Colonoscopy/Endoscopy Q & A

Endoscopy, including colonoscopy and upper endoscopy, is an essential tool for diagnosing and treating a wide range of gastrointestinal conditions. Upper endoscopy is commonly called a gastroscopy, or an EGD, an acronym for esophagogastroduodenoscopy.

Audrey Woolrich, MD is a highly trained endoscopist who spent her early years of private practice in the office of her mentor, Dr Jerry Waye.  He is often referred to as one of the world's best endoscopists as he was instrumental in the development of endoscopic techniques and technology in the United States.

Dr. Woolrich performs most of her endoscopic procedures at Carnegie Hill Endoscopy, just blocks from her Upper East Side office. There she participates in quality metrics and consistently has an adenoma (polyp) detection rate (ADR) and cecal intubation rate above the national average.  She is also an active participant in their charity program that provides endoscopies to people who do not have health insurance.

Whether you are having a gastrointestinal issue such as abdominal pain, a change in bowel function including constipation, diarrhea or blood in your stool or if you are having trouble swallowing, you should consult with Dr Woolrich. If you need a screening or surveillance endoscopy please call her office or schedule an appointment online today.

What is a colonoscopy?

A colonoscopy is a minimally invasive procedure performed by Dr Woolrich to evaluate your lower gastrointestinal tract from the anus to the cecum, and sometimes as far as the distal ileum, the lower part of your small intestine just beyond the ileocecal valve.

She uses the most advanced instruments at Carnegie Hill Endoscopy. A colonoscope is essentially a thin flexible tube with a small camera at the tip that projects magnifiied images on a large screen and has portals for passing various instruments used to obtain biopsies and remove polyps. Dr. Woolrich performs the examination after a day of only clear liquids (refer to patient information sheet) followed by a vigorous preparation that cleans out the entire colon by causing gentle yet rapid diarrhea.

The laxative regimen is personalized to your specific bowel habits, pre-existing conditions and the time of  your scheduled procedure. She will choose the preparation that would be best for you while also considering your preferences. Dr. Woolrich will discuss your medical history and medications as some, such as blood thinners, diuretics and diabetes medication might need to be adjusted or held prior to your procedure.

Dr. Woolrich spends as much time as you need to discuss the colonoscopy and chosen bowel prep, as well as the rare potential complications such as bleeding or a perforation.  The colonoscopy is performed with intravenous sedation administered by a group of outstanding board-certified anesthesiologists that work with her at Carnegie Hill Endoscopy.

What is an upper endoscopy?

An upper endoscopy is a minimally invasive procedure performed by Dr. Woolrich to evaluate your upper gastrointestinal tract from your esophagus to the first portion of your small intestine called the duodenum.

The gastroscope is essentially a shorter and thinner flexible tube than the colonoscope. There is no special prep other than fasting for at least 8 hours prior to the exam. As with a colonoscopy, some of your medications might need to be adjusted prior to the examination. Dr. Woolrich will spend as much time as you need to understand your procedure and the rare potential complications such as bleeding, perforation or aspiration.  Upper endoscopies are always performed with intravenous sedation to prevent gagging and any discomfort.

What can I expect during my colonoscopy or upper endoscopy?

You will arrive at Carnegie Hill Endoscopy, located at 1516 Lexington Avenue between 97th and 98th street, 45 minutes before your scheduled examination.

The front desk asks you to review and complete various documents that include some personal information and the center's policies. Please bring your insurance cards. You will then be brought into an inner office where you will be asked to sign an informed consent and discuss any financial obligations such as copayments and deductibles for the facility fee and anesthesia.

Then, you will be greeted by one of our pre-procedure nurses who get you situated for your exam. If you are a female patient of a certain age, you will be asked to provide a urine sample for a pregnancy test. A positive test would most likely cancel your procedure.

You will next be directed to a large room and your own private cubicle where you will be asked to undress and put on a hospital gown. Your medical history is reviewed by the nurse, your vital signs are obtained, and you might be asked if you are interested in genetic testing. An intravenous catheter is inserted into your arm and then you meet your anesthesiologist, who answers any questions and addresses your concerns. You are then wheeled on a stretcher to your endoscopy room and then meet the endoscopy technician who will be assisting Dr. Woolrich during your exam.

The technician may help by possibly maneuvering your position and applying gentle abdominal pressure when indicated. They will also assist in taking biopsies and removing lesions such as polyps. They will process the removed tissue and send it to a pathology laboratory that participates with your insurance plan.

Your anesthesiologist continues to monitor your vital signs from the time you arrive in the procedure room to after completion of your examination. You will be given supplemental oxygen through nasal prongs. After a medical "Time Out,” which is when you reconfirm your full name, date of birth, any allergies and that Dr. Woolrich will be performing your procedure, your anesthesiologist then begins administering your sedation, which usually consists of propofol, a well-tolerated short-acting drug.

If you are having an upper endoscopy, a small bite block is inserted into your mouth prior to sedation to facilitate the passage of the gastroscope. It is kept in place by your teeth and a strap around your head. You will be able to breathe comfortably through the apparatus.

Once you are sedated and unaware of your surroundings, Dr. Woolrich inserts the endoscope, which has been manually scrubbed and disinfected by the center's processing machines according to specific federal guidelines. You will not feel any pain during the examination. Usually, carbon dioxide is inserted to help with visualization but sometimes room air is used and you might feel a bit gassy after the exam.

Generally, a colonoscopy takes 10-45 minutes depending on the quality of your preparation and the number of biopsies or lesions that have to be removed. An upper endoscopy with biopsies is usually completed within 10 minutes. Dr. Woolrich always takes her time for a complete and thorough inspection.

After your colonoscopy you will be wheeled into the recovery room to your own cubicle with your own nurse, who continues monitoring your vital signs. You will be offered some juice and crackers when you are fully awake. You are required to rest for at least 30 minutes after the exam, and longer if necessary. It is for your safety and benefit that you arrange for someone to pick you up after the exam.  An escort is required for anyone over age 75.

If you do not have an escort, the endoscopy center can recommend an inexpensive escort service.  After you are dressed, Dr. Woolrich meets with you either alone in the consultation room or as you might prefer with your designated escort and discusses her findings. You will be provided with a written report that includes pictures and post-procedure instructions.

More information will be available after pathology testing is completed. She may ask you to contact her office and schedule a follow-up visit in seven to ten days. After the pathology report and subsequent treatment is discussed with you, she will send a report to your private physician.

You are advised to eat lightly after you leave the center and refrain from alcohol, exercising, driving, operating any machinery, or making any major decisions for at least the next eight hours. It is best to go home and rest. You will be advised when to resume your medications — specifically, your blood thinners. Dr. Woolrich asks that you contact her office if you have any concerns or are experiencing any fever, abdominal pain or bleeding that could suggest a rare complication.