Guiding you towards a successful bowel preparation

What is a Colonoscopy?

It is an examination of the large intestines (colon) using a long flexible tube-like instrument known as a Colonoscope. The instrument is passed into the colon via the anus which enables the doctor will be able to see and examine the full lining of the colon and the rectum. Colon

What is a Colonoscopy? This examination also enables the doctor to: -Diagnose colon and rectal problems -Perform biopsies -Remove colon polyps

What is a Colonoscopy? This examination will take minutes. After the examination, you will need to rest in the Day Surgery for about 2 hours.

Why the need for a good preparation?

There are faecal (waste) matters in the colon. They must be cleared from the colon so that the examination of the colon may be carried out smoothly and accurately.

Why the need for a good preparation? Should there be any residual faecal matters in the colon, it will result in an incomplete examination and the examination may have to be stopped and repeated at another date. Therefore it is important to follow the instructions of the preparations closely.

Why the need for a good preparation? Clean colon from a good bowel preparation. Doctors are able to view the colon clearly. Dirty colon from a poor bowel preparation. Doctors are not able to view the colon clearly.

What can I expect?

What can I Expect? 1. You can expect to go home in the afternoon /evening as it is usually as an outpatient procedure. 2. You will be given a sedative and will feel sleepy after your Colonoscopy. Therefore, you will need to arrange for someone to take you home. You are strongly advised not to drive. Should you be unaccompanied, your procedure will have to be rescheduled.

What can I Expect? 3. Inform your doctor if you have any allergies. 4. Prior to the procedure, your nurse will instruct you to put on a hospital gown. 5. The doctor will insert a needle into your vein, either on your arm or at the back of your hand. You will receive sedation through this needle in the Endoscopic room.

What can I Expect? 6. When you are on the procedure table, you will be asked to lie on your left side. 7. When you feel sleepy, the doctor will insert a lubricated Colonoscope or Sigmoidoscope into your rectum. 8. As the doctor inserts the Colonoscope or Sigmoidoscope, air and saline will be channeled into the colon which will provide a better view of the colon. You may feel some pressure and cramping as the air and saline enter the colon.

What can I Expect? 9. Your doctor may take a biopsy if a polyp is found, or remove a polyp based on findings during the procedure. 10. The results of your Colonoscopy will be given to you by the doctor/nurse upon your discharge from the Day Surgery Department.

What will happen after the procedure?

1. Your blood pressure and pulse will be monitored to ensure that there is no bleeding (if polypectomy or biopsy was done). 2. You will be able to eat normally within a few hours after you return home. 3. It is quite normal to experience some gas pains caused by the introduction of air during the procedure. You are advised to take a walk to help relieve the feeling of fullness of bloatedness.

What will happen after the procedure? 4. You are advised not to drive as you may still feel drowsy for some hours after the procedure due to the effects of the sedation. Arrangement should be made for an adult to send you home either by car or taxi. 5. You may return to work the next day 6. If your appointment includes certain procedures- such as the removal of large polyps or treatment for bleeding, you may be required to stay overnight.

When do I need to seek medical help?

See your doctor if you experience the following: 1. Abdominal pain 2. Bleeding from the rectum 3. High fever

Frequently asked questions

Question: What are the risks of Colonoscopy or Sigmoidoscopy? Answer: As with any procedure, there are some risks involved. Some of these include: 1) A rash, dry mouth or redness of the face (flushing) 2) Nausea or vomiting due to the medication 3) Bleeding and tearing (perforation) of the large intestines are rare. Bleeding is usually minor and can be controlled easily. In rare cases, blood transfusions or emergency surgery may be needed.

Special Instructions

1. If you are under 21 years of age, your parent or guardian must be present to give consent for your procedure if it is not taken during your earlier clinics visit. 2. Do dress comfortably 3. Do take your regular hypertension, heart condition medication at 6am with sips of water if you are on any of these medication.

Special Instructions 4. Do not take your regular diabetic medication including insulin injections if you are diabetic. On arrival at the Day Surgery Department, inform the doctor that you are a diabetic. 2. Do not operate any form of vehicle on the day of procedure, as the effect of the sedative may not wear off until a few hours later on the same day.

Special Instructions 6. If you need to change or cancel your Colonoscopy date, please call the Day Surgery Department nurse at at the following times: Mon- Fri: 8.30am and 5.30pm Sat: 8.30am and 12.30pm

Special Instructions 1) Day Surgery Authorisation Form 2) Identity Card or Birth Certificate (if you are under 15 years of age) or Passport (if you are a foreigner). 3) Civil Service Card (if you are a civil servant) or Medical Benefit Identity Memo (MBIM). To help us serve you better, please bring along the following on the day of procedure:

Special Instructions 4) Work Permit (valid and original) or Employment Pass. 5) Complete Medisave Authorisation Form 6) Cash/ ATM card/ Credit Card (VISA/Mastercard)/ Cheque, Cash card 7) Outpatient Appointment Card To help us serve you better, please bring along the following on the day of procedure:

Bowel Preparation Instructions

You will have to drink 500 cc of clear fluids (as stated above) every hour for 4 hours from 8am to 12 pm. 8am - 500cc11am - 500cc 9am - 500cc 12pm - 500cc 10am - 500cc On the day before the examination, you will have to drink clear fluids such as juices, barley water, diluted tea or clear soup.

Bowel Preparation Instructions Examples of clear fluids to drink:

Bowel Preparation Instructions The Oral Fleet is a special cleansing drink to clear the colon of all its contents. 2pm 45 cc Oral Fleet Phosphate Soda 8pm 45 cc Oral Fleet Phosphate Soda At 2pm and 8pm, you will drink 45 cc or 1/2 bottle of Oral Fleet Phosphate Soda diluted with an equal amount of water.

Bowel Preparation Instructions However, you may drink any amount of clear liquid at any time before the procedure. You will have to avoid all solid/semi-solid food.

Bowel Preparation Instructions You can also take clear fluids (without residual) at room/body temperature. You should not take solids/semi solids and milk products

Liquid drinks allowed are: Apple juice (without the pulp) Orange juice (without the pulp) Grapes juice Cranberry juice Lucozade Cordial Soft drinks Water Mineral water Barley water Chestnut water Honey drinks Black tea Chinese tea Coffee with sugar (without milk) Plain jelly (not agar agar) Popsicles Ice cubes Hard candies Clear soup, stock cubes, marmite, brovil, essence of chicken Bowel Preparation Instructions

These fruit juices are not to be taken during the preparation: Tomato juices Prune juices Vegetable juices Juices with pulp Bowel Preparation Instructions

Suggested meal plans

Suggested Meal Plans Breakfast: Clear Fruit Juice Coffee with Sugar Black Tea Barley Water

Suggested Meal Plans Lunch: Clear Fruit Juice Coffee with Sugar Black Tea Clear Soup Barley Water Clear Jelly

Suggested Meal Plans Dinner: Clear Fruit Juice Coffee with Sugar Black Tea Clear Soup Barley Water Clear Jelly

You are now ready for a successful Colonoscopy!