(see Financial Questions below )
Q. Where are endoscopy and colonoscopy performed by Dr. Bell?
A. Dr. Bell performs colonoscopies and upper endoscopies at the Hilton Head Hospital, Bluffton-Okatie Outpatient Center, and The Outpatient Surgery Center of Hilton Head.
Q. When will I be notified to arrive for my procedure?
A. When you are scheduled for a procedure with Bluffton-Okatie Outpatient Center or The Outpatient Surgery Center of Hilton Head, a representative from the facility will call you 1 to 2 days prior to your procedure date and will provide you with an arrival time.
Q. If I have frequent heartburn, do I need a routine upper scope (EGD)?
A. Not necessarily. As a rule, if you have five plus years of frequent heartburn and you are over 40, a “baseline” upper scope is advised.
Q. What is the bottle size of the laxative (Miralax) that is needed for the procedure?
A. You will need one 238 gram bottle of Miralax. Both can be purchased from your local pharmacy or grocery store.
Q. My colonoscopy is scheduled for tomorrow and I lost my instruction sheet. What do I do?
A. The colonoscopy instruction/prep sheet is available on the website. Go to the Preparation page and click on the link beside colonoscopy.
Q. I forgot to take the first two Dulcolax pills two days prior to my colonoscopy procedure. What do I do?
A. Take the second dose of the dulcolax pills at the scheduled time. Do not double up on the dose.
Q. My colonoscopy procedure is tomorrow and I ate popcorn, seeds, nuts, etc. What do I do? Do I need to reschedule?
A. Yes, reschedule your procedure. Contact Coastal Gastroenterology to reschedule the date of your procedure.
Q. I am scheduled for a colonoscopy procedure. What do I do if I have not completed my prep?
A. Reschedule your procedure. Contact Coastal Gastroenterology to reschedule the date of your procedure.
Q. Can I have cream or milk in my coffee or tea the day before my colonoscopy procedure?
A. Yes, you may have up to four ounces of cream or milk for the day with your beverage.
Q. Can I drink low calorie or diet Gatorade/Powerade?
Q. Can I have yogurt the day before my colonoscopy procedure?
A. Yes, you may have four ounces of yogurt for lunch and dinner without fruits or nuts.
Q. I take either aspirin or a blood thinner (Coumadin, Plavix or Pradaxa). Do I need to stop the medication prior to the colonoscopy?
A. During the office visit, current medications will be reviewed and discussed.
Q. I have had joint replacement surgery and I was told to take antibiotics before any procedure. Do I follow this instruction prior to a colonoscopy?
A. Antibiotics are not required prior to a colonoscopy for those at risk for endocarditis and joint infections according to the American Heart Association. Antibiotics are also not required prior to a colonoscopy for those with artificial heart valves, joint replacements, etc. according to the American Heart Association.
Q. When can I take my morning medications?
A. During the office visit, current medications will be reviewed and discussed.
Q. I am a diabetic. Are there any special prep instructions regarding my diet and insulin?
A. During the office visit, diet and medications will be reviewed and discussed.
Q. Should I check my blood sugar before my procedure?
A. It is not necessary to check your blood sugar before a procedure.
Q. Is an office visit required prior to scheduling a colonoscopy?
A. Direct-access colonoscopy is an option for low-risk patients without requiring a prior office visit evaluation. Direct access arrangements may be made by contacting the Medical Assistant at 843-342-2299. If you are scheduled for a direct access procedure, you are required to come into the office to complete paperwork at least a week prior to your scheduled procedure. If paperwork is not completed, your procedure will be cancelled and we will contact you to reschedule.
PLEASE NOTE: if you are on a blood thinner, are a diabetic and/or have a new or chronic medical concern, an abnormal or artificial heart, a defibrillator, a recent prosthetic device (joint, vascular, other), or any kidney problems, an office visit will need to be scheduled.
Q. At what age should colonoscopy begin and how often should it be repeated?
A. Studies suggest that age 50 is the time to begin routine screening to look for early signs of colon cancer. However, there are certain risk factors that lead some patients to begin colonoscopy at a younger age.
A patient is at increased risk if:
- A first-degree (parent, sibling, and child) relative has had colon polyps or colon cancer. The formula determining the first screening exam considers the age when the affected relative was diagnosed. For example, if a parent is diagnosed at age 50, then screening should begin when the patient is 10 years younger. Here, the new patient would begin routine screening at age 40.
- There is a personal history of colon polyps or colon cancer
- There is a personal history of inflammatory bowel disease including Crohn’s disease or ulcerative colitis
- There is a personal history of uterine or ovarian cancer before the age of 50
When the colonoscopy is to be repeated will be determined by the findings at the initial examination. If a patient has no polyps and no family history or other risk factors listed above, they are often instructed to return in 10 years. The important point to remember is that a patient should call his/her doctor and return immediately if he/she develops new symptoms or signs such as rectal bleeding, change in bowel habits or abdominal pain. A patient might also need repeat colonoscopy sooner if a new diagnosis of colon polyps or colon cancer is made in a family member.
If a patient has no polyps or cancer, but they have a family history of colon polyps or cancer, they will likely be asked to return for colonoscopy every five years.
For patients who do have colon polyps found during the exam, they will be asked to return at a time interval depending on how many polyps are found, how large they are and the pathology report. Each case will be discussed in great detail with the doctor who performed the colonoscopy exam. If multiple polyps are found, the exam may have to be repeated in three years. If a very large polyp is found, colonoscopy may even be repeated within one year to ensure that all the polyp tissue was removed.
Q. What does colonoscopy prep involve?
A. Prior to the test, the patient undergoes a colon preparation to empty the colon. This can take one or two days, depending on each patient. Please refer to the Colonoscopy Preparation page for more details.
Q. How is colonoscopy performed and how long does it take?
A. Colonoscopy is an outpatient procedure. Sedation is administered by a provider skilled in anesthesia – a certified nurse anesthetist or anesthesiologist. "Conscious sedation" makes a patient very sleepy and relaxed, but it does not involve general anesthesia. While lying on the left side on a comfortable stretcher, the thin flexible tube is inserted through the anus and the entire colon is examined. There is a small video camera inside the scope that gives the physician a clear view, and pictures can be taken of any abnormal findings. Most often, the exam takes less than 30 minutes, but sometimes longer if multiple polyps are found. For safety, no matter what form of transport you are using, someone must pick you up after the procedure. If not, the procedure will be cancelled.
Q. Is there any pain or discomfort after the procedure?
A. Following the procedure, the patient remains in the recovery area for about one hour to ensure that the vital signs are stable and that he/she can tolerate juice and crackers without getting sick. The colon is insufflated with air during the exam, so some retained gas is common. The patient may experience cramping or bloating, and may pass gas for several hours. The average patient is fully recovered and back to a normal routine on the following day.
The doctor will talk to the patient and review the findings of the exam. The nurse will again read and review written discharge instructions from the doctor before the patient leaves the Endoscopy Unit. In rare instances, a patient may develop side effects and should call the doctor immediately if experiencing any of the following:
- Severe abdominal pain
- Rectal bleeding
Because sedation is administered, each patient must be accompanied by a relative or friend at discharge. The restrictions following sedation include no driving for 24 hours and no drinking of alcohol for 24 hours.
Q. Can I go back to work the day after my procedure?
A. In most cases, yes.
Q. Can I go back to work immediately following my procedure or later that day?
A. In most cases, no.
Q. Do you offer payment arrangements?
A. Yes, payment arrangements may be made by contacting the Practice Administrator at 843-342-2299
Q. What are my payment options?
A. All standard forms of payment are accepted, including cash, check, and major credit cards. To pay by credit card over the phone, please call 843-342-2299. You may also pay in cash at the office or mail your payment to the payment address listed on the patient statement.
Q. Why do I receive separate bills from the hospital and from the physician?
A. When a physician specialist performs these services, he/she is generally required to submit their bill separate from the hospital's bill.
For example, if you came to the emergency room and had an x-ray and laboratory tests, you may receive a bill from the hospital for technical resources, a bill from the emergency room physician for professional services, a bill from the radiologist for interpreting any x-rays, and a bill from the pathologist for analyzing any specimens taken and a bill from an anesthesiologist if a procedure is performed and sedation is required.
Q. I see the same item listed on the physician’s bill and the hospital bill. Why?
A. Every hospital visit involves both physician and hospital resources. Although the hospital and the provider may use the same language to describe each charge, their bills are for separate services. The physician’s bill will be for professional assessment, direction, and oversight. The hospital’s bill will be for the technical resources, including procedures and equipment, medications and supplies.
Q. Will you bill my primary and secondary insurance carriers?
A. Yes, as a courtesy to our patients, Coastal Gastroenterology will submit the bill to your insurance carrier. If you have a secondary insurance company, a claim will be sent to the secondary insurance company after the primary insurance company has paid. You are requested to supply the pertinent billing information that the insurer may require.