If you take the Aspirin because you have had a heart attack, a cardiac stint or stroke then do NOT stop it prior to the procedure.

If you are taking aspirin only as a precaution then you should stop it for the SEVEN days prior to the procedure.

You may be asked to hold your aspirin for a week after the procedure because with some tests it can increase the risk of bleeding.

We try hard to accomodate any patient's schedule. We keep the waiting time in the office to a minimum.

Dr Fefferman: Monday mornings and Tuesdays
Dr Vanneman and Dr. Chipty : Tuesday
Dr Muggia and Dr. Marcal : Wednesday
Dr Libby Thursday.
Linda Corey NP: Wednesday .

As a group we do procedures 5 days a week. We can accomodate any scheduling request. Individual MD schedules change each week and the office secreatries can answer your questions about availability.

This is the toughest part of a colonoscopy. A good prep means a good exam and an excellent prep means a excellent exam. That being said, it is hard to do an excellent prep. Many people surprise themselves by how well they do. Once you are sure you are clean you can stop the preparation. Some people need a gallon and some only a half gallon. We have many different preps available and and your doctor has prescribed what they believe will work best for you. The safest is the 1 gallon or 1/2 gallon prep because phosphosoda and Mag Citrate can cause dehydration. If nausea and vomiting become an issue, you should slow down, take a half hour to an hour break, drink something you like that will settle your stomach and try again. If your exam is in the afternoon you can split the prep by taking 1/2 at night and 1/2 in the morning.

This can be done in special circumstances. We prefer not to do both because it is an ordeal for physican and patient. Sometimes a single procedure is prolonged and the second procedure gets squeezed. More sedation than usual is necessary.

The suction channel in the scope is very small. It can handle liquids and some deformable soft solids. Low roughage means to avoid foods that are solid and chunky and will clog the scope and compromise the exam. Nuts, corn, peas, popcorn, lettuce are all things that can enter the colon poorly digested and clog the colonoscope.

We can only discharge you to a "responsible" person. The assumption is that family and friends will take good care of you when your judgement is clouded. This is not a insult to taxi drivers but we cannot discharge you to someone who may not act in your best interest if there were an unforseen occurence. Additionally you might miscount your money and over tip the driver.

If your exam is before noon you can wait until after your exam to take your medication. If your exam is after noon you may eat a very light breakfast before 8AM, but no solid food within 8 hours of the procedure, and take only half of your diabetes medication. You will be able to eat shortly after your exam. Clear liquids are OK up to 3 hours before the test.

You can drink clear liquids up to 3 hours before the procedure. If you still do not feel right and think your sugar is low you can use hard candy or a sugar packet to increase your blood sugar.

It takes 30 minutes to check you in, complete the pre-procedure assessment and start an IV. The average procedure takes about 20 minutes. You will be in recovery for 1/2 hour before you are ready to be discharged home. This means about 1 1/2 hours between arrival and when you are ready to go home.

It takes 30 minutes to check you in, complete the pre-procedure assessment and start an IV. The average procedure takes less than 10 minutes. You will be in recovery for 1 hour before you are ready to be discharged home. This means about 1.5 hours(90 minutes) between arrival and when you are ready to go home.

This varies among insurance companies. Please try to familiarize yourself with your plan benefits. It is always a good idea to get a referral from your doctor. We will try our best to be sure the exam is covered. With co-pays and deductibles getting more significant every year you should always check with your plan to see what the exam means to you financially. Do NOT skip a important exam because the insurance piece can be complex and frustrating! Your health is still the most important aspect of the process.

The X-rays of the colon are not as useful, biopsies cannot be taken and polyps cannot be removed. The insurance companies will not pay for a X-ray or Virtual colonoscopy yet. In 2-3 years this may be a real option. Researchers are also working on X-rays that can be done without taking a clean out preparation first. Now for the X-rays you still have to do the whole preparation.

The Video Camera Capsule looks at the small bowel but as of now it cannot be reliably used to evaluate the colon. Currently Colonscopy is still the best and most effective screening tool available.

High risk patients, those with polyps or a family history of colon cancer need an exam at least every five years and sometimes sooner. Your gastroenterologist will set a personal screening protocol for you.

Low risk patients who have a normal exam and do not have polyps can go 10 years between exams but this is also individualized.

There are situations where a colonoscopy is repeated in 3 or 6 months. There are many patients who have a colonoscopy every year.

There is no set interval which covers all patients but most exams are done in 5 or 10 year intervals.

We always greet our patients, review the procedure, risks, benefits and alternatives in person before giving any sedation. We are also happy to review the procedure with you, in the office, ahead of time at no charge. If you have medical concerns or issues that you would like to review then we can arrange an office consultation to review them but that would incur a charge and with many insurers require a referral. We have patient education videos in some of the offices which can be watched prior to the procedure.

Digestive Health Associates is available all the time. You are free to call if you have concerns. It does not bother us and it is our job to make this easy for you as we can. We would much rather speak with you than have you get frustrated and cancel an exam that could be life saving!

Liver biopsies are done under ultrasound guidance with a biopsy device. This is safer, quicker and the discomfort from the biopsy is limited to a "pinch." Some people get right shoulder pain after the procedure. Any significant amount of abdominal pain is usually related to bleeding after the biopsy and this is uncommon. Review your information sheet on the specific risks of a liver biopsy.

A polyp is a proliferation of colonic mucosa. Inflammatory polyps are benign. Hyperplastic polyps are also benign. Adenomas, or adenomatous polyps are the "pre-cancerous" polyps that we remove to decrease the chance of getting colon cancer. Some polyps are more atypical than others and when you discuss your results with your doctor ask what kind of polyps you have and what your followup should be.

Endoscopic Retrograde CholanioPancreatography. We can look at the bile ducts and pancreatic duct with this specialized exam. This same test can be done with an MRI but we cannot treat anything by Xray.