Gastroenterology Consultants PLC

Procedure Registration Form

• East Valley Endoscopy Patient Registration

Preps

• Colonoscopy (Nulytely or Golytely)
• Colonoscopy (2 day prep – Nulytely or Golytely)
• Colonoscopy (2 day prep – Miralax and Nulytely)
• Colonoscopy (Miralax)
• Colonoscopy (2 day prep – Miralax)
• Colonoscopy (Suprep)
• Colonoscopy (Sutab)
• Colonoscopy (2 day prep – Miralax and Sutab)
• Colonoscopy (Plenvu)
• CT Scan
• EGD
• Flexible Sigmoidoscopy
• Gastric Emptying Scan
• Liver Biopsy
• Air Contrast Upper GI or Detail Small Bowel X-ray
  • Nothing by mouth after midnight the evening before the test. This test can take 3 hours or more.
• Colon Transit Study
  • No laxatives 5 days prior and do not use them until the test is complete.
• CT Scan Enterography
  • Nothing by mouth 4 hours prior to test, arrive 1 hour prior to the test for the contrast.
• Esophagram
  • Nothing to eat or drink 4 hours prior, wear loose clothing without metal. For afternoon exams, a light breakfast is allowed. Medications may be taken with a small amount of water. Approximately 45 minute exam.
• HIDA Scan
  • No narcotics 6 hours prior to test. Nothing by mouth 4 hours prior to exam.
• MRI/MRCP
  • Nothing to eat or drink 4 hours before the test.
• Ultrasound of Liver, Gallbladder, Pancreas, Abdomen
  • Fat free dinner the night before the test. Nothing to eat or drink after midnight.
• Video Swallow
  • No prep – arrive 15 minutes early. Approximately 30 minute test.