Question- Colonoscopy & Upper GI Endoscopy

T o p i c : Colonoscopy & Upper Gi Endoscopy

Q: My mom (54 years old) tested positive for blood in her stools. She is scheduled for both a colonoscopy and an upper GI endoscopy on the same day. Is it appropriate to perform both procedures on the same day (outpatient)?

A: It is acceptable medical practice to perform both an upper and a lower gastrointestinal endoscopic examination on a patient during one session of conscious sedation. This avoids the patient having to make another long visit to the outpatient department and receive identical sedative medications a second time. Depending on the individual clinical history and circumstances, if a colonic source of the blood is primarily suspected but on examination no significant abnormalities are identified, then it may be necessary and appropriate to proceed immediately to the upper gastrointestinal exam. If however, the clinical history leads the physician to primarily suspect an upper gastrointestinal source of the blood, then it would not be appropriate to subject the patient to the laxative preparation (which most people consider to be the worst part of the lower endoscopic examination). Sometimes, social factors come into play since it is a considerable time-saver for the employed patient who cannot afford to miss another day of work. Insurance companies actually penalize the physician for performing both procedures on the same day. Medicare and other insurers actually reduce the physician's fee by 50 % for the second procedure regardless of the necessity of the procedure.