A gastroscopy is a procedure where a long tube with a camera on the end is used to assess the lining of the upper digestive tract, which includes the esophagus, stomach, and the duodenum.

• Do not eat or drink after midnight.  However, you can have sips of clear fluids until 4 hours prior to the procedure.
• 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.
• 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.

• The procedure typically takes about 10-20 minutes to complete.
• Our anesthetist will provide you with medication through the IV so that you will sleep during the procedure.
• A plastic mouth guard will be used to protect your teeth.
• 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 mouth and passed down your esophagus, stomach and duodenum.
• 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 (e.g. biopsies of the stomach for H. pylori).

• 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.  If biopsies have been taken, 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 biopsy results.
• 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.

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).

• 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.

• 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.

• 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.

A sigmoidoscopy is a test to examine the lower part of your large bowel (colon) using a flexible camera.

• FLEET ENEMA PREPARATION: Go to the pharmacy and purchase TWO (2) Fleet ENEMAS1. Starting at 11 PM the night before the procedure, do not have anything to eat. You can continue to take clear fluids up until 4 hours before the test (water, apple juice, Gatorade, jello, soup broth, popsicles).
• On the day of your test, approximately 30 minutes before leaving home, use the two enemas. Read the instructions on the box. It is best to give them in the bathroom, lying on your left side, on the floor if you have room. You may lubricate the tip of the enema with Vaseline or lubricant jelly.
• Insert the tip carefully, into the anal canal and empty the whole contents of the enema, by squeezing the bottle into the rectum.
• Hold the enema in as long as possible (usually 5 to 10 minutes), then defecate the contents into the toilet.
• Repeat steps 3 and 4 with the second enema.

• Small tissue samples (biopsies) may be taken during the test.
• Air is inserted during the test which you will need to pass out later.
• The enemas taken prior to the procedure help ensure that your rectum is free of stool, letting the doctor see as much as possible at the examination.
• Depending on your preference, you may receive medications (sedation) through an intravenous catheter just before starting the test to keep you comfortable. If you receive sedation, you will not be able to drive or go back to work after your test, and you will need to arrange a ride or take a taxi with someone accompanying you.

• After your procedure, you will rest in the recovery area for about 30 minutes. You may feel some bloating after the procedure because of air that was introduced during the examination. Please allow about 2 hours for your entire appointment.
• While these procedures are associated with very low risk when performed by physicians specially trained in this discipline, they may still occur:
  • Drug reaction: this is rare and usually mild. This may present as rash, hives, or itching at the site of the intravenous.
  • Perforation: puncture of the bowel wall is very rare. If it occurs, surgery may be required to repair the perforation.
  • Bleeding: a small risk of significant bleeding may occur after polyp removal. This can occur up to 7 days later. This usually stops without treatment. Rarely, blood transfusions or surgery is required.
  • Sedation: may cause respiratory depression or lowering of blood pressure.