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Flexible Sigmoidoscopy Instructions

Please see Appointments below for important reasons why you should not change or cancel your appointment without due notice. Also, please read the Precautions set out below.

Preparation

If you have any questions concerning these instructions, please call the clinic at least 3 days before your appointment.

Ahead of Time

An information package will be sent to you when your appointment has been booked. Please read the entire information as soon as you receive it and read again five (5) days before your appointment.
You may notify the doctor who has referred you about this appointment since most doctors would like to be informed about your care. Your doctor will receive a report from us, usually approximately two weeks after your appointment.
If you are diabetic on insulin, you may purchase 3 tins of Ensure liquid meal replacement.
Purchase 2 Fleet Enemas at your drug store.
If you will be sedated for the procedure, please see After the Procedure below for instructions on arranging for transportation after the procedure because you cannot drive until the following morning.

The Day Before Your Appointment

Have a light lunch.
Starting at 2:00 p.m. and until the procedure is finished. You must remain on a diet of clear fluids. No solid foods. You may have only clear fluids, such as apple juice or other clear juices, pop, tea, coffee (no cream/milk), lemon Jello, and clear soups such as consommé and broth.
If you are diabetic, you may take one can of Ensure at each mealtime.

The Day of Your Appointment

Two hours before you leave home, use the 2 Fleet Enemas. Insert the first enema into the rectum and squeeze all of it in. Hold it in for 5 to 10 minutes and use the toilet to empty fully.
After you have emptied out the first enema, use the second enema in the same way. The knee-chest position is best, but on your left side is good too.
A spouse or someone you trust may be able to help you with administering the enemas.

Things To Remember

Bring your Ontario Health Insurance card and a list of your current medications.
Bring something to drink.
Bring the completed questionnaire from the information package you received.
Do not wear nail polish.

After The Procedure

If a polyp has been removed, do not take aspirin for 3 days or exercise strenuously for a few days after the procedure.
You will remain in the recovery room for close observation for approximately ½ hour.
A bloated feeling and flatulence can occur after the procedure if air was used to improve visibility. You can usually get rid of excess gas by sitting on the toilet with your head down.
You will be able to resume your normal diet after the procedure, unless you are instructed otherwise.

If you were sedated for the procedure:

You cannot drive until the following morning and must arrange to have someone else drive you home after the procedure. If you choose to go by taxi or public transit, you must be accompanied by someone.
For safety reasons, the person who drives or accompanies you must meet you inside the clinic after the procedure. You cannot leave the clinic on your own.
Due to the sedation, you may feel disorientated or forgetful for a short time after the procedure. We recommend that you do not sign any legal or other important documents until the following day.

Precautions

Please carefully read and follow these instructions if you are on any of the medications listed below:

If you are on Aspirin (including Bufferin, Novasen), discontinue the medication 10 days prior to your procedure. It may be restarted the next day if no biopsy was done. Otherwise, restart 3 days after the procedure.
If you take Plavix (clopidogrel), discontinue the medication 7 (seven) days before your procedure and restart the next day (or 3 days in case of biopsy). You should confirm with your doctor that it is safe to be off this medication.
If you take iron supplementation, discontinue 5 days before the procedure.
If you are on anti-inflammatory medications (Indocid, Motrin, Advil, etc.), stop the day prior to the procedure. Celebrex and Vioxx are alright to take.
If you need to take medication for pain or headache, use plain Tylenol unless you are on chronic medication.

Only if you are on Coumadin (Warfarin): You must discontinue this medication 5 (five) days prior to the procedure. You should confirm with your doctor that it is safe to be off this medication.

You must have an INR test done before 12 noon on the day before your procedure and have the lab FAX the result directly to us at 905-607-0013 or 416-597-2912. Patients in the Ottawa region, please ask the lab to FAX the result to 613-216-1824.
If you have not received an INR requisition form, please contact us immediately so we can mail it to you. We require the results by 8 a.m. on the day of the procedure.
If your doctor/cardiologist feels that it is unsafe for you to discontinue blood thinners (Coumadin) or if your INR results are not available to us due to any unforeseen event we can still go ahead with your test, but without doing polyp removals or biopsies because of the danger of bleeding.
If we find polyps in those circumstances we can reschedule your procedure for a later time with proper steps taken to ensure that chances of complications are minimized. Your physician can arrange for injections of Lovenox (Enoxaparine) that can act as a bridge therapy while you discontinue Coumadin.

Antibiotics: Antibiotics should be taken if you have a history of endocarditis, artificial heart valves, or had a joint replacement in the last 6 months. Please obtain a prescription for the antibiotic from your family doctor and get it from your local pharmacy prior to the procedure.

Oral antibiotics should be taken 1 hour before the procedure. If the antibiotic is given intravenously, please bring the antibiotic to the clinic and advise us at the time of booking. In this case you need to arrive at the clinic 1-½ hours before your appointment time so that we can administer the antibiotic at the clinic prior to the procedure.

Diabetics: Please ensure that you are booked early in the day for your procedure.

If you are on oral medication (pills) for control of your diabetes, only omit your morning dose on the day of the procedure.
If you are on insulin, please discuss with your doctor about cutting the morning dose in half on the day of the procedure. You can take Ensure as a meal supplement.

Other medications: Medications such as pills for blood pressure, thyroid, and cholesterol should be taken in the morning with sips of clear fluids.

Appointments

We make every effort to give you a firm date and time for your appointment. A procedure room and a surgeon, anesthetist, nurses and support staff are booked just for you. Therefore, please let us know as soon as possible if you have to change or cancel the appointment so we can give this time to another patient who may be urgently waiting for a procedure.

Appointments can be changed or cancelled only by calling our Contact Centre during working hours, 8:00 a.m. to 4:00 p.m., Monday to Friday. One of our representatives will approve the change or cancellation and provide you with a confirmation number. We cannot accept voice messages for changing or cancelling appointments.

To avoid a $200 Fee for a changing or cancelling a sigmoidoscopy appointment, you must notify us at least three (3) business days before the day of your appointment. This fee is not covered by OHIP.
A Cancellation Protection Plan (CPP) is available as an option to protect you against charges in the event that you are unable to give us 3 days advance notice. This plan costs $37.50 per appointment, and it must be paid at the time of booking your appointment.
A Rescheduling Fee of $25.00 will be charged if you change your appointment (date, time or clinic location) more than one time. This fee must be paid at the time of rescheduling your appointment.

Rudd Clinic
Telephone: 416-597-0997
Email:
Website: www.ruddclinic.com