How to prepare to a colonoscopy (Fortrans)?
The condition for the examination is proper preparation (purification) of the intestine. The preparation recommendations should be followed very carefully, as any deviations may result in the test not being performed or its reliability being narrow. In a small percentage of people preparing for colonoscopy, despite all the recommendations, the intestine is not completely cleansed and the whole procedure has to be repeated. Vaccination against hepatitis B is advisable but not obligatory before the examination. All available medical records and current results of the following tests must be presented prior to the examination:
- double blood group or Blood Group Identification Card¹,
- coagulogram (PT/INR, APTT).
In addition to the above tests, for general anaesthesia, please provide:
- ionogram (K, Na),
- EKG (EKG please perform the EKG at least one day before the examination).
We kindly inform you that laboratory tests can be performed Monday through Friday from 7:00-12:00 and on Saturdays from 8:00-12:00 in MediSpace. The waiting time for the result in our laboratory is approximately 1 business day. Up to 3 months the above tests are
IF YOUR LABORATORY RESULTS ARE OUT OF RANGE REFERENCE, PLEASE CONTACT US AS SOON AS POSSIBLE BY PHONE (607-206-707) OR EMAIL (firstname.lastname@example.org) WITH YOUR REGISTRATION.
We would like to kindly inform you that statistically up to 30% of studies conducted WITHOUT GENERAL ANESTHESIA may fail due to discomfort and pain on the part of the patient. Unf ortunately, due to the wear and tear of equipment and staff time, you must pay the same payment as for carrying out a normal examination. Please make an informed consent.
Patients who take anticoagulants such as acenocumarol (e. g. Sintrom), clopidogrel (e. g. Plavix), warfarin (e. g. Warfin), rivaroxaban (Xarelto), etc. should replace the drug with low molecular weight heparin (e. g. Clexane) at an appropriate time determined by the doctor before the examination. At least 8 days before the examination, the type, dosage and the appropriate moment of treatment change should be agreed with the physician in charge of the examination.
Diabetic patients should inform the colonoscopy laboratory before the examination in order to set the date of the examination in the morning.
7 days before the test, you should stop taking oral iron preparations and completely refrain from taking:
- fruits and vegetables containing small seeds, e.g. kiwi, strawberries, raspberries, tomatoes which clog the working channels of the colonoscope and may completely prevent the examination,
- baked goods with grains, poppy seeds and spices (except finely ground).
2 days before the examination, you should be limited to a diet without any fat and exclude other fruits and vegetables.
It is permissible to eat:
- meat and fish,
- pasta, rice and white bread,
- puddings, kisses and jellies,
- water, coffee, tea and clear juices.
If the test is scheduled for 4:00 pm or earlier:
About 20 hours before the planned examination you should completely stop taking food and start preparing the intestine with Fortrans prepatate (preparation sold in pharmacies on the basis of a prescription). The packaging of Fortrans contains four sachets, each of which should be dissolved in 1 litre of still water. The entire volume (4 litres of finished solution) should be drunk within approximately 4-6 hours.
If the test is scheduled after 4:00 pm:
On the day before the examination, at about 10:00 pm, completely stop eating. The packaging of Fortrans contains four sachets, each of which should be dissolved in 1 litre of still water. Start taking fortrans at 10:00 pm. Drink half of the solution (2 litres) by 12:00 pm to 1:00 am. Drink the rest of Fortrans (the remaining 2 litres) from 5:00 am to 7:00-8:00 am on the day of
The finished solution of Fortrans can be cooled and seasoned with clear (seedless) lemon juice or other non-staining fruit juice to improve taste. As a result of taking the solution of Fortrans preparation, there are numerous bowel movements, in the final stage of preparation, with a clear liquid. For persons with constipation and bowel movement difficulties or persons
with BMI above 30 or total weight above 100 kg, it is recommended to drink an additional litre of still water after drinking Fortrans.
The basic condition for the planned colonoscopy is to follow the recommendations related to the preparation of the intestine for the examination and remain fasting, i.e. not to take food and dense liquids, coffee and tea for at least 20 hours. Before the planned colonoscopy
procedure it is allowed to drink water in order not to feel thirsty up to 2 hours before the procedure. The last liquid (still water) can be taken 2 hours before the treatment in the amount not greater than a glass (250 ml). Performing a colonoscopy under anaesthesia in a person with a full stomach may expose him/her to life-threatening complications associated with absorption and aspiration of gastric contents into the lungs.
Medication taken chronically should be taken with a glass of water (250 ml) no later than 2 hours before the procedure. As previously agreed with your doctor, you should stop taking any medications affecting the clotting system (such as acetylsalicylic acid, clopidogrel, warfarin, acenocumarol, dabigatran, rivaroxaban, etc. ) beforehand. Diabetic patients should stop taking oral hypoglycemic drugs or insulin while on fasting (during the period without food, dense liquids, coffee and tea). For patients taking insulin on an insulin pump or using continuous glucose monitoring systems, insulin should be discontinued if blood glucose drops below 100 mg/dL. Patients with kidney failure or heart failure should discuss their individual preparation with their doctor, as this may vary from case to case.
In addition, you should refrain from smoking and chewing gum for 6 hours before the examination. The patient doesn't have to take a change of clothes.
If it's decided for you to have anaesthesia for the procedure, you will be asked to come 30 minutes in advance to fill in an anaesthetic questionnaire about your health (available for download in the tab – downloadable materials). A correctly completed questionnaire will
allow the anaesthesiologist to assess the risks associated with anaesthesia and to adjust anaesthesia to the current state of health. Anaesthesia is designed to provide comfort and will be adjusted to the type of procedure and individual needs of the patient and the doctor performing the procedure. If you experience symptoms of upper respiratory tract infection or an increased body temperature before the procedure, you should report this fact by phone to the clinic. This is a contraindication to anesthesia.
Please be advised that for safety reasons, after anaesthesia you must not drive a motor vehicle until 24 hours after the examination and you must leave the clinic with a companion.
AFTER PROCEDURE YOU ARE OBLIGATED TO COME BACK SAFETLY WITH AN ADULT, RESPONSIBLE PERSON.
IMPORTANT! If a patient has been referred for an endoscopic examination and has more than a serious comorbid condition, you should try out an opinion from one of our programs about endoscopy, surgery and anesthesia. If your illness worsens and your disease becomes difficult to control, you should also consult a specialist.
As a medical team, we take care of the patient’s safety during procedures, therefore a meeting and a pre-procedure consultation in the scenario:
- unstable ischemic heart disease,
- symptoms of a heart rhythm disorder that require anticoagulants,
- having a pacemaker,
- status after a recent heart attack (less than 3 months),
- circulatory failure with exertional dyspnea, – valvular heart disease or condition after heart valve implantation,
- unregulated blood pressure,
- aortic aneurysm,
- status after a recent stroke (less than 3 months),severe lung disease with exercise dyspnea,
- unregulated diabetes,
- chronic phase failure in the pre-dialysis period,
- hemoglobin bowel anemia less than 10 mg / dl,
- active infection or condition after treatment of active infection (1 week),
- age over 75 (with no reason for other diseases or their absence).
|First biopsy with histopathological examination||165 PLN|
|Next biopsy with histopathological examination||100 PLN|
|First polypectomy with histopathological examination||295 PLN|
|The next polypectomy with histopathological examination||200 PLN|
|Video recording of endoscopy (1 examination)||150 PLN|
|Video recording of endoscopy (2 examinations)||200 PLN|
|Consultation||from 220 PLN|
* the price of the examination may increase in case of difficult and non-standard endoscopic examinations and the use of additional equipment (endoscopic clips, endoscopic needles, endoscopic grippers),
**the price of anaesthesia in the case of anaesthesia for gastroscopy and colonoscopy (combined examination) shall be PLN 400.
We kindly inform you that in order to book an appointment for examination under general anaesthesia, it is necessary to pay a deposit in the amount of 350 or 400 PLN one WEEK BEFORE THE EXAMINATION (if 2 examinations are performed – colonoscopy and gastroscopy under anaesthesia). In case of examination under local anaesthesia, please pay the fee of PLN 490 one WEEK BEFORE THE EXAMINATION. The fee is non-refundable unless the Patient cancels the examination 48 hours before. Account number to which you should pay the deposit: mBank 15 1140 2004 0000 3602 7568 3111, in the title, please write the Patient’s name.
¹Legal basis: Ordinance of the Minister of Health of 16.10.2017 on treatment with blood and its components in medical entities performing medical activities such as stationary and round-the-clock health services.