EGD (Upper Endoscopy) with BRAVO pH Testing Preparation Instructions OFF PPI Medication
This EGD with BRAVO pH testing preparation requires a little organization but is an extremely important part of your procedure. If you do not follow these directions, your procedure may be cancelled.
Key Information:
- Bring a list of all your MEDICATIONS (including over-the-counter medications), photo ID, insurance card, co-pay/co-insurance/deductible with you to your procedure.
- DO NOT bring unnecessary belongings. We are not responsible for lost or misplaced items.
- Stop all clear liquids two hours before your procedure arrival time.
Transportation on the day of your procedure:
- A responsible adult MUST BE PRESENT (18 years or older) with you at check-in before your procedure and MUST BE ABLE to pick you up IMMEDIATELY when you are discharged. You are NOT ALLOWED to drive, take a taxi or bus, or leave the Endoscopy Center alone. If you do not have a responsible driver with you to take you home, your procedure WILL BE CANCELLED.
- Because of the sedation, you are NOT ALLOWED to use a bus, taxi, Uber/Lyft, Access-a-Ride, walk home, etc. alone.
Medications:
- Blood thinners: including Coumadin (warfarin), Plavix (clopidrogel), Ticlid (ticlopidine hydrochloride), Brilinta (ticagrelor), Aggrastat (tirofiban), Agrylin (anagrelide), Xarelto (rivaroxaban), Pradaxa (dabigatran), Eliquis (apixaban), Lovenox (low molecular weight heparin), Innohep (heparin) or Effient (Prasugrel), You must follow the instructions provided by our nurses.
- Diabetes/Weight Loss medication: See instructions below.
- ACE Inhibitor Blood Pressure medications: Do NOT take medications ending ‘pril’ the day of your procedure. Examples: lisinopril, benazepril, ramipril, captopril, enalapril, quinapril
- ARB Blood Pressure medications: Do NOT take medications ending in ‘sartan’ the day of your procedure. Examples: losartan, irbesartan, candesartan, valsartan, telmisartan, olmesartan
- Heartburn/Acid Reflux medications: Continue these medications as prescribed.
- All other medications: Including aspirin, should be taken the day of the exam with a sip of water.
Heartburn/Acid Reflux Medications:
- Proton Pump Inhibitors: including Prilsec (omeprazole), Protonix (pantoprazole), Aciphex (rabeprazole), Prevacid (lansoprazole), Nexium (esomeprazole), Zegerid (omeprazole and sodium bicarbonate), Dexilant (dexlansoprazole), Stop these medications one week before your procedure.
- H2 Blockers: including Pepcid (famotidine), Zantac (famotidine), Tagamet (cimetidine), Stop these medications three days before your procedure.
- Antacids: including Milk of Magnesia (magnesium hydroxide), Gaviscon (aluminum hydroxide/magnesium trisilicate), Tums (calcium carbonate), Titralac (calcium carbonate), Gelusil (aluminum hydroxide/magnesium hydroxide/simethicone), Mylanta (aluminum hydroxide/magnesium hydroxide/simethicone), Di-Gel (aluminum hydroxide/magnesium hydroxide/simethicone), Alka-Seltzer (calcium carbonate), Rulox (aluminum hydroxide/magnesium hydroxide/simethicone), Rolaids/Acid Gone (calcium carbonate/magnesium hydroxide), Stop these medications 24 hours before your procedure.
Weight Loss/Diabetes Medications:
- GLP-1 Agonists (Injectable): including Mounjaro (tirzepatide), Zepbound (tirzepatide), Trulicity (dulaglutide), Victoza, Saxenda (liraglutide), Adlyxin (lixisenatide), Ozempic (semaglutide), Wegovy (semaglutide), Bydureon BCise (exenatide), Byetta (exenatide), Stop one week prior to your procedure.
- GLP-1 Agonists (Oral): including Rybelsus (semaglutide tablet), Stop 24 hours prior to procedure.
- Anorectics: including Adipex-P, Lomaira, Suprenza (phentermine hydrochloride), Qsymia (phentermine hydrochloride/topiramate), Stop 5 days prior to your procedure.
If you have diabetes, follow these instructions:
- Long-Acting Insulins (ex. Lantus, Basaglar, Semglee, Toujeo, Insulin Glargine): Decrease basal rate by ½ the day of your procedure.
- Rapid-Acting and Regular Short-Acting Insulin (ex. Lispro, Humalog, Admelog, Regular Insulin): If your blood sugar is high and you need to take a correction, take ½ or 50% of your usual correction.
This applies to the day of your procedure. - Insulin Pump: Decrease basal rate by ½ the day of your procedure. Do not administer bolus doses.
- SGLT2 Inhibitors: including Jardiance (empagliflozin), Brenzavvy (bexagliflozin), Glyxambi (empagliflozin/linagliptin), Invokamet (canagliflozin/metformin), Invokana (canagliflozin), Qtern (dapagliflozin/saxagliptin), Segluromet (ertugliflozin/metformin), Steglatro (ertugliflozin), Steglujan (ertugliflozin/sitagliptin), Synjardy (empagliflozin/metformin), Inpefa (sotagliflozin), Trijardy (empagliflozin/linagliptin/metformin), Xigduo (dapagliflozin/metformin), Farxiga (dapagliflozin), Stop these medications four days prior to your procedure.
- Other Diabetic Oral & Injectable Medications including Glucophage (metformin), Glucotrol/Glynase Pres Tab/Micronase (glipizide), Amaryl (glimepiride), DiaBeta (glyburide), Tradjenta (linagliptin), Januvia (sitagliptin), Nesina (alogliptin), Onglyza (saxagliptin), Zituvio (sitagliptin), Actos (pioglitazone), Avandia (rosiglitazone) or any combination of these medications, Stop these medications the day before your procedure.
- Check your blood sugar at same intervals as usual, and additionally, if needed: If your blood sugar is less than 60, please take glucose tablets at any time before your procedure with a sip of water.
Checklist to Ensure Proper Preparation
To ensure the proper completion of your EGD preparation, we strongly suggest that you PRINT OUT this document and check off each of the instructions as you complete them. This will greatly help you in following the detailed instructions.
5 days before your procedure:
☐ DO NOT take products that contain iron such as multi-vitamins or iron supplements.
Day of your procedure:
☐ DO NOT eat solid food for 9 hours before your arrival time.
For example, if your arrival time is at 9 AM, do NOT eat after MIDNIGHT.
☐ Follow a clear liquid diet using the charts below:
CLEAR LIQUIDS – YOU CAN DRINK:
- Gatorade, Pedialyte, Powerade, Kool-Aid
- Gatorade G2, Propel, Crystal Light
- Popsicles
- Jell-o, Juice without Pulp (ex. Apple Juice)
- Black Coffee
- Tea, Water
- Clear Sodas (ex. Sprite, Ginger Ale)
- Sparkling water
DO NOT DRINK:
- NO Red or Purple Liquids
- NO Milk or Non-dairy Creamers
- NO Alcohol
- NO Broth or soup
- NO Juice with Pulp (ex. pineapple juice)
- NO Liquid you cannot see through
- NO Apple Sauce
- NO Smoothies
☐ Morning medications may be taken as usual except for above-mentioned medications.
☐ No marijuana.
☐ No mints, gum, hard candy, and chewing tobacco.
☐ If you have diabetes, please see diabetes instructions above.
2 hours – before your procedure check-in time
☐ 2 hours before check-in: STOP DRINKING ALL LIQUIDS!
Congratulations, you have completed your prep! Please bring your medication list (including over-the-counter medications), photo ID, insurance card, co-pay/co-insurance/deductible with you to your procedure.
Procedure Cancellation Notice Requirements:
– Procedure cancellations must be made three (3) business days prior to your appointment.
– Failure to provide the required advance notice will result in a $150 Total Cancellation Fee.
($50 Physician cancellation fee from Gastroenterology of the Rockies + $100 Facility cancellation fee from the endoscopy center).