Carolina Digestive Health Associates

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Carolina Digestive Health AssociatesProcedure InformationYou are scheduled for an EGD. Please read all of the attached information as soon as possible so you areprepared for your upcoming procedure.PHYSICIAN PERFORMING PROCEDURE:DATE:LOCATION:PROCEDURE TIME:CHECK-IN TIME:Please closely follow the instructions below in prepping for your procedure. It is very important that youfollow them carefully, or we will be unable to perform the procedure and it will be cancelled.This packet includes:1.Instructions for 7 days, 5 days and 2 days prior to your procedure2.3.Instructions for diabetic patientsInstructions for the day of your procedure4.EGD informationThis information should answer most of the questions you may have about your procedure. If you stillneed additional assistance, please contact our office nearest you.As a reminder, if you cancel your procedure less than 3 business days before your scheduledappointment, you may be charged a 100 no show fee.You must have an adult driver with you at all times when you are at the endoscopy center/hospital.You should expect to be at the endoscopy center/hospital between 2 ½ and 3 hours. Your driver muststay at the endoscopy center/hospital during your procedure.Carolina Digestive Health AssociatesPhone NumbersBillingsley: 704-372-7974Matthews: 704-814-0779Belmont: 704-820-9430Monroe: 704-291-2488Concord: 704-455-9700Pineville: 704-543-7305Davidson: 704-799-2750University: 704-547-8818Revised 11.5.2015

Medication Instructions7 DAYS BEFORE PROCEDURE:oDiscontinue taking Phentermine and Hydroxycut.5 DAYS BEFORE PROCEDURE:oDiscontinue taking medicines that may thin your blood, such as: COUMADIN, PLAVIX, TICLID,Heparin, Aspirin, Excedrin, Effient, Alka Seltzer, Empirin, Ecotrin, Bufferin, Ascriptin, Ibuprofen,Motrin, Advil, Medipren, Nuprin, Naproxen (Naprosyn), Aleve, Sulindac, Clinoril, Piroxicam, Feldene,Indomethacin, Indocin, Diclofenac and Voltaren unless otherwise directed by your physician. If anyof these are a medical necessity for you, please inform us as soon as possible by calling our office.oPlease stop all multi-vitamins and fish oil.o IF YOUR DOCTOR HAS PRESCRIBED ASPIRIN:Please decrease your aspirin to 81 mg a day.oAfter your procedure, you will be informed when you may resume taking your regular medications.oTylenol is safe to use prior to this procedure.o*** If you do not see your medication or supplement listed here, verify with your local pharmacyyour medication doesn’t include Aspirin. ***o*** Contact us if any major health problems occur between now and your procedure.2 DAYS BEFORE THE PROCEDURE:oDiscontinue taking Xarelto, Eliquis, and Pradaxa. If either of these are a medical necessity for you,please inform us NOW.DAY OF THE PROCEDUREoIf you take Blood Pressure Medications, Heart Medications, or Seizure Medications take yourmedicines, at the times you normally would, with a sip of water.GENERAL INSTRUCTIONS FOR DIABETIC PATIENTSooooCheck your blood glucose during the preparation period, especially if you suspect it is too low.Your blood glucose levels may run higher than usual during this period due to adjustments in yourdiabetes medication. If blood glucose becomes extremely high (greater than 350), call our office,your PCP or your diabetes doctor.For low blood glucose levels, you may drink sweetened clear liquids (such as apple juice). Informthe endoscopy nurse upon arrival if this was necessary.Resume your usual diabetic diet and medications immediately after your procedure(s) unless youare instructed to do otherwise. If your diet remains restricted following the procedure, ask forinstructions regarding diabetic medication adjustment.Revised 11.5.2015

Diabetic InstructionsIf you are diabetic and having an EGD, follow these instructions:ORAL DIABETES MEDICATIONS - If you take oral diabetic medications, please hold these medicationsthe morning of your EGD. Restart these medications after the procedure when you resume eating.INSULIN – If you take insulin of any type, follow these guidelines: Lantus or Levmir - Take your usual dose unless your blood glucose is tightly controlled (glucoselevels are usually in the normal range or are occasionally low). In that case, reduce the dosageby one forth on the day before your EGD. Resume your usual dose after the procedure.(Example: If you take 40 units, adjust to 30 units) 70/30 or 75/25 insulin – On the morning of the procedure, take half of your usual dose or, if youhave the procedure before 11:00am, bring your insulin with you to take before your next meal.Resume your usual dose after the procedure. Meal-related insulin – On the morning of the procedure, take half your usual dose or, if youhave the procedure before 11:00am, bring your insulin with you to take before your next meal.Resume your usual dose after the procedure. Sliding Scale Insulin – Continue this as usual. Insulin pump – Reduce the dose of your insulin by one forth the day of the procedure or consultyour endocrinologist for recommendations. Resume your usual dose after the procedure.(Example: If you take 4 units/hour, adjust to 3 units/hour)Revised 11.5.2015

EGDPlease follow the set of instructions marked below based on your scheduled appointment time:Morning Appointment Instructions (Between 7am – 12:40pm)Your procedure is at , please follow the instructions below:After Midnight the evening prior to your procedure – NO Solid foods.However you may have clear liquids ONLY up until (4 hours prior to your scheduledprocedure time).Clear liquid diet guidelines: You may have water, clear fruit juices (white grape, apple), soda (Sprite, Ginger Ale, Pepsi,Coke, and diet colas), Jell-O, ice pops, broth, bouillon, coffee, tea, Gatorade You may NOT have anything red, purple, blue, orangeYou may NOT have milk or milk products (this includes non-dairy creamers)During the 4 hours prior to your scheduled procedure time, you may NOT have anything to eat or drinkincluding: water and all other clear liquids, gum, candy, chewing tobacco, snuff or food items.Afternoon Appointment Instructions (Between 12:40pm – 5pm)Your procedure is at , please follow the instructions below:After Midnight the evening prior to your procedure – NO Solid foods.However you may have clear liquids ONLY up until (4 hours prior to your scheduledprocedure time).Clear liquid diet guidelines: You may have water, clear fruit juices (white grape, apple), soda (Sprite, Ginger Ale, Pepsi,Coke, and diet colas), Jell-O, ice pops, broth, bouillon, coffee, tea, Gatorade You may NOT have anything red, purple, blue, orangeYou may NOT have milk or milk products (this includes non-dairy creamers)During the 4 hours prior to your scheduled procedure time, you may NOT have anything to eat or drinkincluding: water and all other clear liquids, gum, candy, chewing tobacco, snuff or food items.After The Procedure:You may return to a normal diet as tolerated, unless otherwise instructed by your physician. If youexperience abdominal pain, fever or painful swallowing please contact our office immediately. If it isafter hours please go to the emergency room to be evaluated.Revised 11.5.2015

EGD (Esophagogastroduodenoscopy) InformationEsophagogastroduodenoscopy, also known as an upper endoscopy, enables the physician to look insidethe esophagus, stomach, and duodenum (the first part of the small intestine). The procedure might beused to discover and possibly treat the reason for swallowing difficulties, nausea, vomiting, reflux,bleeding, indigestion, abdominal pain, or chest pain.A thin, flexible, lighted tube called an endoscope will be used for the procedure. Right before theprocedure the physician will spray your throat with a numbing agent that may help prevent gagging. Youwill receive medicine to sedate you during the exam. The endoscope transmits an image inside of theesophagus, stomach, and duodenum so the physician can examine the lining of these organs. The scopealso blows air into the stomach; this expands the folds of tissue and makes it easier for the physician toexamine the stomach.The physician can see abnormalities, like ulcers, through the endoscope that doesn’t show up well on xrays. The physician can also insert instruments into the scope to remove samples of tissue (biopsy) forfurther tests. The physician can also use instruments to stop bleeding.Your stomach and duodenum must be empty for the procedure to be thorough and safe. Please see theEGD preparation instructions for complete details. You may resume your normal diet after theprocedure, unless advised otherwise.The procedure takes 5-20 minutes; however, you should be prepared to be at the hospital or endoscopycenter for 2 to 2 ½hours. You must have a responsible driver with you at all times while you are at theendoscopy center/hospital. The day after the procedure, you may return to work or your normalactivities.If biopsies were taken during the procedure, we normally receive the results of the test within 7-10business days. After a doctor reviews the report, the clinical will call or mail you a letter with the resultsand his instructions.

Revised 11.5.2015 Diabetic Instructions If you are diabetic and having an EGD, follow these instructions: ORAL DIABETES MEDICATIONS - If you take oral diabetic medications, please hold these medications the morning of your EGD. Restart thes

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