Frequently Asked Questions

Is the Pezim Clinic public or private?
The Pezim Clinic provides both Medical Services Plan (MSP) and private care.

How long does it take to see the specialist or have a colonoscopy or other procedure?
In most cases, a specialist appointment can be arranged within 2 weeks of initial contact with the Clinic and procedures such as colonoscopy performed within 2 weeks of the first appointment.

Where is the Clinic located?
The Pezim Clinic is located at Suite #30 - 3195 Granville Street in Vancouver, BC, on the northwest corner of Granville Street and 16th Avenue. You can find a map of the area on this website under "About the Pezim Clinic".

What will happen on my first appointment?
During your first visit, the receptionist will verify that we have correct information about you, including your current address and contact information, etc. She will also need to review your current insurance information - so please be sure to bring your insurance card with you. You will then be taken to an examining room where you will be asked to partially disrobe. The doctor will then interview you and perform a focused physical examination. When appropriate, a simple painless examination of the rectum is performed. (This requires no preparation and only takes a few moments). The doctor will then discuss with you his assessment of the situation and what tests may be needed. You are welcome to bring along a family member or friend to join you for this discussion if you wish.

How can I best prepare for my first office visit?
If necessary, bring a written list of all of your current medications or put them in a paper bag and bring them along with you. Write down a list of all prior major illnesses, operations, hospitalizations, and medical allergies. Be aware of what illnesses run in your family. Do not prepare by taking any enemas, laxatives or suppositories. These can make any examination more difficult.

How do I prepare for a colonoscopy exam - (colon scope test)?
This information is presented in the patient instructions section of this website

Should I take my normal medications before a scope test?
Yes. In general, it is best that you take all of your normal medications before and after your scope test. The exceptions would be those patients on diabetic medications (insulin or pills) and those who take medications to prevent clotting such as Coumadin. If you are diabetic check out the patient preparation instruction area of this website. If you are on "blood thinners," our doctor needs to review your medications and decide what should be done.

I am drinking the laxative preparation solution and my bowels have not moved!
Be patient. Our colon-cleansing regimen rarely fails. Most patients have a bowel movement within an hour or two of starting the Citromag. Sometimes, there may be a delay. If you have drunk a full bottle of Citromag and your bowels have not moved, just wait for a while. If nothing happens in an hour, try taking a small disposable 4-oz Fleet enema. They are available at your drugstore. (But be careful not to drive yourself. Send someone else. The preparation may just start to work enroute).

Does it matter which colon-cleansing solution I take?
We prefer that you stick with the routine we have given you as it has proven to be the most well-tolerated and most effective for the examination - over a sample of several thousand patients. If you are unable to take the Citromag regimen, you may try an alternative called a lavage preparation in which a lot of special fluid is consumed over a period of time. There are several brands of the lavage solution - GoLytely, NuLytely, CoLyte, and generic PEG lavage solution. Which one you get depends on what your druggist has in stock and your preference for flavor. They all work the same.

The instructions on the bottle of laxative solution are different from what you gave me?
We provide most patients with printed instructions for their preparation. If you have those, follow them. If you didn't receive any written instructions or misplaced them, please review the colonoscopy preparation instructions on this website. If you are using a lavage preparation, follow the instructions on the container.

Won't my anus be sore after having so many bowel movements during my "cleanout?"
It might be. The very nature of the cleanout process means that you will have many liquid bowel movements over several hours. This might cause some soreness around the anal area. You can minimize this by using particularly soft toilet paper followed by a baby wipe after each bowel movement. Some patients report less problems if they apply 1% Hydrocortisone cream to the anal area after each bowel movement during the preparation. You might consider purchasing these items when you go to pick up your laxative solution.

Should I hold my aspirin prior to a colonoscopy?
Theoretically, aspirin and drugs like ibuprofen can inhibit blood clotting and make the risk of bleeding higher if a biopsy is taken or a polyp removed. But in practice, this does not seem to be a problem. If you are taking a daily aspirin to prevent a stroke or heart attack, and this has been advised by your physician, don't stop without your doctor's approval. If you are only taking these pills for minor problems, it may be safest to stop them 10 days prior to colonoscopy. Of course, if you have any bleeding tendencies, let your doctor know.

Why do I need to bring a driver for my scope test appointment and why does he/she have to stay the whole time I am there?
Scope examinations require sedation to prevent pain and discomfort. These medications make the test quite simple for the patient, but do not wear off immediately. Because of this, you cannot drive your car until the following morning. Therefore, it is necessary for you to come with a friend or family member who can safely drive you home after your test is over.

How long will my scope test take?
If you are scheduled for a colonoscopy, plan to be in the Clinic for about 2 hours. The test usually takes only 30 minutes, but preparation and recovery extend the time required.

Will my scope test be painful?
With modern sedatives, your examination should be comfortable. Some patients hardly remember having it. Others do feel some discomfort. Everyone is different. Every effort is made to minimize any discomfort during the procedure while insuring maximum safety. Most patients tell us afterward that the colon-cleansing procedure was more unpleasant than the colonoscopy itself.

Does a colonoscopy show if I have colon cancer?
Yes. In fact, colonoscopy is considered to be the most accurate way to determine the health of your colon. This includes checking for cancer, polyps, colitis, diverticulosis, and other less common lower digestive problems.

What should I expect during my scope test?
After being checked-in by the receptionist, you will be taken to the endoscopy room. You will be asked to disrobe completely and put on a clinic gown. The physician will talk to you briefly and take your blood pressure. The physician will start an intravenous in your arm and you will be given an oxygen mask to hold lightly over your face. A cardiac monitor probe will be placed on your earlobe or fingertip. Don't be alarmed. This is routine for everyone. The doctor will then administer the sedative into your intravenous line. You will then be asked to roll onto your left side and the colonoscope will be gently inserted into the anus and up into the bowel.

I am afraid that I will say things that I shouldn't while sedated.
This is a normal and common fear. Most individuals are afraid of losing control, giving away their secrets, or saying something embarrassing while they are sedated. Don't worry. The sedation does not work like a truth serum. While in a state of conscious sedation, patients don't say much of anything.

If the doctor finds a polyp during my test, will he remove it?
In most cases, yes. Most polyps can be removed at the time of colonoscopy. Rarely, a polyp is too big or too flat to remove and surgery is necessary.

How will I feel after my test?
After your test, you may have a dry mouth and feel a bit gassy and hungry. The dry mouth is from the sedation. The gassiness is from the air that is inflated into the colon during the test. This helps your doctor see inside your colon more effectively. We try to minimize any air inflated and to remove most of the air at the end of the procedure, but some of it just has to pass naturally. Since fasting is part of the preparation, it is natural to feel hungry afterwards. The colonoscopy assistant will offer you some juice after the procedure once you have recovered adequately. Once you go home, you can pass the rest of the gas and have a meal. Soon, you will be back to normal. Usually there is no real pain after a colonoscopy.

Why can't I stop at a restaurant after my test?
Many patients want to go directly to a restaurant after their examination. We suggest that you go straight home and eat there. This is safer since the sedation can causes drowsiness for several hours. We suggest that you go straight home, have a meal, and take a nap for several hours. After about four hours, you may go out as long as you feel well and do not drive.

How soon will I be able to eat after my test?
Immediately, unless instructed otherwise by the Pezim Clinic physician. Once you have awoken adequately form the procedure, we will offer you some juice. When you go home, you can have a normal breakfast or lunch. Eat whatever you feel like. Just go slow at first. Don't try to make up for 3 missed meals all at once. If a large polyp has been removed, you may be advised by the Pezim Clinic physician to remain on clear fluids for the rest of the day. If you awake the next morning and feel well, you may then start on a normal diet.

How soon can I drink alcohol after my test?
The medicines used for sedation should not be mixed with alcohol. We suggest you do not drink any alcoholic beverages (beer, wine, whiskey) until the day after your scope test.

How soon can I return to work after my test?
Most patients are able to return to work the following morning.

I am drug tested at work. Is this a problem?
The sedatives used for colonoscopy will show up in blood tests for several days. If your job requires random drug testing and you need a written explanation for work, let the doctor know.

How long do I have to wait before I fly or travel after my test?
The risk of complications is very low for these procedures. In general, if you feel well, you may fly or travel the day after your scope test. However, if the doctor removes a large polyp or if your procedure was unusual in any way, he may request that you stay in the area for at least a week after the exam. This rarely occurs. Certainly, you should not travel to any part of the world where medical attention is not readily available right after any medical procedure. Should a complication occur, you may need prompt medical attention.

How long do I have to wait for the results of my test?
Unlike an x-ray, the results of a scope test are immediate. After you awaken from your sedation, the doctor will discuss the results of the test with you and your family. You will also have an opportunity to ask questions. Biopsies or samples taken for analysis take a week to ten days to return. If the results show anything unusual, you will be contacted by the Clinic. Your referring physician will always receive a copy of any tissue analysis results. If, at ten days or so you have not heard about a biopsy or polyp result and are curious, feel free to contact the Clinic to receive the results of the tissue analysis.