Endoscopy Screening Singapore | Endoscopy Procedure

(* Preparation may differ between patients due to medical conditions)

1. What is an Endoscopy Procedure?

The common endoscopy procedures by The Surgeons are Oesophago-gastroduodenoscopy (OGD), flexible sigmoidoscopy, and colonoscopy. These procedure use a thin, long and flexible tube with a tiny video camera and light on one end. An OGD examines the esophageus, stomach and duodenum. Colonoscopy examines the rectum, entire colon and if required, the terminal ileum. Flexible sigmoidoscopy examines the rectum and left colon. Images captured from the video camera is then shown on a TV monitor for a detailed view.

An endoscopy procedure is a safe and effective way to examine and detect cancer or precancerous lesions. Lesions such as polyps may be removed. Biopsies can be performed also during endoscopy. In bleeding lesions therapeutic procedures can be performed during endoscopy for hemostasis.
2. General Advice
- Please do not wear any jewellery or bring any valuables.
- Remove all nail polish. Do not wear high-heeled shoes.
- Bring along admission form and other documents required for registration
- Procedure start time may vary, depending on how complex the previous procedures are before yours
- Hospitalization Leave will be issued to you for the day of your procedure.
3. Sedation Advice
Endoscopy procedures are performed under sedation. The medication will be given to you through intravenous injection. An anaesthetist may be present during the procedure if deep sedation is required or you have certain medical conditions that require additional monitoring.

After the procedure, a caregiver (adult) is required to accompany you home as you will feel drowsy after the procedure. Do not drive, sign legal documents, operate machinery, exercise or drink alcohol after the procedure.

*It has been observed that high use of sleeping tablets, medications for anxiety or depression, smoking or alcohol may reduce effectiveness of sedation. We advise all patients to
- stop alcohol for at least 5-7 days before the scope
- cut smoking as best as you can to just a few sticks a day for a few days before the scope
- discuss with us all medications that you are on to better understand your condition
4. Diet Advice

To allow the endoscopist to look at the bowel lining clearly, you will need to follow a low residue diet for 3 days before the procedure. You may continue to have regular portions at your meal times.

Please refer to Low Residue Diet

5. Medication Advice

Please inform the team all your medications you are taking
Medications to CONTINUE on day of procedure with small amount of plain water: Anti-hypertensives, thyroid medication

Medications to STOP

Category of Medication	Example of medications	Date to stop
Blood-thinning medication*	Aspirin (Cardiprin), Warfarin (Marevan), Clopidogrel (Placta), Ticlopidine (Ticlid), Dipyridamole (Perazodin), Rivaroxaban (Xarelto), Apixaban (Eliquis)	Please consult your doctor
Possibly blood-thinning supplements*	Echinacea, Ephedra, Garlic, Gingko (Tanakan), Ginseng, Valerian, Hypericum (St. John’s Wort), Kava (Kavain), Traditional Chinese Medicine (TCM), Ayurvedic, Jamu	Stop 1 week before procedure unless otherwise advised
Iron supplements	Ferrous Gluconate (Sangobion), Ferrous Fumarate, Ferrous Sulphate	Stop 1 week before procedure unless otherwise advised

*This list is not exhaustive. If you are unsure, please approach our staff for help. If you are unsure which medication to take/stop, please bring along your medication for our staff to check through,

Only for patients with Diabetes mellitus (DM)

This is a general guide and please clarify with our staff. We may require to consult your diabetic doctor for specific medication modifications.

For morning procedure
1. Take DM medication and insulin as usual the day before
2. Oral DM medication – omit morning DM medications. Take any lunch/evening medications as usual and do not take any extra dose to replace missed morning dose.
3. Basal insulin ( eg. Insulatard, Lantus)- take 70% of your usual morning dose. Take dose due at lunch/dinner/bedtime as usual.
For afternoon procedure
1. Take DM medication and insulin as usual the day before
2. Oral DM medication – omit morning and lunch DM medications. Take any evening medications as usual and do not take any extra dose to replace missed morning dose.
3. Basal insulin ( eg. Insulatard, Lantus)- take 70% of your usual morning dose.Take dose due at dinner/bedtime as usual.
4. Short acting insulin (eg Actrapid, Humulog) or premixed insulin (eg Mixtard, Novomix)- do not take morning and lunch dose. Take your normal diner insulin dose.

6. Bowel preparation Advice for colonoscopy
Bowel preparation is important to ensure an accurate and comfortable colonoscopy is performed. A good bowel preparation ensures there is minimal residue in the colon and the internal lining of the colon is well visualised. Inadequate preparation may result in repeating the colonoscopy procedure on another day.

After taking bowel preparation (Picoprep or Fortrans)
- You will pass motion frequently
- Drink plenty of clear liquids to prevent dehydration and to help clean your colon completely
- If vomiting, cramping and/or pain occurs, do stop consuming more bowel preparation. If the clinic is opened, please do consult us. For after-hours we may recommend going to the Emergency department if you are very uncomfortable.