Colonoscopy Afternoon Appointment
What are polyps?
Your doctor has referred you for a colonoscopy to find out why you are having health problems.
Polyp
This booklet explains what a colonoscopy is and what you need to do to prepare for the procedure. What is a colonoscopy? A colonoscopy is a procedure that allows your doctor to look at the lining of the large intestine.
Polyps are harmless growths in the bowel wall
Colorectal cancer
Large intestine
Some can become cancerous over time
This helps your doctor find out why you are having health problems such as blood in your stools, pain and changes in bowel habits. Removing polyps when they are harmless prevents colorectal cancer
It can also be used to check for colorectal cancer and polyps.
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How is a colonoscopy done? A thin flexible tube is gently inserted into the anus and moved around the large intestine.
What are the risks? A colonoscopy is a safe procedure but complications can occasionally happen.
A tiny camera on the tip of the tube allows the doctor to examine the walls of the bowel to look for growths, bleeding, ulcers, swelling and other health problems.
It is important that you understand the risks before signing the consent form.
Growths, polyps and tissue samples may be removed during a colonoscopy, avoiding the need for surgery.
Possible complications include: • Heavy bleeding after tissue or polyp removal • Puncture of the bowel wall needing surgery to repair • Harmful reaction to sedation drugs • Death (very rare) 2
Common Questions What will happen during my visit?
Change into
Register
gown
Pre-operation checks
Next day
Review appointment (if needed)
Phone
check-up
Can’t you do an x-ray instead? An x-ray is not as accurate at detecting polyps and other bowel problems. Your doctor will be able to see clearly by using a camera to look directly at the intestine wall. Samples can be taken at the same time to better diagnose and treat your health problem.
Payment & Home (accompanied by an adult)
into your bowel during the colonoscopy so the doctor can see better. This may cause some discomfort if you are awake. Do I have to be awake? No. Most people choose to be put into a light sleep (sedated) so they do not feel or remember anything. But you can stay awake and watch the monitor if you wish.
Will it hurt? No, the camera is as thick as your thumb so it is thinner than a normal stool. Air is pumped 3
Needle inserted into hand
Advice & medication given (if needed)
Sleeping drugs given (sedation)
Snack
Bowels are dirty – how will the doctor see anything? You will be given special laxatives to fully empty your bowels and you will need to fast. See the next page for more details about preparing for a colonoscopy. How long will it take? The colonoscopy takes 30 to 45 minutes but your whole visit will last 2 ½ to 3 hours.
Colonoscopy
Rest
Will I be sore afterwards? You will not feel any pain from the camera but you may feel bloated from the air that was pumped in during your colonscopy. The only way to get rid of this is to pass gas. I do not want to pass gas in public! Please do not be shy. Our staff want you to pass gas so you will not have trapped wind which can be painful.
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Preparing for your Colonoscopy It is important to fully clear your bowels. Please follow these instructions: Day before appointment Before 6pm
Light dinner Fish porridge or plain bee hoon or plain mee swa No fruit or vegetables No beef, mutton, pork or fried food Clear drinks only
6pm - 8pm
1st Bowel preparation (Laxatives) Mix 2 sachets of PEG (colonic lavage powder) with 2 litres of water. Drink all before 8pm.
Before bedtime
Drink at least 2 cups of clear drinks
Day of appointment Before 7am
Breakfast 2 slices of plain white bread Clear drinks only No food after 8am until after your colonoscopy
8am - 10am
2nd Bowel preparation (laxatives) Mix 2 sachets of PEG (colonic lavage powder) with 2 litres of water. Drink all before 10am. No drinks after ______am/pm (2 hours before colonoscopy)
Do not eat or drink milk or yogurt
Clear fluids/drinks Water Clear fruit juice (e.g. apple juice) Clear soup with no food pieces Isotonic drinks Tea with no milk or cream (kosong)
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When will the laxatives start working? This can vary. Some people start passing motion within minutes of taking the laxatives while others will start after 1 to 2 hours.
You will need to get to the bathroom quickly. Ask family members to bathe before you start your bowel preparation.
How will I know if my bowels are clean? Your stools will come out looking like urine: yellow, clear and liquid.
Your may feel bloated after taking the PEG drink but this eases once you go to the toilet.
Chill your PEG drink and add clear fruit cordial-it tastes better!
Drink the PEG drink slowly over the 2 hours. Take it easy for the rest of the day because you may still feel drowsy.
Stool colour during preparation
Medication Please follow this advice unless told otherwise by your doctor. Not clean Nearly yet clean
Blood thinning medication e.g. Asprin, plavix, warfarin, heparin, dabigatran, rivaroxaban. Stop taking these pills on:
Clean!
Tips from patients A nurse will call one working day before your appointment – ask the nurse any questions about your preparation. Plan quiet time at home while doing your bowel preparation.
_____________________(date) Iron tablets Stop taking these pills on: _____________________(date) Diabetes medication Do not take while fasting
If you have children or pets ask someone to look after them for you.
Other medication Take with sips of water at least 2 hours before your colonoscopy. 6
Please Remember To arrange for an adult to accompany you home. To Bring Appointment card NRIC/ passport, Employment pass/work permit for non-Singaporeans. Civil Service Card (if applicable). Employer’s guarantee letter (if your employer is paying the bill). Supporting documents for verification if using a family member’s Medisave account. Blood donor card/blood donor nominee card. Parent or guardian if below 21 years old. Do not drive for 24 hours after your colonoscopy (if sedated). Do not climb heights or sign important or legal documents for 24 hours after your colonoscopy (if sedated).
Please Do Not Bring/Wear Makeup Jewellery Nail Polish Valuables Appointment Details Date: ________________________ Time: __________________am/pm Venue Khoo Teck Puat Hospital, Tower A, Level 2, Endoscopy Centre (A22) Admiralty Medical Centre, Level 3, Day Surgery Centre (H34) Please arrive 30 minutes before your appointment time. You can change your appointment up to one week before the date. Please call the outpatient clinic at Tel: _________________________. To see a doctor urgently please go to Khoo Teck Puat Hospital A&E (Acute & Emergency Care Centre).
Yishun Health is a network of medical institutions and health facilities of the National Healthcare Group. Admiralty Medical Centre • (65) 6807 8000 • www.admiraltymedicalcentre.com.sg Khoo Teck Puat Hospital • (65) 6555 8000 • www.ktph.com.sg Yishun Community Hospital • (65) 6807 8800 • www.yishuncommunityhospital.com.sg The information is correct at the time of printing and subject to revision without further notice.
ENDO.PE.04.0517