Frequently Asked Questions

Home FAQ’s

How long should I allow for my appointment in Endoscopy?

You should allow between 2-4 hours for your visit to the Endoscopy unit.

Why does it take 2-4 hours?

The appointment time is measured from the time you register at the Endoscopy reception to your departure from the unit. It includes pre procedure checks, the time you spend waiting for the examination, the time the actual examination takes, the time you need to recover from it and the time taken getting yourself ready to go home.

How long does the examination take?

The actual time spent on an examination will vary between patients and examinations. In general, an examination of the stomach (gastroscopy) will take 5-15 minutes and one of the Colon (colonoscopy) 20-40 minutes.

Do I need to starve beforehand?

The instructions sent to you with your appointment details will clearly explain what you will need to do to prepare for the endoscopy.

Do I need to bring someone with me?

Whether you need to bring someone with you as an escort depends on whether you will have a sedative for the endoscopy. If you have a sedative, it is important that you have someone to help you home afterwards, including being driven home. You will be advised of whether you need to have a sedative. For some examinations you can opt not to have a sedative and therefore do not need to have an escort.

Why do we offer you a sedative?

The gut lining does not have nerves that give sharp pains but they can sense movement, stretching or pressure. If no sedative is used, some endoscopies can be uncomfortable but not painful.

For examinations of the pancreas and gall bladder (ERCP), it is accepted practice for people to be offered a sedative. For examinations of the colon (colonoscopy) it is accepted practice to offer a sedative, and most people decide to have one but some prefer not to. For a flexible sigmoidoscopy, which is a shorter examination of the bowel most people chose not to have a sedative.

For other examinations, such as a gastroscopy, the use of a sedative is less necessary because they take less time and are less uncomfortable. About half of the people who come for a gastroscopy elect to have a local anaesthetic throat spray alone, rather than with the sedative injection.

What does the sedative do?

The sedative we use most often is Midazolam (a type of valium) which makes you feel sleepy and more comfortable. Usually the sedative does not actually send you to sleep, but makes you feel sleepy. Also, you might not remember anything about the examination afterwards. These sedatives start to work very quickly but take hours to wear off (up to 24 hours)

How will I feel after having the sedation?

If you have had a sedative after the endoscopy examination you will feel very sleepy at first and then you may feel a little unsteady. After a variable number of hours you will feel much more normal again but we advise you not to resume driving for 24 hours or carry out work or leisure activity that could be compromised by lack of attention. These effects are often why people opt to not have a sedative.

How long do I have to spend in the department after the examination?

 If you haven’t had a sedative you can usually leave immediately after the examination.

If you have had a sedative we encourage you to stay in the department until you are feeling more awake, for example until you can walk safely.

Do I have to have a sedative?

This depends on the test you are having. You can discuss this with someone in Endoscopy beforehand. For examinations of the stomach approximately half of the patients choose to have a local anaesthetic spray to the back of the throat alone. The choice is yours.

What does the throat spray involve?

If you have chosen not to have a sedative injection before a gastroscopy we will spray the back of your throat with a local anaesthetic to numb it (preventing any pain). You will still have a gag reflex but will feel the tube (scope) much less as you swallow it. The numbing lasts about half an hour. If you decide to have throat spray you will remain fully conscious during the procedure and will remember it afterwards. Having the throat spray is a good alternative if you cannot have sedation for any reason, or if you do not want to be sleepy for the rest of the day. If you choose to have the throat spray without a sedative you will be able to leave the department as soon as the examination is complete.

Why does my escort need to pick me up from the unit and why can’t they just come to the entrance to pick me up?

If you are having a sedative injection for the examination it is very important that we know you will have someone to help you get home safely afterwards (you will feel sleepy and must not drive). If you arrive by hospital transport you do not need to arrange your own escort because the drivers can vouch for your safety.

What are functions of the liver?

Liver is situated in the upper right side of the abdomen just below the rib cage. The liver helps fight infections and cleans your blood. lt also helps digest food and stores a form of sugar your body uses for energy. lt produces clotting factors, makes proteins and store vitamins.

How does the liver get damaged?

Liver damage cafl occur suddenly or it can happen over a period of time.

Sudden {Acute) liver failure: – Acute hepatitis – Some drugs(may include herbal treatments, Chinese mediations) – Paracetamol overdose

Chronic (Long term) liver failure:

– Excessive alcohol intake – Hepatitis B, C – Fatty liver ( excessive weight gain, diabetes, high cholesterol) – Autoimmune liver disease

ln children, liver can get damaged due to developmental anomaly of bile duct (biliary atresia) and other metabolic liver diseases.

How do I know if myliver is damaged?

Some signs and syrnptoms of liver problems are r yellowing of the skin and the whites of the eyes, a condition called jaundice

* Feeling tired or weak r losing your appetite r swelling of feet
* Swelling of the abdomen due to water accumulation r losing rnuscle
* Itching
* Bruising or bleeding easily r Blood in the vomit
* Passing black stools
* Conf usion and disorientation

What is liver transplantation?

Liver transplantation is surgery to rerflove a diseased or injured liver and replace it with a healthy one from another person, called a donor. Many people have had liver transplants and now lead normal lives.

How will I know whether I need a liver transplant?

Our transplant team will examine you and evaluate your blood tests. Based on their assessment, they will counsel you regarding requirement for a liver transplant. The team will include liver transplant surgeons; liver specialists, called hepatologists; nurses; social workers; and other health care professionals- The transplant tearn will examine you and run blood tests, x rays, and other tests to help decide whether you would benefit from a transplant.
During your evaluation, and while waiting for a transplant, you should take care of your health. Our team will tell you what you can do to stay strong while you wait for a new liver.

Who needs liver transplant?

A liver transplant is needed when a person’s liver is failing and a doctor recommends he or she be evaluated for a transplant Many diseases can cause liver failure. Cirrhosis scarring of the liver) is the most common reason for liver transplants. Liver cirrhosis after a certain stage is not reversible by medical treatment Other common reasons for liver transplants are: . Chronic hepatitis B and chronic hepatitis C . Alcoholic liver disease o Autoimmune Liver diseases o Primary liver cancer. Fatty liver disease o Acute liver failure r Bile duct diseases. Genetic diseases. Children- Wilson’s disease, biliary atresia, metabolic disorders

ARE COLONOSCOPIES SAFE ?

If performed by particularly trained specialists, colonoscopies are very safe. The risk of perforation is less than 1 in 1,000 cases, and the risk of bleeding is less than 1 percent

HOW LONG DOES ABDOMINAL DISCOMFORT LAST AFTER A COLONOSCOPY?

Victims typically present within 12 hours with inside pain and tenderness, but signs may present up to 5 days after the method.

What is Colonoscopy?

Colonoscopy is a procedure which enables a physician (usually a gastroenterologist) to directly image and examine the entire colon. It is effective in the diagnosis and/or evaluation of various GI disorders (e.g. colon polyps, colon cancer, diverticulosis, inflammatory bowel disease, bleeding, change in bowel habits, abdominal pain, obstruction and abnormal x-rays or CT scans) as well as in providing therapy (for example, removal of polyps or control of bleeding). It is also used for screening for colon cancer. A key advantage of this technique is that it allows both imaging of abnormal findings and also therapy or removal of these lesions during the same examination. This procedure is particularly helpful for identification and removal of precancerous polyps.

Has colonoscopy been shown to be effective in preventing cancer of the colon and saving lives?

Yes. Colonoscopy accomplishes this by detecting and removing polyps, and detecting early cancers. Recent data show that both the number of new cases of colon cancer (incidence) and deaths from the disease are decreased when colonoscopy is performed accordi Yes. Colonoscopy accomplishes this by detecting and excluding polyps and detecting early cancers. Recent data show that both the quantity of new cases of colon cancer (incidence) and deaths from the disease are decreased when colonoscopy is performed according to established guidelines ng to established guidelines.

Why do I need to have someone I know drive me home?

The majority of our procedures are done with conscious sedation, including the intravenous administration of medication (usually a combination of a narcotic and a sedative). The use of these drugs changes your reflexes and perception, which makes you unfit to drive. Our hospital protocol requires that a responsible individual ensures that you arrive safely at your home. Public transportation or a taxi service is acceptable as long as you are accompanied by an adult you trust and will help you inside your house or apartment.

How long will my visit take?

The medium length of your visit is dependent upon which method is implemented and the length of your improvement. The visit length varies for each patient, however, it is usually between two to three hours.

Will I be able to eat after my procedure?

While there may be restrictions on the type of foods allowed, the majority of patients resume a normal diet after discharge. Depending on the result of the procedure, dietary modifications may be recommended. You may not drink alcohol on the day of your procedure.

If I take medication, are there any risks?

In general, most medications do not interfere with this procedure. However, if you are on insulin, your dosage may need to be adjusted – or changed – for the preparation period and the day of the exam. Also, if you take anti-coagulant or blood-thinning medicines, they will have to be stopped (and be possibly started on a bridge medication) before the procedure to allow for biopsy and/or polyp removal. Ask your physician about adjusting your medication.

How many days do I need to take off work?

You will need to take off work the day of the procedure. Some patients who work evenings also take off work the day before the procedure to do the bowel prep.

HOW DO I KNOW IF MYLIVER IS DAMAGED?

Some signs and symptoms of liver problems are r yellowing of the skin and the whites of the eyes, a condition called jaundice
1. Skin and eyes that appear yellowish (jaundice)
2. Abdominal pain and swelling.
3. Swelling in the legs and ankles.
4. Itchy skin.
5. Dark urine color.
6. Pale stool color, or bloody or tar-colored stool.
7. Chronic fatigue.
8. Nausea or vomiting.
+ Endoscopy

How long should I allow for my appointment in Endoscopy?

You should allow between 2-4 hours for your visit to the Endoscopy unit.

Why does it take 2-4 hours?

The appointment time is measured from the time you register at the Endoscopy reception to your departure from the unit. It includes pre procedure checks, the time you spend waiting for the examination, the time the actual examination takes, the time you need to recover from it and the time taken getting yourself ready to go home.

How long does the examination take?

The actual time spent on an examination will vary between patients and examinations. In general, an examination of the stomach (gastroscopy) will take 5-15 minutes and one of the Colon (colonoscopy) 20-40 minutes.

Do I need to starve beforehand?

The instructions sent to you with your appointment details will clearly explain what you will need to do to prepare for the endoscopy.

Do I need to bring someone with me?

Whether you need to bring someone with you as an escort depends on whether you will have a sedative for the endoscopy. If you have a sedative, it is important that you have someone to help you home afterwards, including being driven home. You will be advised of whether you need to have a sedative. For some examinations you can opt not to have a sedative and therefore do not need to have an escort.

Why do we offer you a sedative?

The gut lining does not have nerves that give sharp pains but they can sense movement, stretching or pressure. If no sedative is used, some endoscopies can be uncomfortable but not painful.

For examinations of the pancreas and gall bladder (ERCP), it is accepted practice for people to be offered a sedative. For examinations of the colon (colonoscopy) it is accepted practice to offer a sedative, and most people decide to have one but some prefer not to. For a flexible sigmoidoscopy, which is a shorter examination of the bowel most people chose not to have a sedative.

For other examinations, such as a gastroscopy, the use of a sedative is less necessary because they take less time and are less uncomfortable. About half of the people who come for a gastroscopy elect to have a local anaesthetic throat spray alone, rather than with the sedative injection.

What does the sedative do?

The sedative we use most often is Midazolam (a type of valium) which makes you feel sleepy and more comfortable. Usually the sedative does not actually send you to sleep, but makes you feel sleepy. Also, you might not remember anything about the examination afterwards. These sedatives start to work very quickly but take hours to wear off (up to 24 hours)

How will I feel after having the sedation?

If you have had a sedative after the endoscopy examination you will feel very sleepy at first and then you may feel a little unsteady. After a variable number of hours you will feel much more normal again but we advise you not to resume driving for 24 hours or carry out work or leisure activity that could be compromised by lack of attention. These effects are often why people opt to not have a sedative.

How long do I have to spend in the department after the examination?

 If you haven’t had a sedative you can usually leave immediately after the examination.

If you have had a sedative we encourage you to stay in the department until you are feeling more awake, for example until you can walk safely.

Do I have to have a sedative?

This depends on the test you are having. You can discuss this with someone in Endoscopy beforehand. For examinations of the stomach approximately half of the patients choose to have a local anaesthetic spray to the back of the throat alone. The choice is yours.

What does the throat spray involve?

If you have chosen not to have a sedative injection before a gastroscopy we will spray the back of your throat with a local anaesthetic to numb it (preventing any pain). You will still have a gag reflex but will feel the tube (scope) much less as you swallow it. The numbing lasts about half an hour. If you decide to have throat spray you will remain fully conscious during the procedure and will remember it afterwards. Having the throat spray is a good alternative if you cannot have sedation for any reason, or if you do not want to be sleepy for the rest of the day. If you choose to have the throat spray without a sedative you will be able to leave the department as soon as the examination is complete.

Why does my escort need to pick me up from the unit and why can’t they just come to the entrance to pick me up?

If you are having a sedative injection for the examination it is very important that we know you will have someone to help you get home safely afterwards (you will feel sleepy and must not drive). If you arrive by hospital transport you do not need to arrange your own escort because the drivers can vouch for your safety.

+ Liver Transplant

What are functions of the liver?

Liver is situated in the upper right side of the abdomen just below the rib cage. The liver helps fight infections and cleans your blood. lt also helps digest food and stores a form of sugar your body uses for energy. lt produces clotting factors, makes proteins and store vitamins.

How does the liver get damaged?

Liver damage cafl occur suddenly or it can happen over a period of time.

Sudden {Acute) liver failure: – Acute hepatitis – Some drugs(may include herbal treatments, Chinese mediations) – Paracetamol overdose

Chronic (Long term) liver failure:

– Excessive alcohol intake – Hepatitis B, C – Fatty liver ( excessive weight gain, diabetes, high cholesterol) – Autoimmune liver disease

ln children, liver can get damaged due to developmental anomaly of bile duct (biliary atresia) and other metabolic liver diseases.

How do I know if myliver is damaged?

Some signs and syrnptoms of liver problems are r yellowing of the skin and the whites of the eyes, a condition called jaundice

* Feeling tired or weak r losing your appetite r swelling of feet
* Swelling of the abdomen due to water accumulation r losing rnuscle
* Itching
* Bruising or bleeding easily r Blood in the vomit
* Passing black stools
* Conf usion and disorientation

What is liver transplantation?

Liver transplantation is surgery to rerflove a diseased or injured liver and replace it with a healthy one from another person, called a donor. Many people have had liver transplants and now lead normal lives.

How will I know whether I need a liver transplant?

Our transplant team will examine you and evaluate your blood tests. Based on their assessment, they will counsel you regarding requirement for a liver transplant. The team will include liver transplant surgeons; liver specialists, called hepatologists; nurses; social workers; and other health care professionals- The transplant tearn will examine you and run blood tests, x rays, and other tests to help decide whether you would benefit from a transplant.
During your evaluation, and while waiting for a transplant, you should take care of your health. Our team will tell you what you can do to stay strong while you wait for a new liver.

Who needs liver transplant?

A liver transplant is needed when a person’s liver is failing and a doctor recommends he or she be evaluated for a transplant Many diseases can cause liver failure. Cirrhosis scarring of the liver) is the most common reason for liver transplants. Liver cirrhosis after a certain stage is not reversible by medical treatment Other common reasons for liver transplants are: . Chronic hepatitis B and chronic hepatitis C . Alcoholic liver disease o Autoimmune Liver diseases o Primary liver cancer. Fatty liver disease o Acute liver failure r Bile duct diseases. Genetic diseases. Children- Wilson’s disease, biliary atresia, metabolic disorders

+ Colonoscopy

ARE COLONOSCOPIES SAFE ?

If performed by particularly trained specialists, colonoscopies are very safe. The risk of perforation is less than 1 in 1,000 cases, and the risk of bleeding is less than 1 percent

HOW LONG DOES ABDOMINAL DISCOMFORT LAST AFTER A COLONOSCOPY?

Victims typically present within 12 hours with inside pain and tenderness, but signs may present up to 5 days after the method.

What is Colonoscopy?

Colonoscopy is a procedure which enables a physician (usually a gastroenterologist) to directly image and examine the entire colon. It is effective in the diagnosis and/or evaluation of various GI disorders (e.g. colon polyps, colon cancer, diverticulosis, inflammatory bowel disease, bleeding, change in bowel habits, abdominal pain, obstruction and abnormal x-rays or CT scans) as well as in providing therapy (for example, removal of polyps or control of bleeding). It is also used for screening for colon cancer. A key advantage of this technique is that it allows both imaging of abnormal findings and also therapy or removal of these lesions during the same examination. This procedure is particularly helpful for identification and removal of precancerous polyps.

Has colonoscopy been shown to be effective in preventing cancer of the colon and saving lives?

Yes. Colonoscopy accomplishes this by detecting and removing polyps, and detecting early cancers. Recent data show that both the number of new cases of colon cancer (incidence) and deaths from the disease are decreased when colonoscopy is performed accordi Yes. Colonoscopy accomplishes this by detecting and excluding polyps and detecting early cancers. Recent data show that both the quantity of new cases of colon cancer (incidence) and deaths from the disease are decreased when colonoscopy is performed according to established guidelines ng to established guidelines.

Why do I need to have someone I know drive me home?

The majority of our procedures are done with conscious sedation, including the intravenous administration of medication (usually a combination of a narcotic and a sedative). The use of these drugs changes your reflexes and perception, which makes you unfit to drive. Our hospital protocol requires that a responsible individual ensures that you arrive safely at your home. Public transportation or a taxi service is acceptable as long as you are accompanied by an adult you trust and will help you inside your house or apartment.

How long will my visit take?

The medium length of your visit is dependent upon which method is implemented and the length of your improvement. The visit length varies for each patient, however, it is usually between two to three hours.

Will I be able to eat after my procedure?

While there may be restrictions on the type of foods allowed, the majority of patients resume a normal diet after discharge. Depending on the result of the procedure, dietary modifications may be recommended. You may not drink alcohol on the day of your procedure.

If I take medication, are there any risks?

In general, most medications do not interfere with this procedure. However, if you are on insulin, your dosage may need to be adjusted – or changed – for the preparation period and the day of the exam. Also, if you take anti-coagulant or blood-thinning medicines, they will have to be stopped (and be possibly started on a bridge medication) before the procedure to allow for biopsy and/or polyp removal. Ask your physician about adjusting your medication.

How many days do I need to take off work?

You will need to take off work the day of the procedure. Some patients who work evenings also take off work the day before the procedure to do the bowel prep.

HOW DO I KNOW IF MYLIVER IS DAMAGED?

Some signs and symptoms of liver problems are r yellowing of the skin and the whites of the eyes, a condition called jaundice
1. Skin and eyes that appear yellowish (jaundice)
2. Abdominal pain and swelling.
3. Swelling in the legs and ankles.
4. Itchy skin.
5. Dark urine color.
6. Pale stool color, or bloody or tar-colored stool.
7. Chronic fatigue.
8. Nausea or vomiting.

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