What is the required prep for a colonoscopy?

Question:  Prior to a colonoscopy, can I take pills instead of drinking the gallon of liquid?

Answer:  A colonoscopy is an examination of the lining of the rectum and colon (the large intestine) through a flexible tube called a colonoscope. This allows a specially trained physician to directly view this area and identify any abnormalities.

The preparation for a colonoscopy involves drinking the liquid, Nulytely®.  We suggest drinking the liquid with a combination of Miralax and Gatorade.  Pills are not available for this procedure.

For more detailed information, please view Penn’s guidelines for colonoscopy preparation.

To schedule a consultation with a Penn physician, please call 800-789-PENN (7366) or request an appointment online.

What can I eat prior to an Upper GI series procedure?

Question:  I was told that I could have toast with jelly the day before my Upper GI series.  Could I have butter instead of jelly?

Answer: An upper GI series is an x-ray procedure designed to examine the esophagus, stomach and duodenum.  After these organs have been relaxed by medication and distended with gas, a thin coating of barium suspension is applied to outline their inner surfaces.

It is very important to fast for the requested time before an upper GI series; Penn Gastroenterology gives our patients the following instructions:

Preparation:  The presence of food or fluid materials would interfere with the accuracy of the examination. It is therefore necessary to avoid all intake of food or liquid from 9pm of the day preceding your appointment.

After Care: Resume your normal diet. Increase fluid intake and drink plenty of water.
For most patients with normal bowel habits, the passage of barium in the form of "white stools" will present no problem. Patients with a history of constipation may use a mild laxative.

For more detailed information on patient preparation view the full instruction manual.

To schedule a consultation with a Penn physician, please call 800-789-PENN (7366) or request an appointment online.

What could be the cause of persistent diarrhea?

Question:  I am experiencing symptoms that include: sweating, clamy, hot and cold, cramping and fast heart rate.  I have also had diarrhea twice in one week and frequently throughout the year. Could I have a serious problem?

Answer:  You should seek evaluation with a gastroenterologist related to complete history, physical exam, blood tests, urine tests, imaging studies and endoscopic studies.  It would be important to ensure there is no release of “hormones” that can trigger the diarrheal state.

To schedule an evaluation with a Penn gastroenterologist, please call 800-789-PENN (7366) or request an appointment online.

What do you recommend for treating sessile polyps?

Question:  Due to right lower quadrant pain three weeks ago, a CAT scan was done that showed inflamed ileum.  One week ago, a colonoscopy revealed normal ileum and diverticular disease.  An upper endoscopy showed multiple semi-sessile polyps. I have been on proton pump inhibitors (PPI) for GERD for three years.  A biopsy indicated no crohn’s or celiac disease.  I have a family history of first degree relatives with esophageal and colon cancer that are deceased.  There was no recommendation for a follow up for sessile polyps.  I am looking for a GI doctor at Radnor for the above diagnosis.

Answer:   It is best to see a gastroenterologist to thoroughly evaluate these concerns and recommend a course of treatment.  Dr. David Jaffe and Dr. Octavia Pickett-Blakely are available for appointments at Penn Medicine Radnor.  To schedule a consultation, please call 800-789-PENN (7366) or request an appointment online.

What can be done for Sphincter of Oddi Dysfunction?

Question:  I have been diagnosed with Sphincter of Oddi Dysfunction after gallbladder surgery.  I am told ERCP (Endoscopic Retrograde Cholangiopancreatogram) is too risky.  I am told to live with the pain, which is severe and constant.  Does Penn Medicine have a specialist for this disorder?

Answer:  There is controversy over the authenticity of the condition of Sphincter of Oddi Dysfunction.  It would be best to schedule a consultation with Dr. Nuzhat Ahmad who can discuss your symptoms and recommend next steps.

To schedule a consultation with Dr. Ahmad, please call 800-789-PENN (7366) or request an appointment online.

How long after eating should I wait to take my medication?

Question: I have been diagnosed with Barrett's Esophagus. I take 40 mg of Prilosec® twice a day. Should I take the Prilosec® before meals and at bedtime? If I should take the medication at bedtime, how long after eating should I wait?

Answer: It is best to wait 30 minutes before breakfast and dinner.   It is important to see a gastroenterologist about a surveillance upper endoscopy.  At Penn, Dr. Gary Falk is a national leader in Barrett’s Esophagus.

Gary Falk, MD, MS is available for appointments at the Perelman Center for Advanced Medicine.  He is a Professor of Medicine specializing in Gastroenterology and Co-Director of the Esophageal and Swallowing Disorders Center at Penn Medicine. To schedule a consultation with Dr. Falk or another Penn physician, please call 800-789-PENN (7366) or request an appointment online.

What medications can alleviate gas and diarrhea?

Question: I have gas and diarrhea. What medications can help with my symptoms?

Answer: It is best to have an evaluation by an internist or gastroenterologist to see if you might have small bowel bacterial overgrowth, malabsorption (e.g. lactose intolerance, or even celiac sprue), or possibly colonic disorders. To schedule a consultation with a Penn physician, please call 800-789-PENN (7366) or request an appointment online.