procedure. After getting off at the bridge level you will walk through a glassed-in bridge and go straight. You will pass the 77 building (D) elevator, which will be located on your left. The registration office is located in the next hallway on your left. Once inside, a member of the registration staff will help you complete some additional paperwork, and then escort you to the GI Lab for your procedure. This should take approximately 15 minutes.

STOP AND READ:

  • If you do not follow these instructions your procedure may be delayed or cancelled.
  • Please note that you cannot have any solid foods after midnight the day before your procedure.
  • The day of the procedure you may not have gum, mints, ice chips, hard candies or cigarettes.
  • You may have clear liquids up to two and a half hours before your procedure. This includes the prep solution.
  • You cannot have anything in your mouth (gum, mint, cough drop, ice chips etc.) two and a half hours before your procedure.

PREPARATION

To ensure a successful exam, please follow all instructions carefully. Failure to accurately and completely prepare for your exam may result in the need for an additional procedure and both procedures will be billed to your insurance.

  • Stop eating solid foods at midnight.
  • Clear liquids are okay to drink (examples: water, Gatorade, clear broth, black coffee and apple juice).
  • Do not drink red liquids or alcoholic beverages.
  • You may take your usual medications (exceptions noted above) with up to 4 oz. of water at least 4 hours prior to your procedure. Be sure to wear comfortable clothes and shoes that will remain on your feet (preferably tennis shoes) to your procedure. Please do NOT wear flip flops, sandals, or backless shoes.
  • Please remove ALL jewelry including earrings, rings, bracelets, anklets, necklaces, and watches prior to the procedure, and be sure to leave any and all valuables at home.
  • Plan to spend up to two hours at the endoscopy center the day of your procedure. The exam itself takes about 30-60 minutes to complete.

Before the exam:

  • You will change into a gown and robe.
  • Your medical history will be reviewed with you.
  • You will be given a consent form to sign.
  • A nurse will insert an intravenous (IV) line into your hand or arm.
  • Menstruating women under the age of 50 will be asked to give a urine sample for a pregnancy test.

During the exam:

  • Medicine will be given through the IV line to help you relax and feel drowsy.
  • Your heart rate and oxygen levels will be monitored. If your blood pressure is low, you may be given fluids through the IV line.
  • The doctor will insert a flexible, hollow tube - called an endoscope - into your mouth and will advance it slowly through the esophagus, stomach and duodenum (the first part of your small intestine).
  • You may have a feeling of pressure or fullness.
  • If you have difficulty swallowing, and the doctor finds a narrowing in your esophagus, it may be possible for the area to be expanded during the exam.
  • If abnormal tissue is found, the doctor may remove it through the endoscope for closer examination, or biopsy. Tissue removal is painless.

What happens after the exam?

  • The doctor will talk with you about the initial results of your exam.
  • The doctor will prepare a full report for you and the physician who referred you for the upper endoscopy.
  • You may feel bloated after the procedure. This is normal.
  • Your throat may feel sore for a short time.
  • Medication given during the exam will prohibit you from driving for the rest of the day.
  • Following the exam, you may resume your normal diet. Avoid alcohol until the next day.
  • You may resume your regular activities the day after the procedure.
  • A nurse will provide you with complete discharge instructions before you leave the endoscopy center. Be sure to ask the nurse for specific instructions if you take blood thinners such as aspirin, Coumadin or Plavix.
  • Any tissue samples removed during the exam will be sent to a lab for evaluation. It may take 5-7 working days for you to be notified of the results.

What are the possible complications of EUS?

Although serious complications from EUS are rare, any medical procedure has the potential for risks. There is a slight risk of infection if fluid is removed from any cysts and antibiotics may be given as a preventative measure. Other risks include:
  • Perforation, or a tear, of the lining of the stomach, esophagus, colon or rectum.
  • Bleeding from the biopsy site, if any tissue was removed.
  • Reaction to medications used during the procedure.

A nurse will review all potential warning signs with you before you leave the endoscopy center. The risk of complications slightly increases if a deep needle aspiration is performed during the EUS examination. There is also a small risk of infection if fluid is removed from any cysts, and antibiotics may be given to prevent this. These risks must be balanced against the potential benefits of the procedure and the risks of alternative approaches to the condition.

Esophageal Manometry Testing at Piedmont Hospital Instructions(printable version)

What is an esophageal motility (manometry)?

An esophageal motility (or manometry) is a procedure that enables your doctor to evaluate the muscles in your esophagus. It is performed by passing a small flexible tube through your nose into your esophagus. Once the tube is in place, it allows muscle activity to be assessed. This procedure is used to help diagnose patients who suffer from chest pain, heartburn, acid reflux or difficulty swallowing. It is also used to measure the pressure of the muscle at the lower end of the esophagus before surgery.

What should I expect during esophageal motility?

Plan to spend up to 2 hours at the center the day of your procedure. The actual procedure takes about 10 to 15 minutes to complete. You will be lying down during the procedure. Once the tube is in place, you will need to swallow when you are asked. The tube will not interfere with your breathing. No sedation is required. A nurse designated by the physician will do the procedure.

What happens after the exam?

You may return home or to work after the exam and resume your usual diet and activities.

Are there possible complications with esophageal motility?

This exam is very safe and there are very few potentially serious complications. You may feel minor discomfort during the procedure or have a sore throat after the procedure.

PRE-PROCEDURE CHECKLIST

If you have diabetes, ask your regular doctor for diet and medication restrictions. Do not take your oral diabetes medicine on the day of your procedure. If you take metformin, stop taking it the day before your endoscopy. Also, please bring your Insulin and Insulin syringes with you to your procedure; we will check your blood sugar before and after the procedure.

If you take a medication to thin your blood (such as Coumadin, Plavix, Pradaxia or Lovenox) be sure to discuss this with the doctor performing your procedure. You must get your prescribing doctor's permission if you need to stop these medications.

If you currently are taking other prescription medications, you may continue to take all other medications as instructed by the prescribing physician.

If you are or may be pregnant, please discuss the risks and benefits of this procedure with your doctor.

You MUST arrange for a ride for the day of your exam. If you fail to arrange transportation with a responsible adult, your procedure will need to be cancelled and rescheduled. Your driver must check in with you and stay in our office the entire time that you are there. We cannot start your procedure if you do not have a driver present. In addition to this, you may not take a taxi or ride the bus by yourself. This is for your safety.

If you must cancel or reschedule your appointment, please call 404-355-3200 at least three days prior to your procedure to avoid any late cancellation fees.

If you have any special needs, such as a pacemaker, internal defibrillator, latex allergy, need an interpreter, or if you are allergic to eggs, nuts or soy, please contact our office immediately. Your procedure may need to be rescheduled.

PREPARATION

To ensure a successful exam, please follow all instructions carefully. Failure to accurately and completely prepare for your exam may result in the need for an additional procedure and both procedures will be billed to your insurance.

The night before your exam:

  • Stop eating solid foods at midnight.
  • Clear liquids are okay to drink (examples: water, Gatorade, clear broth, black coffee and apple juice).
  • Do not drink red liquids or alcoholic beverages.

The day of your exam:

  • You may take your usual medications with up to 4 oz. of water at least 2.5 hours prior to your procedure. Be sure to wear comfortable clothes and shoes that will remain on your feet (preferably tennis shoes) to your procedure. Please do NOT wear flip flops, sandals, or backless shoes.
  • Please remove ALL jewelry including earrings, rings, bracelets, anklets, necklaces, and watches prior to the procedure, and be sure to leave any and all other valuables at home.
  • Plan to spend up to two hours at the endoscopy center the day of your procedure. The exam itself takes about 15 minutes to complete.
  • Please call 404-605-3840 if you have any questions regarding the actual procedure.

Additional information:

The Piedmont Hospital GI lab is located on the first floor of the 77 building. It is most convenient to park in the North parking deck. Take the elevator to the bridge level (BR). You will need to go to the 77 building registration office to register for your procedure. After getting off at the bridge level you will walk through a glassed-in-bridge and go straight. You will pass the 77 building (D) elevator, which will be located on your left. The registration office is located in the next hallway on your left. Once inside, a member of the registration staff will help you complete some additional paperwork, and then escort you to the GI Lab for your procedure. This should take approximately 15 minutes.

Please be certain to have all of the following items with you:

  • A list of all of your current medications, including any allergy or over-the-counter medications.
  • A photo ID.
  • All your up-to- date insurance information, such as your insurance card or required referral forms.
Pneumatic (Balloon) Dilation Prep Instructions(printable version)

Location: Piedmont Hospital GI Lab

Report to Hospital GI Lab on __________________at ____________am/pm

Park in the “North” parking deck. Take the elevator to the bridge level BR). Sign will say “Bridge to Hospital”. Get off at the “bridge” level; Walk over the glassed in covered bridge.

Turn right and then left. Look for sign to GI Lab. Check in at the window when you enter the GI Lab. You will be registered there.

Procedure Guidelines

You should have liquids only for 24 hours prior to procedure. Nothing to drink after midnight the night before your procedure.

Because you will be sedated, you cannot drive after the procedure is over. You must have someone to drive you home or the procedure will not be performed. This is for your safety. You may not take a taxi by yourself or ride the bus. You may have a friend or family member pick you up at the hospital pick up area. If you give us a phone number when you are being admitted, we will be happy to speak with the person driving you home and call them and arrange a time to meet them. You will be with us approximately 4 hours.

You should not take any Aspirin, Motrin or like medications 10 days prior. No Plavix for 5 days before the procedure. Please notify your physician if you take Coumadin.

After the balloon dilation is completed you will be sent to radiology for a barium swallow to make sure there is no complication.

PLEASE NOTE:

  • Wear comfortable clothes to procedure.
  • BRING YOUR INSURANCE CARDS WITH YOU.
  • BRING A LIST OF YOUR CURRENT MEDICATIONS.
  • LEAVE YOUR CAR KEYS AND PARKING TICKET WITH YOUR DRIVER.
  • IF YOU HAVE ANY SPECIAL NEEDS, PLEASE NOTIFY STAFF PRIOR TO PROCEDURE (INTERPRETER, PACEMAKER, INTERNAL DEFIBRILLATOR, OR LATEX ALLERGY).
  • If you are Diabetic, please bring your Insulin and Insulin syringes with you. We will check your sugar before and after the procedure we may need to give you a dose.

If you have any questions or need to cancel, please call 404-355-3200. Thank you.

Gastric Emptying Study(printable version)

Location: Out Patient Diagnostic Center, 95 Building on the Ground Floor

Check In at Registration Desk

The Gastric Emptying study is performed in nuclear, within the radiology department at Piedmont Hospital. The test will involve eating the white part of eggs.

You will remain lying on your back for the duration of the test, which will depend on how fast your stomach empties the food. Allow a minimum of 1 hour.

Please arrive 30 minutes prior to your appointment time.

You should arrive at _____________am/pm.

PLEASE NOTE:

  • Nothing to eat or drink after midnight the night before the test.
  • No barium studies for 48 hours prior to study.
  • No pain medications or sedatives for 12 hours prior to the procedure. Do not take any reglan, domperidone, or any other antacids after midnight the night before the test.
  • You should not have this test if you are pregnant, or if there is the possibility that you might be pregnant. Please notify your doctor immediately.
  • Wear comfortable clothes to the procedure.
  • Bring your insurance cards with you to the test.

If you have any questions or need to cancel, please call 404-355-3200.

PH Monitoring (24 Hour) Testing at Piedmont Hospital Instructions(printable version)

What is 24 hour pH/impedance monitoring test?

This test enables you doctor to determine the number of episodes of gastroesophageal reflux, which means the backward flow of the stomach's contents into the esophagus.  It can determines how long each of these episodes last and what the acid measurement is. The impedance part of the test measures the volume of gastroesophageal reflux.   Understanding this is important in recommending the correct treatment for you.

Why is 24 hour pH/impedance recommended?

pH monitoring can be helpful to evaluate chest pain, reflux, heartburn, respiratory symptoms, voice hoarseness or vomiting.

PRE-PROCEDURE CHECKLIST

If you have diabetes, ask your regular doctor for diet and medication restrictions. Do not take your oral diabetes medicine on the day of your procedure. If you take metformin, stop taking it the day before your colonoscopy. Also, please bring your Insulin and Insulin syringes with you to your procedure; we will check your blood sugar before and after the procedure.

If you take a medication to thin your blood (such as Coumadin, Plavix, Pradaxia or Lovenox) be sure to call 404-605-3840.

If you are or may be pregnant, please discuss the risks and benefits of this procedure with your doctor.

If you must cancel or reschedule your appointment, please call 404-355-3200 at least three days prior to your procedure to avoid a late cancellation fee of $150.00.

If you have any special needs, please notify the admitting nurse prior to your procedure (i.e. a pacemaker, internal defibrillator, latex allergy, need an interpreter, or are allergic to eggs, nuts, or soy).

If you currently are taking other prescription medications, you may continue to take all other medications as instructed by the prescribing physician. However, your doctor may want to do this study off of the following medications for 10 days: Aciphex® (rabeprazole), Nexium® (esomeprazole), Prevacid® (lansoprazole), Dexilant® (dexlansoprazole), Prilosec® (omeprazole), Protonix® (pantoprazole) or Zegerid® (omeprazole/ sodium bicarbonate). The following medications may not be taken for two days: Pepcid® (famotidine), Tagament® (cimetidine), Zantac® (ranitidine), Axid® (nizatidine).   Your doctor will let you know prior to the test if you should stop your medications or continue your medications.

PREPARATION

To ensure a successful exam, please follow all instructions carefully. Failure to accurately and completely prepare for your exam may result in the need for an additional procedure and both procedures will be billed to your insurance.

The night before your exam:

  • Stop eating solid foods at midnight.
  • Clear liquids are okay to drink (examples: water, Gatorade, clear broth, black coffee and apple juice).
  • Do not drink red liquids or alcoholic beverages.

The day of your exam:

  • You may take your usual medications (exceptions noted above) with up to 4 oz. of water at least 2.5 hours prior to your procedure. Be sure to wear comfortable clothes and shoes that will remain on your feet (preferably tennis shoes) to your procedure. Please do NOT wear flip flops, sandals, or backless shoes.
  • Please remove ALL jewelry including earrings, rings, bracelets, anklets, necklaces, and watches prior to the procedure, and be sure to leave any and all valuables at home.
  • A staff member designated by the physician will place the tube.  A very thin tube will be passed through your nose into your esophagus.  The tube will be secured to your nose with tape.  The external end will be attached to a small recorder.  You can wear the recording device on a belt around your waist or carry it like a shoulder strap.  For 24 hours (your testing time), you will be asked to keep a diary of when you eat, sleep, and any symptoms that you experience.  These symptoms (example: coughing or heartburn) will then be correlated with the information from the tube in your esophagus.
  • Plan to spend up to two hours at the endoscopy center the day of your procedure. The exam itself takes about 15 minutes to complete.
  • Please do not take any over the counter antacids during the study period, such as Tums® , Rolaids®, Maalox®, Mylanta®, Gaviscon or Carafate® (sucralfate).
  • You will return to the hospital and the tube will be removed the next day. A computer will analyze the information from your recording device and your diary.  The results will be given to a doctor who will study the combined data and send a report to your primary physician.

Are there any complications?

This test is very safe with very few potential serious complications.  You may feel minor discomfort while the tube is in place and it is normal to feel some "tugging" while eating.

Please call 404-605-3840 if you have any questions regarding the actual procedure.

Additional information:

The Piedmont Hospital GI lab is located on the first floor of the 77 building. It is most convenient to park in the North parking deck. Take the elevator to the bridge level (BR). You will need to go to the 77 building registration office to register for your procedure. After getting off at the bridge level you will walk through a glassed-in bridge and go straight. You will pass the 77 building (D) elevator, which will be located on your left. The registration office is located in the next hallway on your left. Once inside, a member of the registration staff will help you complete some additional paperwork, and then escort you to the GI Lab for your procedure. This should take approximately 15 minutes.

Please be certain to have all of the following items with you:

  • A list of all your current prescription medication and all your over the counter medications.
  • A photo ID.
  • Co-pays are required on the day of your appointment. If you have any questions about pre-certification, please call our business office at 404-603-3543.
Motility Study and 48-Hour Bravo PH Monitoring on Antacid Medications(printable version)

Location: Piedmont Hospital GI Lab

Report to Hospital GI Lab on __________________at ____________am/pm Park in the “North” parking deck. Take the elevator to the bridge level BR). Sign will say “Bridge to Hospital”. Get off at the “bridge” level; Walk over the glassed in covered bridge. Turn right and then left. Look for sign to GI Lab. Check in at the window when you enter the GI Lab. You will be registered there.

Guidelines

IF YOUR STUDY IS IN THE MORNING:

You should have nothing to eat or drink after midnight.

IF YOUR STUDY IS IN THE AFTERNOON:

You should have nothing to eat or drink after midnight. The morning of your test you may have liquids only, but not after 8:00 am.

YOU SHOULD TAKE YOUR REGULARLY SCHEDULED MEDICATIONS WITH WATER UNLESS OTHERWISE INSTRUCTED.

NOTE FOR DIABETIC PATIENTS:

You will need to be scheduled with an early morning appointment. Please advise the doctor managing your diabetic care that you are having this test. Your medication may be changed in preparation for this test. Continue all antacid medications such as Zantac, Pepcid, Tagamet, Axid, Prolosec, Prevacid, Protonix. Aciphex or Nexium.  You should take all other regularly scheduled medications with water unless otherwise directed. Please notify your Physician if you are taking Coumadin. For the Esophageal Motility Study, a catheter will be placed through your nose into your esophagus. Pressures will be measured in your esophagus for about 20 minutes. Depending on the indication for this procedure, and after discussing the situation with your physician, we may do additional studies in order to obtain more information from this test. For the 48 hour pH study, a small catheter containing a probe about the size of a Tylenol gel cap will be placed through the nose. Using a small amount of suction, the probe will be attached to the inside of the esophagus. The catheter inserted through the nose will be removed. The probe will transmit information to a pager size receiver that is worn on the wrist for 48 hours. The receiver will be returned 48 hours later at the designated time. It is very important that the receiver be returned to the GI Lab promptly at the designated time. Several days after the study, the probe naturally detaches from the esophagus and passes through the digestive tract. If you have any questions regarding these instructions, please feel free to call your physician or the Piedmont GI Lab at 404-605-3462. The results of this study will reach your physician’s office in 7 ­ 10 days. This is a safe, simple and well tolerated study.
Esophageal Motility Study and 24 Hour PH Monitoring(printable version)

IF YOUR STUDY IS IN THE MORNING:

You should have nothing to eat or drink after midnight.

IF YOUR STUDY IS IN THE AFTERNOON:

You should have nothing to eat or drink after midnight. The morning of your test you may have liquids only, but not after 8:00 am.

YOU SHOULD TAKE YOUR REGULARLY SCHEDULED MEDICATIONS WITH WATER UNLESS OTHERWISE INSTRUCTED.

NOTE FOR DIABETIC PATIENTS:

You will need to be scheduled with an early morning appointment. Please advise the doctor managing your diabetic care that you are having this test. Your medication may be changed in preparation for this test. Do not take any H2 blocker medication such as Zantac, Pepcid, Tagament or Axid for 48 hours prior to the study. If you are taking Prilosec, Prevacid, Aciphex or Protonix you must discontinue this for 10 days prior to the study. You may take an antacid like Tums, Maalox, Gavison, Mylanta, and Rolaids up until Midnight the night before. For Esophageal Motility Study, a catheter will be placed through your nose into the esophagus. Pressures will be measured in your esophagus for about 20 minutes. Depending on the indication for this procedure, and after discussing the situation with your physician, we may do additional studies in order to obtain more information from this test. For the 24 hour pH study, a small catheter will be placed through your nose into the esophagus. This catheter will remain in place until the next day about the same time when you will return to have it removed. Please arrive at the GI Lab the 1st floor at Piedmont Hospital approximately 30 minutes prior to your study so that all the preliminary paperwork can be completed and we can begin the study on time. If you are late by 30 minutes or greater, your appointment is subject to being rescheduled. Please register with the receptionist. If you have any questions regarding these instructions, please feel free to call 404-605-2715. The results of this study will reach your physician’s office in 7-10 days. This is a safe, simple and well tolerated study.
Endoscopy and 48-Hour Bravo PH Prep Instructions 2(printable version)

Location: Piedmont Hospital GI Lab

Report to Hospital GI Lab on __________________at ____________am/pm Park in the “North” parking deck. Take the elevator to the bridge level BR). Sign will say “Bridge to Hospital”. Get off at the “bridge” level; Walk over the glassed in covered bridge. Turn right and then left. Look for sign to GI Lab. Check in at the window when you enter the GI Lab. You will be registered there. You may continue to take Celebrex and Vioxx up until your procedure.

Please Read!!!   10 days prior to procedure

Unless you were instructed by your physician to continue antacid medication, Stop taking Prilosec, Prevacid, Protonix, Aciphex, and Zantac, Pepcid, Tagamet or Axid 48 hours prior to your study. You may take and antacid like Tums, Maalox, and Gaviscon, Mylanta or Rolaids up until midnight the night before your procedure.

Also 10 prior to procedure

Stop taking Aspirin, Ibuprofen, Motrin, Advil, and Aleve or arthritis medications 10 days prior. Stop taking Vitamin E one week prior to the procedure. ***If you are on Coumadin you must get your doctor’s permission to stop the drug. ***

5 days prior

Stop taking Plavix.

Procedure day

You may take your blood pressure medication with a sip of water on the day of your procedure.

Procedure preparation

Nothing to eat or drink after midnight the night before your procedure. If your procedure is after noon, you may have 8 oz of clear liquid before 8 am then nothing by mouth. You must have someone to drive you home after the procedure or it will not be performed. You may not take a taxi by yourself or ride the bus. You may have a friend or family member pick you up at the 95 building pick up area. If you give us a phone number when you are being admitted, we will be happy to speak with the person driving you home and call them and arrange a time to meet them. If you have any questions or need to cancel, please call 404-355-3200

PLEASE GIVE US AT LEAST 48 HOURS IF YOU NEED TO CANCEL.

PLEASE NOTE:

  • Wear comfortable clothes to the procedure.
  • Bring your insurance cards with you.
  • Bring a list of your medications.
  • Leave your car keys and parking ticket with your driver. If you have any special needs please notify the staff prior to your procedure (pacemaker, internal defibrillator, latex allergy, need interpreter).
If you have any questions regarding insurance or precertification, please call our Business Office at 404-603-3543. Please Note: When you receive your statement from this procedure, there will be an invoice for the doctor’s fee, an invoice for the endoscopy center (supplies and nursing care), anesthesia invoice for Propofol and you may receive a separate bill from the Pathology laboratory if biopsies are obtained. If you have any questions regarding insurance or pre-certification, please call our billing office at 404-603-3543. **If your insurance does not cover this procedure and you have been notified that there is a deductible or Coinsurance that you need to pay, please bring a credit card (VISA, MC or AMEX only) or a check.

Bravo Ph Monitoring

The Bravo 48-hour pH test is being recommended by your physician as a tool in the diagnosis of Gastro esophageal Reflux Disease (GERD). During the Bravo pH procedure, a catheter containing a probe about the size of a Tylenol gel cap will be placed in the esophagus (the tube leading from the mouth to the stomach). This will be placed either through the nose or directly into the mouth, depending on the recommendation from the physician. Using a small amount of suction, the probe will be attached to the inside of the esophagus. This procedure is simple, safe, and very well tolerated. The Probe transmits esophageal pH data (or acid in the esophagus) using radio frequency to a small pager size receiver that is worn by the patient for 48 hours. After this time the receiver will automatically stop recording information. The receiver is then uploaded into the computer, and analysis by both the computer and physician allows a detailed report to be devised for diagnosis. Several days after the study, the probe naturally sloughs off the esophagus and passes through the digestive tract. Compared to the traditional pH test, the Bravo pH System provides greater patient comfort and convenience. Patients are able to maintain their regular diet. There are no visible tubes. Since there are no external tubes, throat and nasal discomfort are virtually eliminated.
Endoscopy and 48-Hour Bravo PH Prep Instructions On Medications(printable version)

Location: Piedmont Hospital GI Lab

Report to Hospital GI Lab on __________________at ____________am/pm Park in the “North” parking deck. Take the elevator to the bridge level BR). Sign will say “Bridge to Hospital”. Get off at the “bridge” level; Walk over the glassed in covered bridge. Turn right and then left. Look for sign to GI Lab. Check in at the window when you enter the GI Lab. You will be registered there.

Instructions

Nothing to eat or drink after midnight the night before the procedure. If your procedure is after 12 noon, you may have 8 oz of a clear liquid before 8 am then nothing by mouth. Because you will be sedated, you cannot drive after the procedure is over. You must have someone to drive you home after the procedure or it will not be performed. This is for your safety. You may not take a taxi by yourself or ride the bus. You may have a friend/family member pick you up at the 95 building pick up area. If you give us a phone number when you are being admitted, we will be happy to speak with the person driving you home and call them an arrange a time to meet them. You will be with us approximately 2 ½ hours. You should not take any Aspirin, Motrin or like medications 10 days prior. No Plavix for 5 days before the procedure. If you are on Coumadin, you must get your doctor’s permission to stop this drug. We will let you know when you can start back on it. Stop taking Vitamin E 7 days prior to your procedure.

PLEASE NOTE:

  • Continue antacid medication, such as Prilosec, Prevacid, Protonix, Aciphex, and Nexium, Zantac, Pepcid, Tagamet or Axid. You may take your medication the morning of the procedure with a small sip of water.
  • Wear comfortable clothes to procedure.
  • Bring your insurance card with you.
  • Bring a list of your current medications.
  • Leave your car keys and parking ticket with your driver.
  • If you have any special needs, please notify staff prior to your procedure (Interpreter, pacemaker, internal defibrillator, latex allergy).
  • If you are a Diabetic, please bring your Insulin and Insulin syringes with you. We will check your sugar before and after the procedure and may need to give a dose.
If you have any questions or need to cancel, please call 404-355-3200. Thank you. When you receive your statement from this procedure, there will be an invoice for the doctor’s fee, an invoice for the endoscopy center (supplies and nursing care), anesthesia invoice for Propofol and you may receive a separate bill from the Pathology laboratory if biopsies are obtained. If you have any questions regarding insurance or pre-certification, please call our billing office at 404-603-3543. **If your insurance does not cover this procedure and you have been notified that there is a deductible or Coinsurance that you need to pay, please bring a credit card (VISA, MC or AMEX only) or a check. ***Digestive Healthcare of Georgia Endoscopy center is co-owned and operated by The Physicians of Digestive Healthcare and Piedmont Hospital. ***
Endoscopy and 48-Hour Bravo PH Prep Instructions(printable version)

Location: Piedmont Hospital

Report directly to the hospital GI Lab in 77 building on _________________ at _____________ am/pm. Enter at Collier Road entrance. Park in the “North” parking deck. Take elevator to the bridge level (BR). Sign will say “Bridge to Hospital”. Get off at the bridge level. Walk over the glassed in covered bridge. Turn right and then left. Look for sign to GI Lab. Check in at the window when you enter the GI Lab. You will be registered there.

OR Location: Digestive Healthcare Endoscopy Lab (Our Office)

(Building 95, Suite 4075) Report to the office on __________at __________ am/pm. Enter at the Collier Road entrance. Park in the “South” parking deck. Take the elevator to the “Orange Level”. Cross over the glassed in covered bridge. You are now in the 95 building. You do not have to check in at the hospital. Go up to the 4th floor and look for Suite 4075. Sign in at the window. If someone is sitting at the window, let them know you have arrived.

Procedure Preparations

Nothing to eat or drink after midnight the night before your procedure. If your procedure is after noon, you may have 8 oz of clear liquid before 8 am then nothing by mouth. Because you will be sedated, you cannot drive after the procedure is over. You must have someone to drive you home after the procedure or it will not be performed. This is for your safety. You may not take a taxi by yourself or ride the bus. You may have a friend/family member pick you up at the 95 building pick up area. If you give us a phone number when you are being admitted, we will be happy to speak with the person driving you home and call them an arrange a time to meet them. You will be with us approximately 2 ½ hours. You should not take any Aspirin, Motrin or like medications 10 days prior. No Plavix for 5 days before the procedure. If you are on Coumadin, you must get your doctor’s permission to stop this drug. We will let you know when you can start back on it. Stop taking Vitamin E 7 days prior to your procedure. Unless you were instructed by your physician to continue antacid medication, such as Prilosec, Prevacid, Protonix, Aciphex, and Nexium, must be discontinued 10 days prior to your study. Do not take H2 blocker medication such as Zantac, Pepcid, Tagamet or Axid 48 hours prior to the study. You may an antacid like Tums, Maalox, Gaviscon, Mylanta or Rolaids up until midnight the night before your procedure.

PLEASE NOTE:

  • Wear comfortable clothes to procedure.
  • Bring your insurance card with you.
  • Bring a list of your current medications.
  • Leave your car keys and parking ticket with your driver.
  • If you have any special needs, please notify staff prior to your procedure (Interpreter, pacemaker, internal defibrillator, latex allergy).
  • If you are a Diabetic, please bring your Insulin and Insulin syringes with you. We will check your sugar before and after the procedure and may need to give a dose.
If you have any questions or need to cancel, please call 404-355-3200. Thank you. When you receive your statement from this procedure, there will be an invoice for the doctor’s fee, an invoice for the endoscopy center (supplies and nursing care), anesthesia invoice for Propofol and you may receive a separate bill from the Pathology laboratory if biopsies are obtained. If you have any questions regarding insurance or pre-certification, please call our billing office at 404-603-3543. **If your insurance does not cover this procedure and you have been notified that there is a deductible or Coinsurance that you need to pay, please bring a credit card (VISA, MC or AMEX only) or a check. ***Digestive Healthcare of Georgia Endoscopy center is co-owned and operated by The Physicians of Digestive Healthcare and Piedmont Hospital. ***
Diabetic Patient Going For Out Patient Testing(printable version)It is important to keep your blood sugar controlled when you are having an outpatient procedure. The following directions will guide you in managing you diabetes medicines before and after your test or procedure.

The Evening Before Your Test or Procedure

Continue usual diabetes medicine until midnight. Follow all directions your doctor gives you for test preparation. If a clear liquid diet has been prescribed, follow the diet below. It is OK to take liquids containing sugar as listed in the sample diet. Sample Diet – May substitute equivalent clear liquids
  • 8 oz regular soft drink
  • 8 oz regular jello
  • 1 regular popsicle
  • 8 oz apple juice
  • Broth
Nothing to eat or drink after midnight.  If you wish to drink additional fluids, those should be diet or calorie free.

The Morning of the Test or Procedure

Nothing to eat or drink Check blood sugar first thing this morning (and at 12 noon if you are not at the hospital) and write down the results. Bring these results and your blood Sugar log book with you to the hospital. If your blood sugar is less than 60, take one of the following before your arrival at the hospital:

a). 3 glucose tablets b). 4 oz juice (prefer clear juice such as apple or grape) c). 6 Life Savers™

DO NOT TAKE your diabetes pills this morning. If you take Insulin: TAKE ½ your usual amount of morning insulin-see example 1 and 2. (includes all types of insulin such as NPH, 70/30, 50/50, Regular, Humalog, Lente) Example 1: Your usual morning dose is 15 units NPH and 8 units Regular. You would take 7 units NPH and 4 units Regular the morning of the surgery. Example 2: Your usual morning dose is 27 units of 70/30 insulin. You would take 13 units of 70/30 insulin the morning or surgery.

When You Arrive at the Hospital

Check in for your test or procedure as directed by your doctor Tell the technician:|

a). You have diabetes. b). What your blood sugar was this morning. c). If you take insulin, how much insulin you took this morning.

After the Test or Procedure

Go back to your usual meal plan. Take diabetes pill unless you take GLUCHPAGE (Metformin) If you take GLUCOPHAGE: Do Not Take Glucophage for 48 hours after having X-ray test which require an IV dye injection (eg: IVP, cardiac cath, angioplasty, etc). Resume your usual insulin dose at the next scheduled time. If your blood sugar is higher than 200, call your doctor.
Nulytely Colonoscopy Preparation Instructions(printable version)

Location: PIEDMONT HOSPITAL GI LAB (Bldg 77, 1st Floor)

Enter at Collier Road entrance. Park in the “North” parking deck. Take elevator to the bridge level (BR). Sign will say “Bridge to Hospital”. Get off at the bridge level. Walk over the glassed in covered bridge. Turn right and then left. Look for sign to GI Lab. Check in at the window when you enter the GI Lab. You will be registered there. OR

DIGESTIVE HEALTHCARE ENDOSCOPY LAB (Bldg 95, Suite 4075)

Enter at the Collier Road entrance. Park in the “South” parking deck. Take the elevator to the “Orange Level”. Cross over the glassed in covered bridge. You are now in the 95 building. You do not have to check in at the hospital. Go up to the 4th floor and look for Suite 4075. Sign in at the window. If someone is sitting at the window, let them know you have arrived. **You will need 1 container of one of the following by prescription: Colyte, Golytely, or Nulytely, 1 Reglan tablet (Prescription) and 4 Dulcolax tablets (over the counter). ***You will be with us approximately 1 ½ - 2 hours from the time your instructions tell you to arrive to the time you are ready to leave. Your ride must check in with you and remain in the clinic until your procedure is complete***

2 weeks prior to procedure

If you are on Plavix, get your doctor’s permission to stop taking.

1 week prior to your procedure

Stop taking Aspirin, Ibuprofen, Motrin, Advil, Aleve, Vitamin E, iron supplement or arthritis medications and herbal products for 7 days prior to and 7 days after your procedure especially if you are going to have a polyp removed. ***If you are on coumadin you must get your doctor’s permission to stop taking the drug. If we remove a polyp, we will let you know when you can start back on it.

Procedure Day

You may take your blood pressure medication with a sip of water on the day of your  procedure.

Procedure Preparation

On the day before your procedure begin a clear liquid diet.You may have beverages such as tea, coffee, carbonated drinks, strained fruit juices, popsicles (not red) jello (no red jello), broth or bouillon. NO CREAMED SOUPS OR MILK PRODUCTS. You may have clear liquids up until midnight the day before your procedure. You will receive a prescription for ONE of the following: Colyte, Golytely or Nulytely, Solutions are the same, just different brands. This is the liquid laxative that will cleanse the colon for your procedure. 1:00 pm- Take Dulcolax (4) tablets. If you are Dr Michael  Galambos, Dr Sims or Dr Rubin’s patient only take (2) tablets. Start drinking the laxative around 4:00 pm the day before your procedure.   Drink an 8 oz glass of the prep every 10 -15 minutes until all has been consumed. Even if your results are clear, continue drinking. Clear results are clear, yellow or green colored water. You may have results of a sandy sediment that sinks to the bottom of the toilet. This is okay. You should be having results within 1 – 3 hours.  If you are not able to drink the laxative and begin vomiting, please call 404-355-3200. Take the raglan 10 mg tablet as you begin to drink the laxative. This will help with nausea and bloating. Nothing to eat or drink after midnight the night before your procedure. If your arrival time is 12 noon or later, you may have 8 oz of a clear liquid at 7 am and then nothing by mouth until after your procedure.

PLEASE NOTE:

  • Bring your insurance cards and picture ID with you.
  • Bring a list of your medications.
  • Leave your car keys and parking ticket with your driver.
  • If you have any special needs please notify the staff prior to your procedure (Pacemaker, internal defibrillator, latex allergy, need interpreter).
  • *Wear comfortable clothes to your procedure. Please do not wear shoes that will not remain on your feet (i. e. No flip flops, sandals or backless shoes.)*
  • Attention Patients scheduled in Digestive Healthcare’s Endoscopy Lab: Your driver must check in and wait for you in the Endoscopy waiting room.  It generally takes 1 ½ - 2 hours for a procedure to be completed.

If you cannot keep your appointment you must call and cancel the appointment 72 hours prior to the appointment to avoid being charged a cancellation or no show fee of $150.00.

When you receive your statement from this procedure, there will be an invoice for the doctor’s fee, an invoice for the endoscopy center (supplies and nursing care), anesthesia invoice for Propofol and you may receive a separate bill from the Pathology laboratory if biopsies are obtained. If you have any questions regarding insurance or pre-certification, please call our billing office at 404-603-3543. **If your insurance does not cover this procedure and you have been notified that there is a deductible or Coinsurance that you need to pay, please bring a credit card (visa or master card only) or check. ***Digestive Healthcare of Georgia Endoscopy Center is Co-Owned by the physicians of Digestive Healthcare and Piedmont Hospital. ***
Half Lytely Colonoscopy Preparation Instructions(printable version)

Location: Piedmont Hospital GI Lab (Bldg 77, 1st Floor)

Enter at Collier Road entrance. Park in the “North” parking deck. Take elevator to the bridge level (BR). Sign will say “Bridge to Hospital”. Get off at the bridge level. Walk over the glassed in covered bridge. Turn right and then left. Look for sign to GI Lab. Check in at the window when you enter the GI Lab. You will be registered there.

Location: Digestive Healthcare Endoscopy Lab (Bldg 95, Suite 4075)

Enter at the Collier Road entrance. Park in the “South” parking deck. Take the elevator to the “Orange Level”. Cross over the glassed in covered bridge. You are now in the 95 building. You do not have to check in at the hospital. Go up to the 4th floor and look for Suite 4075. Sign in at the window. If someone is sitting at the window, let them know you have arrived. ** You will need 1 container of one of the following by prescription: Half Lytely. You may also need 1 Reglan tablet. Your physician will tell you if you do. ** You will be with us approximately 1 ½ -2 hours from the time your instructions tell you to arrive to the time you are ready to leave.

2 weeks prior to procedure

If you are on Plavix, get your doctor’s permission to stop taking.

1 week prior to your procedure

Stop taking Aspirin, Ibuprofen, Motrin, Advil, Aleve, Vitamin E, iron supplement or arthritis medications and herbal products for 7 days prior to and 7 days after your procedure especially if you are going to have a polyp removed. **If you are on coumadin you must get your doctor’s permission to stop taking the drug. If we remove a polyp, we will let you know when you cane start back on it.

Procedure Day

You may take your blood pressure medication with a sip of water on the day of your procedure. Procedure Preparation
  1. On the day before your procedure ___________ begin a clear liquid diet. At noon, take all (4) bisacodyl tablets with water.
    • Do not chew or crush.
    • Do not take the bisacodyl tablets within 1 hour of taking an antacid.
  2. At 1:00pm Mix solution
    • Add lukewarm drinking water to top of the line on bottle.
    • Cap bottle and shake to dissolve the powder.
    • The reconstituted solution will be clear and colorless.
    • Chill in refrigerator.
    • Use within 48 hours (Do not add anything else, such a as flavorings, to solution.)
  3. If you have a bowel movement between 1:00pm – 6:00pm take the reglan tablet after the bowel movement and start drinking the solution 30 minutes later. Or if no bowel movement by 5:30pm take the reglan tablet and then start drinking the solution 30 minutes later.
  4. Drink 1 (8 oz) glass every 10 minutes (about 8 glasses). Drink each glass quickly rather than drink small amounts continuously. Drink all the solution.

PLEASE NOTE:

  • Bring your insurance cards and picture ID with you.
  • Bring a list of your medications.
  • Leave your car keys and parking ticket with your driver.
  • Patients scheduled in Digestive Healthcare's Endoscopy Lab – Your driver must check in and wait for you in the Endoscopy waiting room.
  • If you have any special needs please notify the staff prior to your procedure (pacemaker, internal defibrillator, latex allergy, need interpreter).
  • Wear comfortable clothes to your procedure. Please wear shoes that will stay on your feet (no flip flops, sandals or backless shoes).
  • You will be sedated for the procedure.
  • You must have someone drive you home after the procedure or it will not be preformed. This is for your safety.
  • You may not take a taxi by yourself or ride the bus.
  • You are not to drive for 24 hours.
  • It generally takes 1 1/2 to 2 hours for a procedure to be completed.
When you receive your statement from this procedure, there will be an invoice for the doctor’s fee, an invoice for the endoscopy center (supplies and nursing care) and you may receive a separate bill from the Pathology laboratory if biopsies are obtained. If your insurance does not cover this procedure and you have been notified that there is a deductible you need to pay, please bring a credit card (Visa or Mastercard only). If you are paying by check, bring 2 checks with you (one for the Doctor’s fee and one for the center).

TO AVOID BEING CHARGED A CANCELLATION OR NO-SHOW FEE OF $150.00, YOU MUST CALL AND CANCEL YOUR APPOINTMENT AT LEAST 72 HOURS PRIOR TO THE APPOINTMENT.

If you have any questions regarding insurance or pre-certification, please call our billing office at 404-603-3543.
Colonoscopy Preparation with Half Lytely(printable version)

Location: Piedmont Hospital GI Lab (Bldg 77, 1st Floor)

Enter at Collier Road entrance. Park in the “North” parking deck. Take elevator to the bridge level (BR). Sign will say “Bridge to Hospital”. Get off at the bridge level. Walk over the glassed in covered bridge. Turn right and then left. Look for sign to GI Lab. Check in at the window when you enter the GI Lab. You will be registered there.

Location: Digestive Healthcare Endoscopy Lab (Bldg 95, Suite 4075)

Enter at the Collier Road entrance. Park in the “South” parking deck. Take the elevator to the “Orange Level”. Cross over the glassed in covered bridge. You are now in the 95 building. You do not have to check in at the hospital. Go up to the 4th floor and look for Suite 4075. Sign in at the window. If someone is sitting at the window, let them know you have arrived. ** You will need 1 container of one of the following by prescription: Half Lytely. You may also need 1 Reglan tablet. Your physician will tell you if you do. ** You will be with us approximately 1 ½ -2 hours from the time your instructions tell you to arrive to the time you are ready to leave.

2 weeks prior to procedure

If you are on Plavix, get your doctor’s permission to stop taking.

1 week prior to your procedure

Stop taking Aspirin, Ibuprofen, Motrin, Advil, Aleve, Vitamin E, iron supplement or arthritis medications and herbal products for 7 days prior to and 7 days after your procedure especially if you are going to have a polyp removed. **If you are on coumadin you must get your doctor’s permission to stop taking the drug. If we remove a polyp, we will let you know when you cane start back on it.

Procedure Day

You may take your blood pressure medication with a sip of water on the day of your procedure. Procedure Preparation
  1. On the day before your procedure ___________ begin a clear liquid diet. At noon, take all (4) bisacodyl tablets with water.
    • Do not chew or crush.
    • Do not take the bisacodyl tablets within 1 hour of taking an antacid.
  2. At 1:00pm Mix solution
    • Add lukewarm drinking water to top of the line on bottle.
    • Cap bottle and shake to dissolve the powder.
    • The reconstituted solution will be clear and colorless.
    • Chill in refrigerator.
    • Use within 48 hours (Do not add anything else, such a as flavorings, to solution.)
  3. If you have a bowel movement between 1:00pm – 6:00pm take the reglan tablet after the bowel movement and start drinking the solution 30 minutes later. Or if no bowel movement by 5:30pm take the reglan tablet and then start drinking the solution 30 minutes later.
  4. Drink 1 (8 oz) glass every 10 minutes (about 8 glasses). Drink each glass quickly rather than drink small amounts continuously. Drink all the solution.

PLEASE NOTE:

  • Bring your insurance cards and picture ID with you.
  • Bring a list of your medications.
  • Leave your car keys and parking ticket with your driver.
  • Patients scheduled in Digestive Healthcare's Endoscopy Lab – Your driver must check in and wait for you in the Endoscopy waiting room.
  • If you have any special needs please notify the staff prior to your procedure (pacemaker, internal defibrillator, latex allergy, need interpreter).
  • Wear comfortable clothes to your procedure. Please wear shoes that will stay on your feet (no flip flops, sandals or backless shoes).
  • You will be sedated for the procedure.
  • You must have someone drive you home after the procedure or it will not be preformed. This is for your safety.
  • You may not take a taxi by yourself or ride the bus.
  • You are not to drive for 24 hours.
  • It generally takes 1 1/2 to 2 hours for a procedure to be completed.
When you receive your statement from this procedure, there will be an invoice for the doctor’s fee, an invoice for the endoscopy center (supplies and nursing care) and you may receive a separate bill from the Pathology laboratory if biopsies are obtained. If your insurance does not cover this procedure and you have been notified that there is a deductible you need to pay, please bring a credit card (Visa or Mastercard only). If you are paying by check, bring 2 checks with you (one for the Doctor’s fee and one for the center).

TO AVOID BEING CHARGED A CANCELLATION OR NO-SHOW FEE OF $150.00, YOU MUST CALL AND CANCEL YOUR APPOINTMENT AT LEAST 72 HOURS PRIOR TO THE APPOINTMENT.

If you have any questions regarding insurance or pre-certification, please call our billing office at 404-603-3543.
Botulism Toxin (Botox) Prep Instructions(printable version)

Location: Piedmont Hospital GI Lab (see map)

Report to Hospital GI Lab on __________________at ____________am/pm Park in the “North” parking deck. Take the elevator to the bridge level BR). Sign will say “Bridge to Hospital”. Get off at the “bridge” level; Walk over the glassed in covered bridge. Turn right and then left. Look for sign to GI Lab. Check in at the window when you enter the GI Lab. You will be registered there. Nothing to eat or drink after midnight the night before the procedure. If your procedure is after 12 noon, you may have 8 oz of a clear liquid before 8 am then nothing by mouth. Because you will be sedated, you cannot drive after the procedure is over. You must have someone to drive you home after the procedure or it will not be performed. This is for your safety. You may not take a taxi by yourself or ride the bus. You may have a friend/family member pick you up at the 95 building pick up area. If you give us a phone number when you are being admitted, we will be happy to speak with the person driving you home and call them an arrange a time to meet them. You will be with us approximately 2 ½ hours.

PLEASE NOTE:

  • You should not take any Aspirin, Motrin or like medications 10 days prior. No Plavix for 5 days before the procedure. Notify your physician if you take Coumadin.
  • Wear comfortable clothes to procedure.
  • Bring your insurance card with you.
  • Bring a list of your current medications.
  • Leave your car keys and parking ticket with your driver.
  • If you have any special needs, please notify staff prior to your procedure (Interpreter, pacemaker, internal defibrillator, latex allergy).
  • If you are a Diabetic, please bring your Insulin and Insulin syringes with you. We will check your sugar before and after the procedure and may need to give a dose.
If you have any questions or need to cancel, please call 404-355-3200. Thank you.
Anorectal Motility Study(printable version)You may have a light breakfast and lunch.

NOTE FOR DIABETIC PATIENTS: You will be scheduled with an early morning appointment. Please advise your doctor managing your diabetic care that you are having this test. Your medication may be changed in preparation for this test.

For this study, a catheter will be placed in your rectum to measure the pressures of the sphincter muscle and test the ability of your sensing in this area. Please take two Fleet Enemas at least 2 to 3 hours prior to your procedure appointment time. Please arrive at the GI Lab on the 1st floor at Piedmont Hospital approximately 1 hour prior to study so that all the preliminary paperwork can be completed and we can begin the study on time. If you are late by 30 minutes or greater, your appointment is subject to being rescheduled. Please register with the receptionist. If you have any questions regarding these instructions, please feel free to call 404-605-2715. The results of this study will reach your physician’s office in 7 ­-10 days. This is a Safe, simple and well­ tolerated study.
Abdominal Ultrasound Instructions For Piedmont Hospital Out Patient Diagnostic Center(printable version)

Location: 95 Collier Rd. NW, Atlanta, GA 30309,

Phone: 404-605-1800

Please report to the office 5 minutes before the time of your examination.

To prepare for exam:

Nothing to eat or drink after midnight the evening before the test. Stay away from gas producing foods and carbonated drinks 24-48 hours before the test.

During the exam:

Most of the examination will be performed while you are lying on your back or side. Non- staining ultrasound gel will be applied to your skin and wiped off afterwards. There is absolutely NO pain involved.

After the examination:

The examination can take from 10 minutes to 45 minutes. You will be completely comfortable during the examination. After the examination the stenographer who performed the exam will give the picture to your doctor, who will review them. The nurse will contact you regarding the results within 48 hours. If you have any questions, please do not hesitate to contact our office at 404-355-1690.