Dr John Wright

Gastroenterologist
MbChB MRCP(UK) PhD

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Colonoscopy in the Rooms

We perform all our procedures in the rooms.

We use a fully equipped endoscopy room with trained staff. The advantage of this is that it makes procedures quick and simple for the patient and us. A colonoscopy takes about 10 to 25 minutes. Because we are not subject to hospital costs our prices are much lower. This benefits patients and medical aids.

Recently a problem has arisen with the payment for colonoscopy with most medical aids except for those administered by Discovery Health to whom we are contracted and no cost is passed on to the patient for any procedure.

The problem is a little complicated but it concerns payment of code “0004” as opposed to “0075” for colonoscopy in rooms.

Some medical aids will not pay for code “0004” which is the charge for the use of the procedure room used to perform colonoscopy. This room is fully equipped for all eventualities, as are all our staff. They will only pay a general allowance code “0075” which covers simple procedures such as a gastroscopy.

We charge R4446.50 for performing colonoscopy and the use of our facility (Codes: 1653, 0004, 0074 and 0007). If the “0004” is not paid and “0075” substituted, the charge would be R2924.10. This reduction of R1522.40 makes the performance of colonoscopy in our rooms financially not viable. Discovery Health gladly pays the “0004” as we offer the lowest cost for colonoscopy.

The alternative is that patients would be admitted to hospital for the procedure. The hospital costs would significantly exceed what we charge. It is not possible for me to spend an hour in a hospital theatre for a 10 to 25-minute procedure we can perform in the rooms.

On our registration form an estimate is given that colonoscopy will cost R5850 which adequately covers the above costs and drugs and disposables.

On the morning of your colonoscopy have a light breakfast (See below). You will probably have been given 4 Dulcolax tablets to take at this time. If you are constipated, you may need to take a laxative on the previous evening but this is seldom required. If you are on iron therapy this should be stopped 4 days before your colonoscopy.

At the time indicated below drink the "KleanPrep" solution at a rate of 1 litre of solution per hour. This is made up by dissolving 1 sachet of the powder in a litre of cold water. Normally 4 litres are needed to clear your colon out completely. The diarrhoea starts 60 minutes after you start drinking and finishes 1.5 hours after completion. You may have cramps for a few hours after the procedure.

You can drink the solution faster than the normal rate of 1 Litre per hour. Some find it easier to drink a litre every half-hour. You may experience some distension discomfort but this will resolve once the diarrhoea starts. The taste and volume are probably the most unpleasant aspects of the procedure. You may also feel nauseous but be patient, it is important that you drink the solution until you are passing clear, straw-coloured fluid. If your bowel is not adequately cleaned, the procedure may be impossible to perform so please drink more rather than less of the solution. Adding an acidy solution such as lemon may help. Try and drink as much as possible in one swallow, sipping makes the taste very much worse.

Please arrive at the Fairfield Suites at the appointment time. During the procedure, you will be given sedation so please arrange a lift home an hour after your appointment time.

“UpToDate” Patient Education: Colonoscopy   Based on Linda Lee, MD 2016

A colonoscopy is an exam of the lower part of the gastrointestinal tract (the colon or large intestine (bowel)). It is a safe procedure that provides information other tests may not provide.

Colonoscopy is performed by inserting a device called a colonoscope into the anus and advancing through the entire colon. The procedure generally takes between 20 minutes and one hour.

The most common reasons for colonoscopy are:

Medicines
You can take most medicines right up to the day of the colonoscopy. You should tell the doctor if you are allergic to any medicines. Some medicines increase the risk of bleeding if you have a polyp removed during the colonoscopy. Ask your doctor how and when to stop Warfarin, Plavix, aspirin or any other blood thinning medicine.

The procedure
An IV line will be inserted in your hand or arm. Your blood pressure, heart rate, and breathing will be monitored during the test.

The colonoscope is a long black flexible tube, approximately the diameter of the index finger. The doctor will gently pump air through the scope into the colon to inflate it and allow the doctor to see the entire lining. You might feel bloating or gas cramps as the air opens the colon. Do not be embarrassed about passing this gas (it is just air). Let your doctor know if you are uncomfortable. You may feel like you have to go to the bathroom during the procedure, this is normal.

During the procedure, the doctor might take a biopsy (small pieces of tissue) or remove polyps. Polyps are growths of tissue that can range in size from the tip of a pen to several inches. Most polyps are benign (not cancerous). However, some polyps can become cancerous if allowed to grow for a long time. Having a polyp removed does not hurt.

Complications
Colonoscopy is a safe procedure, and complications are rare but can occur:

After the procedure call your doctor immediately if you have: