Formerly Taburn Specialist Medical Centre
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GP Information

Open access endoscopy is available at Glen Iris Private, though we recommend that the following patients are referred for consultation PRIOR to scheduling a procedure

Contra-indications to Open Access Endoscopy include:

  1. Patients less than 16 years
  2. Patients with significantly increased anaesthetic risk, including:
  1. Morbidly obese patients (BMI > 45)
  2. Recent AMI (within prior 6 months)
  3. Severe COAD
  4. Immobility preventing getting onto a trolley

These recommendations are not exhaustive. If you or the patient wishes, a pre-procedural consultation can be arranged with Dr. David Fone, Dr. Howard Tang (Gastroenterologists) or Mr. Andrew Smith (Surgeon) for the patient to discuss any of these issues. We are all available for phone advice via Glen Irs Private, on 9808 7111.

Before their procedure, your help in managing patients is of enormous value. Several issues listed below have links to general guidelines.
  • Antihypertensives
    All usual medications are taken on the morning of a procedure despite fasting, with a sip of water. This applies to all classes of antihypertensives. As a rule, diuretics are also taken, though these may be withheld in a patient having bowel preparation.
  • Diabetes
    Type 1
    1. The patient should be placed first on a morning list.
    2. Normal management on the day before procedure for gastroscopy. Reduce Insulin Dose by 20% in the evening if taking bowel preparation.
    3. Halve the 1st morning dose of insulin on the day of procedure.
    4. Consider advice from the patient's endocrinologist.
    Type 2
    1. If diet-controlled on no medications, then treat as for a normal patient.
    2. On oral hypoglycaemics
      1. Normal Tablets on the day prior to procedure, EXCEPT that Daonil (glibenclamide) is withheld on the evening before procedure.
      2. No diabetic tablets taken on the morning of procedure.
    3. On Insulin
      1. Normal management on the day before procedure.
      2. No insulin on the morning of the procedure while fasting.
      3. Consider advice from the patient's endocrinologist.
  • Platelet inhibitors
    1. Aspirin can be continued until the day prior to gastroscopy or colonoscopy.
    2. Iscover and Plavix have a profound anti-platelet effect which is irreversible. These agents are a contraindication to polypectomy, or to biopsy of any vascular lesion. They should be ceased for 10 days prior to endoscopy if possible. Advice from the relevant cardiologist may be required. They are not to be ceased in patients with drug-eluting coronary stents.
  • Warfarin

    A patient anti-coagulated on Warfarin should not undergo polypectomy, or have a biopsy of any vascular lesion. Frequently the warfarin can be ceased temporarily, with the patient missing 4 pre-procedural doses. If possible, an INR is done on the day prior to the planned procedure. Some patients cannot have their warfarin ceased. You and the patient's physician are in the best position to make this decision. Such patients will be able to have a diagnostic but not therapeutic procedure at Glen Iris Private, and it may be better for them to be endoscoped in a major hospital environment.

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