ENDOSCOPY

What to expect at our facility:

GENERAL INFORMATION
You will be given your arrival time to the facility. This will allow the staff to have you ready in time for your procedure.

Although we have a list of your medications, it is important for you to bring all of your current prescription and over-the-counter vitamins/medications with you. This is to ensure that we have all accurate information regarding your medications.

Please take your heart, blood pressure, seizure, and breathing medications including the day of your procedure unless otherwise directed by your doctor. If you usually take in the am, please make sure you take it at least 2 hours prior to arrival time.

Follow specific directions for your blood thinner medications such as Plavix, Aspirin, Lovenox, Pradaxa, etc… as instructed by your doctor.

Stop non-essential vitamins, iron and fiber supplement medication 7 days prior to your procedure.

No use of Phenteramine or other weight loss drugs two weeks prior. No use of recreational drugs.

You will be asked to bring a responsible adult to accompany you home after the procedure is complete. This person will be asked to stay at the facility and will need to provide their name and phone number at check-in.

Women 50 years of age and under will be asked to provide a urine sample for pregnancy testing. If you have had a hysterectomy or tubal ligation, this will not be necessary.

UPON ARRIVAL (CHECK-IN)
If your insurance information has changed since your last clinic appointment, please provide current information to the receptionist. Please notify the receptionist if your name, address, phone number or any other information has changed.

You will be asked to sign the following documentation electronically:

  • Business Consents:
    • Authorization to Release Information
    • Financial Policy
    • Patient’s Rights and Responsibilities
    • Receipt of Privacy Practices
    • Ownership statement
    • Advance Directives statement
  • Anesthesia Consent
  • Procedure Consent:
    • Colonoscopy
    • Esophagogastroduodenoscopy (EGD)

Examples of these forms may be found under the Patient Form tab found to the left.  After you are checked in, you will be asked to have a seat in the lobby until the pre-op nurse calls your name. (Although coffee, tea and cocoa are available for your driver, it is important that you NOT eat NOR drink anything while you are waiting).

PRE-OP
The nurse will call you into the pre-op area and your ride will be asked to wait in the lobby until your exam is complete. If you have special needs and require assistance in pre-op, please let the nurse know so that arrangements can be made.

The pre-op nurse will ask for all your medications and will review them with you. Updates will be made to the chart if needed. She/he will also need to know what medications you took the morning of the procedure and when you took them. Please follow directions.

The nurse will ask you about your prep and when you last ate and/or drank. It is very important you have nothing for 2 hours prior to your procedure. She/he will also review your medical history, allergies and reactions to food or medications.

She/he will review the process of the procedure and basic discharge instructions. This is an opportunity for you to ask questions regarding the procedure itself and what to expect after it is complete. An IV will be started to be used for sedation during the procedure.

If you are Diabetic please let the nurse know so that we can check your blood sugar before the procedure. You will have an opportunity to speak to the Nurse Anesthetist and your Physician before the procedure starts.

Please leave phones, purse/wallet and electronic devices with the driver as well as removed dentures and glasses. Electronics are not allowed in the patient care area.

PROCEDURE ROOM
You will be taken by stretcher to the Procedure Room, the procedure will be performed by your Physician. Sedation will be administered by a Registered Nurse or a Nurse Anesthetist who will monitor you throughout your procedure.

After your endoscopy is completed, you will be transported to the recovery area for care and observation until most of the effects of the medication have worn off.

RECOVERY AREA
At this time your driver or family member will be asked to join you if you agreed for them to do so. As you become more alert, your nurse will verify your ability to swallow and will offer you a drink if not contraindicated.

The physician will review the results of the procedure with you and answer any of your questions at this time. Your nurse will remove your IV and reinforce your specific written discharge instructions as ordered by your doctor.

After you get dressed and sign your discharge consent, one of our staff members will accompany to your vehicle.

It is recommended that you refrain from driving, operating any heavy equipment or make any important decisions the day of your procedure, you should be able to resume your regular activities the day after. A member of our staff will call you the next day to follow-up.

Conscious Sedation
The purpose of Conscious Sedation is to help you relax during your procedure. You will still breathe on your own and cough as needed. You may fall asleep, but you will wake up easily to respond to verbal cues and touch. After conscious sedation, you may feel drowsy and not remember much about your procedure.

The use of sedation during a procedure will help you relax and become more comfortable, in order to facilitate a good exam.
The medications we commonly use are a combination of Versed (sedative), and Fentanyl (pain medication). These will be administered through your IV by a Registered Nurse under the direct supervision of the Physician. With conscious sedation, you will feel drowsy and may sleep throughout the procedure but can be woken up easily when spoken to or touched. You may or may not remember being in the procedure room or the procedure itself. You will be monitored throughout the procedure and in the recovery area until ready for discharge.

Conscious Sedation may decrease your cognitive function and coordination, you will need a responsible adult to drive home. You WILL NOT be permitted to ride home alone in a taxi or bus. We also recommend for you to rest and NOT work or make any important decisions the day of the procedure. These rules also apply when using FAST.

If you have experienced an allergic or adverse reaction to Versed, Fentanyl, please notify you doctor prior to your procedure or on the day your appointment.

Propofol
Patients at this facility are offered the option of choosing deep sedation with a drug called Propofol as a choice for sedation during endoscopic examinations. There are several benefits to propofol sedation when compared to conscious sedation or other sedative agents. There is also emerging evidence that patients sedated with Propofol may have an increased incidence of polyp detection during colonoscopy. This is likely attributed to the fact that patients are comfortable during the procedure and may tolerate a more thorough examination.

  • Propofol has a very rapid onset of action
  • Propofol also has a very short duration of action so that at the conclusion of your procedure you will have very little to no residual drowsiness.
  • With propofol you will be completely unaware of the procedure and will not experience any pain.
  • Propofol does not induce nausea or vomiting like some other sedative drugs.

At this facility propofol is administered by an anesthesiologist or nurse anesthetist who will be with you throughout your procedure. The anesthesia provider will monitor your blood pressure, heart rate and respiratory status. There is a separate fee for the administration of propofol by our anesthesia provider. You will be billed after the procedure by All American Anesthesia, who will also as a courtesy file with your insurance carrier where appropriate.

Contraindications to Propofol
Propofol may be contraindicated in patients with a known hypersensitivity or allergic to Propofol Injectable Emulsion. Propofol is also contraindicated in patients with allergies to eggs, egg products, soybeans or soy products. Please notify your nurse if you have any allergies to these products.

Robinul
As part of your anesthetic at this facility you may also receive the drug Robinul in your IV in the pre-procedure room before your exam. The primary purpose of this drug is to assist in drying up any oral secretions that you might have while deeply sedated for your exam. This will significantly reduce any coughing that you may experience during the procedure. Should you have severe glaucoma or significant prostate enlargement associated with urinary retention, please notify your nurse prior to the procedure. Your physician and anesthesia provider may choose not to administer the drug under those circumstances.

Cape Fear Center for Digestive Diseases accepts most major insurances, to include but not limited to the following:

  • Aetna
  • GEHA
  • Mailhandlers
  • Medicaid
  • BCBS
  • Medicare
  • Cigna
  • Humana Military Services (Tricare)
  • United Healthcare
  • Coventry (Wellpath)
  • Medcost
  • Medicare Advantage Plans

As a courtesy to our patients, we will file claims with insurance companies. It is the patient’s responsibility to understand the benefits payable under their insurance coverage. The patient is also responsible for paying any deductible amount, co-insurance, or other balance not paid by the insurance company.

To verify our participation with your insurance, you may contact your insurance carriers Customer Service Department on your insurance card. You may also call our Claims Department at (910) 323-2477.

Patients should bring their insurance card(s) with them for their office visit.
We strongly encourage patients to check directly with their insurance provider if they have questions about their benefits, and to determine whether a referral is required.
We perform charitable medical care to low-income uninsured patients through “The Care Clinic.”