Gastroenterology
What is a gastroenterologist?
A gastroenterologist is a specialist in the digestive system.
Gastroenterologists complete four years of medical school and three years of internal medicine residency, followed by a fellowship in gastroenterology. The rigorous fellowship takes two to four years to complete and ensures the physician is uniquely and highly qualified to diagnose and treat disorders of the digestive tract. The digestive system includes the 25-foot-long tube that processes food and nutrients, plus the liver, pancreas and gallbladder. These organs break down and absorb the food we eat so that the nutrients can be transported into the blood stream and delivered to cells throughout the body.
Appointments
Do I need a referral to schedule an appointment?
Your insurance may require a referral before your visit. Contact them to learn if this is necessary.
How do I make an appointment?
You can call one of our offices to make your appointment or your primary care physician may schedule one for you. Depending on which office you would like to be scheduled at please call:
- Portsmouth, NH: 603-433-2488
- Somersworth, NH: 603-692-2228
What are your hours?
Our hours are 8:00 am - 5:00 pm, Monday - Friday
What should I bring to my first appointment?
Bring a completed health history questionnaire (if one was mailed to you), a list of medications (including dose), and your insurance card. You should also bring cash, a check, or credit card to cover any visit co-payments.
How long will my first visit take?
The amount of time varies depending on the type and complexity of your problem. We value your time and try to run on time, but unexpected events sometimes cause delay.
Locations
Where are your offices located?
21 Clark Way, Route 108, Somersworth, NH 03878
330 Borthwick Avenue, Suite 311, Portsmouth, NH 03801
Insurance & Costs
Note—this information is intended as general guidance to help inform patients about this subject. Because of the large number of insurance plans we work with, it is not possible to address all questions here. You are ultimately responsible for checking with your insurance plan to determine your coverage and your personal responsibility for the cost of your care.
What insurance plans do you accept?
See our current plans at our insurance page.
How much will an office visit cost?
The specific amount of an office visit will vary depending on your insurance plan and the type of service you need.
For patients with insurance—Because of insurance company requirements, the amount that you will be responsible for can only be determined after your visit has been completed and documented, since it depends on a number of factors relating to the complexity of the care that is actually provided during the visit, and the benefits that your insurance plan provides. Most insurance plans require a co-payment (a co-payment is a specific amount which is collected at the time of the visit, and is typically the same for each visit). Some plans require a higher co-payment for specialty physicians, which we are. Co-payments must to be paid at the time of your appointment. The amount that you must pay will also depend on whether you have a deductible amount (a deductible differs from a co-payment, and is typically an amount that must be paid by the subscriber prior to the plan paying for benefits—today most insurance plans have a deductible). After your deductible has been met, some plans also have a co-insurance amount that must be paid by the patient (co-insurance means that the patient is responsible for a portion of the cost, even after the deductible amount has been met).
Will my insurance cover my procedure?
Most health insurance benefit plans cover routine colonoscopy screening procedures at 100% of their cost while diagnostic colonoscopy procedures and other procedures are subjected to a co-insurance and/or a deductible contribution(s) each calendar year.
While the physicians and staff of Atlantic Digestive Specialists are aware insurance benefits may differ depending on the outcome of your procedure, they are sometimes unable to predict whether your test will be a screening exam or a diagnostic test before the procedure. During the colonoscopy your doctor may take a sample of tissue from your colon this includes polyps. This sample will be sent to a lab for evaluation. The lab may have a separate charge for that evaluation.
You should contact your insurance company to determine what, if any, financial responsibilities you may incur from your health insurance plan prior to your procedure.
What will my colonoscopy procedure cost?
There is a physician fee from Atlantic Digestive Specialists which varies by procedure.
Will there be other charges?
Yes, there will also be a fee that is charged by the facility where your procedure is performed (either a hospital or an ambulatory surgery center), and they may also have additional charges (separate from Atlantic Digestive Specialists), from anesthesiology, and pathology. We do not have cost estimates for hospital, surgery center, pathology, lab or radiology services, and they may vary depending on where your procedure is done. You should contact the facility where your procedure is scheduled directly to determine these costs.
Will my insurance cover the removal of any abnormality my physician finds during my procedure?
If a polyp is found during your colonoscopy, testing will be done to determine if it is precancerous or cancerous. Depending upon the terms of your specific insurance policy, this may not be covered the same as just a screening. Please contact your insurance company for more information.
Procedures - Colonoscopy
What is the difference between a screening colonoscopy and a diagnostic colonoscopy?While there is no difference in what the physician does during a screening or diagnostic colonoscopy, how the insurance company treats the procedure for determining your share of the cost may vary depending on whether it is considered screening or diagnostic.
A patient is referred for a diagnostic colonoscopy when the following symptoms exist:
- Blood in stool/hemopositive stool
- Bleeding from rectum
- Iron deficiency anemia of unknown cause, confirmed by lab findings
- Change in bowel habits
- Persistent abdominal pain
- A previous colonoscopy that results in the finding of an abnormality in the colon
A procedure that is planned as a diagnostic colonoscopy will be considered as diagnostic (not screening) by insurance plans, and, depending on your plan, may result in a higher direct cost to the patient than a screening colonoscopy.
Do I need an office visit prior to my screening colonoscopy?
An office visit is generally not necessary prior to a screening colonoscopy and therefore is not typically covered by insurance. If you do decide to have an office visit prior to a planned screening colonoscopy, and your doctor determines you need a colonoscopy based on symptoms or history, it may no longer qualify as a screening colonoscopy.
Will my colonoscopy be painful?
You will be administered a sedative that usually makes the procedure painless.
What risks are associated with my procedure?
The risks will be reviewed prior to your procedure at your hospital or surgery center.
Like any invasive exam, colonoscopy has a number of potential risks, including bleeding that may require transfusion, a tear that my require surgery, kidney damage related to your preparation, reactions to medicines used to sedate you, and an inability to detect potentially serious abnormalities. These risks are small. Colonoscopy is generally a safe procedure. We believe the benefits far outweigh the risks.
Other procedures
How can I learn about other procedures?
See the site sections below:
Procedure Results & Findings
What if my physician finds a polyp during my procedure?
If a polyp is found during your screening test, it will be removed and a pathologist will perform a biopsy. A biopsy is the removal and microscopic examination of the polyp to establish a precise diagnosis.
Will I need another colonoscopy?
It depends on what was found during your first colonoscopy. If no polyps or only non-cancerous ones were found, you won’t need another one for 10 years unless you experience symptoms or your family history warrants more frequent exams.
Patients with Diabetes
How do I prepare for my colonoscopy and/or endoscopy if I have diabetes?
Procedures are often scheduled in the morning — consult your physician for specific instructions if your procedure is scheduled in the afternoon.
Follow a clear liquid diet that contains foods with sugar that are okay to drink.
Continue your blood sugar testing before your procedure; perform a test at home before leaving for your procedure and report the result to the nurse upon your arrival at the hospital.
If you are taking tablets that contain Metformin (Glucophage, Avandamet, Metaglip, Glucovance or generic forms of Metformin), discontinue the day before your procedure and resume the day after your procedure.
Other tablets for diabetes (including Glyburide, Glipizide, Actos, Avandia, Prandin, Starlix, Glyset, Precose) may be taken on the day and night before your procedure, but not on the morning of your procedure. Resume the tablets when you return home.
If you are taking long acting insulin (Lantus), do not stop it. If your long acting insulin is NPH, Lente, or Ultralente, take your normal dose the evening before, but only 2/3 your usual dose on the morning of your procedure.
If you are taking a rapid acting Insulin (Regular, Humalog, Novolog) do not take any the morning of procedure, unless blood sugar is above 200 mg/dl in which case take 1⁄2 usual dose.
If blood sugar is high before, during, or after the procedure, you may receive extra shots of insulin.
Patients Taking Medications
Can I take my heart, seizure, pain, anxiety, and antidepressant medication while prepping?
Yes, with a small sip of water.
Patients Taking Blood Thinners
How do I prepare for my colonoscopy or endoscopy if I take blood thinners?
Tell your physician about any blood thinner medication you take at your first appointment.
How To Make Your Prep as Comfortable as Possible
What do I do if I have not had a bowel movement after taking the recommended dosage?
Keep drinking clear liquids. Most people have a bowel movement after an hour; some people may take two hours or longer. If you have not had a bowel movement 2 hours after completing the evening dose of prep solution continue drinking clear liquids until you have a bowel movement. Stop drinking the bowel prep solution and contact our office if you experience distention or bloating, pain, or vomiting.
How do I prevent nausea during my prep?
Some people experience nausea during their prep. Chilling the prep beverage and drinking it slowly can help alleviate this.
How can I make my prep taste better?
- If the taste of your prep beverage is unpleasant to you:
- Add Crystal Light powder to it (no red or purple varieties)
- First suck on a Popsicle (no red or purple) to numb your tongue
- Chill the prep solution and use a straw
- Rinse your mouth with water or a mouthwash
- Place a spearmint lifesaver under your tongue
- Drink while holding your nose
