Health Check-up Guide

General Instructions Colonoscopy Medication Guide CT Scan Coronary CT Angiography MRI Scan Blood Test/Hair Mineral Analysis

Preparation for the checkup

For patients with a scheduled health check-up

Please complete the Medical Questionnaire by the day before your appointment.

Refrain from excessive stress and do not drink alcohol preferably 2 to 3 days prior to the checkup.

If you are scheduled for a colonoscopy, please confirm receipt of the delivery package containing the bowel preparation medication and detailed instructions.

For patients scheduled for a sedated endoscopy (conscious sedation)

Driving is not permitted on the day of the procedure due to the effects of sedation.

As recovery time may vary depending on the individual, accompaniment by a guardian or companion is strongly recommended.

It is advisable to rest for the remainder of the day after the examination. Please adjust any important appointments or work-related schedules in advance.

Instructions for the Checkup

A day before the checkup(D-1)

Please have a light breakfast consisting of low-fat foods.

Refrain from drinking alcohol, excessive stress or strenuous exercise and get enough sleep.

· Patients scheduled for a colonoscopy should refer to the separate examination instructions provided.

· From 12:00 a.m. (midnight), please observe complete fasting, including water, chewing gum, and smoking.

※ However, patients who have previously undergone gastric surgery may drink water only after lunch, and must observe complete fasting (including water) from midnight.

Please collect a stool sample on the day before the examination and bring it in the provided container.

· Patients scheduled for a colonoscopy should collect the sample before taking the bowel preparation medication.

※ After collection, store the sample in a cool place and bring it with you on the day of your appointment.

· Collect your stool sample (5 g; the size of a kidney bean) in the container

On the checkup day (D-day)

If you take anti-hypertensive drugs or anti-convulsant drugs, bring the medication with you or take them with a small sip of water.

If you wear glasses or contact lenses, please bring them with you.

Please do not wear jewelry or other valuable items (necklace, earring, Cartier bracelet, ring, piercing, etc).

Instructions for Women

· Please do not schedule your medical checkup during your menstrual period as menstruation may interfere with the gynecological exam and urinalysis.
· Radiographic examinations can affect the care of the fetus and are not to be done during pregnancy.
· If you are pregnant or if you think you might be, inform our staff.
· If you are scheduled for cervical cancer screening, refrain from using vaginal tablets, engaging in sexual intercourse, or using vaginal douche for 3 days prior to the exam.
· Mammograms are not recommended for breastfeeding women.

Guide to medication(Applicable to All Exam Patients, Including Those Undergoing Upper Endoscopy)

· Healthy individuals without a history of conditions like myocardial infarction, angina, ventricular fibrillation, or cerebrovascular diseases (stroke) who are taking aspirin for primary prevention should stop taking aspirin 7 days prior to the examination.
· The following patients should consult with their prescribing doctor about the use of medication before the examination, as there may be an increased risk of bleeding after biopsy during upper and colonoscopy or polypectomy.

Patients with a history of myocardial infarction, angina, cerebrovascular diseases (stroke), or similar conditions who are taking aspirin or antiplatelet drugs (e.g., ticlopidine, clopidogrel, dipyridamole, Pletal) for secondary prevention

Patients with a history of ventricular fibrillation, heart valve disease, or embolism who are taking anticoagulants (e.g., Coumadin, Warfarin)
· Patients taking antihypertensive or anticonvulsant medications are advised to take their medication with a small amount of water at 6:00 a.m. on the day of the examination.

Be sure to check if you are taking any antiplatelet medications, such as aspirin.
(Examples: Aspirin, Astrix, Plavix, Pletal, Anplague, Warfarin, Trental, Trombit, Xarelto, Pradaxa, Eliquis, Lixiana, Yuyucreed, Disgren, Persantine, Ibustrin, etc.)
· Patients taking diabetes medication or insulin injections should discontinue the medication and injections starting from the fasting period.

If you are undergoing a CT scan with contrast,Metformin (a diabetes medication)should not be taken for at least 48 hours before and after the test.
(Examples: Diabex, Diabex XR, Glupa, Glucophage, Glucovance, SugarMet, Grimmel, Gabes, JanuMet, Glavis, Glumet, etc.)
· If you are taking Phentermine-based diet medications (e.g., Dietamin, Qsymia), please discontinue the medication 7 days before the examination.
· If you are using injectable weight loss medications such as Wegovy, Saxenda, or Trulicity, please discontinue the medication 1 month before the examination.

Guidance on Colonoscopy

It is a test designed to directly observe the internal aspects of large intestine through monitor images by inserting flexible electronic endoscope with lens and light source attached to the end of thin and flexible tube with diameter of approximately 1.2cm into anus. It is the most accurate test for diagnosis of diverse range of lesions of large intestine including colorectal cancer, colon polyp, colitis and hemorrhoids, etc. In addition, it has the advantage of making pathohistological diagnosis by performing biopsy at the area of lesion immediately if needed.

· Prior to the insertion of the endoscope, medications to suppress bowel movement and relieve abdominal discomfort (such as sedatives and analgesics) are administered via injection.
· During the examination, air is insufflated into the colon to allow for detailed observation. This may cause abdominal bloating, discomfort, or intermittent abdominal pain, but these symptoms usually resolve naturally within a few hours after the examination.
· The procedure typically takes 15–30 minutes, but the duration may vary depending on the presence, number, and condition of any lesions or polyps.

Prior to the test

· Patients taking antihypertensive medications or anticonvulsants should take their medication early in the morning on the day of the examination with a small amount of water.
· Patients using insulin should not inject insulin starting from the evening before the examination. Oral diabetes medications should also be discontinued from the evening before. To prevent hypoglycemia, please prepare candy, chocolate, or orange juice on the day of the examination.
· As polypectomy may be performed on the day of the examination, patients taking anticoagulants (e.g., Warfarin/Coumadin) or antiplatelet agents (e.g., Aspirin, Plavix) should consult their prescribing physician and discontinue these medications at least 7 days prior to the examination.
· Please inform us in advance if you have diabetes, glaucoma, asthma, benign prostatic hyperplasia, or arrhythmia.
· If you have any other medical conditions (including heart, respiratory, liver, kidney diseases, or allergies), please notify us in advance at the time of reservation.
· From the evening before the examination until the morning of the test, you will pass watery stools, and on the day of the examination, passing clear liquid similar to urine is normal. Please do not be alarmed.
· Patients undergoing sedated colonoscopy are not allowed to drive on the day of the examination. Please be accompanied by a guardian or use public transportation.
· If bowel preparation is insufficient, a repeat examination may be required depending on individual circumstances.

After the test

· You may feel inclination for stool or pain due to injection of air during the test. It is recommendable to discharge gas by massaging the lower abdomen while seated on the toilet or while walking . Placing heat pad on the abdomen could also be helpful.
· Please be careful of having foods that are spicy or strong-tasting. Overeating on the day of the test could induce abdominal pain.
· If you experience severe abdominal pain, persistent blood in your stool, or large amounts of black stool after the colonoscopy, please immediately visit the nearest emergency room or contact Chaum's main office for further assistance.
· Please do not take flight for 7 days after polypectomy.

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Bowel Preparation Instructions

Diet Restrictions 3days Before Colonoscopy

Foods to avoid	Foods You Can Eat
Fruits with seeds and skins (e.g., strawberries, watermelon, cantaloupe, grapes, kiwis) Mixed grain rice, black rice, brown rice, sesame seeds Seaweed (e.g., miyeok, dashima, gim) Bean sprouts, ferns, spinach, and other leafy vegetables Vegetable salads, mushrooms, kimchi, and chili seeds	White rice, plain rice porridge (juk) Eggs, tofu, jelly, potatoes Fish Clear juices, milk, and soft foods Avoid overeating.

Tip

· If dietary restrictions are not properly followed, residual stool may significantly reduce the accuracy of the examination.

※ In severe cases, the colonoscopy may fail, requiring re-taking the bowel preparation and repeating the examination.
· Please check your scheduled examination time and strictly adhere to the recommended timing for taking the bowel prep.

※ For patients who have undergone gastric surgery, only water is allowed after lunch, and complete fasting (including water) must be observed from midnight

Category	Examination
Early Morning	07:30 ~ 09:00
Late Morning	09:30 ~ 11:30
Afternoon	13:30 ~

Cleanview Olsan Orapang

Guide to medication

Examination Start Time		Bowel Prep Medication Time		Instructions Before the Exam
Examination Start Time		1st dose	2nd dose	Instructions Before the Exam
Morning/Late Morning	07:30 ~ 12:00	Day before, 8:00 PM	On the day, 5:00 AM	· Breakfast: Plain porridge, no side dishes · Lunch: Plain porridge, no side dishes · Dinner: No food
Afternoon	13:30 ~	On the day, 5:00 AM	On the day, 8:00 AM	· Dinner: No food

1st Dose

1
Pour A, B and 500ml of water In the bottle and shake well.
2
Slowly take 500ml of hte prepared solution for 30minutes.
3
Additionally drink atleast 1L of water. Stay hydrated by drinking extra water.

Summary Cleanview 500ml Water 1L

2nd Dose

1
Pour A, B and 500ml of water in the bottle and shake well.
2
Slowly take 500ml of the prepared solution for 30 minutes.
3
Additionally drink at least 1L of water. Lastly, take Endocol and begin fasting(not even water.)

Summary CleanViewal 500ml Water 1L Endocol

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Guide to medication

Category		Bowel Prep Medication Time		Instructions Before the Exam
Category		1st dose	2nd dose	Instructions Before the Exam
Morning	07:30 ~ 08:30	Day before, 8:00 PM	On the day, 4:00 AM	· Breakfast: Plain porridge, no side dishes · Lunch: Plain porridge, no side dishes · Dinner: No food
Late Morning	09:00 ~ 12:00	Day before, 8:00 PM	On the day, 5:00 AM
Afternoon	13:30 ~	Day before, 10:00 PM	On the day, 9:00 AM	Dinner: Plain porridge, no side dishes

1st dose

1
Drink one cup of water before taking the medication.
2
Prepare 14 Orapang tablets. Take them slowly with water, one by one or in small groups.
3
Drink 1 liter of water slowly over the course of one hour.

Summary 1 cup of water 14 Orapang tablets 1L of water

2nd dose

1
Drink two cup of water before taking the medication.
2
Prepare 14 Orapang tablets. Take them slowly with water, one by one or in small groups.
3
Drink 1 liter of water slowly over the course of one hour.

Summary 2 cup of water 14 Orapang tablets 1L of water

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What is a CT Scan?

A CT(computerized tomography) Scan combines a series of X-ray images taken from various angles to obtain cross-sectional images of the body. The CT scanner is an open ring-like structure that rotates around the body.

It can provide more detailed information than plain X-rays and help to diagnose disorders at early stage, detect structural abnormalities, and monitor the effectiveness of certain treatments.

· The duration of the procedure will be about 5 to 15 minutes on average. Depending on the part of your body that is being inspected, it may take longer.

· You will be instructed to lie comfortably on the scanning table.

· For chest and abdomen CT, you will be given specific breathing instructions.

· The decision of whether or not to use the contrast agent is dependent on the type of condition present in the patient and the goal of the CT scan.

Prior to the test

· You will experience localized feeling of warmth when contrast agent is administered during CT. Other mild side effects include vomiting, rash, itching, flushing, coughing, hoarse voice, runny nose, skin spots, and temporary shortness of breath.

Hypersensitivity reaction rarely leads to death. Contrast agent-related mortality is reported to vary from about 1/30,000~1/100,000.

Please inform our staff if you experience any of these symptoms. Our staffs are trained to respond appropriately to the possible side effects.
· Do not eat or drink anything for at least 6 hours prior to the test.
· If you take blood pressure medication, take it as prescribed with a small sip of water.
· Do not take diabetic pills or insulin while fasting to prevent hypoglycemia.
· If you take Metformin (Diabex, Diabex XR, Glucophage, Glucophage XR, Fortamet, Glumetza, etc), withhold your medication 48 hours before and after the exam.
· If you have asthma, you are likely to be experience dyspnea related allergic reaction. Please bring your inhaler to your appointment.
· The contrast agent is flushed out in urine by the kidneys. After the exam, drink at least 1.5 L of fluids or eat water-rich food to help excrete the contrast material from your body.

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What is a Coronary CT Angiography?

A Coronary CT Angiography* is an imaging test that looks at the arteries that supply blood to your heart.

The images generated during the scan are reformatted to create three-dimensional (3D) images.

* The coronary arteries deliver blood to the heart, providing a continuous supply of oxygen and nutrients. When plaque builds up, it narrows or blocks coronary arteries. Decreased blood flow to the heart may cause chest pain (angina), myocardial infarction, or other types of coronary artery diseases.

Prior to the test

· Because the heart is always beating, we need to stabilize your heart rate to get clear images. You will be given medication before the scan; please wait until the medicine takes effect before we begin the procedure.

If the heart rate cannot be controlled below 65 beats per minute, or if arrhythmia causes irregular heartbeats, it may be difficult to assess narrowing, and the exam may not be possible. (Response to the medication may vary by individual.)

If the heart rate cannot be controlled or arrhythmia is present, there are limitations to the exam.

Patients with asthma who may be at risk from heart rate–controlling medications may have restrictions on undergoing the exam.

Patients with coronary stents may have restrictions for the exam.

If a significant amount of calcification is observed during the calcium scoring part of the exam, there may be limitations.
· Blood vessels smaller than 2 mm in diameter may not be visible on the images.
· When a contrast agent is injected through a vein in the arm, you may experience a brief warm sensation, a slight odor of the contrast, or dizziness. Do not be alarmed; staying calm helps obtain high-quality images.

※ Patients with hypersensitivity to CT contrast agents cannot undergo the exam.
If you are taking diabetes medication containing Metformin, you must stop the medication 48 hours before and 48 hours after a contrast-enhanced exam.
(Examples: Glucophage, Glufazone, Diabex XR extended-release tablets)

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What is an MRI Scan?

An MRI(Magnetic Resonance Imaging) is a test using magnetism and radio waves to produce high resolution images of certain body structures. Inside the circular magnet tube, a strong magnetic field aligns the protons of hydrogen atoms, which are exposed to a beam of radio waves.

Then, the various protons of the body produce a signal, which is later processed by a computer. An MRI accurately and harmlessly detects structural and functional abnormalities, and pathological information for medical diagnosis and treatment.

· The procedure will last for about 40 minutes.

· You will be instructed to lie comfortably on the scanning table.

· For abdomen MRI, you will be given specific breathing instructions.

· A headphone will be provided to minimize the loud noise during the test.

· Certain MRI scan may require the use of a contrast agent given intravenously to assist in visualizing certain structures in the body more effectively.

Prior to the test

· Please do not eat or drink for at least 6 hours prior to the test.
· Confirm whether a contrast agent will be used.
· MRI involves the use of an extremely powerful magnet and requires precaution. You must inform our staff prior to the scan if you have metal implants or objects.

Heart Pacemaker Contraceptive device (IUD) Hearing aid 24-hour EKG (Holter) Metal joint replacement Claustrophobia Insulin Pump Continuous Glucose Monitor Cerebral aneurysm clip Carotid artery clip Dental Prosthesis, Dentures

After the test

· You may experience mild side effects to contrast agent such as rash and itching. Please inform our staff if you experience any of these symptoms. Our staffs are trained to respond appropriately to the possible side effects.

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Guide to Blood Test

· Do not eat or drink for 8 hours.
· Early morning testing is required to check hormone levels.
· Bruising may occur at the needle site, but it will gradually disappear.
· Avoid strenuous activity, and remove the pressure bandage carefully, as strong adhesion may damage the skin.

Guide to Hair Mineral Analysis

· Hair sample will be taken from the root of the hair.
· Hair sample must be of virgin hair. If you had hair bleach, hair dye, perms or any other chemical hair treatment within 2 weeks, sample can be taken from the body.
· Using hair spray, hair gel, or other hair products will not affect your results. Hair sample must be of virgin hair. If you had hair bleach, hair dye, perms or any other chemical hair treatment within 2 weeks, sample can be taken from the body

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