Southern New Mexico Surgery Center

Southern New Mexico
Surgery Center
2301 Indian Wells Rd. Suite B
Alamogordo, NM 88310
www.snmsc.org

Phone: 575.437.0890
Fax: 575.437.0905
Email: info@snmsc.org

Specialty Programs

Southern New Mexico Surgery Center is a multi-specialty center, providing excellent care to all of our patients. Click here to learn more about the various programs.

Post Surgery

Who wants to go to a hospital? We provide an alternative to a hospital stay that can be uncomfortable and disruptive to one's routine. Click here to learn more.

Endoscopy

Upper endoscopy | Colonscopy | Colonoscopy Preparation

Upper Endoscopy Procedure

What is upper endoscopy?

Upper endoscopy is a routine, outpatient procedure in which the inside of the upper digestive system is examined.

The procedure is commonly used to help identify the causes of:

Abdominal or chest pain
Nausea and vomiting
Heartburn
Bleeding
Swallowing disorders

Endoscopy can also help identify inflammation, ulcers and tumors.

Upper endoscopy is more accurate than X-rays for detecting abnormal growths and for examining the inside of the upper digestive system. The improved accuracy is especially important if you have had upper-digestive-tract surgery in the past.

What happens during the procedure?

During the procedure, a physician uses an endoscope (a long, thin, flexible instrument about 1/2 inch in diameter) to examine the inside of the upper digestive system.

Abnormalities can be treated through the endoscope: polyps (usually benign growths) can be identified and removed, and tissue samples (biopsies) can be taken for analysis. Procedures such as stretching narrowed areas, removing swallowed objects or treating bleeding from the upper digestive system can also be performed as part of upper endoscopy.

Before the procedure

Special conditions

Tell your physician if you are pregnant, have a lung or heart condition, or if you are allergic to any medications.
Tell your physician if you have:
— Ever been told you need to take antibiotics before a dental or surgical procedure
— Ever had endocarditis
— An artificial heart valve
— Rheumatic heart disease

If you have any of these conditions or devices, you may need to take antibiotics before the upper endoscopy.

Medications

Medications for high blood pressure, heart conditions or thyroid conditions may be taken with a small sip of water before the procedure.
If you have diabetes and use insulin, you must adjust the dosage of insulin the day of the test. Your primary physician will help you with this adjustment. Bring your diabetes medication with you so you can take it after the procedure.
STOP ALL BLOOD THINNERS THREE TO FOUR DAYS PRIOR TO THE PROCEDURE (CONSULT YOUR PHYSICIAN ON A SPECIFIC TIME FRAME): Stop all anti-inflammatories three to four days prior to the exam. This will include motrin, aleve, ASA, Tylenol, etc

Eating and drinking

An endoscopy requires that you have an empty stomach before the procedure. Do not eat any solid food for 8 hours before the procedure. You may drink clear liquids up until 2 hours before the procedure. Clear liquids include clear broth, hard candy, plain gelatin, black coffee, black tea, apple juice, ginger ale, 7UP, colas, Kool-Aid, Gatorade, Hi-C, and popsicles.

Transportation

You will need to bring a responsible adult with you to accompany you home after the procedure. You should not drive or operate machinery for at least 8 hours after the procedure. The sedation given during the procedure causes drowsiness, dizziness and impairs your judgment, making it unsafe for you to drive or operate machinery.

On the day of the procedure

A physician will explain the procedure in detail, including possible complications and side effects. The physician will also answer any questions you may have.

During the procedure

The procedure is performed by an experienced endoscopy physician.
You are asked to wear a hospital gown, remove your eyeglasses and dentures.
A local anesthetic (pain-relieving medication) may be applied at the back of your throat.
You are given a pain reliever and a sedative intravenously (in your vein). You will feel relaxed and drowsy.
A mouthpiece is placed in your mouth. It does not interfere with your breathing.
You will lie on your left side during the procedure.
The physician inserts an endoscope into your mouth, through your esophagus (the "food pipe" leading from your mouth into your stomach) and into your stomach. The endoscope does not interfere with your breathing.
The procedure lasts from 15 to 20 minutes.

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After the procedure

You will stay in a recovery room for about 30 minutes for observation.
You may feel a temporary soreness in your throat. Lozenges may help.
The physician who performs the endoscopy will send the test results to your primary or referring physician.
Your physician will discuss the results with you after the procedure. If the results indicate that prompt medical attention is needed, the necessary arrangements will be made and your referring physician will be notified.
A responsible adult must accompany you home. Do not drive or operate machinery for at least 8 hours after the procedure.

If you have severe abdominal pain, a continuous cough, fever, chills, chest pain, nausea or vomiting within 72 hours after the procedure, please call your doctor.

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Colonscopy

Colonoscopy is the visual examination of the large intestine (colon) using a lighted, flexible fiberoptic or video endoscope. The colon begins in the right-lower abdomen and looks like a big question mark as it moves up and around the abdomen, ending in the rectum. It is 5 to 6 feet long. The colon has a number of functions including withdrawing water from the liquid stood that enters it so that a formed stool is produced.

Equipment

The flexible colonoscope is a remarkable piece of equipment that can be directed and moved around the bends in the colon. These colonoscopies now come in two types. The original purely fiberoptic instrument has a flexible bundle of glass fibers that collets the lighted image at one end and transfer the image to the eye piece. The newer video endoscopes use a tiny, optically sensitive computer chip at the end. Electronic signals are then transmitted up the scope to a computer which displays the image on a large video screen. An open channel in these scopes allows other instruments to be passed through in order to perform biopsies, remove polyps or inject solutions.

Reasons for Exams

There are many types of problems that can occur in the colon. The medical history, physical exam, laboratory tests and X-rays can provide information useful in making a diagnosis. Directly viewing the inside of the colon by colonoscopy is usually the best exam.

Colonoscopy is used for:

Colon cancer-a serious but highly curable malignancy
Polyps-fleshy tumors which usually are the forerunners of colon Cancer
Colitis (Ulcerative or Crohn’s)-Chronic recurrent inflammation of the colon
Diverticulitis and Diverticulosis-pockets along the intestinal wall that develop over time and can become infected
Bleeding lesions-bleeding may occur from different points in the Colon
Abdominal symptoms, such as pain or discomfort, particularly if associated with weight loss or anemia
Abnormal barium X-ray exam
Chronic diarrhea, constipation, or a change in bowel habits
Anemia

Preparation

To obtain the full benefits of the exam, the colon must be clean and free of stool. The patient receives instructions on how to do this. It involves drinking a solution which flushes the colon clean or taking laxatives and enemas. Usually the patient drinks only clear liquids and eats no food for the day before the exam. The physician advises the patient regarding the use of regular medications during that time. colonscopy

The Procedure

Colonoscopy is usually performed on an outpatient basis. The patient is mildly sedated; the endoscope is inserted through the anus and moved gently around the bends of the colon. If a polyp is encountered, a thin wire snare is used to lasso it. Electrocautery (electric heat) is applied to painlessly remove it. Other tests can be performed during colonoscopy, including biopsy to obtain a small tissue specimen for microscopic analysis.

The procedure takes 45 minutes to an hour and is seldom remembered by the sedated patient. A recovery area is available to monitor vital signs until the patient is fully awake. It is normal to experience mild cramping or abdominal pressure following the exam. This usually sub subsides in an hour or so.

Results

After the exam, the physician explains the findings to the patient and family. If the effects of the sedatives are prolonged, the physician may suggest an appointment at a later date. If a biopsy has been performed or a polyp removed, the results are not available for three to seven days.

Benefits

A colonoscopy is performed to identify and/or correct a problem in the colon. The test enables a diagnosis to be made and specific treatment can be given. If a polyp is found during the exam, it can be removed at that time, eliminating the need for a major operation later. If a bleeding site is identified, treatment can be administered to stop the bleeding. Other treatment can be given through the endoscope when necessary.

Alternative Testing

Alternative tests to colonoscopy include a barium enema or other types of X-ray exams that outline the colon and allow a diagnosis to be made. Study of the stools and blood can provide indirect information about a colon condition. These exams, however, do not allow direct viewing of the colon, removal of polyps, or the completion of biopsies.

Side Effects and Risks

Bloating and distension typically occur for about an hour after the exam until the air is expelled. Serious risk with colonoscopy, however, is very uncommon. One such risk is excessive bleeding, especially with the removal of a large polyp. In rare instances, a tear in the lining of the colon can occur. These complications may require hospitalization and rarely surgery. Quite uncommonly a diagnostic error or oversight may occur.

Due to the mild sedation, the patient should not drive or operative machinery following the exam. For this reason, someone should be available to drive the patient home.

Summary

Colonoscopy is an outpatient exam that is performed with the patient lightly sedated. The procedure provides significant information used to determine which specific treatment will be given. In certain cases, therapy can be administered directly through the endoscope. Serious complications rarely occur from colonoscopy. The physician can answer any questions from the patient.

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Colonoscopy Preparation

The most important part of a successful Colonoscopy is the preparation. This means making sure that the entire stool in your colon is cleaned out and all that is left is some clear liquid.

PART ONE: COLON PREPARATION: WHAT EVERYONE SHOULD DO:
It is very important that these rules are followed carefully. There are two things that you need to do.

1. DRINK LOTS OF LIQUIDS. YOU SHOULD DRINK AT LEAST 6 GLASSES OF WATER A DAY STARTING 2 DAYS BEFORE THE PROCEDURE. It is important for the stool in your bowel movements to be soft. This makes it easier to be cleaned out. If you don't drink a lot of water the stool can get hard and this makes it harder for the preparation to flush it out.

2. EAT A LOW ROUGHAGE DIET STARTING 3 DAYS BEFORE THE PROCEDURE. DECREASE THE AMOUNT OF THE FOLLOWING FOODS: WHOLE GRAIN BREAD AND CEREAL, VEGETABLES THAT HAVE A LOT OF FIBER SUCH AS BROCCOLI, CAULIFLOWER, SALAD GREENS, CABBAGE, CARROTS, CELERY, SPINACH, SWEET POTATOE, AND SUNFLOWER. STOP ANY ADDED FIBER SUCH AS METAMUCIL AND FIBERCON. Fiber makes the stool firmer and more difficult to clean out. Normally you should be on a high fiber diet but for this test it is easier if your diet is low in fiber for a few days before the test. AVOID FOOD WITH RED DYES IN THEM LIKE JELLO.

3. THE REQUIRED DIET THE DAY PRIOR TO THE EXAM IS SPECIFIC. ON THE DAY PRIOR TO THE EXAM YOU MAY HAVE A LIGHT BREAKFAST. This includes: any clear liquids, one boiled or poached egg or small portion of skinless chicken/turkey or fish, white toast with no butter, or one 8 oz can ensure, do not take ensure plus. NO MORE REGULAR MEALS FOLLOWING THIS, YOU MAY HAVE ALL THE CLEAR LIQUIDS YOU WISH. Clear liquids include the following: soft drinks, Gatorade, kool-aid (no red or purple dyes), strained fruit juices without pulp, water, tea or coffee (no milk or creamer), low sodium chicken or beef bouillon/broth, hard candies, JELL-O (no red or purple dyes), popsicles (no red or purple dyes, or sherbets or fruit bars)

4. STOP ALL BLOOD THINNERS THREE TO FOUR DAYS PRIOR TO THE EXAM. Consult your physician for a specific timeframe. STOP ALL ANTI-INFLAMMATORIES THREE TO FOUR DAYS PRIOR TO THE EXAM. This will include motrin, aleve, Tylenol, ASA, etc. FAILURE TO DO SO MAY RESULT IN CANCELLATION OF PROCEDURE.

PART TWO: CLEANSING THE BOWEL
Clearing all of the stool out of the bowel is the most difficult and the most important part of the examination. There are several ways of preparing the bowel and each one can be used depending on you and your doctor's preference.

Click here to download a printable version of the colonscopy preparation. When downloading, you will need Adobe Acrobat Reader® to view and print. If you do not have the reader, you can get free software from Adobe's Web site by clicking on the icon below.

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News & Media

Southern New Mexico Surgery Center is a recipient of the 2010 / 2011 Apex Quality Award. This distinction recognizes outstanding healthcare organizations that demonstrate the highest levels of excellence in patient satisfaction throughout the United States in markets served by CTQ.