• Please see Dr. Sam’s preparation sheet (English and Chinese versions available).  If you have further questions about the procedure, please contact Dr. Sam’s office (416-222-0660).
• Please make note of the location of the endoscopy clinic when you are contacted by our office with the appointment.  
• Dr. Sam performs these procedures at:
  • Dynamic Medical Centre (5734 Yonge Street, 3rd Floor) at Yonge St. and Finch Ave. East (across from Finch subway station).  Parking is free.
  • At Dynamic Medical Centre, there is parking at the back of the building (enter from Yonge St.).  Inform the parking attendant that you are seeing Dr. Sam at Dynamic Medical Centre and the parking will be free.  www.dmchealth.ca.
  • North Toronto Endoscopy Clinic (7155 Woodbine Ave, Unit 125 at Woodbine Ave. and Steeles Ave.)
• This procedure is fully funded by OHIP.  Please remember to bring your OHIP card to the appointment.
• Please ensure that you have someone to accompany you home after the procedure.  We cannot provide sedation unless you have someone to accompany you home.  You cannot drive or operate any heavy machinery for the rest of the day after receiving sedation.
• Please note that there is a cancellation fee of $50 if you do not show up for the appointment or if you cancel less than 3 business days before the test.

COLONOSCOPY

What is a colonoscopy?

• A colonoscopy is a procedure where a long tube with a camera on the end is used to assess the lining of the large intestine (colon).

How should I prepare for a colonoscopy?

• Buy: 4 DULCOLAX (Bisacodyl) tablets (5 mg each) and a container of polyethylene glycol bowel prep (e.g. PEGLYTE 4 LITRES) – it will come in a jug with powder which you will reconstitute with water.
• 1 week before the test: Stop taking vitamins, iron, calcium
• 3 days before the test: Do not eat any uncooked fruits, vegetables, whole bran bread or high fibre cereals or food with seeds
• 1 day before the test: DO NOT EAT ANY SOLID FOOD THE DAY BEFORE YOUR COLONOSCOPY.  DRINK CLEAR FLUIDS (E.G. water, ginger ale, clear broth, Jell-O, apple or white grape juice, etc.)
  • Reconstitute the PEGLYTE into 4 L as directed
  • You may take Gravol before starting the bowel preparation; you can refrigerate the prep and also add some lemon juice to the prep to a make it more palatable and drink from a straw.
• At 2 PM the day before the test: take 4 Dulcolax tablets with 1 glass of water.  Drink 3 LITRES of the PEGLYTE between 4PM-10 PM.  You may have additional clear fluids until bedtime.  On the day of the procedure, finish the 4th LITRE (about 4 glasses) of PEGLYTE between 4-6 hours before the appointment time.  
• It is important to have this “split bowel preparation” as studies have shown a cleaner bowel preparation which will allow for better visualization of your colon.
• You may have additional clear fluids up to 4 hours before your test.
• You can take your prescribed medications (as outlined by your doctor) with a small sip of water up until 2 hours prior to the procedure.  Take only the essential medications (e.g. anti-seizure medications, blood pressure medications, etc).
• Arrange for a friend or family member to take you home after the procedure.  We cannot provide sedation unless you have someone to accompany you home.  You cannot drive or operate any heavy machinery for the rest of the day after receiving sedation.
• You may be asked to adjust the dose of your medications (e.g. insulin/other diabetic medications) – if you have questions, please contact Dr. Sam’s office (416-222-0660).
• If you are taking blood thinning medications, please check with your prescribing physician if and when these medications can be stopped for the endoscopic procedure.

• When you arrive for the procedure, you will check-in at the front desk of the endoscopy clinic.
• You will fill out a questionnaire about your past medical history, previous surgical history and medications and allergies ***PLEASE BRING YOUR LIST OF MEDICATIONS
• You will meet our nurse.  You will be asked to change into a gown.  Please do not bring any valuable belongings.  Your belongings will be placed under your stretcher.
• An intravenous (IV) needle will be inserted into your arm or hand.  This will be used to provide medication during the procedure.

What happens during a colonoscopy?

• The procedure typically takes about 20-30 minutes to complete but can take longer.
• Our anesthetist will provide you with medication through the IV so you will sleep during the procedure.
• You will get oxygen through the nasal prongs during the procedure.  You will get attached to a monitor to assess your heart rate and rhythm, oxygen status and blood pressure throughout the procedure.
• A flexible tube with a camera on the end with be inserted into your anus and up into the rectum and large bowel.  Your doctor will look at the inside lining of your colon.  In order to do so, air will be pumped into the colon through the tube to inflate the colon.
• The doctor may take biopsies (small samples of tissue from the lining of the digestive tract) to send for histologic analysis to help make a diagnosis.  Polyps (growths in the colon that can potentially grow and lead to colon cancer) may be removed during the procedure if seen.

What happens after a colonoscopy?

• After your test, you will be observed in the recovery area by our nurse until the sedative medication wears off.
• Once you have met the discharge criteria, you will be able to go home.  Prior to leaving, Dr. Sam will speak to you and give you a sheet of paper with pertinent details about the findings and any important instructions.  If any tissue was taken for analysis, it will take several weeks for the results to return.  Your family doctor (or the referring doctor) will also receive a copy of the report and any pathology results.
• You may feel bloated after the procedure.  This is common and the feeling usually goes away, especially when you start to pass gas or walk around.
• Do not return to work on the day of the procedure.
• Do not drive a vehicle or operate machinery until the day after your procedure.
• You may eat normally after the procedure.