Utahgastro.com

ph-Bravo-Probe and Esophageal-Motility Prep Instructions
PLEASE READ THESE CAREFULLY
5 DAYS PRIOR TO YOUR EXAM:
• Ideally, anti-clotting medications are stopped 5 days prior to your colonoscopy to reduce the risk of bleeding (i.e. to avoid nose bleeds etc.) during or after your procedure. If you take anti-clotting medications such as Coumadin, Plavix, Pradaxa, Effient, Brilinta, or Xarelto, then please
discuss these medications with the prescribing physician (i.e. cardiologist, neurologist, or primary care provider). You are on these medications for an
important clinical reason (i.e. heart disease, cardiac stent, atrial fibrillation, stroke, mechanical heart valve, history of blood clots). Please let us know
if you are not allowed to stop these medications or if you are advised to use Lovenox or Heparin prior to your procedure.
• If you have diabetes, your primary care provider will advise you how to manage your medications prior to the procedure (i.e. insulin), as you will have MEDICATIONS TO DISCONTINUE PRIOR TO PROCEDURE:
• Certain medications may affect esophageal motility and alter the study results.
• Call our office before adding any medications not previously discussed. A) - ESOPHAGEAL MOTILITY STUDY: (Dysphagia patients only)
• Calcium Channel Blockers - discontinue for 2 days (unless for pre-Nissen surgery) (please review this with your PCP or cardiologist, as these are blood-pressure and cardiac medications and may potentially not be stopped): Dilacor, Cardizem, Calan, Norvasc, Procardia • Inhalers: discontinue for 1 days (unless for pre-Nissen surgery evaluation): Proventil, Serevent • OTHER MEDS TO STOP: Atrovent -2 days, Entex LA -2 days, Guaifenesin-2 days, Histussin-2 days, Lortab -1 days, Metoclopramide-3 days, Nitroglycerin-12 hours, Soma-3 days, Tylox-2 days B) - pH-PROBE (BRAVO) PATIENTS:
• Unless otherwise specifically discussed with your provider please discontinue medications as per schedule below: • Proton pump inhibitors - discontinue for 7 days unless otherwise specifically instructed by your provider: Protonix, Prilosec, Prevacid, Nexium, • H2 Blockers - discontinue for 4 days unless otherwise specifically instructed by your provider: Axid, Pepcid, Tagamet, Zantac • Antacids - discontinue for 1 day unless otherwise specifically instructed by your provider: Tums, Maalox, Rolaids C) pH-PROBE CATHETER BASED IMPEDANCE MANOMETRY PATIENTS (ZEPHYR)
• Please review with your provider whether the testing shall be done on medications vs. off medications (see above section B) and adjust accordingly.
1 DAY PRIOR TO YOUR EXAM:
• You may eat a regular dinner, but stop eating solid foods after 7:00 pm. Restrict your diet to clear liquids thereafter. No solid food until after the THE DAY OF YOUR EXAM:
• Remember not to have any food until after your procedure! • You may drink water until three hours prior to your scheduled arrival time. • If you have diabetes, test your blood sugar before coming in for your exam and bring the reading with you. If you take oral medications for your diabetes, don’t take them the morning of your procedure unless otherwise instructed by your doctor. If you take insulin, take only ½ of your usual morning dose and bring the insulin with you to the procedure.
• You may take your usual medications (i.e. for blood pressure). Any medications taken the day of your procedure may be taken with a small sip of water, AT LEAST 2 HOURS PRIOR TO YOUR ARRIVAL TIME.
You will not be sedated for a Motility or Zephyr (impedance Manometry study) and therefore won’t need a
designated driver. For the Bravo/EGD, please bring a designated driver, as you will be sedated/anesthetized
for the exam. You may not take a taxi home. You may not drive for 12 hours after the procedure.
You may be in the Endoscopy Lab for 2-3 hours. The staff will talk to you before and after the exam and will give you recommendations on diet,
medication, follow up care, etc. Wear comfortable clothing; bring your glasses, hearing aids, insurance cards and completed information forms.
Avoid bringing valuables. We will expect payment of co-pays, coinsurance and deductibles at the time of service. Additional information can be
found at our website www.utahgastro.com.
You may receive up to 4 separate bills: 1-Physician, 2-Facility, 3–Pathology, 4-Anesthesia
(continued on other side)
YOUR PROCEDURE IS SCHEDULED FOR (date):
. Check-in at the center marked below 1 hour prior to your exam time.
For Questions
Davis Hospital & Medical Center
please call one
11600 Antelope Drive, Layton, UT. 801-807-7034 Use the ER Entrance.
of our offices:
Dixie Regional Medical Center — 1380 E Medical Center Drive St George, UT.
435-251-1000. Northwest entrance 2nd floor Outpatient surgery Endoscopy Lab. If not contacted by the day before your procedure, call to pre-register 435-251-1839.
Intermountain Alta View Endoscopy
North Specialty Center, 9450 S 1300 East, Sandy, UT. Please call 801-442-8600 1-2 days prior to your procedure to pre-register.
Intermountain LDS Hospital — 8th Avenue & C Street, SLC, UT., 801-408-1057
Entrance West Wing of Hospital. Call 801-442-8600 or toll free 888-269-8674 the day before your procedure to pre-register - Free Valet Parking Available.
Intermountain Medical Center — 5121 South Cottonwood Drive, Murray, UT.
801-507-3262. Check in at the Eccles Outpatient Building, Level 2. Free Valet Parking Available. Call 801-442-8600 or toll free 888-269-8674 the day before to pre-register.
Lakeview Hospital
630 E Medical Dr., Bountiful, UT., 801-299-4657. South Entrance, Same Day Surgery Registration.
Lakeview Endoscopy Center
620 E Medical Dr., Suite 200, Bountiful, UT., 801-299-6760. Call the day before your procedure to pre-register.
Mountain West Endoscopy Center
6360 South 3000 East, Ste 320, SLC, UT., 801-944-3166. If not contacted by the day before your procedure, call to pre-register.
Riverton Hospital
3741 West 12600 South, Riverton, UT. 801-442-8600 or toll free 888-269-8674. Call the day before your procedure to pre-register.
St. George Endoscopy Center
368 E Riverside Drive, Suite B, St. George, Utah 84790. 435-674-3109. St. Mark’s Hospital Endoscopy
1200 E. 3900 S., Salt Lake City, UT., 801-269-7140. Call 801-268-7341 to pre-register 1-2 days prior to your procedure. Check-in at the registration desk inside the main entrance of the hospital.
Wasatch Endoscopy Center
1200 East 3900 South, #1B, Salt Lake City, UT., Call 801-281-3657 Monday-Friday to pre-register 1-2 days prior to your appointment. Enter through the canopied “Emergency” entrance on the north side of St. Mark’s hospital. Wasatch Endoscopy Center is the first door on your left.
Utah Gastroenterology
6360 South 3000 East Suite 310, SLC, UT 801-944-3141 Valley View Medical Center
1303 N Main Cedar City, UT. 435-868-5000. Routine Diagnostic Center

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