Endoscopic examinations are crucial for diagnosing diseases of the digestive system. However, to ensure a successful and accurate diagnosis, it is essential that the patient is properly prepared. A lack of pre-examination preparation can lead to inaccurate results, the need to repeat the examination, or even the failure to detect pathological changes.
This guide provides detailed information on what you need to do before undergoing endoscopic examinations – in particular, gastroscopy (stomach endoscopy) and colonoscopy (large bowel endoscopy). Our aim is to provide you with all the necessary information so that you can prepare for the procedure with confidence and with as little discomfort as possible. The Endomedix At our gastroenterology centres, we are committed to providing our patients with comprehensive information, as we know that proper preparation is the basis for an accurate diagnosis.
What is an endoscopy, and why is it important to prepare for it?
Endoscopy is a diagnostic procedure in which a thin, flexible instrument (an endoscope) fitted with a camera and a light source is inserted into the body’s cavities. This enables the doctor to examine the mucous membranes of internal organs, such as the oesophagus, stomach or large intestine, directly.
The aim of the preparation is to ensure that the section of the bowel being examined is completely clean and empty. Food residue remaining in the stomach or faeces in the large bowel can obscure the surface of the mucous membrane, making it difficult or even impossible to detect pathological changes such as polyps, inflammation or tumours. If the bowel has not been adequately cleansed, the examination may fail and will need to be repeated at a later date, causing further inconvenience and taking up more of the patient’s time.
From Endomedix We use state-of-the-art technology at our centres, but the success of the examination depends largely on your cooperation and your strict adherence to the preparation instructions.
General preparations before any endoscopic examination
Although different types of tests require different specific preparations, there are a number of general considerations that must be taken into account in every case.
Consultation and review of medication
Before the examination, please be sure to inform your doctor or the Endomedix Please inform our staff of all the medicines you are taking, including over-the-counter medicines and dietary supplements.
- Anticoagulants: It is particularly important to discuss the use of anticoagulants (e.g. Syncumar, Marfarin) and antiplatelet agents (e.g. Aspirin, Plavix, Brilique). The doctor will decide whether it is necessary to temporarily stop or adjust your dose of these medicines. Diagnostic tests can usually be carried out whilst you are taking these medicines, but if a procedure (e.g. polyp removal) is also planned, it may be necessary to adjust your medication.
- Copper products: If you are due to have a colonoscopy, you must stop taking iron supplements at least 5–7 days before the examination, as these can turn the stools black and cause them to stick to the bowel wall, making it more difficult to cleanse the bowel and carry out the examination.
- Medicines for diabetes: If you have diabetes, consult your doctor about adjusting your insulin dose or oral medication during the preparatory diet and the fasting period.
Arranging for an accompanying person
Endoscopic examinations are carried out under general anaesthesia to ensure the patient’s comfort. The Endomedix Following examinations carried out under anaesthesia at our centres, we only allow our patients to go home if they are accompanied by someone.
Preparing for a gastroscopy (stomach examination)
A gastroscopy is an examination of the upper gastrointestinal tract – the oesophagus, the stomach and the initial section of the duodenum. Preparation for this procedure is relatively straightforward.
On an empty stomach
The most important rule is that the test must be carried out on a completely empty stomach.
- Before the investigation Do not eat any solid food for 6–8 hours.
- Clear liquid (e.g. still water, tea) may be consumed in small quantities 2–4 hours before the test, but not afterwards.
- Morning medication can usually be taken with a sip of water, but you should always check with your doctor first.
Food or liquid remaining in the stomach not only hinders an accurate diagnosis, but may also pose a risk of choking during the examination.
Preparing for a colonoscopy
A colonoscopy is an examination of the entire large intestine and the final section of the small intestine. A prerequisite for a successful colonoscopy is a completely clean bowel, which requires thorough preparation on the part of the patient. The Endomedix A high-quality colonoscopy carried out by specialists is the most effective means of preventing and detecting bowel cancer at an early stage.
The process of bowel cleansing is carried out by the so-called. Boston Bowel Preparation Scale (BBPS) It is assessed using a scoring system that rates the clarity of the bowel. The aim is to achieve a score of over 6, which means that the entire length of the bowel mucosa is clearly visible.
1. Special diet (3–5 days before the examination)
Bowel preparation begins several days before the examination with an appropriate diet. Avoid the following foods, as the fibre in them can stick to the bowel wall and be difficult to remove:
- Small-seeded fruits and vegetables (e.g. grapes, kiwis, raspberries, strawberries, tomatoes, cucumbers)
- Wholemeal baked goods, bran products
- Pulses (beans, lentils, peas)
- Oilseeds (walnuts, hazelnuts)
What can you eat? Easily digestible, low-fibre foods:
- White bread, rice, pasta
- Boiled potatoes (peeled)
- Meat broth (without vegetables)
- Well-cooked, steamed meats (chicken, fish)
- Eggs, dairy products (provided they do not cause any symptoms)
2. Liquid diet (on the day before the examination)
On the day before the examination, You must not eat any solid food. Drink plenty of clear, transparent fluids throughout the day.
- Recommended fluids: water, strained meat stock, fruit tea (with a tea bag), light-coloured, non-carbonated soft drinks, strained fruit juices (without pulp, e.g. apple).
- Liquids to avoid: milk-based drinks, fruit juices containing pulp, and red or purple-coloured drinks (as they can discolour the intestinal wall and may look like bleeding).
Staying properly hydrated is essential, as laxatives cause fluid loss. Drink at least 2–3 litres of fluid throughout the day.
3. Taking the bowel-cleansing solution (on the day before the examination)
To cleanse your bowels, you will need to drink a special laxative solution, which your doctor will prescribe for you. There are several types of preparation available (e.g. high- or low-volume solutions); always follow the instructions you are given exactly.
- Timing: The laxative is often recommended to be taken in two doses (split-dose regimen). The first dose should be taken on the afternoon or evening before the examination, and the second on the morning of the examination (4–6 hours before the procedure). Research shows that this method results in more effective bowel cleansing, particularly on the right-hand side of the colon.
- Preparation and consumption: The powder should be dissolved in water according to the instructions in the box. Most solutions taste unpleasant, but there are a few tricks that might help:
– Chill the solution before drinking.
– Drink it through a straw so that the solution comes into contact with as few taste buds as possible.
– Between doses, drink other clear liquids of your choice.
- Effect: The laxative usually takes effect within 1–2 hours and causes severe, watery diarrhoea. It is therefore important that you stay at home, close to the toilet, whilst the laxative is taking effect. At the end of the process, your stools should be completely clear, watery and yellowish in colour, with no solid pieces. This indicates that the bowel has been successfully cleansed.
Preparing for specialised endoscopic examinations
Small bowel capsule endoscopy
This is a procedure in which the patient swallows a small capsule fitted with a camera, which then travels through the digestive system.
- Preparations: Similar to a colonoscopy, it requires a special diet and the consumption of a bowel-cleansing laxative solution. You must stop taking non-steroidal anti-inflammatory drugs (NSAIDs) up to 4 weeks before the examination.
- During the examination: Two hours after swallowing the capsule, you may start drinking clear liquids, and after four hours, you may eat light, solid food. Physical activity (such as walking) helps the capsule to move through the digestive tract.
Endoscopic Retrograde Cholangiopancreatography (ERCP)
This procedure is used to examine the bile ducts and the pancreatic duct. The preparations are the same as for a gastroscopy: the patient must have fasted for 6–8 hours.
What to expect after the examination
Following the examination, you will be able to rest in a recovery room until the effects of the anaesthetic have worn off. Depending on the procedure, you may experience mild bloating or cramps due to the air that has been blown into your body, but this usually subsides quickly. After the examination, you may eat light meals. At the end of the examination, the doctor will inform you of the results and, if a tissue sample has been taken, will explain that you will need to wait a few weeks for the results.
Summary
Preparing for an endoscopic examination may be uncomfortable, but it is essential for an accurate diagnosis. Inadequate preparation jeopardises the success of the examination and unnecessarily exposes you to the need for a repeat procedure.
From Endomedix At our gastroenterology centres, every patient receives a detailed written information sheet explaining what to do. If you have any questions regarding how to prepare, please do not hesitate to contact us. Our team of experts is on hand to assist you every step of the way, ensuring a smooth and successful examination.
