Prep instructions

• Obtain any medical clearances prior to scheduling procedure, if applicable.
• Stop Iron, Alka-Seltzer, and all non-steroidal anti-inflammatories (NSAIDS), including Ibuprofen (Advil, Motrin, Nuprin), Naproxen (Aleve, Naprosyn), Aspirin (Bayer, Ecotrin, Miniprin), Diclofenac (Voltaren, Cambia), Celecoxib (Celebrex), Meloxicam (Mobic), Indomethacin (Indocin), Ketorolac (Toradol), Nabumetone (Relafen), Piroxicam (Feldene), Ketoprofen (Oruvail), Etodolac, Sulindac (Clinoril), Percodan, Empirin, Excedrin, Medipren, for 5 days prior to procedure. Acetaminophen (Tylenol) is ok to take.
• Blood thinners will also need to be held prior to your procedure. Because the timing varies depending on the drug, please discuss with your Gastroenterologist AND prescribing provider prior to scheduling your procedure. These medications include, but are not limited to, Coumadin, Warfarin, Eliquis, Brilinta, Aspirin, Plavix, Clopidogrel, etc.

• Stop all vitamins and supplements
• Avoid all beans, peas, corn, nuts, tomatoes, cucumbers, pickles, sesame seeds, strawberries, watermelon, oatmeal, kiwi, and grapes (foods containing small seeds or skins)

• Hold SGLT2 Inhibitors (e.g. Canagliflozin (Invokana), Dapagliflozin (Farxiga), Empagliflozin (Jardiance), Ertugliflozin (Steglatro) & Sotagliflozin (Inpefa))
• Hold oral GLP-1 medications (e.g. Rybelsus), Metformin, Glyburide
• Avoid all alcoholic beverages
• Drink as many fluids as you can tolerate

• Do not eat or drink anything until the completion of your procedure to avoid delays and a possible cancellation of your procedure.
• No gum, mints, or hard candy
• If you take medication, you may have it the morning 4 hours prior to the procedure with a small sip of water.
• You may brush your teeth but do not swallow.
• Arrive at the Endoscopy Center 45 minutes prior to your scheduled procedure.

You may experience mild bloating, gas, or a sore throat. These symptoms are usually temporary and resolve within a day.

You can usually resume eating once you are fully awake, starting with light meals unless instructed otherwise. Some less common side effects include nausea, dizziness, and bloating.

If sedation is used, you should rest for the remainder of the day and avoid driving or making important decisions. Most people return to normal activities the next day.

• Obtain any medical clearances prior to scheduling procedure, if applicable
• Stop all Proton Pump Inhibitors unless instructed otherwise by your provider, including Lansoprazole (Prevacid), Rabeprazole (Aciphex), Pantoprazole (Protonix), Esomeprazole (Nexium), Omeprazole (Prilosec, Zegarid), and Dexlansoprazole (Dexilant)
• Stop Iron, Alka-Seltzer, and all non-steroidal anti-inflammatories (NSAIDS), including Ibuprofen (Advil, Motrin, Nuprin), Naproxen (Aleve, Naprosyn), Aspirin (Bayer, Ecotrin, Miniprin), Diclofenac (Voltaren, Cambia), Celecoxib (Celebrex), Meloxicam (Mobic), Indomethacin (Indocin), Ketorolac (Toradol), Nabumetone (Relafen), Piroxicam (Feldene), Ketoprofen (Oruvail), Etodolac, Sulindac (Clinoril), Percodan, Empirin, Excedrin, Medipren, for 5 days prior to procedure. Acetaminophen (Tylenol) is ok to take.
• Blood thinners will also need to be held prior to your procedure. Because the timing varies depending on the drug, please discuss with your Gastroenterologist AND prescribing provider prior to scheduling your procedure. These medications include, but are not limited to, Coumadin, Warfarin, Eliquis, Brilinta, Aspirin, Plavix, Clopidogrel, etc.

• Stop all vitamins and supplements
• Avoid all beans, peas, corn, nuts, tomatoes, cucumbers, pickles, sesame seeds, strawberries, watermelon, oatmeal, kiwi, and grapes (foods containing small seeds or skins)
• Stop all H2 blockers unless instructed otherwise by your provider, including Ranitidine (Zantac), Cimetidine (Tagamet), Famotidine (Pepcid), Nizatidine (Aaxld), or the promotility drug Metoclopramide (Reglan).

• Hold SGLT2 Inhibitors (e.g. Canagliflozin (Invokana), Dapagliflozin (Farxiga), Empagliflozin (Jardiance), Ertugliflozin (Steglatro), and Sotagliflozin (Inpefa))
• Hold oral GLP-1 medications (e.g. Rybelsus), Metformin, Glyburide
• Avoid all alcoholic beverages
• Drink as many fluids as you can tolerate

• Do not eat or drink anything until the completion of your procedure to avoid delays and a possible cancellation of your procedure.
• No gum, mints, or hard candy. You may brush your teeth but do not swallow.
• If you take medication, you may have it in the morning 4 hours prior to the procedure with a small sip of water.
• Arrive at the Endoscopy Center 45 minutes prior to your scheduled procedure.

An esophageal pH test measures and records the level of acid (pH) in your esophagus. This helps determine whether you have gastroesophageal reflux disease (GERD). The test may also be used to evaluate how well medications or surgery are working to treat GERD.

Esophageal reflux occurs when stomach contents, including acid, flow backward into the esophagus (the tube that carries food from your mouth to your stomach).

At the bottom of the esophagus is a muscle called the lower esophageal sphincter (LES). This muscle opens to allow food and liquids to enter the stomach, then closes to keep them there. If the LES does not close properly, stomach acid and food can move back up into the esophagus. This is called gastroesophageal reflux. When reflux happens frequently, it can irritate or damage the lining of the esophagus over time.

During an upper endoscopy, your provider places a small capsule (about the size of a gel cap) onto the wall of your esophagus. The capsule measures the acid levels in your esophagus and sends the information wirelessly to a small receiver you wear. The receiver has buttons you will press to record symptoms such as heartburn. You will be asked to keep a diary to track when you eat and drink, when you lie down and get back up, and when you experience symptoms. Your care team will review this information along with the recorded data to better understand your symptoms and guide treatment.

• Obtain any medical clearances, if applicable.
• Stop Iron, Alka-Seltzer, and all non-steroidal anti-inflammatories (NSAIDS), including Ibuprofen (Advil, Motrin, Nuprin), Naproxen (Aleve, Naprosyn), Aspirin (Bayer, Ecotrin, Miniprin), Diclofenac (Voltaren, Cambia), Celecoxib (Celebrex), Meloxicam (Mobic), Indomethacin (Indocin), Ketorolac (Toradol), Nabumetone (Relafen), Piroxicam (Feldene), Ketoprofen (Oruvail), Etodolac, Sulindac (Clinoril), Percodan, Empirin, Excedrin, Medipren, for 5 days prior to procedure. Acetaminophen (Tylenol) is ok to take.
• Blood thinners will also need to be held prior to your procedure. Because the timing varies depending on the drug, please discuss with your gastroenterologist AND prescribing doctor prior to scheduling your procedure. These medications include, but are not limited to, Coumadin, Warfarin, Eliquis, Brilinta, Aspirin, Clopidogrel, etc.

• Hold SGLT2 Inhibitors (e.g. Canagliflozin (Invokana), Dapagliflozin (Farxiga), Empagliflozin (Jardiance), Ertugliflozin (Steglatro), & Sotagliflozin (Inpefa))
• Stop all vitamins and supplements
• Please avoid all beans, peas, corn, popcorn, nuts, tomatoes, cucumbers, pickles, seeds, strawberries, watermelon, oatmeal, kiwi, and grapes (foods containing small seeds or skins)

• Hold oral GLP-1 medications (e.g. Rybelsus), Metformin & Glyburide
• Begin the first half of the bowel preparation at 5 PM. Do not consume anything by mouth after midnight. Please refer to the prep instruction sheet for detailed guidance.
• Clear liquids only. This includes:
  • Soups – Clear broth or consommé (chicken, beef, or vegetable)
  • Sports drinks – Gatorade, Powerade, Propel
  • Juices – White cranberry, white grape, apple, limeade, strained lemonade
  • Beverages – Black tea & coffee, iced tea (ex: Snapple), Kool-aid, Sprite, seltzer, ginger ale, boost breeze, and water
  • Desserts – Italian ice, popsicles, Jell-O

• If you take medication, you may have it 4 hours prior to the procedure with a small sip of water unless otherwise specified by your doctor. You may brush your teeth but do not swallow
• No gum, mints, or hard candy
• Begin the second half of your bowel preparation 5 hours before your procedure. Please refer to the prep instruction sheet for detailed instructions.
• Arrive at the Endoscopy Center 45 minutes prior to your scheduled procedure.

The stool should be water in consistency. It does not have to be clear in color like water since digestive juices will continue to tint the stool yellow, and small flecks of debris are not a problem as long as the stool is not muddy or thick.

Some common side effects include cramping, abdominal discomfort, urgent need to have a bowel movement, and mild rectal irritation. Some less common side effects include nausea, dizziness, and bloating.

The prep can affect how your body absorbs medications, especially those taken shortly before or during the prep. You may be instructed to adjust or temporarily stop certain medications. Always follow your provider's instructions regarding your medications prior to the procedure.

• Obtain any medical clearances, if applicable.
• Stop Iron, Alka-Seltzer, and all non-steroidal anti-inflammatories (NSAIDS), including Ibuprofen (Advil, Motrin, Nuprin), Naproxen (Aleve, Naprosyn), Aspirin (Bayer, Ecotrin, Miniprin), Diclofenac (Voltaren, Cambia), Celecoxib (Celebrex), Meloxicam (Mobic), Indomethacin (Indocin), Ketorolac (Toradol), Nabumetone (Relafen), Piroxicam (Feldene), Ketoprofen (Oruvail), Etodolac, Sulindac (Clinoril), Percodan, Empirin, Excedrin, Medipren, for 5 days prior to procedure. Acetaminophen (Tylenol) is ok to take.
• Blood thinners will also need to be held prior to your procedure. Because the timing varies depending on the drug, please discuss with your gastroenterologist AND prescribing doctor prior to scheduling your procedure. These medications include, but are not limited to, Coumadin, Warfarin, Eliquis, Brilinta, Aspirin, Clopidogrel, etc.

• Stop all vitamins and supplements
• Please avoid all beans, peas, corn, popcorn, nuts, tomatoes, cucumbers, pickles, seeds, strawberries, watermelon, oatmeal, kiwi, and grapes (foods containing small seeds or skins)

• Hold SGLT2 Inhibitors (e.g. Canagliflozin (Invokana), Dapagliflozin (Farxiga), Empagliflozin (Jardiance), Ertugliflozin (Steglatro), & Sotagliflozin (Inpefa))
• Hold oral GLP-1 medications (e.g. Rybelsus), Metformin & Glyburide
• Nothing by mouth after midnight.

• Do not eat or drink anything until the completion of your procedure to avoid delays and a possible cancellation of your procedure.
• No gum, mints, or hard candy
• You may brush your teeth but do not swallow
• If you take medication, you may have it the morning 4 hours prior to the procedure with a small sip of water
• Arrive 40 minutes prior to your scheduled procedure time.

• Two 4.5oz bottles of Fleet Enema Saline Laxative

• Lie on your left side and administer one Fleet Enema Saline Laxative (follow package instructions)
• After administering, lie on your right side for 5 minutes
• Then switch back to your left side and remain there until you feel the urge to use the restroom

Repeat the same process using one Fleet Enema Saline Laxative:

• Lie on your left side and administer one Fleet Enema Saline Laxative (follow package instructions)
• After administering, lie on your right side for 5 minutes
• Then switch back to your left side and remain there until you feel the urge to use the restroom

• Flexible sigmoidoscopy prep instructions