Gastroenterology Associates of Athens
740 Prince Avenue, Building 15
Athens, GA 30606
Small Bowel Video Capsule Endoscopy Scheduled:____/____/______Arrive at ______AM
Things to purchase prior to your procedure:
1. Simethicone liquid drops
2. Miralax
Do not take Iron supplements for 5 days prior to exam.
NO Carafate or antacids for 24 hours prior to Capsule ingestion.
NO SMOKING for 24 hours.
The Day Before your exam ____/____/______, You will be on a Clear liquid diet only the entire day prior to the test. This includes clear fruit juices, broth, popsicles, jello, coffee, tea, etc. Please do not consume any beverage with RED or PURPLE coloring and NO milk, creamer, or dairy products.
q At 6:00 p.m. mix 51-grams (3 capfuls) of MIRALAX in 24 oz of water. Shake the solution until MIRALAX is dissolved.
q Drink 8 oz every 10-15 minutes until the entire solution is gone.
q Continue clear liquids until bedtime.
YOU MAY HAVE NOTHING TO EAT, DRINK, or SMOKE AFTER MIDNIGHT.
The Morning of your exam
q You may take only critical medication (heart medication, seizure medication, etc.) at least 2 hours before the capsule ingestion, or 2 hours after you swallow the capsule.
q Please wear comfortable, loose, 2 piece cotton clothing and undergarments the day of your procedure.
q Diabetics should consider reducing Insulin dose the day of exam (as instructed by your doctor).
When you arrive at your appointment
q You will be fitted for the apparatus and will ingest the camera pill.
q It is important to drink only water after you swallow the pill with a couple of drops of over the counter simethicone in each glass.
At Noon the day of your procedure you will be allowed a light snack (such as soup or a salad) and after that your may eat your normal diet.
DO NOT go home and rest after ingestion of the pill. The more you move the more your GI tract moves and this will allow the best possible outcome of your individual exam.
You must return to the office at 4:30 PM for our staff to remove the sensors and recorder. Do not attempt to remove the equipment yourself. Please call (706) 548 –0008 if you have any questions or problems. Please ask for RITA.
Telephone: (706) 548-0008 · Fax: (706) 369-9673