Pouchoscopy with Sedation

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Most patients undergoing pouchoscopy require no sedation. These instructions are only for those undergoing the exam with sedation. If sedation is not required, refer to the Pouchscopy without sedation instructions.

What is it and why do I need it?

Pouchoscopy is a procedure that examines the lining of your small intestinal pouch.
It is used to diagnose inflammation, abnormal growths or tissue.

The risks

You will be asked to sign a consent form at the time of the exam. During a pouchoscopy, the doctor inserts a slim, flexible tube called an endoscope that has a camera at the tip to provide a close-up view of the inside of the pouch. The risks of pouchoscopy are low; but do include perforation, or a tear through the lining of the pouch, and bleeding from biopsy site may occur. If you have concern about these risks, please contact your physician before your procedure. You will also be able to discuss this with your physician at the time of the exam.

The preparation

At least a day prior to the procedure, purchase two Fleets enemas from your pharmacy (over the counter). 

You will administer these enemas 1-2 hours before your procedure in order to cleanse the lower part of your colon of stool.  Insert the 1st enema rectally (directions are included with the enema) and try to hold it for several minutes. Then repeat this with the 2nd enema 20-30 minutes later.  If you cannot take enemas, let us know.

You may consume clear liquids up until 2 hours before the procedure. Don’t eat solid food after midnight.
A liquid breakfast is OK if you have an afternoon procedure.

You may take your usual medications right up until procedure time (with small amounts of water).
Iron supplements are usually held 2 days before the exam.

If you take insulin or other diabetic medicines, dosage adjustments will be provided for you. 

The procedure

In the preparation area, you will be asked questions about your health history. Your procedure usually takes from 10 to 20 minutes and may be done with or without sedation. If you choose to have the procedure with sedation, you must have an adult driver (18 yrs. or older) to drive you home.

Once you are asleep, the endoscope will be inserted into your rectum and advanced slowly into the pouch.
You may have a temporary feeling of pressure, bloating or mild cramping. Your physician will then carefully examine the lining of your pouch for abnormal tissue or inflammation. If abnormal tissue is found, the physician may remove a sample for further examination or biopsy. The tissue removal is painless.

After the procedure

In the recovery unit, your physician will discuss the results with you and give you discharge instructions. If any biopsies are taken, you will be contacted with the results. A report will also be sent to your referring physician.  You will need to remain in recovery until your sedation has worn off to satisfactory level. After discharge, you may resume your usual activities and diet, and return to work the following day.

However, you may not drive, make important decisions or operate machinery the rest of the day.  You must have someone at least 18 yrs. old with you during the entire time from check-in through recovery and to drive you home after the exam (a taxi or bus is not an option).