Gastrointestinal Endoscopy Package

All subjects undergoing health checkups are reminded that even though screenings can effectively diagnose a disease in advance and reduce its threat to your health, all examination items and medical instrument-based screenings do not have full sensitivity to various diseases. In addition, due to the diversity of the individual characteristics and health statuses of subjects, it is impossible to fully diagnose every disease.
Furthermore, after receiving a checkup, it is recommended that you receive follow-ups or treatment according to the doctor's recommendations, adjust your daily lifestyle, and avoid risk factors that may affect your health, so as to achieve the fullest potential of healthcare management and preventive medicine.

Aim of examination: Gastrointestinal endoscopy is a painless procedure that determines the health of your esophagus, stomach, duodenum, and large intestine without causing discomfort. Treatment can be done at the same time if a lesion or polyp is detected, thereby effectively reducing the incidence of cancer.
Examinations include: Painless and anesthesia-based endoscopy, esophagogastroduodenoscopy, colonoscopy.

Gastrointestinal Endoscopy Package	Premium
Esophagogastroduodenoscopy	V
Colonoscopy	V
Painless anesthesia	V
Summarized and Consultation of Health Checkup Report	V
Cost of package	NT$ 13,700

When Not to Undergo an Endoscopy

If you have the following conditions, in order to guarantee your safety, it is recommended that you do not undergo an endoscopy. The examination will be rescheduled once your condition has improved or if the doctor has determined that you are sufficiently fit.

Any major operation within the last three months.
An abdominal operation within the last six months.
Pregnancy or suspected pregnancy.
Unable to lie on the left side (due to the examination requirements, subjects must lie on their left sides for 20 to 30 minutes).
Suffering from the following cardiovascular and lung diseases:
(1) Angina, chest pain, chest tightness, or acute myocardial infarction within the last three months.
(2) Cardiac catheterization or bypass surgery within the past year.
(3) An EKG indicating acute myocardial infarction or other unstable conditions caused by major abnormalities.
(4) Blood pressure greater than 180/100 mmHg.
(5) Severe cough, recent asthma attacks, or poor lung function.
Age above 85 years old, unless necessary.
Unable to stop the use of anticoagulant drugs.
Drug or alcohol addiction, inability to cooperate due to poor consciousness, or loose teeth.
Other major systemic diseases, such as uncorrected coagulation disorders, or pulmonary embolism or stroke within the last six months (please inform us beforehand if you are suffering from a major disease).

Please contact us if you are unsure whether you can undergo an endoscopy based on your medical history. In order to ensure the safety of the examination and reduce the possibility of unnecessary risks, the HMC reserves the right to not conduct a gastrointestinal endoscopy.

Gastrointestinal Endoscopy and Low-residue Diet

According to the latest statistics from the Ministry of Health and Welfare, cancer ranks first among the ten leading causes of death in Taiwan, with colorectal cancer being one of the major types of cancer. An endoscopy is crucial for the early detection of colorectal tumors. The precancerous condition of colorectal cancer is a lesion known as a colorectal tumor or an adenomatous colorectal polyp. After five to ten years, a part of the polyp may result in colorectal cancer. A gastrointestinal endoscopy can not only be used to diagnose colorectal cancer, but can also be used to remove any adenomatous colorectal polyps detected during the process, thereby reducing the risk of colorectal cancer by 80%. The preparation for a gastrointestinal endoscopy directly affects the detection of colorectal tumors, with inadequate bowel emptying having a significant impact on detection and diagnosis. Therefore, we ask for your full cooperation with the following guidelines.　　

Food preparation for a gastrointestinal endoscopy

1. What is a low-residue diet?
A low-residue diet is a diet that reduces the amount of digested food residue in the gastrointestinal tract. The adoption of a low-residue diet before a gastrointestinal endoscopy enhances the effect of laxatives, prevents lesions covered by feces from being unobserved, and increases the efficiency of the endoscopy drugs.

2. Choice of foods
Please adopt a low-residue diet three days before a gastrointestinal endoscopy. Start with light foods and avoid high-fiber fruits and vegetables (pressed juice is acceptable). Also avoid irritating foods (such as deep-fried or pan-fried foods), milk, and dairy products. Please cook foods until they become soft. Choose meat with a tender texture, refined grains or processed legumes, and seafood (such as fish).

Types of Food in a Low-residue Diet

Dairy

None

Meat and fish

Skinned and trimmed tender meat such as minced, diced, or stewed lean meat and fish.

Eggs

Steam or boiled eggs are acceptable. Avoid deep frying and pan frying.

Legumes and legume products

Processed legumes such as soy milk, tofu, and tofu pudding.

Grains

Refined grains such as rice, porridge, noodles, and bread

Fruits

All types of pressed juice.

Vegetables

All types of pressed juice.

Fats

All kinds of plant and animal oils and their products. However, these foods should be light and not too oily.

Snacks

Cakes, biscuits.

Others

None
Dairy

All types of dairy products.

Meat and fish

Unskinned and untrimmed meat and fish; deep fried and pan fried meat and fish; and chicken gizzards and beef tendon.

Eggs

Fried eggs, poached eggs, and hardboiled eggs stewed for too long.

Legumes and legume products

Fried legumes and unprocessed legumes such as soybean, mung bean, and adzuki bean.

Grains

Whole grains such as rice bran, brown rice, wheat bran, oat, and corn; wholemeal bread, brown bread, and bran bread; root vegetables such as sweet potato and taro.

Fruits

Unpressed juice. High-fiber fruits such as apple, tomato, pear, grapes, mandarin, orange, mango, guava, persimmon, dragonfruit, jujube, pomegranate, watermelon, and kiwi. Processed fruits such as preserved fruits, dried persimmon, and dried mango.

Vegetables

The roots, stem, and withered leaves of vegetables; high-crude fiber vegetables such as bamboo shoots, celery, sponge gourd, pumpkin, seaweed, and seaweed sauce; uncooked vegetables such as cucumbers and raw salads.

Fats

Nuts such as cashew, peanut, walnut, almond, chestnut, and sesame.

Snacks

Fruits, walnut, shredded coconut, sesame, and biscuits, cakes, cake rolls, and pies that contain ingredients that should be avoided; overly oily snacks such as sachima, mung bean pastry, and eight treasures rice pudding.

Others

Irritating seasonings such as chili, garlic, pepper, and curry, as well as oily and heavily seasoned soups.

Recommended menu

Less than four grams of crude fiber intake per day

- Breakfast
  - One plain mantou (90g)
  - One hard-boiled egg
  - A glass of pressed juice (A small pack of fruit juice)
- Lunch
  - One bowl of plain noodles (520cc, without Chinese chives or beansprouts)
  - Chilled tofu (half a box of plain tofu)
- Dinner
Daily calories

Calories: 1620／Protein: 45／Fat: 38／Carbohydrates: 265／Crude fiber: 2.1

Notes
1. Serving sizes can be adjusted according to one's appetite.
2. Plain mantou, white bread, plain buns, plain rice, plain noodles, or plain porridge can be interchanged.
3. Please choose lean and tendon-free meat.
4. Pork can be replaced with fish, chicken, egg, and tofu.
5. If you have a chronic disease such as diabetes or if you have other requirements, please consult the Department of Nutrition for a recommended menu.
Reference for buying

low-residue foods Please refer to the contents and nutrition facts before purchasing.
1. Century egg porridge with lean meat (less vegetables)
2. Plain noodles (without Chinese chives/beansprouts)
3. Udon noodles (less vegetables)
4. Chilled tofu (without bonito flakes)
5. Japanese-style cold noodles (with a choice of sauce but without lettuce and fermented cucumber)
6. Plain mantou or bown sugar mantou
7. White bread
8. Residue-free (fiber-free) soy milk
9. Pressed fruit juice
10. Tea egg/egg custard
- Breakfast
  - One bowl of plain porridge
  - One piece of stewed tofu (half a box of plain tofu)
  - Two scoops of fish floss
  - 1/3 bowl of fried cucumber
- Lunch
  - One bowl of plain rice
  - A slice of steamed cod seasoned with onion
  - Half a bowl of marinated shredded chicken
  - 1/3 bowl of gingered winter melon
  - A cup of goji tea
- Dinner
Daily calories

Calories: 1560／Protein: 46／Fat: 33／Carbohydrates: 272／Crude fiber: 1.6

Notes
1. Serving sizes can be adjusted according to one's appetite.
2. Plain mantou, white bread, plain buns, plain rice, plain noodles, or plain porridge can be interchanged.
3. Please choose lean and tendon-free meat.
4. Pork can be replaced with fish, chicken, egg, and tofu.
5. If you have a chronic disease such as diabetes or if you have other requirements, please consult the Department of Nutrition for a recommended menu.
Reference for buying

low-residue foods Please refer to the contents and nutrition facts before purchasing.
1. Century egg porridge with lean meat (less vegetables)
2. Plain noodles (without Chinese chives/beansprouts)
3. Udon noodles (less vegetables)
4. Chilled tofu (without bonito flakes)
5. Japanese-style cold noodles (with a choice of sauce but without lettuce and fermented cucumber)
6. Plain mantou or bown sugar mantou
7. White bread
8. Residue-free (fiber-free) soy milk
9. Pressed fruit juice
10. Tea egg/egg custard
- Breakfast
  - Two slices of white bread
  - Two scoops of meat floss
  - One glass of soy milk with sugar (260cc)
- Lunch
  - A bowl of fish porridge (520cc)
  - Stewed bitter gourd
  - A glass of pressed juice (A small pack of fruit juice)
- Dinner
Daily calories

Calories: 1135／Protein: 45／Fat: 15／Carbohydrates: 205／Crude fiber: 1.4

Notes
1. Serving sizes can be adjusted according to one's appetite.
2. Plain mantou, white bread, plain buns, plain rice, plain noodles, or plain porridge can be interchanged.
3. Please choose lean and tendon-free meat.
4. Pork can be replaced with fish, chicken, egg, and tofu.
5. If you have a chronic disease such as diabetes or if you have other requirements, please consult the Department of Nutrition for a recommended menu.
Reference for buying

low-residue foods Please refer to the contents and nutrition facts before purchasing.
1. Century egg porridge with lean meat (less vegetables)
2. Plain noodles (without Chinese chives/beansprouts)
3. Udon noodles (less vegetables)
4. Chilled tofu (without bonito flakes)
5. Japanese-style cold noodles (with a choice of sauce but without lettuce and fermented cucumber)
6. Plain mantou or bown sugar mantou
7. White bread
8. Residue-free (fiber-free) soy milk
9. Pressed fruit juice
10. Tea egg/egg custard

Methods for Emptying Bowels for Colonoscopy

1. Time of laxative consumption

Take the laxative at 3 or 4 o'clock in the morning of the day of checkup, and please complete the procedure before 5 o'clock. Please do not drink anything after 5 o'clock (does not affect the blood test results).

2. Sleep

Rest early on the night before the checkup. Rise at 3 or 4 o'clock on the day of checkup to take the laxative, and then continue sleeping.

3. Bowel condition

Taking the laxative in the morning will initiate its effect immediately. Your bowels will be emptied around 6 o'clock. A colonscopy between 9 o'clock to 1 o'clock on the day of checkup generates the best results as the colon has the least amount of residue in the six to ten hours after it has been emptied.

4. Medication use
- Dissolve a pack of Niflec powder in 2000 c.c. of warm plain water.
- Consume 1000 c.c. of the solution within 30 minutes (those with difficulties may have an additional 30 minutes).
- Finish the second half of the solution within the next hour.
- In general, you will start to empty your bowels one after consuming the laxative.
- If you have frequent constipation or cloudy discharge, it is recommended that you drink more water, but no more than 2000 c.c. (do not drink more than 4000 c.c. of water).
- The bowel movement is completed when the discharge is transparent yellow.
- In order to ensure the quality of the procedure, please do not undergo a colonoscopy if you drank less than 1500 c.c. of water together with the laxative.
5.Bowel movement results

Early stage of colon cancer detected during screening

6. On the night before the checkup, please do not eat or drink anything after 12 o'clock (excluding the laxative).

7. It takes three to four hours to complete the bowel movements.

8. Stop taking the laxative immediately if you experience a fever or nausea. This may be an allergic reaction.

9. If you have a chronic disease (such as hypertension, heart disease, diabetes, asthma, etc.) or are on long-term medications, please stop taking those medications on the morning of the day of checkup (you may still use your inhaler). Please bring your medications with you as you may take them 60-120 minutes after the colonoscopy.

10. If you have any inquiries or if you feel any discomfort during laxative consumption, please call 0972-651004.
1. Time of laxative consumption

Take the laxative two to three hours (around 9 o'clock) after having dinner on the night before the checkup, and please complete the procedure before 11 o'clock. Please do not eat or drink anything after 12 o'clock.

2. Sleep

Take the laxative on the night before, which takes effect after one or two hours. However, this will easily interrupt your sleep.

3. Bowel condition

The bowel movement may not be complete since the optimum time has passed. In deep sections close to the small intestine, the colon is easily covered by feces and intestinal fluid. As a result, the covering of any polyps may affect the effectiveness of the examination, thus requiring one or two enemas during the day of checkup.

4. Medication use
- Dissolve a pack of Niflec powder in 2000 c.c. of warm plain water.
- Consume 1000 c.c. of the solution within 30 minutes (those with difficulties may have an additional 30 minutes).
- Finish the second half of the solution within the next hour.
- In general, you will start to empty your bowels one after consuming the laxative.
- If you have frequent constipation or cloudy discharge, it is recommended that you drink more water, but no more than 2000 c.c. (do not drink more than 4000 c.c. of water).
- The bowel movement is completed when the discharge is transparent yellow.
- In order to ensure the quality of the procedure, please do not undergo a colonoscopy if you drank less than 1500 c.c. of water together with the laxative.
5.Bowel movement results

Sections covered by feces will affect screening

6. On the night before the checkup, please do not eat or drink anything after 12 o'clock (excluding the laxative).

7. It takes three to four hours to complete the bowel movements.

8. Stop taking the laxative immediately if you experience a fever or nausea. This may be an allergic reaction.

9. If you have a chronic disease (such as hypertension, heart disease, diabetes, asthma, etc.) or are on long-term medications, please stop taking those medications on the morning of the day of checkup (you may still use your inhaler). Please bring your medications with you as you may take them 60-120 minutes after the colonoscopy.

10. If you have any inquiries or if you feel any discomfort during laxative consumption, please call 0972-651004.