What should I expect at Southwest Endoscopy?

The cleaner your colon is, the safer and more complete your exam. If your colon is not well cleaned out, your doctor may have to qualify your results by saying, “Well, I didn’t see any polyps, but I couldn’t see every surface”. If your prep is quite unsatisfactory, your doctor may recommend you reschedule another colonoscopy (with another prep). It is therefore very much in your best interest to try to follow your prep instructions as best as possible.

Some time is required before the procedure starts for changing into a gown, getting your IV started, answering nursing questions, last minute trips to the bathroom, etc.

Some patients experience some crampy abdominal pain caused by advancement of the scope around turns in the colon, but this is minimized by the sedation you will receive. Most patients are given two medications through their IV line. One is a narcotic, which provides relief from pain and contributes to drowsiness. The other is a sedative, which makes one sleepy and also causes a brief amnesia surrounding the procedure, making it hard to remember the procedure itself. Together, these medications provide what is called conscious sedation. The patient is sleepy and comfortable, but can still be awakened if shaken or called by name. Conscious sedation is much safer that general anesthesia, and it is all that is required for a procedure such as a colonoscopy.

You will be facing the monitor, but you may not remember what your colon looks like. Sometimes there is a little stool left in the colon, which usually looks yellow. Some patients ask about little white spots on the screen. These are simply reflections of light off the lining of your colon.

The most common reason for having a colonoscopy is to detect and remove polyps. Polyps are small mushroom- like growths of the colon lining. They are significant because almost all colon cancers start off as polyps, and having polyps removed can reduce the risk of developing colon cancer. Most, but not all, polyps can be removed at the time of colonoscopy. No one knows exactly what causes polyps to grow. It is not thought to be significantly related to diet or other environmental factors, and mostly reflects genetic susceptibility and the effects of aging.
 
If the doctor removes polyps, they will be sent to the lab where a pathologist will examine them under the microscope. Your doctor will then send you a letter or call you regarding the results of this pathology exam.

It varies from person to person, but ranges from 4 to 6 feet.

Diverticula are small-pocket like sacs in the wall of the bowel. Anatomically speaking they are actually herniations of the inner bowel lining out through the bowel’s muscle layer. They are thought to develop over time from muscular squeezing by the colon wall. They are not growths and have no pre-cancerous potential. They are extremely common, especially in people over age 50. They rarely cause problems, but occasionally get infected (called diverticulitis) or bleed.

Yes. You might feel wide awake immediately after the procedure is completed, but you often won’t remember any discussion with the doctor at that point. Therefore, your doctor will visit you in the recovery room about 30 minutes after your procedure is completed and review your results with you, as well as any special instructions and plans for future care or tests. The reason for waiting 30 minutes is to allow time for the medication to wear off so that you will remember the discussion better. Nevertheless, some patients still have trouble remembering, and so it is best if you can have a family member present.

Generally yes. However, if any polyps are removed, you should not take any non-steroidal medicines for 2 weeks after the procedure. Non-steroidals are pain and arthritis medicines such as aspirin, Motrin, ibuprofen, Advil, Aleve, etc. This includes baby aspirin. If you usually take Coumadin, you should discuss when to restart it when you speak to the doctor in the recovery room.

You can eat when you get home. But you should start slowly and avoid greasy or fatty food for your first meal.

Due to the sedation given during the procedure, you should plan to rest at home for the remainder of the day. You may resume your usual activities the day after your procedure.

Due to the sedation given during the procedure, you are considered legally impaired. The sedation medication impairs your judgment and reflexes. You will not be permitted to drive for 12 hours following your procedure.

No, due to the sedation given during the procedure, you are considered legally impaired. The sedation medication impairs your judgment and reflexes. A trusted person must be with you to drive you home or accompany you on public transit.

Open-Access simply refers to the easy access to a routine screening colonoscopy based on health factors. With Open-Access, the initial office visit with the doctor is eliminated and only a brief summary is provided following the colonoscopy procedure. There is no difference in procedure itself. Open-Access service is designed—and guided by Medicare and medical insurers—to save the doctor’s time for qualifying patients, while the patient benefits by saving a co-pay/office visit fee.
 
Some Open-Access patients elect to have an in-depth consultation with the doctor, in which case, an office visit may be scheduled. However, the Open-Access qualifying patient should expect to cover costs of this visit as it will not be covered by medical insurance.
 
Patients with significant illnesses—poorly controlled diabetes, significant cardiac disease, severe breathing problems, kidney problems—are required to schedule an office visit prior to the procedure and are not eligible for the Open-Access service. Also, if symptoms are present, such as underlying abdominal pain, changes in bowel habits, or any other gastrointestinal issues, an Open-Access Colonoscopy will not be the best initial procedure. In this case as well, a regular office visit should be scheduled.