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Indications | Patient Preparation | Time Requirements | Fees | Practical Considerations
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Patient preparation - Endoscopy

• Esophagus - No food for 12 hours
• Stomach/Duodenum - No food for 12 - 18 hours (24 hours if delayed gastric emptying is suspected)
  No water for 4 hours prior. No atropine/glycolpyrollate unless necessary. Left lateral recumbency.
• Colon - No food 24 - 36 hours. Follow one of the preparation protocols below:
• GoLytely or equivalent given twice two hours apart the afternoon before the procedure (30 ml/kg each dose). GoLytely or equivalent given once, two to four hours before the procedure (30ml/kg). Warm water enema two hours before (20ml/kg).

or

• Without GoLytely, no food 36 - 48 hours before procedure. Two enemas given late in the day before the procedure. Final enema given two hours before procedure.

It is important that these preparation guidelines be followed in order to adequately prepare the patient and insure the best possible results. In the case of colonoscopy, it is absolutely vital that these guidelines are followed so that the colon is completely cleared of fecal matter. The presence of fecal matter in the colon will require abandoning the procedure and repeating the preparation. In may be necessary to hospitalize the patient to insure the guidelines are followed and the patient is adequately prepared.

Patient preparation - Ultrasound

Ultrasound - As air in the intestinal tract will tend to reflect sound waves and obscure the image, it is desirable to fast the patient overnight, allowing water up to 4 hours before the procedure. No other preparation is needed.

Radiographs of the area to be ultrasounded are recommended and, in some cases, vital.

Shaving the area to be examined is necessary and, if done ahead of time, will help speed up the procedure. Abdominal studies require shaving from the 10th intercostal space proximally to the pubis distally and to the border of the epaxial muscles laterally on each side. Echocardiograms require shaving from the axilla to the costal margin and approx. 1/3 of the way up the thoracic wall. No other preparation is needed.

If at all possible, it is best to admit the patient into the hospital early on the morning of the procedure and shave the patient at least one hour before the procedure. These measures are recommended to alleviate patient anxiety. This is especially helpful with echocardiograms to minimize sinus tachycardia and panting which complicate obtaining and evaluating images.