BowelPrepGuide https://bowelprepguide.com Your guide to excellent bowel prep Sun, 12 Aug 2018 15:58:26 +0000 en-US hourly 1 https://wordpress.org/?v=4.9.8 92279279 Is coffee a clear liquid diet for colonoscopy https://bowelprepguide.com/is-coffee-a-clear-liquid/ https://bowelprepguide.com/is-coffee-a-clear-liquid/#respond Sun, 29 Jul 2018 01:05:03 +0000 https://bowelprepguide.com/?p=7704   Coffee is the most popular beverage in America. Worldwide, about 1 billion people drink this beverage every day. People love coffee for different reasons. For some, it is the boost in brain power and energy they get from the drink. For others, it is the social interactions often associated with the beverage. Whatever the […]

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is coffee a clear liquid diet

 

Coffee is the most popular beverage in America. Worldwide, about 1 billion people drink this beverage every day. People love coffee for different reasons. For some, it is the boost in brain power and energy they get from the drink. For others, it is the social interactions often associated with the beverage. Whatever the reason, people enjoy coffee. For a lot of people, a cup of joe in the morning is a necessity. Are you one of those people?

Food, Drinks and Colonoscopy 

Restrictions are often placed on what you can eat and drink prior to colonoscopy. Most physicians recommend a clear liquid diet the day before colonoscopy.  Read What food can I eat before colonoscopy. 

Is coffee a clear liquid diet? 

Yes. Coffee without milk or cream is considered clear liquid for colonoscopy.  This is despite the fact that clear liquid diet is often described as liquid you can read a newspaper through.  So go ahead, have your morning joe without milk. Adding milk or cream disqualify it as a clear liquid diet.

Tea without milk or cream is also a clear liquid diet for colonoscopy.

 

what to eat before colonoscopy

 

Coffee Facts 

  • The beans are the seeds of berries (cherries) from the Coffea plant.
  • There are 2 growing areas for the plant. Low altitude areas like Indonesia have more oxygen and more yield. And then high altitude areas like Ethiopia with low oxygen. The plants utilize anaerobic respiration. The beverage from this region is sweeter and creamier.
  • We have two ways of extracting beans from the berries. The wash method and the natural method. The wash method is a wet process while the natural method is a dry process.
  • Different roasts of coffee exist. They depend on how long the bean stays in the oven. There are light, medium, and dark roasts. Dark roasts retain more of the original flavor yet light roasts have more caffeine
  • There are different ways of brewing coffee. The two main ways are the total immersion (French press) method and the pour over (Chemex) method.
  • There are several ways of serving the beverage.

 

Coffee Benefits

 

Suggested Reading 

 

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Medications and foods to stop before colonoscopy https://bowelprepguide.com/stop-before-colonoscopy/ https://bowelprepguide.com/stop-before-colonoscopy/#respond Mon, 09 Jul 2018 00:40:51 +0000 https://bowelprepguide.com/?p=7615 Medications and food may affect your bowel preparation for colonoscopy. Some medications may cause you to bleed more during or after colonoscopy. This is particularly true if some form of therapeutic procedures (biopsies, dilation, polypectomy) are performed during colonoscopy. Some medication and food may affect the cleanliness of your colon. Certain medications and food can […]

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stop before colonoscopy

Medications and food may affect your bowel preparation for colonoscopy. Some medications may cause you to bleed more during or after colonoscopy. This is particularly true if some form of therapeutic procedures (biopsies, dilation, polypectomy) are performed during colonoscopy.

Some medication and food may affect the cleanliness of your colon. Certain medications and food can slow your gut causing constipation and therefore poor bowel prep. You need to stop before colonoscopy certain medications and foods.

Medications to stop before colonoscopy 

Anti-platelet medications 

Anti-platelet medications are used to prevent stroke and heart attack. In addition, they can prevent any artery from getting blocked like arteries in the leg.

You do not need to stop aspirin before colonoscopy. On the other hand, some people need to stop their plavix before colonoscopy. Talk to your doctor if you take any of these medications and ask if you need to stop or continue them.

Examples of anti-platelet medications
  •  Aspirin
  • Clopidrogel (Plavix)
  • Ticlopidine (Ticlid)
  • Prasugrel (Effient)
  • Ticagrelor (Brillinta)
  • Dipyridamole (Persantine)
  • Aggrenox (dipyridamole plus aspirin)
  • Abciximab (ReoPro)

Anti-coagulation medications

Anticoagulants are blood thinners that are used to prevent or treat blood clots. They are used in patients with arrhythmia such as atrial fibrillation, deep vein thrombosis, pulmonary embolism, mechanical heart valves, heart attack and stroke.

You need to stop your anti-coagulation medications before your colonoscopy. Heparin has to be stopped 4-6 hours before your colonoscopy. Lovenox is usually stopped about 12 hours before colonoscopy.  Warfarin (Coumadin) is usually stopped 5-7 days before your colonoscopy. Other oral anticoagulation medications like Eliquis and Xarelto can be stopped 2-3 days before colonoscopy.

Examples of anticoagulation medications
  • Heparin
  • Coumadin (Warfarin)
  • Rivaroxaban (Xarelto)
  • Apixaban (Eliquis)
  • Dabigatran (Pradaxa)
  • Bivalirudin (Angiomax)
  • Argatroban
  • Enoxaprin (Lovenox)
  • Dalteparin (Fragmin)
  • Tinzaparin (Innoprin)
  • Fondaparinux (Arixtra)

Diabetic medications

There are 2 types of diabetes mellitus. Insulin-dependent and non-insulin dependent diabetes mellitus. There are 2 main types of medications-insulin and non-insulin medications. Take only half the usual dose of your pills or insulin the day before your colonoscopy while you’re on clear liquid diet. Do not take oral diabetic medications or short-acting insulin on the day of your colonoscopy. Read Diabetes and colonoscopy. How to take your medications before colonoscopy.

Examples of diabetic medications

Click list of medications for diabetes mellitus. 

Anti-diarrhea medications

Some people with diarrhea take medications that can reduce their stool counts. Medications like  Imodium®, Lomotil®, and Pecto Bismol® should be stopped about 1 week before your colonoscopy. You want to be cleaned out therefore anything that will make you hold on to your stool should be avoided.

Non-steroidal anti-inflammatory agents (NSAIDS)

These medications include aspirin, ibuprofen, naproxen, meloxicam, indomethacin, diclofenac, and sulindac. There are others. Aspirin is mostly used for heart conditions while the others are mainly pain medications. In general, these medications may be used in the days before colonoscopy. You do not need to stop any of these medications before colonoscopy particularly aspirin. However, follow the specific instruction of your physician because these medications may affect some of your colonoscopy findings. 

Fiber and supplements

Fiber supplements include psyllium, glucomannan, methylcellulose, flaxseed, wheat dextrin, calcium polycarbophil, and inulin. They are found in products such as Metamucil®, Citrucel®, and Benefiber®. They should be stopped 1 week before your colonoscopy.

Food to stop before colonoscopy 

Food affects bowel prep. Avoid high fiber diet starting 3 days before your colonoscopy. A day before your colonoscopy, your physician will put you on either a clear liquid diet or a low fiber diet. Most people are placed on a clear liquid diet a day before colonoscopy. Read What food can I eat before colonoscopy.

 

Suggested Reading 

 

 

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Diabetes and colonoscopy. How to take your medications before colonoscopy. https://bowelprepguide.com/diabetes-and-colonoscopy/ https://bowelprepguide.com/diabetes-and-colonoscopy/#respond Sat, 30 Jun 2018 23:26:55 +0000 https://bowelprepguide.com/?p=7658 If you have diabetes mellitus, preparing for colonoscopy requires special instructions.  Food, bowel preparation and the colonoscopy procedure affect your blood sugar. Make sure you discuss your diabetes with your physician before your colonoscopy. Diabetes and colonoscopy. Why you need special instructions You cannot eat regular diet before your colonoscopy. As a result, your need for medications […]

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diabetes and colonoscopy

If you have diabetes mellitus, preparing for colonoscopy requires special instructions.  Food, bowel preparation and the colonoscopy procedure affect your blood sugar. Make sure you discuss your diabetes with your physician before your colonoscopy.

Diabetes and colonoscopy. Why you need special instructions

  • You cannot eat regular diet before your colonoscopy. As a result, your need for medications to lower your blood sugar is lower.
  • Your blood sugar will fluctuate depending on what you eat therefore checking your blood sugar frequently is important.
  • Diarrhea from the bowel cleansing agent can cause dehydration and affect your blood sugar.

Diabetes and colonoscopy. What to eat before colonoscopy

  • Most people are on clear liquid diet a day before colonoscopy. Some people can eat low fiber diet a day before colonoscopy.
  • Your doctor will direct you on what kind of food you can have a day before your colonoscopy. Clear liquid diet or low fiber diet.

Diabetes and Colonoscopy. How to take your bowel preparation agent

 

Diabetes and Colonoscopy. How to take your diabetic medications.

  • Take only half the usual dose of your pills or insulin the day before your colonoscopy while you’re on clear liquid diet.
  • Check your blood sugar before meals and at bedtime on the prep day and the day of your colonoscopy.
  • Do not take oral diabetic medications or short-acting insulin on the day of your colonoscopy.
  • You may be told to take half the usual dose of your long-acting insulin on the day of your colonoscopy.
  • If you have an insulin pump, your endocrinologist or diabetes specialist will give you instructions on what to do.
  • Your doctors will guide you on how to take your medications before your colonoscopy.

 

Suggested reading before your colonoscopy

 

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The gastroparesis diet for slow stomach https://bowelprepguide.com/gastroparesis-diet/ https://bowelprepguide.com/gastroparesis-diet/#respond Tue, 26 Jun 2018 05:37:02 +0000 https://bowelprepguide.com/?p=7635 The gastroparesis diet is recommended for patients with gastroparesis (slow stomach). What is gastroparesis? Gastroparesis is a low stomach. It is delayed gastric emptying in the absence of a mechanical obstruction. What causes gastroparesis? Idiopathic-unknown cause. Diabetes mellitus. Viruses. Medications like narcotics, antidepressants, and anti-hypertensive drugs. Autoimmune disorders. Neurologic disorders like parkinson’s disease and multiple […]

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Gastroparesis diet for slow stomach

The gastroparesis diet is recommended for patients with gastroparesis (slow stomach).

What is gastroparesis?

Gastroparesis is a low stomach. It is delayed gastric emptying in the absence of a mechanical obstruction.

What causes gastroparesis?

  • Idiopathic-unknown cause.
  • Diabetes mellitus.
  • Viruses.
  • Medications like narcotics, antidepressants, and anti-hypertensive drugs.
  • Autoimmune disorders.
  • Neurologic disorders like parkinson’s disease and multiple sclerosis.
  • Surgeries like gastric bypass.

How do you diagnose gastroparesis?

  • Symptoms of gastroparesis like nausea, vomiting, easy fullness, abdominal pain, bloating.
  • Upper endoscopy to exclude mechanical obstruction.
  • Gastric emptying study. When more than ten percent of a standardized meal is still present in the stomach after 4 hours.

How do you treat gastroparesis?

  • Diet.
  • Medications like Reglan, erythromycin, Zofran.
  • Gastric electrical stimulation.
  • Surgery.

What is the gastroparesis diet? 

Gastroparesis diet can reduce the symptoms of gastroparesis and provide nutritional support.

How to eat when you have gastroparesis

  • Liquid diet is better because gastric emptying of liquids is preserved in patients with gastroparesis.
  • Low fat is better because fat delays gastric emptying.
  • Low fiber is better because fiber delays gastric emptying.
  • Small size meal is better because the stomach may only empty 1-2kcal per minute.
  • It is better to have small low fat, low fiber meals 4-5 times a day.
  • Avoid alcohol and tobacco smoking because they can affect gastric emptying.
  • If you have diabetes mellitus, control your blood sugar because high blood sugar delays gastric emptying.

 

How to eat during an acute episode of gastroparesis

How to eat immediately after an acute episode of gastroparesis

  • Liquids and solids. May have less than 40 grams of fat.
  • Examples are skim milk, low fat yogurt, low fat cheeses, fat free consommé and bouillon, and fat free broth. Also, white rice, egg noodles, low fat crackers, eggs, vegetable juice, and cooked vegetables without skins. In addition, frozen yogurt, fruit ice, gelatin, puddings and custards.

How to eat to maintain weight and nutritional needs

  • Liquids and solids. May have less than 50 grams of fat per day. High fiber diet is discouraged.
  • Examples are skim milk, low fat yogurt, low fat cheeses, fat free consommé and bouillon, and fat free broth. Also, white rice, egg noodles, low fat crackers, eggs, vegetable juice, and cooked vegetables without skins. In addition, frozen yogurt, fruit ice, gelatin, puddings and custards.
  • You may have other foods in small quantities while avoiding high fiber foods.

 

 

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How to use Golytely for severe chronic constipation https://bowelprepguide.com/golytely-for-severe-chronic-constipation/ https://bowelprepguide.com/golytely-for-severe-chronic-constipation/#respond Mon, 25 Jun 2018 03:57:36 +0000 https://bowelprepguide.com/?p=7630 For some patients with chronic constipation, nothing helps. These patients have had constipation for years. They have done blood tests, CT scans, and colonoscopy. Many have done motility testing and anorectal manometry. Some can go for a week or more without a bowel movement. They have severe chronic constipation. These patients have tried all available over the counter laxatives […]

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How to use Golytely for severe chronic constipation

For some patients with chronic constipation, nothing helps. These patients have had constipation for years. They have done blood tests, CT scans, and colonoscopy. Many have done motility testing and anorectal manometry. Some can go for a week or more without a bowel movement. They have severe chronic constipation.

These patients have tried all available over the counter laxatives like senna, Dulcolax, magnesium citrate, miralax. Some have even tried prescription medications like Amitiza® and Linzess®. Can anything work?

Can I use the same medication I use for colonoscopy for severe chronic constipation?

Polyethylene glycol (PEG) based lavage solutions are used for bowel cleansing prior to colonoscopy and surgery. They include Colyte (Alaven), GoLYTELY (Braintree), NuLYTELY (Braintree), and TriLyte (Alaven). GoLYTELY is the most popular. These medications can be used in similar fashion.  The main ingredient-polyethylene glycol is also the main ingredient in MiraLax®.

How to use GoLYTELY® (or similar PEG-based medications) for severe chronic constipation

  • Make sure you are under the care of a physician. And follow the direction of your physician.
  • GoLYTELY® (or similar PEG-based medications) are approved by the Food and Drug Administration (FDA) for bowel preparation. They are not FDA approved for constipation. Yet they can be used for constipation.
  • Do not mix the GoLYTELY® solution like you want to have colonoscopy. Do not follow that instruction.
  • Remove the powder inside the bottle of GoLYTELY®. Each bottle contains enough powder for about 16 doses.
  • Put the powder in a clean and dry container.
  • If your bottle comes with artificial favor packets, mix the powder with the GoLYTELY® powder for flavor.
  • If your bottle does not come with artificial flavor, you may add one packet of Crystal Light® Lemonade mix powder to the GoLYTELY® powder for flavor.
  • Each day, dissolve 1 tablespoon of the GoLYTELY® powder in an 8 ounce glass of water. Refrigerate to chill.
  • Drink the glass of GoLYTELY® solution every day (preferably morning). Follow this with 1-2 glasses of water or fluid.
  • You may need less or you may need more. 1-2 glasses of GoLYTELY® solution is often enough.
  • You may continue your other medications and supplements with this regimen.
  • This regimen is usually used for a short period of time.
  • Always follow the instruction of your physician.

 

 

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You have anemia. Why you should see a gastroenterologist https://bowelprepguide.com/have-anemia/ https://bowelprepguide.com/have-anemia/#respond Sun, 17 Jun 2018 03:38:02 +0000 https://bowelprepguide.com/?p=7567 Anemia affects a lot of people. One-quarter of the world’s population have anemia. More than 3 million Americans have anemia. The most common form of anemia is iron deficiency anemia. This is anemia caused by lack of enough iron. Iron deficiency anemia is bad. It can reduce your quality of life and cause premature death. […]

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You have anemia

Anemia affects a lot of people. One-quarter of the world’s population have anemia. More than 3 million Americans have anemia. The most common form of anemia is iron deficiency anemia. This is anemia caused by lack of enough iron.

Iron deficiency anemia is bad. It can reduce your quality of life and cause premature death.

What is anemia?

The World Health Organization defines anemia as hemoglobin below 13.0 g/dL in male adults, below 12.0 g/dL in non-pregnant female adults, and below 11.0 g/dL in pregnant women.

What is iron deficiency anemia?

Iron deficiency is suggested by low mean corpuscular volume (MCV), wide red cell distribution width (RDW), transferrin saturation less than 20% or a ferritin level lower than 30 ng/mL.

What causes iron deficiency anemia?

Iron deficiency anemia can be due to poor iron intake, poor absorption of iron, increased demand for iron, gastrointestinal loss, gynecologic loss and others.

Lack of iron consumption
  • Vegetarian diet. Click HERE for foods high in iron.
Poor iron absorption
  • Celiac disease.
  • Surgery such as gastric resection, gastric bypass, and duodenal resection.
  • Autoimmune gastritis.
  • Helicobacter pylori gastritis.
  • Crohn’s disease affecting the small intestine.
Not enough iron due to increased need
  • Pregnancy.
  • Lactation.
  • Use of erythropoiesis stimulating agents.
Gastrointestinal Loss
  • Malignancy like stomach cancer, colon cancer.
  • Peptic ulcer disease like gastric ulcer and duodenal ulcer.
  • Variceal bleeding.
  • Esophagitis.
  • Mallory-Weiss tear.
  • Angiodysplasia and vascular ectasia.
  • Dieulafoy lesions.
  • Cameron lesions.
  • Meckel diverticulum.
  • Infectious colitis.
  • Inflammatory bowel disease (ulcerative colitis and crohn’s disease).
  • Diverticular disease like diverticular bleeding and diverticulitis.
  • Anal fissure.
  • Rectal ulcers.
  • Hemorrhoids.

 

Gynecologic Loss
  • Menorrhagia (heavy menses).
  • Uterine cancer.

 

Other causes
  • Blood loss from trauma, surgery, childbirth.
  • Blood donation.
  • Medications such as non-steroidal anti inflammatory drugs.
  • Parasites such as hookworm and tapeworm.
  •  Idiopathic pulmonary hemosiderosis.
  • Hereditary hemorrhagic telangiectasia.

 

Why you should see a gastroenterologist for iron deficiency anemia

  • If you are older than 50 years or a post-menopausal woman, iron deficiency anemia is often due to gastrointestinal loss.
  • Gastroenterologists are trained to perform various endoscopic procedures.  They can identify bleeding lesions within the gastrointestinal tract and control them. A gastroenterologist is also trained to take endoscopic biopsies if necessary and remove lesions within the gastrointestinal tract.
  • If you see a gastroenterologist, you are likely to get an upper endoscopy and a colonoscopy. An upper endoscopy is also called esophagogastroduodenoscopy (EGD). If EGD and colonoscopy are negative, you may also get a capsule endoscopy. Also, you may need a push enteroscopy or balloon enteroscopy.  There are other tests that may be necessary for iron deficiency anemia such as nuclear bleeding scan, arteriography, or meckel’s scan. If no bleeding source is found, you may need a bone marrow biopsy.

Treatment for iron deficiency anemia 

  • Blood transfusion if necessary.
  • Iron supplementation (oral or intravenous).
  • Identify the cause of iron deficiency anemia.
  • Stop further loss of blood.

 

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When your patient has colon cancer https://bowelprepguide.com/colon-cancer/ https://bowelprepguide.com/colon-cancer/#respond Mon, 11 Jun 2018 00:10:44 +0000 https://bowelprepguide.com/?p=7564 Jane (not true name) was referred to me for iron deficiency anemia. This is anemia due to lack of enough iron. She was 62 years old and attained menopause at age 55 after removing her uterus due to fibroid. Jane was divorced yet she enjoyed life and liked to socialize. Bring up the possibility even […]

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when your patient has colon cancer

Jane (not true name) was referred to me for iron deficiency anemia. This is anemia due to lack of enough iron. She was 62 years old and attained menopause at age 55 after removing her uterus due to fibroid. Jane was divorced yet she enjoyed life and liked to socialize.

Bring up the possibility even before the diagnosis

We discussed her blood count and the evidence that supports iron deficiency. Her anemia was not severe enough to require blood transfusion.  I asked her if she saw blood in her stool or have black stool and she said no. We discussed all the possible reasons she may have iron deficiency anemia including cancer.

All patients referred to me for unexplained iron deficiency anemia gets an upper endoscopy and colonoscopy unless information points to a specific location as the source of blood loss.

Tell them what you see looks like cancer but confirmation needed

Jane’s upper endoscopy was normal. There was no evidence of celiac disease. Her colonoscopy however showed a large mass in the colon. The mass occupied about 50% of the lumen of the colon. Biopsies were obtained from the mass and submitted to the pathologist for analysis.

After the procedure, Jane was taken to the recovery room. Patients often come for procedures accompanied by a family member or friend. Mary (not true name) accompanied Jane. I asked Jane some questions to ascertain her level of alertness. She said it was okay to discuss her health in the presence of her friend. I described what I found. Furthermore, I was direct in telling them that I think the mass was colon cancer and the reason she has iron deficiency anemia. Confirmation of the diagnosis is needed from the pathologist, I told them. I ordered a tumor marker called Carcinoembryonic Antigen (CEA test). And, I ordered a CT scan.  In addition, I called the pathology department to put a rush on the request.

Over the phone or in-person 

Two days later, I received a call from the pathologist. It was poorly differentiated adenocarcinoma of the colon. I asked my medical assistant to make an appointment for Jane to see me. She was told to bring a a family member.

Again, Jane came with Mary. I told her she has colon cancer. Also, her CEA level was high but the CT scan did not show any spread of cancer anywhere else. I waited for her to digest the news. I waited for a response. She expressed understanding of the result.

Where do we go from here 

Because the cancer is limited to the colon, there is a chance for cure. I went over treatment options. I asked her what she wanted to do. She chose to pursue treatment and fight. A referral was sent to a medical oncologist and a colorectal surgeon.

Last week, I saw Jane for her 1 year surveillance colonoscopy. She had surgery and chemotherapy. Her colonoscopy did not show any polyp or mass. She had beaten colon cancer.

How to tell patients they have colon cancer

  • Know your patient. A knowledge of your patient’s clinical, psychological, social, and economic background will help you take care of the whole person.
  • Have someone else with the patient when you break the news. If possible, tell patients of their diagnosis in the presence of a family member or close friend. Often, patients don’t hear any other word after the word cancer has been mentioned.
  • If possible, tell the patient in-person. There are times when a phone call will suffice. Usually, there are follow up questions by the patient or a family member. Having the patient in front of you allows you to connect with the patient at their most vulnerable point.
  • Be direct. Be frank and honest with your patient regarding the diagnosis and prognosis.
  • Stay. Be with the patient has they journey through treatment. Assist in any way possible.
  • Recognize your limitation. Despite your best efforts, communication may go wrong or treatment may fail.

 

Suggested Reading

 

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My colonoscopy bill: The true cost of colonoscopy. https://bowelprepguide.com/colonoscopy-bill/ https://bowelprepguide.com/colonoscopy-bill/#respond Wed, 06 Jun 2018 03:15:32 +0000 https://bowelprepguide.com/?p=7537 Colonoscopy is a life-saving procedure but it comes with a bill. There are so many factors that influence the cost of colonoscopy. The cost of colonoscopy varies from region to region, facility to facility and provider to provider. Components of a colonoscopy bill Doctor’s visit. Bowel cleansing agent. Cost of missing a day’s work. Facility […]

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colonoscopy bill

Colonoscopy is a life-saving procedure but it comes with a bill. There are so many factors that influence the cost of colonoscopy. The cost of colonoscopy varies from region to region, facility to facility and provider to provider.

Components of a colonoscopy bill

  1. Doctor’s visit.
  2. Bowel cleansing agent.
  3. Cost of missing a day’s work.
  4. Facility fee. The fee charged by the facility where the procedure is performed.  This fee covers the use of the facility, equipment, and staff.
  5. Professional fee. This includes professional fee for the physician (gastroenterologist), the anesthesiologist (if one is used), and the pathologist (if one is used).

 

Why colonoscopy bill may be different

  1. Type of colonoscopy.  There are 3 types of colonoscopies. Screening colonoscopy, diagnostic colonoscopy and therapeutic colonoscopy. Screening colonoscopy is covered for free under the Affordable Care Act. However, if a polyp is removed, it changes to a therapeutic colonoscopy and you may have a co-pay. Therapeutic colonoscopy costs more than screening or diagnostic colonoscopy.
  2. Type of facility.  There are four different facilities where a colonoscopy can be done. Hospital, hospital out-patient department (HOPD), ambulatory surgery center (ASC), and physician office. Colonoscopy is more expensive in hospital and HOPD.
  3. Type of sedation.  Colonoscopy can be done without sedation but most people prefer sedation. If sedation is used, it can be minimal, moderate, deep or general anesthesia. Minimal and moderate sedation can be achieved using intravenous medications like fentanyl and midazolam (versed). Sometimes diphenhydramine (benadryl) is also used. Minimal and moderate sedation can be given by the same physician performing the colonoscopy. Deep sedation can be achieved with propofol. If deep sedation or general anesthesia is required, a separate provider (an anesthesiologist or nurse anesthetist) is usually involved. This provider charges an anesthesia fee that increases the cost of the colonoscopy.
  4. Type and number of specimen (biopsies).  Any biopsy or tissue (polyp, growth, cancer) removed during colonoscopy is sent to the pathologist for analysis. The more the bottles of specimen submitted for analysis, the more expensive the procedure.

 

Fees and Charges associated with colonoscopy bill

  • Technical fee. The fee charged by the facility where the colonoscopy is performed.
  • Professional fee. The fee charged by the physician (gastroenterologist, anesthesiologist, pathologist).
  • Co-Pay. This is a fixed amount you pay for health-care services. Under the Affordable Care Act, co-pays and deductibles are waived for preventive services like screening colonoscopy.
  • Deductible. This is the amount you have to pay for health-care services before your insurance company begins to pay.
  • Co-Insurance. This is your share (in percentage) of the cost of health-care services. If you have co-insurance, you usually pay this after paying your deductible.
  • Billed charge. The amount the provider charges the insurance company.
  • Reimbursement (Allowed) amount. The amount actually paid by your insurance company.
  • In-Network. This means your physician or procedure facility already has an agreement with the insurance company to provide services for you. In-Network providers cost less than Out-Network providers.

Find out the cost of colonoscopy in your area

For the cost of colonoscopy in your area, click HERE.

 

Suggested Reading

The 3 P’s of colonoscopy: Factors that determine the outcome of colonoscopy.

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How to use Plenvu for colonoscopy bowel preparation https://bowelprepguide.com/how-to-use-plenvu/ https://bowelprepguide.com/how-to-use-plenvu/#respond Fri, 01 Jun 2018 05:06:51 +0000 https://bowelprepguide.com/?p=7531   Plenvu is the first 1 liter PEG-based bowel cleansing agent. Plenvu can be used alone or in conjunction with over the counter laxatives like bisacodyl or magnesium citrate. If an over the counter laxative is also recommended by your physician, it is usually used about 1 hour before the bowel cleansing agent. There are […]

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how to use plenvu

 

Plenvu is the first 1 liter PEG-based bowel cleansing agent. Plenvu can be used alone or in conjunction with over the counter laxatives like bisacodyl or magnesium citrate. If an over the counter laxative is also recommended by your physician, it is usually used about 1 hour before the bowel cleansing agent. There are 2 main ways to take your bowel cleansing agent: the day before regimen or the split dose regimen.

Day-Before Bowel Preparation For Colonoscopy Using PLENVU

What do I do a day before the colonoscopy?

  • Have a clear liquid diet throughout the day. Clear liquid diet excludes red and purple colored substances. No solid foods, milk products, fruits, seeds & nuts.
  • Be sure to keep hydrated by drinking 8oz of clear liquid every hour.
  • If you have diabetes mellitus, you may need to take half the dose of your medication while on clear liquid diet. Please, talk to your provider about this.
  • Open the carton and remove the dose 1 sachet.
  • Pour the contents of dose 1 into a measuring container that can hold 500 ml of fluid.
  • Add water to make up to 500 ml and stir until all the powder has dissolved. This may take up to approximately 8 minutes.
  • Drink the 500 ml Plenvu dose 1 solution over 30 minutes by drinking 1 glassful every 10 to 15 minutes. This should be done in the afternoon or early evening before the colonoscopy (e.g., 4:00 to 6:00 PM).
  • Following the Plenvu dose, drink a further 500 ml of clear fluid over a further 30 minutes.
  • If severe bloating, distention, or abdominal pain occurs, following the first dose, delay the second dose until the symptoms resolve.
  • Dose 2 – Approximately 6 hours later in the evening the night before the colonoscopy (e.g., 10:00 PM to 12:00 AM):Take the second dose of Plenvu.
  • Pour the contents of dose 2 into a measuring container that can hold 500 ml of fluid.
  • Add water to make up to 500 ml and stir until all the powder has dissolved. This may take up to approximately 8 minutes.
  • Drink the 500 ml Plenvu dose 2 solution over 30 minutes by drinking 1 glassful every 10 to 15 minutes.
  • Following the Plenvu dose, drink a further 500 ml of clear fluid over a further 30 minutes.

What do I do on the day of the colonoscopy?

  • You may take your morning medications as usual unless as directed by your doctor.
  • Avoid further fluid intake 2 hrs before your scheduled colonoscopy.
  • If you are diabetic, do not take oral diabetic medications or short-acting insulin on the day of your colonoscopy. Talk to your provider about this.

 

Split-Dose Bowel Preparation For Colonoscopy Using PLENVU

What do I do a day before the colonoscopy?

  • Have a clear liquid diet throughout the day. Clear liquid diet excludes red and purple colored substances. No solid foods, milk products, fruits, seeds & nuts.
  • Be sure to keep hydrated by drinking 8oz of clear liquid every hour.
  • If you have diabetes mellitus, you may need to take half the dose of your medication while on clear liquid diet. Please, talk to your provider about this.
  • Take the first dose of Plenvu during the evening before the colonoscopy (e.g., 5:00 to 9:00 PM).
  • Open the carton and remove the dose 1 sachet.
  • Pour the contents of dose 1 into a measuring container that can hold 500 ml of fluid.
  • Add water to make up to 500 ml and stir until all the powder has dissolved. This may take up to approximately 8 minutes.
  • Drink the 500 ml Plenvu dose 1 solution over 30 minutes by drinking 1 glassful every 10 to 15 minutes.
  • Following the Plenvu dose, drink a further 500 ml of clear fluid over a further 30 minutes.
  • If severe bloating, distention, or abdominal pain occurs, following the first dose, delay the second dose until the symptoms resolve.

What do I do on the day of the colonoscopy?

  • Take the second dose of Plenvu 4-5 hours before your scheduled colonoscopy.
  • Pour the contents of dose 2 into a measuring container that can hold 500 ml of fluid.
  • Add water to make up to 500 ml and stir until all the powder has dissolved. This may take up to approximately 8 minutes.
  • Drink the 500 ml Plenvu dose 2 solution over 30 minutes by drinking 1 glassful every 10 to 15 minutes.
  • Following the Plenvu dose, drink a further 500 ml of clear fluid over a further 30 minutes.
  •  Avoid further fluid intake 2 hours before your scheduled colonoscopy.
  • If you are diabetic, do not take oral diabetic medications or short-acting insulin on the day of your colonoscopy. Talk to your provider about this.

 

Day-Before Bowel Preparation For Colonoscopy Using PLENVU and Bisacodyl (Dulcolax)

What do I do a day before the colonoscopy?

  • Have a clear liquid diet throughout the day. Clear liquid diet excludes red and purple colored substances. No solid foods, milk products, fruits, seeds & nuts.
  • Be sure to keep hydrated by drinking 8oz of clear liquid every hour.
  • If you have diabetes mellitus, you may need to take half the dose of your medication while on clear liquid diet. Please, talk to your provider about this.
  • Take 4 tablets of bisacodyl (Dulcolax) around 3:00-4:00 PM.
  • Open the carton and remove the dose 1 sachet.
  • Pour the contents of dose 1 into a measuring container that can hold 500 ml of fluid.
  • Add water to make up to 500 ml and stir until all the powder has dissolved. This may take up to approximately 8 minutes.
  • Drink the 500 ml Plenvu dose 1 solution over 30 minutes by drinking 1 glassful every 10 to 15 minutes. This should be done in the afternoon or early evening before the colonoscopy (e.g., 4:00 to 6:00 PM).
  • Following the Plenvu dose, drink a further 500 ml of clear fluid over a further 30 minutes.
  • If severe bloating, distention, or abdominal pain occurs, following the first dose, delay the second dose until the symptoms resolve.
  • Dose 2 – Approximately 6 hours later in the evening the night before the colonoscopy (e.g., 10:00 PM to 12:00 AM):Take the second dose of Plenvu.
  • Pour the contents of dose 2 into a measuring container that can hold 500 ml of fluid.
  • Add water to make up to 500 ml and stir until all the powder has dissolved. This may take up to approximately 8 minutes.
  • Drink the 500 ml Plenvu dose 2 solution over 30 minutes by drinking 1 glassful every 10 to 15 minutes.
  • Following the Plenvu dose, drink a further 500 ml of clear fluid over a further 30 minutes.

What do I do on the day of the colonoscopy?

  • You may take your morning medications as usual unless as directed by your doctor.
  • Avoid further fluid intake 2 hrs before your scheduled colonoscopy.
  • If you are diabetic, do not take oral diabetic medications or short-acting insulin on the day of your colonoscopy. Talk to your provider about this.

 

Split-Dose Bowel Preparation For Colonoscopy Using PLENVU and Bisacodyl (Dulcolax)

What do I do a day before the colonoscopy?

  • Have a clear liquid diet throughout the day. Clear liquid diet excludes red and purple colored substances. No solid foods, milk products, fruits, seeds & nuts.
  • Be sure to keep hydrated by drinking 8oz of clear liquid every hour.
  • If you have diabetes mellitus, you may need to take half the dose of your medication while on clear liquid diet. Please, talk to your provider about this.
  • Take 4 tablets of bisacodyl (Dulcolax) around 3:00-4:00 PM.
  • Take the first dose of Plenvu during the evening before the colonoscopy (e.g., 5:00 to 9:00 PM).
  • Open the carton and remove the dose 1 sachet.
  • Pour the contents of dose 1 into a measuring container that can hold 500 ml of fluid.
  • Add water to make up to 500 ml and stir until all the powder has dissolved. This may take up to approximately 8 minutes.
  • Drink the 500 ml Plenvu dose 1 solution over 30 minutes by drinking 1 glassful every 10 to 15 minutes.
  • Following the Plenvu dose, drink a further 500 ml of clear fluid over a further 30 minutes.
  • If severe bloating, distention, or abdominal pain occurs, following the first dose, delay the second dose until the symptoms resolve.

What do I do on the day of the colonoscopy?

  • Take the second dose of Plenvu 4-5 hours before your scheduled colonoscopy.
  • Pour the contents of dose 2 into a measuring container that can hold 500 ml of fluid.
  • Add water to make up to 500 ml and stir until all the powder has dissolved. This may take up to approximately 8 minutes.
  • Drink the 500 ml Plenvu dose 2 solution over 30 minutes by drinking 1 glassful every 10 to 15 minutes.
  • Following the Plenvu dose, drink a further 500 ml of clear fluid over a further 30 minutes.
  •  Avoid further fluid intake 2 hours before your scheduled colonoscopy.
  • If you are diabetic, do not take oral diabetic medications or short-acting insulin on the day of your colonoscopy. Talk to your provider about this.

 

Click HERE for video on how to use your bowel cleansing agent. 

Click HERE for full prescribing information.

 

 

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Why do I have blood in my stool? https://bowelprepguide.com/blood-in-stool/ https://bowelprepguide.com/blood-in-stool/#respond Sat, 26 May 2018 23:40:06 +0000 https://bowelprepguide.com/?p=7297 Blood in stool can be a sign of a life threatening disease like cancer or a vexing but benign condition like hemorrhoid. Blood in the stool can be visible or invisible. When it is visible, it can be black and tarry (melena), burgundy (maroon) or bright red. When it is invisible, it can only be detected […]

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blood in stool

Blood in stool can be a sign of a life threatening disease like cancer or a vexing but benign condition like hemorrhoid. Blood in the stool can be visible or invisible. When it is visible, it can be black and tarry (melena), burgundy (maroon) or bright red. When it is invisible, it can only be detected by a stool test. Stool-based tests for colon cancer are designed to detect blood in the stool.

Why do I have blood in stool?

Hemorrhoids

Hemorrhoids are swollen veins around the anus or lower part of the rectum. They are common affecting more than 50% of people over the age of 50. Sometimes they bother people and sometimes they don’t. They may cause painless rectal bleeding or what is called “bright red blood per rectum.” They can be inside or outside. They do not lead to cancer. For more information on hemorrhoids, click HERE.

Colitis

Colitis is inflammation of the colon. This can be acute or chronic. Colitis can be due to infection, ischemia, or inflammatory. Infection or ischemia (when blood supply is blocked) can lead to acute colitis. Chronic inflammation is usually due to inflammatory bowel disease. There are 2 types of inflammatory bowel disease-ulcerative colitis and crohn’s disease.

Diverticular disease

The presence of a diverticulum or diverticula in the colon is called diverticulosis. A diverticulum is a pouch within the wall of the colon. Inflammation of the pouch is called diverticulitis. Diverticula can bleed without inflammation or infection. Diverticulitis can also lead to blood in the stool.

Angiodysplasia

Angiodysplasia is also called angioectasia or arteriovenous malformation (AVM). These are abnormal blood vessels on the wall of the colon. They can also be present in any part of the gastrointestinal tract. They may bleed on and off.

Solitary rectal ulcer syndrome 

This is a rare condition that is associated with constipation. Solitary rectal ulcer syndrome causes rectal bleeding, straining during defecation and a sense of incomplete evacuation.

Colorectal cancer 

By far the most worrisome reason why you may have blood in the stool is colorectal cancer. It is a leading cause of cancer deaths in the U.S. If you have blood in the stool and have not recently had a colonoscopy, you probably need one. If your stool test is positive for blood, you need a colonoscopy. Read Colorectal Cancer in 2018: The Good, the Bad and the Ugly.

Others

There are many other reasons why you may have blood in the stool. The blood may be coming from your upper gastrointestinal tract (esophagus, stomach and small intestine). An ulcer or cancer in the esophagus, stomach or small intestine can also make you have blood in the stool. Blood in stool may be due to a bleeding or clotting disorder. Certain medications like blood thinners may make bleeding worse.

You should see a physician if you have blood in your stool.

 

 

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