EGD Preparation Instructions

Manoj K. Mehta, MD

Laura K. Bianchi, MD 

Rebecca W. Tsang, MD MPH

Endoscopy Center of the North Shore, LLC

www.ginorthshore.com

PHONE:  847-256-1855 FAX:  866-375-3001

EGD (Upper Endoscopy) INSTRUCTIONS

We are offering you a free app to guide you through the process and answer any questions you might have. Why? Avoid errors that might result in cancellation or rescheduling! This was developed by Dr. Mehta and this practice. It takes less than a minute to register, is tailored to your exact procedure and appointment time, and is available 24-7! Scan the QR code or go to the website. 

Preparation for EGD requires an empty stomach, so you must be fasting prior to the procedure, and some further instructions regarding blood thinners and having a ride. Please see the details listed below in Special Instructions.

A note about oral intake and what “nothing by mouth” means on the day of the test:

• midnight – stop all intake by mouth
  • 4 hours – only essential medications with a sip of water. Ideally, take afterwards.

7 Days Prior to Procedure	Discontinue all non-medical aspirin products, vitamin E, fish oil or any inflammatory agents for 7 days prior to the procedure. If your endoscopy is less than 7 days away, stop taking any of these medications starting now. Hold any GLP-1 agonists (Ozempic, Wegovy, Mounjaro, Zepbound, including pills, and other brands) and phentermine. DO NOT take your usual dose of these medications for at least one week (a full 7 days) prior to the exam or you cannot have anesthesia.
2-5 days prior to procedure	Discontinue any blood thinners (Plavix, Effient, Pradaxa, Brillinta, Coumadin, Xarelto, Eliquis etc.). Aspirin for your heart is OK.  The exact number of days to stop the medication is specific to exactly what you are taking and why. Prior to stopping medications, please contact your PCP or cardiologist for directions. If you have to stay on your blood thinner, let us know.
The Day Before	Discontinue metformin-containing diabetes medicationsIf you have been taking a GLP-1, have only clear liquids for dinner
Midnight the night before	No food or drink after midnight
The Day Of:	Only essential medications no less than 4 hours preopHave a ride home (no taxi’s, Uber, etc.)Arrive to the G.I. Lab 30 minutes early (or as directed)Be prepared to be picked up one hour after your scheduled start time.

Report to the G.I. lab 30 minutes (or as directed) before your scheduled appointment time. Please arrange for someone else to drive you home and be with you for 12-24 hours. If they can be flexible with the timing, we might call you in early, and we will make every effort to update them if we are behind. No taxi’s or Ubers are allowed. A limo service is available at your expense if needed, but this has to be arranged ahead of time.

A note about anesthesia – If you have special anesthesia needs, please make an office appointment first. All procedures done at the office involve the use of propofol and an anesthesiologist or CRNA. You will not be able to drive home because of this. Anesthesia at the hospital is usually conscious sedation unless by special arrangement, but even then they make no guarantees.

A note about billing – You may see charges for consultation or physical exam as well as the procedure. You may likely see separate bills from the hospital, anesthesia provider, and pathologist.

Afterwards – The doctor will speak to you before you leave and will share a copy of your procedure note via our patient portal. You must sign up for the patient portal if you want to be able to see and save your records, discuss results remotely, have prescriptions sent, etc. We do not print paper copies of reports.

Special Instructions:

• If you are on a blood thinner talk to your physician whether it can be discontinued and when. Do not discontinue unless OK’d by primary doctor, cardiologist, or another prescribing doctor.
• If you are on a GLP-1 agonist (Ozempic, Wegovy, Mounjaro, Zepbound, newer pill forms, and other brands) DO NOT take your usual dose for at least one week (a full 7 days) prior to the exam.
• If you are on phentermine, DO NOT take your usual dose for at least one week (a full 7 days) prior to the exam.
• Do NOT take elective pain medication such as naproxen or ibuprofen for 7 days before your procedure. Tylenol is OK. Aspirin for your heart is OK.
• Diabetics should NOT take diabetes medicines the day of the procedure, but you should bring these medicines with you. If you take metformin or a metformin-containing diabetes medication, do NOT take it for 24 hours prior to the procedure. If you have brittle diabetes, talk to your primary doctor or endocrinologist regarding glucose management the day before and the day of the test.
• You should take all your other regular medications every day, including the day of the procedure. You must take any necessary medications at least 4 hours before the procedure. Otherwise, take them afterwards.
• Patients with pacemakers or automatic implantable cardiac defibrillators (AICD) must contact the GI lab once the procedure is scheduled. The hospital may require interrogation of your device before and after the test. The office will NOT perform procedures with AICD’s or  pacemakers.

Should you cancel your procedure for any reason we ask that you notify the office at least 72 hours in advance or a fee will be charged. Please be respectful of the many other patients who are waiting for openings. We cannot simply call someone in for a colonoscopy if there is a last minute cancellation, so these spots are valuable to people.

If you have any questions, call the office well in advance. If you have any urgent issues the night before, you can page the physician through the office number. You can also check the website for FAQ’s. If you have any questions please call the office, (847) 256-1855.