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ENDOSCOPY SUITE 110 Irving Street, N.W. Rm 3A3 Washington, DC 20010 Name: __________________ Appointment Date: __________________ PATIENT INSTRUCTIONS FOR CAPSULE ENDOCOPY/SMART PILL Please tell your doctor about any previous Bowel Surgery Stop multivitamin with iron 1 week prior to test THE DAY BEFORE: After lunch, begin the liquid diet Gelatin, Popsicles (no red or purple) Coffee, tea, soda Fat-free chicken, beef, vegetable broth Nothing by mouth AFTER midnight, except for necessary medications. Do not take medications 2 hours before the test. If diabetic you may need change of insulin or pills. THE DAY OF THE TEST: Wear loose fitting clothing; you will have to wear a monitor attached to little sticky pads (electrodes). Arrive at 7:00am to register at the Endoscopy suite room 3A3 in the main Hospital, Please bring physician order with you to your appointment. If you have any questions please contact Endoscopy suite 202-877-7108. A nurse will meet you in the waiting room and take you to the testing room. Liquid diet 2 hours after the test. If necessary, you may take your prescribed medications at this time. After an additional 2 hours (4 hours after the procedure) you may have a light lunch (soup, gelatin, beverages, and low fiber). Return to the Endoscopy suite @ 4:00pm the same day and the nurse will remove the monitor for you. NOTE: The capsule study is contraindicated in patients with know or suspected bowel obstruction, patients with pacemakers or other implanted electromedical devices, and patients suffering from swallowing disorders. MedStar Health 110 Irving Street NW • Suite 3A3 • Washington DC 20010-2975