Pre-Procedure Instructions

Before you arrive for the procedure, make sure you have a driver who can take you home after your appointment. You will not be discharged after the procedure unless this person is available to accompany you. This is because your judgment may be impaired due to sedation. If you do not have a family or friend who could drive you for the procedure, alternate transportation options include Royal Chariot Transportation Services and Comfort Keepers may be acceptable. Please note that taxis, Uber, Lyft, and other shared driving options are not permitted.

If you are having a colonoscopy, it is very important that you follow the diet and bowel prep instructions given to you by your doctor. Please contact your doctor if you have not received instructions for taking the colon prep. Please read the following instructions carefully at least 1 week prior to your procedure.

If you are only having upper endoscopy, you do NOT need a specific diet plan or bowel preparation. Please proceed directly to the instructions for the DAY OF PROCEDURE. If you are diabetic or on blood thinner of any kind, please follow the medication instructions carefully.


5 days prior to your procedure, stop taking Vitamin supplements, Iron products, Metamucil, Citrucel, Milk of Magnesia, or chalky antacids (Tums, Rolaids, Mylanta, etc.)

Avoid eating foods high in fiber such as whole grain breads and cereals, fruits, nuts, seeds, quinoa, popcorn, and cooked or raw vegetables.

If you are taking blood thinners such as Coumadin/warfarin, Plavix/clopidogrel, Prasugrel, Brillinta, Pradaxa, Eliquis, Cilastazol, Aggrenox, etc. , you may have to stop them 2 to 5 days prior to the procedure. Please contact your prescribing physician well in advance for specific instructions about how long to hold the blood thinners.


Do not eat any solid food for the entire day.

Drink plenty of clear liquids. Drink at least 8 – 10 large glasses of water or clear liquids to avoid dehydration. Click here for details on the clear liquid diet

Avoid liquids or jello that are red or purple in color (since it may appear to the endoscopist as bloody fluid during your colonoscopy).

Avoid dairy products including milk, cream, yogurt, ice cream, cream/milk tea or coffee.

Start taking your colon prep in the afternoon at the specified time and complete it as instructed. Follow the Prep instructions provided very carefully.

No alcohol the night prior to surgery (there is a possibility of alcohol reacting with the anesthetic agents).


Do not eat or drink anything (other than water or clear liquids) after midnight unless otherwise instructed. You may brush your teeth or rinse your mouth, but please do not swallow. You may be allowed a small drink of water and clear liquids until about 3-4 h before your procedure. Please Stop drinking anything 2h prior to your scheduled reporting time.

Bathe in the morning before coming to the surgery center and wear clean comfortable clothing.

Do not chew gum 2 (two) hours prior to your procedure.

Leave all valuables, including money and jewelry, at home.

If you are a smoker, please refrain from smoking the day of your procedure; This includes cigarettes, cigars, pipe, e-cigarette and marijuana.

Medications: You may take your regular medications that morning with a small sip of water except for. Insulin and other diabetic medications and, blood thinners (see below)



  • The Day before your procedure: Take ½ (half) of your normal dose of diabetic medications
  • The morning of your procedure: Do not take any of your diabetic medications. You may bring your medication with you to take after the procedure
  • If you have an Insulin Pump, DO NOT REMOVE. Discuss adjusting your rates with your prescribing physician (PCP or Endocrinologist)

Please contact your prescribing physician (PCP or Endocrinologist) if you have and questions regarding the adjustment to your medication.


You will generally be instructed to stop taking the following blood thinners 2-5 days prior to your procedure: Coumadin, Xarelto, ELIQUIS, Plavix, Pradaxa, Prasugrel, Brilinta, Cilostazol, Aggrenox etc. Baby Aspirin (ASA 81 mg) is usually allowed and there is no need to stop. Please contact the health care provider who prescribed these medications and whether and how long you should stop. You will receive instructions about when to resume these medications after the procedure.

  • If you have an artificial heart valve, or a history of DVT or pulmonary embolism, you need to call your prescribing physician or cardiologist to discuss a possible alternate anticoagulation well in advance. You may be required to be on a Lovenox or Heparin bridge for the duration of the procedure.

PREP Instructions

Frequently Asked Questions

What do I need to bring to my appointment?

A current insurance card and photo ID.

Do not bring any valuables with you. The center will not be responsible for any lost or stolen items including jewelry, watches, cell phones, laptops, etc.

Will I be able to drive myself home?

You will receive sedation, and therefore, YOU MUST HAVE A RESPONSIBLE ADULT TO RECEIVE DISCHARGE INSTRUCTIONS AND DRIVE YOU HOME. If you have not made arrangements, your procedure will be cancelled and rescheduled for a later date.

If your driver will not be staying in the facility, give a phone number to contact your driver in the event of an emergency during your procedure. Failure to provide an emergency number may result in cancellation of your procedure.

Alternative transportation options:

Royal Chariot Transportation Services, (540) 642-5927

Comfort Keepers (540) 205-8743

What should I wear to the Endoscopy Center

Please wear loose comfortable clothing. You may keep most clothing on for upper endoscopy as well as comfortable shirt and socks for colonoscopy. Women may keep their bra on for the procedure. Please do not wear lotions, oils or perfumes/cologne to the center due to the monitoring devices.

What should I do if I experience nausea or bloating while drinking the colon preparation?

Many people taking the preparation may experience these symptoms. It is more important to drink the entire preparation, therefore if you experience these symptoms, you may want to try taking a glass every 15-20 minutes instead or wait until the symptoms subside and then continue the prep. In the event you are unable to continue, please call (540) 371-7600 or (540) 408-0800 for further instructions. Failure to complete the preparation may result in an inadequate preparation and possible cancellation of the procedure.

What problems may occur with the laxative?

It is important to drink clear liquids throughout the day in addition to your bowel preparation to reduce the possibility of symptoms associated with dehydration. The actual bowel preparation does not help with hydration. Symptoms of dehydration may include lightheadedness, nausea, vomiting, weakness, headache and chills. Drinking clear liquids throughout the day will help minimize these symptoms.

What can I do to make the prep more tolerable?

Make sure to mix the preparation early in the day and keep refrigerated to allow chilling of the solution prior to drinking it. Your preparation may come with flavor packets. As with any liquid you may get tired of the same flavor, therefore it is recommended to flavor the mixed solution in smaller quantities, either by the quart or glass. In addition to the flavor packets, you may use Tang or crystal light powder, Kool-Aid etc. as long as it is not red or purple in color. This way if you grow tired of the flavor you can switch to another flavor. Do not pour the solution over ice as this will only increase the amount. Some people do better drinking the solution quickly, through a straw or plugging their nose. Others may take a bite of Jell-O or suck on a hard candy after drinking a glass. Others find chewing gum right before drinking helpful. Once again, the most important thing is to finish the preparation even if it may take slightly longer.

What are common side effects after the procedure and how should I treat them?

There are common side effects that you may experience after your procedure.

Mild abdominal pain, bloating, excessive gas – Rest, eat lightly, use heating pad. Walking may help ease the symptom.

Redness and/or swelling where the IV was – Apply heat and elevate.

Mild sore throat – Treat with lozenges and gargle with warm salt water.

Soreness at bottom- use baby creams and baby wipe.

Blood in stool: Small amount of blood with first bowel movement after colonoscopy is common but if you continue to pass blood or clots, please call your doctor.

What should I do if I have an emergency after my procedure?

In the event of an emergency, call 911 or go to the nearest Emergency Room or Urgent Care. Otherwise call the physician on call (540) 371-7600.

What symptoms should I report to the doctor after my procedure?

Although we do not anticipate any complications after the procedure there are always certain risks associated with endoscopic procedures and sedation.

Symptoms to report to the physician after Upper Endoscopy include:

Severe sore throat or inability to swallow and/or eat usual diet
Chills or fever > 101 degrees occurring within 24 hours after procedure
Pain in chest or neck
Severe continuing abdominal pain, vomiting, nausea or bleeding
Swelling to the neck area
IV site stays red or swollen for more than two days
Persistent black bowel movements (may indicate hidden blood)

Symptoms to report to the physician after Colonoscopy include:

Chills or fever > 101 degrees occurring within 24 hours after procedure.
Severe continuing abdominal pain or bloating.
Large amount rectal bleeding that does not stop.
IV site stays red or swollen for more than two days.
Inability to keep food or drink down.

How many charges can I expect to receive?

You will always receive at least three charges…one charge from your Doctor, one for the use of the Facility (Fredericksburg Endoscopy Center) and a charge for the Anesthesiologist
Additionally, if clinical findings necessitate a biopsy, then you will receive a charge for the Pathology Laboratory’s services.
Thus, you could receive as many as 4 different bills for your colonoscopy.


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