Digestive Health
Digestive Health Center
HOW TO PREPARE FOR YOUR
COLONOSCOPY OR
UPPER ENDOSCOPY
FOR QUESTIONS OR TO
SCHEDULE YOUR PROCEDURE
CALL (217) 383-3309
PATIENT NAME
CLINIC NUMBER
PROCEDURE
PROCEDURE DATE
DOCTOR
REPORT TIME
Table of Contents
PLEASE READ THE FOLLOWING SECTIONS
Your digestive system
3
What to expect
4
Clear liquid diet
5
Starting your procedure
6
Colonoscopy
6
Upper-Endoscopy
9
Frequently Asked Questions
10
Diabetic instructions
11
Map Legend
North Tower
N
E
Patient
drop off
Elevator
E
To Fairground Parking ➜
On the day of your procedure,
you must first check in at hospital
registration. Registration is located
in the main lobby
across from the Orchard Street
North Parking Garage.
E
E
Breezeway/
Concourse
The Forum
at Carle
Rogers
Parkview
E
Lobby/
Center Building
Check-in
Emergency
Department
Coler Avenue
North
Clinic
2
Main Entrance
Circle Drive
University Avenue
South Clinic
E
Orchard Street
North
Parking
Garage
E
3rd Floor Walkway
E
E
McCullough Avenue
Once checked in, you will proceed
to Digestive Health, located on the
first floor of the North Tower.
E
E
E
Mills Breast Cancer Institute/
Carle Cancer Center
South
Parking
Garage
Digestive Health Center
THANK YOU FOR CHOOSING CARLE
DIGESTIVE HEALTH CENTER.
You have been scheduled for a Colonoscopy
and/or Upper Endoscopy. This booklet will
help you get ready for your procedure. If you
have questions, review the Frequently Asked
Questions at the end of this book or speak to a
staff member at (217) 383-3023.
MOUTH
ESOPHAGUS
LIVER
GALL
BLADDER
STOMACH
DUODENUM
PANCREAS
COLON
RECTUM
COLONOSCOPY
One out of every 16 Americans will get colon
cancer. There is no single cause for colon cancer,
but nearly all colon cancers begin as noncancerous polyps. A polyp is a small growth on
the inside surface of your colon that can turn
cancerous. Removing polyps early increases
your chance of surviving or preventing colon
cancer which is why screening colonoscopies are
recommended for adults beginning at age 50.
During a colonoscopy, the doctor uses a scope
to inspect your colon and remove any polyps.
The purpose of the colon prep is to clean out
your colon. It is very important to have your
colon as clean as possible so the doctor can get
a clear look.
SMALL
INTESTINE
UPPER ENDOSCOPY
Gastroesophageal Reflux Disease (GERD) is
one of the main reasons we perform an upper
endoscopy. During an upper endoscopy, the
doctor uses a scope to inspect the upper portion
of your gastro intestinal (GI) tract. Your upper GI
tract is made up of your esophagus, stomach and
duodenum (the first portion of the small bowel).
3
What to Expect
PATIENT EDUCATION
You have been scheduled for a
EMMI Video: You will receive a code to
procedure requiring sedation. Please
access an online video about your procedure.
review these instructions carefully. Plan The program will provide you with general
to be at Carle for two to four hours. This information about the procedure, prep and
sedation. Please watch the video before coming
includes registration, prep, procedure
for your procedure. If you do not have internet
access at home, a computer is available in the
and recovery time. Some procedures
Digestive Health Center. Call (217) 383-3309 if
may require longer. Do not plan to
you have not received an access code to view
the video at www.startemmi.com.
drive, or return to work or school until
the next day.
Your code: ___________________________
THE FOLLOWING THREE ITEMS COULD
SIGNIFICANTLY DELAY OR CAUSE YOUR
PROCEDURE TO BE CANCELED:
1.DRIVER: Bring a driver with you. The
medications used during the procedure will
affect your memory and judgment. Your driver
will need to accompany you to your procedure,
stay with you in the department, and remain
with you afterwards for a reasonable period
of time. You cannot use a taxi or bus unless
a responsible person comes with you. Your
procedure will be canceled if you do not have
a driver who stays in the department with
you during your procedure.
2.JEWELRY: You must remove all jewelry,
including wedding rings and body piercings
before your procedure. It is strongly
recommended that you leave jewelry at home.
Consult a jeweler if you are unable to remove
your jewelry. The presence of jewelry may
cause injuries including burns, swelling and
dislocations, skin tears or circulation problems.
Moderate Sedation - What to expect: You
will be given medication during your procedure
to help relieve discomfort and anxiety. The
medication may cause brief memory loss during
the procedure and for a short time after. Certain
medications may affect your ability to fully relax
with the sedation. Your nurse will monitor you
closely to provide you with the best sedation and
comfort possible. Because of this sedation, you
will receive specific restrictions upon discharge.
THINGS TO BRING:
•Bring a current list of all medications and
dosages, including supplements and over the
counter.
•If you have sleep apnea, bring your CPAP or
breathing mask with you.
•If you have a living will and/or durable power of
attorney for health care, bring a copy to be filed
in your electronic medical record (EMR).
IF YOU ARE DIABETIC OR TAKE
ANTICOAGULANTS (ASPIRIN, NSAIDS,
OR BLOOD THINNERS):
•Special instructions will be provided for you
to follow.
3.PREGNANCY TESTING: All female patients
of childbearing age will be asked to provide
a urine sample upon arriving in the Digestive
Health Center. Please notify the receptionist if
you need to use the restroom before you have
spoken with a nurse.
LEGAL GUARDIAN:
•If you are the parent or legal guardian of the
patient, you must stay in the Digestive Health
Center before, during and after the procedure.
The procedure will be canceled if no parent
or legal guardian is available to sign the
consent or talk with the doctor.
4
What is a Clear Liquid Diet?
It is important to follow a clear liquid diet as indicated for your procedure. Solids,
such as pulp and milk products can obstruct the view of your digestive system,
and your procedure may be canceled or rescheduled. Your doctor needs the
cleanest prep possible to accurately assess and view your digestive system.
CLEAR LIQUIDS INCLUDE:
•water
•tea
•coffee (sugar is ok, no cream)
•fruit juices (strained, no pulp, not red) such as
apple or white grape
•lemonade from powder mix
(not fresh squeezed)
•soft drinks or carbonated beverages
•sports drinks such as Gatorade®, All-Sport®,
Powerade® (not red)
•fruit-flavored drinks such as Kool-Aid®,
Crystal Light® (not red)
•fat free broth, bouillon, consommé
•plain or flavored gelatins such as Jell-O®
(no fruit or topping, not red)
•Popsicles (not red) •Italian ice or sorbet (no fruit or cream, not red)
•Clear liquid nutritional supplements
•Honey and sugar
•Hard candy such as butterscotch or peppermint
disc, lemon drops, lollipops
YOU CAN HAVE
YOU CANNOT HAVE
A good rule of thumb, if you place the glass
of clear liquid on a newspaper, you should
be able to see the newsprint easily in the
bottom of the glass. If in doubt, avoid it.
Red-colored clear liquids,
milk, cream, or dairy substitutes,
alcohol products.
5
Starting
Colonoscopy
your procedure
HOW THE COLONOSCOPY WORKS
10 DAYS BEFORE YOUR PROCEDURE:
The colon is a hollow tube that helps to absorb
water and pass stool and waste products from
your body. Like other parts of your digestive
system, it can be affected by many conditions
and diseases.
•If you take any of the anti-coagulants
listed below, call your primary doctor
or your Anticoagulation Management
Service (AMS) to see if you can stop taking
these medications or if you need special
instructions. Once approved by your
physician or AMS, stop these medications
seven days before your procedure or as
instructed.
The purpose of colonoscopy is to look inside
your colon for polyps, cancers, ulcers and
other conditions. Colon cancer usually has
no symptoms until advanced stages. It is
very important to have your colon as clean as
possible so the doctor can get a clear look. You
will receive medication (a sedative) during the
procedure to help you avoid discomfort.
•Aspirin®
•Jantoven®
(Warfarin)
•Heparin®
•Plavix®
•Ticlodipine®
The endoscope is a thin flexible tube with a
light and camera at the tip. If the doctor finds
any polyps, he will remove them. A colonoscopy
usually takes 20-30 minutes.
•Coumadin® (Warfarin)
•Dabigatran® (Pradaxa)
•Lovenox®
•Clopidogel®
•other blood thinners
•If you take these or other NSAID’s
(non-steroidal anti-inflammatory drugs) like:
•Ibuprofen
•Motrin® or Aleve®
•Meloxicam®
•Advil®
•Celebrex®
•Naprosyn®
call your primary doctor to see if you can
stop taking them seven days before your
procedure.
•It is okay to take acetaminophen or Tylenol®
if needed for pain relief.
The scope bends as it passes
through the colon. The headlight
provides light so the doctor can see.
5 DAYS BEFORE YOUR PROCEDURE:
•Stop taking iron pills and multi-vitamins
that contain iron. Other names for iron are
ferrous sulfate, ferrous gluconate or ferrous
fumarate.
HELPFUL HINTS
IF you become nauseated or feel full, stop
•Stop taking fiber medications such as
Metamucil®, Fibercon®, Citrucel®,
Benefiber®, Colon Care Capsules®, or
Psyllium.
drinking for 20-30 minutes. Then resume
the Miralax prep using smaller amounts (4-6
ounces) every 15-20 minutes.
•Stop eating nuts, popcorn and seeds or
foods that contain them. Remove skins and
seeds from fruits and vegetables before
eating. Just use your best judgment. If in
doubt, don’t eat it.
IF you would like to add the Miralax powder
directly to the Gatorade bottle, you must first
pour out and set aside one glass to make
room for the powder. Mix as directed above.
SOFT DRINKS
You can add the glass of liquid back into the
container later when there is room.
6
Digestive Health
DAY BEFORE PROCEDURE
STEP 2:
Begin the bowel prep (Dulcolax® or Biscodyl tablets
and Miralax®) as early in the day as your schedule
allows, but no later than 6 p.m. You may be up late if
you do not start early in the day.
•Mix the entire bottle of Miralax powder (either
238 or 255 grams) in 64 oz. of Gatorade or other
clear liquid (DO NOT USE RED LIQUIDS). Mix
until Miralax is completly dissolved.
The prep is designed to clean out your colon. It will
usually cause you to have loose bowel movements
within two to six hours.
STEP 3:
Drink 8 ounces every 10-15 minutes until 32
ounces, or half, of the prep is finished. This
should take about one hour to drink.
MEDICATIONS
HELPFUL HINT: A ONE CUP MEASURING CUP
EQUALS 8 OUNCES.
•You may take all of your regular medications.
If you take diabetes medications, follow the
instructions on page 11. If you take anticoagulants
(aspirin or blood thinners) please follow the special
instructions you were given.
STEP 4:
•When you have finished drinking the first
32 ounces of prep, take the remaining two
Dulcolax tablets.
DIET
•No solid food
•Refrigerate the remaining 32 ounces of
Miralax® prep and plan to drink the rest in the
morning. You will need to start drinking early
to finish in time for your procedure, so plan
accordingly.
•Follow a clear liquid diet the entire day
STEP 1:
•Take two Dulcolax or Biscodyl tablets.
•Two hours later, start drinking the Miralax Prep
(The generic of Miralax is Polyethylene Glycol).
STEP 5:
Continue to drink 8 ounces of clear liquid every
hour until bedtime, even after you have finished
the prep. Extra fluids will continue to clean out
your colon and will keep you hydrated.
IS MY PREP WORKING?
The stool should eventually look like what you are drinking – clear or light yellow,
without many small particles.
Dark and
murky.
Brown and
murky.
Dark orange
and
semi-clear.
Light orange
and
mostly clear.
Yellow and
clear,
like urine.
NOT OK
NOT OK
NOT OK
ALMOST
THERE!
YOU’RE
READY!
7
Colonoscopy
(cont.)
Digestive Health
DAY OF PROCEDURE
THINGS TO BRING:
MEDICATIONS:
•Bring a current list of all your medications
and dosages; include any over-the-counter
supplements.
•Bring a responsible adult to drive you home.
•You may take all of your regular medications.
If you take diabetes medications, follow
the instructions on page 11. If you take
anticoagulants (aspirin or blood thinners)
please follow the special instructions you
were given.
•If you have sleep apnea, bring your CPAP
breathing mask.
•If you have a living will and/or a durable power
of attorney for healthcare, bring a copy to be
scanned into your electronic medical record
(EMR).
DIET:
•No solid food
After the procedure, you will recover for about
30-60 minutes. You may feel the need to pass
gas during your recovery. You need to have
a responsible adult to drive you home. They
should stay with you until the total effects of the
sedation wear off.
•Follow a clear liquid diet the entire day.
START BOWEL PREP:
STEP 1:
Start drinking second half of Miralax prep
that was refrigerated from the night before at
___________________ (write in time).
•Drink 8 ounces every 10-15 minutes until the
remaining 32 ounces are finished. It should
take about an hour to drink.
STEP 2:
•After you have finished the prep, continue
drinking at least one cup of clear liquids every
hour until two hours before you are to report to
registration. This will help keep you hydrated.
STEP 3:
•STOP drinking all liquids two hours before you
are scheduled to report to registration.
Stop drinking clear liquids at
REPORT TO HOSPITAL REGISTRATION:
•Registration is located in the main lobby across
from the Orchard Street North Parking Garage.
•Digestive Health is located on the first floor of
the North Tower.
8
Upper-Endoscopy
An upper-endoscopy or EGD is a test that REPORT TO HOSPITAL:
examines the upper portion of your GI tract: the
esophagus, the stomach and the duodenum (first
portion of the small bowel). Gastroesophageal
reflux disease (GERD) is one of the main reasons
this test is done. Abdominal pain, difficulty
swallowing, intestinal bleeding, and GI cancers
are additional reasons you may be scheduled for
this procedure. A physician will use a scope to
inspect the lining of your esophagus, stomach
and duodenum to best diagnose and treat
your symptoms. You will be given medication
(a sedative) during the procedure to keep you
comfortable.
•Registration is located in the main lobby across
from the Orchard Street North Parking Garage.
•Digestive Health is located on the first floor of
the North Tower.
THINGS TO BRING:
•Bring a responsible adult who is able to drive
you home.
•Bring a current list of all your medications
and dosages; include any over-the-counter
supplements.
•If you have sleep apnea, bring your CPAP
breathing mask with you.
NOTE: as part of your preparation, please read
and follow the instructions given on page 6 in
the following sections:
•If you have a living will and/or a durable power
of attorney for healthcare, bring a copy to be
filed in your electronic medical record (EMR).
“10 days before your procedure:”
“5 days before your procedure:”
MEDICATIONS:
•If you take diabetes medications or
anticoagulants (aspirin or blood thinners) you
should have received special instructions from
your primary care provider or anticoagulation
management service (AMS). Please follow those
instructions.
•You may take medications with water two hours
before you are scheduled to arrive for your
procedure. This includes your blood pressure
pills.
FOOD:
•No solid food, starting at midnight before your
procedure.
•You may have clear liquids until two hours
before your report time. (see clear liquid diet
list on page 5). You may brush your teeth or
rinse, but do not swallow.
STOP DRINKING CLEAR LIQUIDS AT __________.
9
After the procedure you will recover for about
30-60 minutes. You may feel a slight sore throat.
You need a responsible adult to drive you home.
They should stay with you until the total effects
of the sedation wear off.
Digestive Health
Frequently
Asked Questions
WHAT IF I TAKE BLOOD PRESSURE
MEDICINE?
If you take blood pressure medicine, be sure
to keep taking the medicine as you get ready
for the procedure. The day of the procedure,
take your blood pressure medicine with water at
least 2 hours before the procedure. If you have
questions about your medicine, please call your
doctor before the day of the procedure.
WHY CAN’T I DRIVE MYSELF HOME
AFTER MY PROCEDURE?
MY PREP HASN’T STARTED WORKING YET.
People react differently to the bowel prep. Some
may have a bowel movement right away. Others
may not have a bowel movement for a few hours.
If you have not had a bowel movement in 3
hours, take the second part of your bowel prep
and drink clear liquids. If you finish drinking all
64 ounces without a bowel movement, call the
Digestive Health Center at (217) 383-3023 or
Patient Advisory Services at (217) 383-3233.
WHY DO I NEED A BOWEL PREP?
You will be given medicine to make you sleepy
during the procedure. This would make it unsafe
for you to drive home. You must have someone
drive you home after your procedure. You may
use public transportation (taxi or bus), but only if
you have someone who can escort you home.
Your colon must be clean to do the procedure.
If it is dirty, your doctor may not be able to see
everything, like polyps or cancer. A clean colon
is like a clean windshield, easy to see through,
but a dirty colon is like looking through a dirty
windshield. If your colon is dirty, you may have to
reschedule your procedure.
HOW LONG WILL THE PROCEDURE TAKE?
WHAT TO EXPECT AFTER YOUR
PROCEDURE
Times are specific to which test you are having
done. Expect to be at the Digestive Health
Center for 3-4 hours, which includes your
recovery time.
WHAT ARE THE SIDE EFFECTS OF THE
BOWEL PREP?
The bowel prep is meant to give you diarrhea.
This will start anywhere from 30 minutes to 3
hours after you start your bowel prep. Plan to
be at home near a toilet. Some people feel
bloating and mild abdominal discomfort. Do not
be worried if you feel these symptoms. Some
people have an upset stomach while taking
the prep and may vomit. If this happens, take
a break from drinking the prep for 30 minutes.
Start again drinking your prep in 4 ounce doses
every 20-30 minutes until the solution is done.
All liquids, including the prep, must be stopped
2 hours before the procedure.
If vomiting does not stop, call the Digestive
Health Center at (217) 383-3023 during regular
business hours or Carle Patient Advisory after
hours at (217) 383-3233, for further orders.
•Gas and/or cramps
•Smear of blood on toilet tissue
•Patients who have had an upper endoscopy
may have a sore throat.
•You may feel sleepy for several hours. This
feeling should go away by the next day
WHAT ARE THE RISK FACTORS FOR
COLON CANCER?
You may be at a higher risk for colon cancer if:
•you are older than 45-50
•you have had polyps before
•someone in you family has a history of polyps
or colon cancer
You may also be more likely to get polyps if you:
•eat a lot of fatty food
•smoke
•drink alcohol
•are overweight
•do not exercise
Please ask you doctor how you can reduce the
risk of colon cancer.
10
Diabetic
Digestive
Instructions
Health
If you have diabetes or follow any
special care for pre-diabetes, please
follow these instructions.
During your procedure, the Digestive
Health care team will work to control
your blood sugar. Before your
procedure, follow these instructions.
DIABETIC GENERAL INSTRUCTIONS
•Monitor your finger stick blood sugar level
every four hours while awake or more often if
you feel your blood sugar is low.
•Treat a low blood sugar according to your
doctor’s instructions. If less than 70 after two
treatments, call your primary care doctor for
further instructions.
•You will be given non-slip footies to wear for
the procedure. If you prefer, you may bring
slippers from home.
•Bring your diabetic medications with you to
take after your procedure (insulin and diabetic
pills).
DIABETIC MEDICATIONS
Day before procedure
•You may take your usual diabetic medications
(pills and injections) the day before your
procedure.
Day of procedure
•Lantus – Take your full dose
•NPH – Take half of your usual dose
•Humalog/Novalog or Regular insulin – DO
NOT TAKE any before your procedure
•Diabetic pills – DO NOT TAKE any before your
procedure but bring them with you
DIABETIC DIET DURING COLON PREP
•Follow colon prep instructions, you may mix
your Miralax prep with Gatorade or clear liquids
that contain sugar if your blood sugar is low
or normal. You may choose a sugar-free clear
liquid such as Crystal Light or sugar free tea if
your blood sugar is high.
•You should replace lost meals with clear liquids
that contain sugar (Example: Broth, Jell-O with
sugar, clear fruit juice no pulp). Stay within your
usual recommended carbohydrate allowance as
instructed by your doctor or diabetic educator.
•To stay hydrated between meals, drink at least
one cup of sugar-free clear liquids every hour.
11
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