Frequently Asked Questions

 

What is Gastroenterology?

Gastroenterology is a medical specialty involved with the diagnosis and treatment of disorders and diseases of the digestive system; this includes the esophagus, stomach, small intestine, colon and rectum, pancreas, liver, gallbladder and biliary system.

Office Visits

  • If you are new to our practice, please download our New Patient Packet forms and bring the completed forms with you to your scheduled appointment. Please make sure you have your current insurance card with you when you arrive for your appointment.

  • New patients arrive 30 minutes before your appointment, allowing time for our staff to make the necessary copies of your insurance information and process paperwork required prior to your visit.

    Established patients should arrive 15 minutes before your appointment, to make sure we have the most current insurance and demographic information on file.

  • If you have seen another physician for the same medical problem that brings you to our office, please request copies of those records be sent to the physician you will be seeing. If there is not enough time to receive the records by mail, ask the office to fax them to (816) 561-8217 or pick up and bring with you to your appointment.

Refills

  • You may request a refill by calling (816) 561-2000 and select option 4. We only process refills during our normal office hours, when your chart is available and your physician may be contacted should we have a question.

Upper Endoscopy (EGD)

  • Upper endoscopy allows your doctor to examine the lining of the upper part of your gastrointestinal tract, which includes the esophagus, stomach and duodenum (first portion of the small intestine). An EGD is used for stretching a narrowed esophagus if you are experiencing difficulty swallowing, the removal of polyps or swallowed foreign objects. For more information, visit www.asge.org.

  • Upper endoscopy helps your doctor evaluate symptoms of persistent upper abdominal pain, nausea, vomiting, difficulty swallowing or the cause of bleeding from the upper gastrointestinal tract.

  • Your stomach must be empty. Do not eat or drink anything, including water, for approximately six hours before the procedure. Our schedulers will tell you when to start fasting.

  • Sedation will be given before and during the procedure to help you relax and make you sleepy. You will lie comfortably on your left side. The doctor will pass the endoscope through your mouth and into the esophagus, stomach and duodenum. The endoscope does not interfere with your breathing. The scope blows air into the stomach to expand the folds of tissue making it easier for the physician to examine your stomach. You should experience little to no discomfort with this procedure.

  • Your throat may be slightly sore, and you might feel bloated because of the air introduced into your stomach.

  • A suspicious area may be found and a biopsy is needed to distinguish between benign and cancerous tissues. This is done with small forceps passed through the scope with no discomfort to the patient. Biopsies are done even if cancer is not suspected. Your doctor may do a biopsy to test for Helicobacter pylori, bacteria that cause ulcers.

Colonoscopy

  • Colonoscopy enables your doctor to examine the lining of your colon (large intestine) and rectum. It is the most effective way to evaluate your entire colon for the presence of colorectal cancer or polyps. Early detection can prevent surgery and save lives.

    For more information, visit www.asge.org.

  • A colonoscopy requires a cleansing preparation of the colon the day before the procedure so that the colon can be fully visualized. This is usually accomplished by drinking a liquid that causes complete emptying of the colon. Our schedulers will tell you what dietary restrictions to follow and what cleansing routine to use as prescribed by your doctor. It is important to follow your directions carefully.

  • Yes, the procedure can still be performed. We ask that you use a tampon if possible (not absolutely necessary).

  • Clear liquids include black coffee, tea, soda pop (Coke, Pepsi, 7-Up or Sprite), apple juice, Gatorade, Popsicles, Jell-O, broth, and bouillon. Do not consume any milk products or anything that is red or purple as these can give the appearance of gastrointestinal bleeding.

  • No. You must be on a clear liquid diet all day the day before your colonoscopy. If you did have breakfast, please call our office to reschedule your appointment.

  • Please follow all instructions and make every effort to drink all of the purging solution. The height and weight of a patient does not determine the amount of solution needed to purge your colon. Remember, we are trying to clean out your entire digestive tract. If your colon is not clean, the physician cannot do a thorough exam. We may have to reschedule your test for another day.

  • Yes, you must take the prep as directed by your doctor. Your colon is approximately 6 feet long. The entire colon must be emptied for your physician to see the colon clearly. There could be solid stool higher in the colon that needs to be eliminated.

  • Dizziness and headache could be signs of low blood sugar or low blood pressure. Drinking a regular carbonated beverage (not diet or red or purple coloring) or apple juice may alleviate these symptoms.

  • If you develop symptoms of nausea or vomiting, stop the prep for an hour then resume the process. If you are not able to complete the prep, call our office at (816)561-2000 and the physician on call will assist you. It may be necessary to reschedule your procedure and try an alternative prep.

  • To clean the area, avoid rubbing. Gently pat with a wet washcloth or moist tissue paper. Use Vaseline, Preparation H, or Desitin sparingly.

  • If your last bowel movements were clear enough that you were able to see the bottom of the toilet that should be fine. It is okay if you have some small flecks of material. The yellow color results from the bile that normally is found in feces and will not interfere with the exam.

  • Medications for blood pressure, heart conditions, and seizures should be taken the morning of your exam regardless of the color of the pill, tablet, or liquid. Please follow the instructions you were given at your office visit or during your nurse assessment.

  • Call your doctor’s office at least five days before the procedure and ask for instructions.

  • Call our office or your cardiologist at least seven days before your procedure. If your doctor tells you that you cannot stop the anti-coagulant, please call us immediately to make us aware of this. We will then discuss with you the options available for performing your procedure.

  • If you are having a colonoscopy, stop the iron five days before the procedure. Iron can interfere with the colonoscopy preparation resulting in a poorly cleaned colon. You do not need to stop iron if you are having an upper endoscopy only.

  • It is best to stop any herbal medications five days before the procedure as some of them can thin the blood and increase the risk of bleeding during the procedure.

  • Sedation will be given before and during your procedure to help you relax and make you sleepy. You will lie on your left side as a flexible tube is inserted into your anus and slowly advanced into the rectum and colon. The procedure will cause you little to no discomfort.

  • A polyp is an abnormal growth found in the colon lining. They vary in size and shape, and while most are benign (non-cancerous), some may turn into cancer. It is important to remove pre-cancerous polyps as a preventative measure for colorectal cancer. Very small polyps may be totally destroyed by fulguration (burning). Larger polyps are removed by a technique called snare polypectomy. A wire loop (snare) is passed through the scope and removes the polyp from the intestinal wall. This technique causes no pain to the patient.

  • You may experience some bloating or mild cramping because of the air introduced into your colon. These symptoms should disappear when you pass gas.

  • Yes. If your procedure was done by another physician, reports are needed because follow-ups vary with previous findings. If you had previous colon polyps, the physician will know from the report the location and size of the polyps.

Procedure Related Questions

  • Because of the sedation given during your procedure, you will need a friend or family member to come with you and drive you home. These medications make the test easier for the patient, but do not wear off immediately. For your safety, you should not operate machinery or drive following your procedure. You may not use public transportation unless accompanied by family or a friend.

  • Yes.

  • Yes, you may wear your dentures to the endoscopy suite. However, you may be asked to remove them prior to the procedure.

  • You may take Tylenol (acetaminophen) as directed.

  • The actual procedure will take 15-20 minutes. Registration, pre-operative and post-operative care will keep you in our facility approximately 1½ to 2 hours.

  • The physician will speak with you about the visual findings on your procedure before you go home. If biopsies were taken or polyps removed, you should call the office for results a week from your procedure date.

  • Unless your physician gives you dietary restrictions, you are free to eat a normal breakfast or lunch after leaving our endoscopy center.

  • Most patients are able to return to work the following day.

  • Follow-up care is an important part of your treatment plan. We have a recall system that notifies the patient by mail when you are due for follow up care such as an office visit, labs or procedure. Once you receive your recall letter, please contact our scheduling department to schedule your next appointment.

  • Our findings and recommendations will be discussed with you and a letter and/or copy of your procedure note will be forwarded to your primary care physician for their records.

  • Virtual colonoscopy is a technique designed to reconstruct three-dimensional images of the colon using a CAT scan. Studies have suggested that this technique might miss a significant percentage of smaller polyps that can be found with colonoscopy. Virtual colonoscopy requires you to be cleansed just as if you were having a traditional colonoscopy. Furthermore, if polyps were detected by virtual colonoscopy, you would still need a traditional colonoscopy to remove these polyps, thus resulting in two procedures. We do not recommend virtual colonoscopy as an adequate screening test.

Financial Policy

Thank you for choosing Mid-America Gastro-Intestinal Consultants and G. I. Diagnostics for your health care needs. It is our goal to make the financial aspects of your health care as convenient and efficient as possible. Please read the following billing policies to understand your financial responsibilities as a patient.

Download this information as PDF document: Financial_Policy.pdf

  • We are participating providers with Medicare and most major insurance plans. The patient should know if the physician and, if applicable, the facility where the procedure will be performed participates with your insurance plan. If your insurance plan is an HMO or EPO and requires a referral form from your primary care physician, it is your responsibility to obtain prior to your appointment. It is important for you to know your out-of-pocket costs not covered by your insurance which include deductibles, co-payments, co-insurance and non-covered services. You will be responsible for payment in full of any balance on your account upon receipt of your Explanation of Benefits from your insurance company or a balance due statement from our office. Co-pays are due at the time of service.

  • We accept payment by cash, check or money order, VISA, MasterCard or Discover. There will be a $25.00 service charge on all returned checks.

  • Patients will be required to pay in full the estimated charges prior to procedures being performed. Office visits are to be paid in full at the time of service.

  • You will receive an itemized statement on any outstanding balance on your account. Statements are mailed monthly. The balance should be paid in full unless financial arrangements have been made with our business office. Past due accounts will be reviewed for possible collection proceedings.

  • We make every effort to accommodate your scheduling needs. It is important to be on time for your procedure, arriving early as requested, and to notify us in the event you need to reschedule your appointment. We reserve for our patients, the amount of time we need to provide quality health care. Therefore, sufficient notice to change your procedure appointment is necessary in order to offer this time to another patient.

    We require a minimum of three (3) business days prior to your scheduled procedure appointment for any cancellation or rescheduling needs.

    PROCEDURE APPOINTMENTS CANCELLED/RESCHEDULED WITHOUT SUFFICIENT NOTICE (3 BUSINESS DAYS) WILL INCUR A CHARGE OF $ 100. THIS CHARGE IS NOT COVERED OR PAID BY ANY INSURANCE COMPANY; THEREFORE THE CHARGE WILL BE BILLED DIRECTLY TO THE PATIENT.

  • The business office will contact you once benefits have been verified with your insurance plan. Deductible amounts are the responsibility of the patient. Advance payment is required on procedure appointments.

  • We will contact your insurance company to obtain pre-certification on procedures scheduled by our office. Pre-certification does not guarantee coverage and/or payment by your insurance plan. It is your responsibility to know the extent of coverage for services provided by our office.

  • If your procedure is done in our endoscopy center, you will receive two bills; one for the physician’s professional services and the other for facility fees. The professional fee is billed by Mid-America Gastro-Intestinal Consultants and reflects the services provided by the physician. The facility fee is billed by G. I. Diagnostics.

    You may receive a statement from Plaza Anesthesia. This company bills for anesthesia services provided during your procedure.

    Any pathology performed during your procedure will be billed by the entity providing the service.

  • Insurance companies often provide screening benefits for routine screening colonoscopy. However, if during your screening procedure the physician removes a polyp or performs biopsy, the procedure may be considered diagnostic and may not be covered as a screening exam. In this case, some insurance companies drop financial responsibility to the patient for all or part of the procedure cost. It is important for you to know if this may apply to your routine screening benefits.