How to Prep

An abdominal ultrasound (or sonogram) is a noninvasive (from outside of the body) imaging procedure used to examine organs in the abdomen including the gallbladder, kidneys, spleen, liver, pancreas and other abdominal organs. Ultrasound uses high-frequency sound waves that reflect off of a body structure to form an image. The echoes from the sound waves give information regarding size, distance and uniformity of the organ and are recorded and displayed on a monitor screen. These pictures are recorded in “real-time” which means that the screen is displaying what is actually happening during the exam. In turn, this helps them to diagnose a variety of conditions. The scan is safe and painless; There is no radiation exposure involved.

• To determine the cause of abdominal pain.
• To detect gallstones in your gallbladder. Gallstones are hardened collections of cholesterol and other substances located in the gallbladder.
• To determine the cause of blocked urine flow in a kidney or to look for kidney stones (small clusters of calcium).
• To determine whether a mass in an abdominal organ is solid or a fluid-filled cyst.
• To help identify the cause for enlargement of an abdominal organ.
• To evaluate the liver – size, shape, position, etc.
• To detect problems with the pancreas such as inflammation or cancer.
• To assist in the placement of a needle for biopsy or to drain fluid from a cyst or abscess.

• It may also be necessary for you to avoid anything to eat or drink for at least 6 hour prior to your test. Medications can be taken prior to the exam.
• You should wear comfortable, loose-fitting clothing for your ultrasound exam

• You may resume you normal diet and activities.

• Antiplatelet agents like Aspirin or Plavix and anticoagulant agents like Coumadin (Wafarin), Xarelto, or Eliguisshould be discontinued at least 5 days prior to procedure, but it may vary with individual, so please consult with doctor during consultation.
• Stop taking any iron supplements or multivitamins that contain iron.Start a low-fiber diet.

• DO NOT eat fruit with seeds (strawberry, watermelon, etc), fruit juices with unstrained fruit, seaweed, grains, and high fiber food, as they may interfere with the test results.

• Stop taking ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), diclofenac, sulindac, or Clinoril. You can take acetaminophen (Tylenol).
• Make sure you drink at least 2 quarts of liquids today.

• DO NOT eat any solid food. Drink only clear liquids such as juice (apple, grape, or cranberry), broth, black coffee, tea, lemonade, sports-drinks, soda pop or Jell-O (but not red or orange Jell-O). DO NOT drink milk. Drink at least 2 quarts of clear liquids today.
• In the morning: Prepare the GoLytely solution by adding water to the container. Mix to dissolve.  Store it in the refrigerator.
• At 6 pm: Drink 3 liters of GoLytely (3/4 of the container) within 3 hours. It should cause diarrhea.  Store the rest of the GoLytely in the refrigerator.
• Continue to drink clear liquids.

• DO NOT eat any solid food.
• 5 hours before your appointment: Drink the rest of the GoLytely (1 liter) within 1 hour.
• Take blood pressure medications with water 1 hour before or after you drink the GoLytely.
• We encourage you to drink clear liquids up to 2 hours before your appointment. After that, you cannot take anything by mouth.
• Bring a list of all medicines you take.
• Arrange for a responsible family member or friend to take you home.  You cannot drive on the day of your test.

• Diabetic medication and insulin should be reduced to ½ the amount the day before the exam, since food intake is reduced. On the day of the procedure, do not take diabetic medication.
• If you have severe constipation or you are taking chronic pain medicine, you will need an extra preparation:
• 2 days before your exam: At 4 pm, drink 1 bottle of Magnesium Citrate.  You can buy this at most drugstores without a prescription.
• Please reschedule the procedure if you are pregnant or suspect you are pregnant.

A colonoscopy is a test that allows your doctor to look at the lining of your large intestine.  To do the colonoscopy, your doctor will use a flexible tube that is about as wide as a finger.  The tube will be placed in your rectum.

You will receive a sedative through an intravenous line (IV) to help you relax.  Most patients fall asleep.  You may have some cramping.  Your doctor may also take biopsies (tissue samples) or remove polyps, but you will not feel this.

The actual test takes about 30 minutes.  Your appointment will last longer to allow time for preparation and recovery.  When you wake up after the test, we will share your results with you.  If your results are not ready right after the test, we will tell you when you can expect to receive them.

Please call if you have questions or concerns.

Monday, Tuesday, Thursday, and Friday between 7 am and 3 pm, Wednesday and Saturday between 7 am and 12 pm, call Yonsei Gastroenterology/Endoscopy Center, 213-381-3630.

• Nothing by mouth after mid-night (12:00am)
• You may drink water till 2 hours before procedure to prevent dehydration.
• Gargling or rinsing of your mouth is acceptable to prevent drying of mouth.
• Diabetic medication and Insulin should be reduced to ½ the amount the day before the exam,
• since food intake is reduced. Do not take Diabetic medication on the morning of the procedure.
• Take blood pressure medication on  theprocedure date.
• Bring other medications, so you can take after the procedure.
• Guardian must be accompaniedbecausept is not able to drive after the procedure  due to sedation effect.
• Please reschedule the procedure if you are pregnant or suspect that you are pregnant.

• Antiplatelet agents like Aspirin or Plavix and anticoagulant agents like Coumadin (Warfarin), Xarelto, or Eliquis should be discontinued at least 5 days prior to procedure, but it may vary with individual, so please consult with doctor during consultation.
• DO NOT eat fruit with seeds (strawberry, watermelon, etc), seaweed, grains, and high-fiber food, as they may interfere with the test results. As for preparation for colonoscopy,Please refer to the pamphlet.
• Have a light meal the day before. No meal after lunch except water and clear liquids such asapple juice or tea.
• Diabetic medication and insulin should be reduced to ½ the amount the day before the exam,since food intake is reduced. On the day of the procedure, do not take diabetic medication. Please consult with your doctor during your consultation for detail instruction.
• Blood pressure medication can be taken on the morning of the procedure.
• Bring other necessary medication, so you can take after the completion of the procedure.
• Guardian must be accompanieddue to endoscopy involving sedation during procedure, which would prevent you from driving.
• Please reschedule the procedure if you are pregnant or suspect you are pregnant.

Hemorrhoids are enlarged veins in your rectum. Banding can correct minor internal hemorrhoids. A small, lighted scope is placed into your anus to fully see the anus and lower rectum. With small tools, a latex band is wrapped around the base of the hemorrhoid. The band cuts off the blood supply to the hemorrhoid. The hemorrhoid and band then fall off in 3-10days.

The bowel prep before the banding

A few days before your bowel prep, go to your local drugstore and buy:

• 1 bottle of magnesium citrate
• 2 Fleet enemas

• After lunch, drink only clear liquid. Do not eat or drink solid foods, juice with pulp, dairy products, or alcohol.
• At 4:00-6:00 PM , drink magnesium citrate 1 bottle . It is best to drink it chilled. When done, keep drinking clear liquids until you go to bed.
• Do not eat or drink after midnight.

• 1 ½ hours before you leave home, give yourself the first enema.
• Give yourself the second enema ½ hour later. Shower.

• Nothing strenuous for the first 24-48 hours.
• Do not lift more than 20 pounds for 24-48 hours.

You may have rectal pressure and painful rectal spasms. This can last until the bands fall off. To help relieve these pains, sit in a bathtub of warm water 2-4 times a day and after each bowel movement. You may also take Tylenol OTC.

You may have some bleeding with bowel movements until the bands fall off and for a few days after with each bowel movement.

• Follow the urge to have bowel movement when you have that feeding.
• Be sure to drink 8 to 10 (8-ounce) glasses of fluid ( water, juice, tea ) per day.
• Eat plenty of foods high in fiber such as fruits, vegetables, and whole grain cereals.
• Schedule a stool softener (docusate sodium, Colace^®) a couple of times a day or use a bulk fiber laxative lie Metamucil^®.

• Pain not relieved by pain pills.
• Heavy bleeding after the bands and tissue fall off.
• Excess bleeding that does not stop after you apply pressure to rectal area for 10 minutes.
• Temperature ( by mouth) greater than 100.4°F, for 2 reading taken 4 hours apart.
• Problems passing urine.

• You may have a light breakfast or have clear liquids ONLY; please
  have nothing for dinner

• DO NOT drink milk
• DO NOT eat or drink anything colored red or purple
• DO NOT drink alcoholic beverages

• Water
• Strained fruit juices (without pulp) including apple, orange,
  white grape, or white cranberry
• Limeade or lemonade
• Coffee or tea (DO NOT use any dairy or non-dairy creamer)
• Chicken broth
• Gelatin desserts without added fruit or topping
  (NO RED OR PURPLE)

NOTE:

• SUPREP Bowel Prep Kit is indicated for cleansing of the colon as a
  preparation for colonoscopy in adults
• Be sure to tell your doctor about all the medicines you take,
  including prescription and non-prescription medicines, vitamins, and
  herbal supplements. SUPREP Bowel Prep Kit may affect how other
  medicines work
• Medication taken by mouth may not be absorbed properly when
  taken within 1 hour before the start of each dose of SUPREP Bowel
  Prep Kit
• The most common adverse reactions after administration of
  SUPREP Bowel Prep Kit were overall discomfort, abdominal
  distention, abdominal pain, nausea, vomiting, and headache
• If you have any questions about taking SUPREP Bowel Prep Kit,
  call your doctor

You must complete Steps 1 through 4 using one (1) 6-ounce bottle before
going to bed:

For this dose, repeat Steps 1 through 4 shown above using the other
6-ounce bottle.

NOTE: You must finish drinking the final glass of water at least 2 hour ,
or as directed, before your colonoscopy.