The gastroenterology team at Manhattan Gastroenterology comprises Ivy League-trained, highly rated GI doctors, renowned researchers, and highly skilled experts in preventing, diagnosing, and treating digestive disorders. For more information about diagnostic colonoscopy that help identify polyps and other growths inside your colon, please visit us in Midtown or the Upper East Side in Manhattan.

Frequently Asked Questions

I. Questions About Medications

Do I need to stop my blood thinner (ie. Coumadin, Plavix, Pradaxa, Lovenox, etc)?

Yes! There are many indications for a patient to be on blood thinning medications. These medications have to be held prior to your procedure in order to minimize any risk of bleeding. Each blood thinner has a different half life, therefore, its ability to stay in your blood stream varies from drug to drug. Please bring up your medication list with your provider and they will help you understand what to hold and when to begin holding such drugs prior to your endoscopic procedure.

I take iron pills. Do I need stop taking this medication?

Yes. Iron pills can lead to constipation and its advised to stop taking them 7 days prior to a colonoscopy. You do not have to hold iron supplements before an upper endoscopy. This will help optimize the quality of your bowel preperation prior to your procedure.

Do I take diabetes medications?

This is individualized patient to patient. Some medications are held, some the medication doses are halfed, and others may be continued. Please discuss your diabetes type/status, and medication list with your gastroenterologist and/or your endocrinologist prior to your procedure.

Should I take my anti-hypertensive and anxiety medications?

If you take your anxiety or blood pressure medications in the morning then it is advised to take them on the morning of your procedure with a small sip of water. We want your mental health and your blood pressure to be optimal leading upto the procedure itself.

II. Questions About your Prep

What type of Prep am I taking?

There are MULITPLE prep options: Miralax, Suprep, Clenpiq, Golytely, Moviprep, Sutab, Plenvu. Those who have a known history of constipation are often advised to do a “two day prep”. Each practice and provider may have personal preferences. At MGI our default options is the miralax bowel prep. Please go to our website for detailed pre procedure patient instructions. We have taken the time to carefully explain how to use any pertinent bowel prep. Our website: www.manhattangastroenterology.com > patient information > procedure instructions.

What colored liquids am I not supposed to drink during the prep process?

Avoid Red, Purple, or Orange

My pharmacy hasn’t received the prescription yet. What do I do?

This is a common problem and there is an easy and stress free answer. The default product that we use “Miralax bowel prep” is all available over the counter. Meaning no prescription is requires. Please go to our website: www.manhattangastroenterology.com > patient information > procedure instructions > colonoscopy > Miralax Prep. It will outline what to purchase over the counter and how to use it in great detail.

I haven’t gone to the bathroom yet, and I already took the first half of the prep. What should I do?

For some patients there is a delay in colonic activity up to 2-4 hours. Lets first go over the fundementals: The standard model for bowel preparation is “split prep model” where you take half the prep the day prior and half the prep 5 hrs prior to the procedure. If you take the first half the day before, and do not see any colonic activity within the ifrst two hours, then go ahead and finish the 2nd half of your bowel prep the day before your procedure. Now 5 hours prior to the procedure you should take a product called “magnesium citrate” ( a liquid solution, 10oz bottle). This additional component should optimize your bowel preperation.

What if I’ve taken all of the preparation but haven’t started moving my bowels yet?

Same as the above answer. If you have finished the full miralax prep, and then magnesium citrate, and your stool is still not clear yellow then contact your GI provider and let them know this information. It is possible you may need to reschedule your procedure and come up with an extended bowel preparation strategy.

What if I’ve taken all my preparation and am still passing solid stool on the day of my exam?

Same as the above answer. If you have finished the full miralax prep, and then magnesium citrate, and your stool is still not clear yellow then contact your GI provider and let them know this information. It is possible you may need to reschedule your procedure and come up with an extended bowel preparation strategy.

When will I stop moving my bowels?

Typically after your colonoscopy is done most of the liquids will be removed using the colonoscope. You may have some residual liquids stools for a a few hours after the procedure. Overall it should not last more than 24 hours after the procedure.

Do I really have to do half the prep tonight and half tomorrow?

Yes. Research has shown that doing a “split prep” model helps provide a much cleaner colon. The biggest benefit to the split prep is the “bile” that enters into the empty colon can stain it yellow and obscure the doctors views. The “split prep'” which encourages you to take the 2nd half 5 hours pre-procedure eliminates this bile from the colon and provides the best visibility for your doctor. This yields the most optimal exam.

Do I need to drink all of the preparation?

Yes. Please follow the instrucitons as listed on our website. www.manhattangastroenterology.com > patient information > procedure instructions

What do I do when I have to go to the bathroom in the morning? I have a long drive.

The send half of your bowel prep is 5 hours pre-procedure. That will provide ample time to drink the product, use the restroom, tidy up, and commute to the office.

I can’t stomach the prep. What can I do to make it go down easier?

If you are having a difficult time with the bowel prep then take a 30 minute break, wait for the nausea to subside. Then restart with drinking a smaller quantity at a time, take longer interval breaks in between each cup of bowel prep product.

I started vomiting after taking the prep. Can I still have my procedure?

Yes. Do your best to finish the prep. If you are having a difficult time with the bowel prep then take a 30 minute break, wait for the nausea to subside. Then restart with drinking a smaller quantity at a time, take longer interval breaks in between each cup of bowel prep product. As long as your stools are looking clear yellow then you did your job!

Can I continue to drink clear liquids after I have started taking the preparation?

No, you should stop consuming any clear liquid diet at that point.

I ate solid food on the day before my colonoscopy. Can I still have my procedure?

If you had solid food >24 hours prior to your procedure then you should be in the clear. If you had solid food <24 hours before your procedure its likely that your bowel prep will not be adequate and visualization will be impaired during the colonoscopy. Please contact your provider. Its very possible they will want you to reschedule.

I took mag citrate the last time. Can I do that this time?

Magnesium citrate will be offered as part of a “two day bowel prep” only for specific patients who have pre-existing history of constipation. If you have a history of kidney disease you should avoid this product so please make sure to let your GI provider know such details.

Will the preparation irritate my hemorrhoids or skin?

The bowel preparation itself should not affect your hemorrhoids. However, the frequent use of your rectal muscles in order to pass your bowel movements can irritate your hemorrhoids. This should not impede you from doing your bowel prep and your provider can you manage your hemorrhoids afterwards.

I currently have my period. Is this a problem?

No. It should not impede you from having a successful procedure.

I am severely constipated. I do not feel the prep was adequate last time or I feel I will not be cleaned out with the prep. What do I do?

If you have a pre-existing history of constipation please let your GI doctor know. There are 2 day bowel preps for these situations and we have these instructions listed on our website.

My directions say to stop eating fiber-containing food for 3-5 days before I start my prep. What can I eat?

Begin a LOW FIBER Diet including: white or sour dough bread, white rice, pasta, eggs, chicken, turkey, fish, cheese, yogurt, milk, ice cream, pudding, canned or cooked fruit/vegetables without skin or peel (carrots, cucumbers, potatoes) , pureed fruits/vegetables (smoothies, strained puree soups), creamy peanut or almond butter. Please note this is listed in detail in our bowel prep instructions.

III. Questions about your Escort

In general, how long will I spend in the endoscopy unit and what time should I be picked up?

General expectastion is that you will be in our practice 2-3 hours door to door. Please keep in mind that delays can occur for a variety of reasons and we aim to do our best to keep you on schedule.

How long is my procedure?

Most procedures are scheduled for 30 minute intervals.

Why do I need an escort?

After having sedation for your procedure it is advised to have an escort to get you home safely. Above all else patient safety comes first.

IV. Pre-Procedure Questions

Why do I need to arrive at the GI Endoscopy unit 45 minutes before my test?

In our practice it is advised to arrive 30 minutes prior to your procedure in order to get registered, review and sign consesnts, get changed and triaged, and have a health care provider get your initial pre procedure vitals along with IV line access. This takes a minimnum of 30 minutes and if you do not show up 30 minutes pre-procedure then you will automatically be late and will delay everyone elses procedure that comes after you.

What is moderate sedation? Will I be going to sleep?

Yes you are asleep for your procedure. The idea is to keep the patient comfortable, pain free, while under direct supervision of an anesthesiologist.

I am taking pain pills. Will the moderate sedation medicines work for me?

Yes.

What are common complications that arise from colonoscopy or endoscopy?

Complications are generally very rare and can include, infections, bleeding, abdominal bloating, and nausea. A rare but important complication is called a perforation: where the mucosa of the digestive disease lining is torn from mechanical tension of the instrument. These often require urgent hospitalization and surgical correction of such a perforation.

Read more about #1 Prep Instructions for Your Colonoscopy

Updated on Sep 20, 2023 by Dr. Shawn Khodadadian (Gastroenterologist) of Manhattan Gastroenterology