If you are new to our practice or have not been seen for over a year, please come early to allow time to fill out necessary paperwork. Bring a written list of all of your current medications or put them into a paper bag and bring them along with you. Write down a list of all prior major illnesses, operations, hospitalization, and medical allergies. Be aware of what illnesses run in your family. Don’t forget to bring your insurance cards with you.
(To save time, you may wish to Download Patient Registration Materials from our website. Print it out and write down the information and bring it with you on the day of your appointment.)
If you are taking your laxative solution and develop symptoms of nausea or vomiting, stop the preparation process for an hour or so. Then, if you feel better, try to pick up where you left off. If you can’t complete the preparation, let our staff know. Your test may need to be rescheduled or an alternative preparation tried. You may reach our staff (8:00 am – 4:30 pm) or on-call physician at (434) 817-8484.
Be patient. This laxative solution rarely fails. Most patients have a bowel movement within three hours of starting the solution. Sometimes, there may be a delay. If nothing happens after 4 hours, try taking a small disposable 4-oz Fleet’s enema. They are available at your drugstore. (A hint: don’t drive. Send someone else. Your bowels may “wake up” en route.) Another hint that we tell patients in the office is to avoid constipation on the day you take your laxative prep. If you feel that you are constipated the day before the prep day, take whatever laxative works for you to open things up a bit. A good choice would be 2 tablespoons of Milk of Magnesia and several glasses of water.
Scope examinations such as gastroscopy and colonoscopy require sedation to prevent pain and discomfort. These medications make the test quite simple for the patient but do not wear off immediately. Because of this, you can not drive your car at least 12 hours or until the following morning. Therefore, it is necessary for you to come with a friend or family member who can safely drive you home after your test is over. Ideally, we ask that your driver come with you and stay the entire time you are at our center. This makes them available for questions and allows the doctor to meet with them in the recovery room after your test to explain the results.
After your test, you will probably have a dry mouth and feel drowsy, gassy, and hungry. The dry mouth and drowsiness are from the sedation. These symptoms will gradually wear off. The gassiness is from the air that is inflated into the digestive tract during the scope test. This helps your doctor see inside your stomach or colon. We try to remove most of the air after the procedure, but some of it just has to pass naturally. Of course, since fasting is part of the preparation, you will feel hungry. Our recovery room nurse will offer you some juice or soda after your procedure.
Once you go home, you can pass the rest of the gas and have breakfast. Soon, you will be back to normal. Usually there is no real pain after a scope test nor sore throat after gastroscopy. The sedation given during your examination will likely prevent you from remembering exactly what the doctor had to say. However, you are given a written report of the findings to take home and read once you are more alert. You are also welcome to schedule a follow-up office visit if you feel you have any unanswered questions about your exam.
Most patients are able to return to work the following morning.
The sedatives used for sedation will show up in blood tests for several days. If your job requires random drug testing and you need a written excuse for work, let the doctor know.
The risk of complications is very low for these procedures. In general, if you feel well, you may fly or travel the day after your scope test. However, if the doctor removes a large polyp or if your procedure was unusual in any way, he may request that you stay in the area for at least a week after the exam. This rarely occurs. Certainly, you should not travel to any part of the world where medical attention is not readily available right after any medical procedure. Should a rare complication occur, you may need prompt medical attention.
Barrett’s is a reaction to longstanding esophageal damage caused by corrosive stomach acid refluxing into the esophagus. After many years of heartburn, the cells in the lower esophagus begin to transform into a different type of cell that resembles the intestines below. In a small percentage of patients, the cells go on to form “dysplasia”, or early pre-cancerous changes. Some of these changes progress further to high grade dysplasia or cancer. This is why it is important to undergo routine surveillance endoscopy procedures to assure that there has been no progression of the Barrett’s.
It is true that the risk of esophageal cancer is higher if you have Barrett’s – about 40 times normal. But you have to realize that the typical risk of esophageal cancer in the general population is extremely small – so you are multiplying 40 times a very small number… and the overall risk in those with Barrett’s is only a few percent. Of course, if you are one of those, numbers make no difference. Follow-up is important, especially for those with dysplasia.
Diverticulosis is a condition rather than a disease. The majority of adults have some degree of diverticulosis. It affects the large intestine, or colon. A normal colon is strong and relatively smooth. A colon affected by diverticulosis has weak spots in the walls. These defects allow the development of balloon-like sacs or outpouches – much like a bubble forming on a worn innertube. These hollow pouches, called diverticulae, occur when the inner intestinal lining has pushed through weakened areas of the colon wall. A single pouch is called a diverticulum. The presence of these pouches on the colon is called diverticulosis. When the pouches are inflamed or infected, it is called diverticulitis, a more serious ailment. Most individuals with diverticulosis never develop diverticulitis.
When your stomach slips upward into your chest, we call that a hiatal hernia. The diaphragm is a tough flat muscle that separates your chest from your abdomen. Your stomach is normally entirely below the diaphragm in the abdomen. To connect with your stomach, your esophagus must pass down the middle of your chest and through a hole in the diaphragm called the hiatus.
In simple terms, some people’s hiatus weakens and opens up. This allows the esophagus to “pull the stomach up” into the chest cavity. Since part of the stomach herniates, or pushes through the opening, this condition has been termed a Hiatal Hernia. A hiatal hernia is a common finding in adults and may cause no symptoms at all. Sometimes it is associated with a weakness in the lower esophageal valve and can worsen symptoms of acid reflux, or GERD. Some slip up into the chest one day and back down into the abdomen another. This is called a sliding hiatal hernia. When they become large and permanently stuck above the diaphragm, they are called a fixed hiatal hernia.
Everyone gets a little “stomach bug” from time to time and develops a bit of diarrhea. The cause is not usually known. Sometimes it’s due to emotional stress or a virus. Often the cause is unrecognized food poisoning. Some cases are a reaction to the use of antibiotics. Whatever the cause, most cases are mild and disappear in a few days. Don’t try to stop diarrhea as soon as it develops. Diarrhea is the body’s way of getting rid of whatever food, virus, or bug that is causing it. If the diarrhea is not severe and there is no fever, rectal bleeding, or severe abdominal pain, simple measures are usually effective. This might include using a BRATT diet (bananas, rice, applesauce, toast, tea) for 48 hours and replacing lost fluids. The main initial concern is dehydration, especially in young children and the elderly. Symptoms of dehydration include fatigue, weakness, dry mouth, dark urine, decreased urine flow. Authorities recommend drinking at least 8 to 10 glasses of fluid daily while the symptoms are active. Don’t drink plain water, but instead use a solution such as a sports drink or Pedialyte that also contains needed electrolytes such as sodium and potassium.
If the diarrhea does not respond to fluid and diet changes in a day or two, try one of the over-the-counter antidiarrheal medicines such as Kaopectate, Pepto-Bismol (will blacken bowel movements), or Imodium AD. Simply follow the label instructions.
Rarely, diarrhea is a sign of a more serious infection or ailment. You should call your doctor for the following reasons: