Procedures

Colonoscopy

To examine the colon, or large intestine, a colonoscopy is performed on an outpatient basis. The colon is approximately five to six feet in length and has numerous functions. This procedure aids doctors in diagnosing cancer, polyps, colitis and other serious disorders. Prior to the procedure, the patient will receive instructions on how to clean and empty the colon. This generally consists of a special solution, laxatives or enemas followed by a clear liquid diet until the colonoscopy is performed. The patient will receive a mild sedative to reduce discomfort.  A colonoscope
is gently passed through the anus and into the colon, so the doctor may view images on a monitor. Other procedures, such as a biopsy and removing polyps, can be performed during a colonoscopy, if necessary. Following the procedure, you may experience some slight cramping in your abdomen. This will generally subside within an hour.  Colonoscopy results are immediate, while other procedures performed during the colonoscopy may take up to two weeks to obtain results.

Flexible Sigmoidoscopy

This 10 to 20 minute procedure allows your physician to examine the inside of the large intestine from the anus through the last part of the colon, also known as the sigmoid or descending colon. Doctors may use flexible sigmoidoscopy, to determine the cause of diarrhea, abdominal pain, constipation or look for signs of cancer. Your doctor will insert a short flexible, lighted tube, called a sigmoidoscope, into your anus and gradually guide the tube into the colon.  The scope of the instrument produces an image of the inside of the anus and colon, enabling the doctor to see bleeding, inflammation, abnormal growths or ulcers. If any abnormalities, such as a polyp are found, your physician can remove a piece of it by using instruments inserted into the scope. You may feel pressure and slight cramping in your lower abdomen during the procedure.

Prior to the procedure, the patient will receive instructions on how to clean and empty the colon. This generally consists of a special solution, laxatives or enemas followed by a clear liquid diet until the sigmoidoscopy is performed. Possible complications include bleeding and puncture of the colon. However, these complications are rare.

Upper Endoscopy (EGD)

If you have pain in your upper abdomen, swallowing difficulty, nausea or vomiting, an upper endoscopy may help your doctor diagnose your symptoms. Your doctor will pass an endoscope through your mouth and into your upper gastrointestinal tract. An endoscope consists of a thin, flexible tube with a small light and camera lens, which allows your doctor to view images of your upper GI, including the stomach, esophagus and duodenum. Prior to the procedure, the patient will receive instructions when to stop eating to prepare for the procedure.  The doctor will review your medications and allergies. A local anesthetic or sedative may be given to ease discomfort. You may feel slight soreness in your throat and bloating following the procedure, but these side effects will soon subside. EGD results are immediate, while pathology results may take up to two weeks to obtain results.

ERCP – Endoscopic Retrograde Cholangiopancreatography

ERCP can be useful in treating and diagnosing problems associated with the GI tract. The GI tract includes the stomach, lower intestine and other parts of the body linked to the intestine, such as the liver, pancreas and gallbladder. Your physician will pass a thin, flexible tube with a tiny video camera and light on the end, known as an endoscope, down your throat, into the esophagus, through the stomach and into the duodenum. The duodenum is a part of the small intestine. This procedure may be helpful when there is a blockage of the bile ducts by gallstones, tumors or scarring. Bile, a substance produced by the liver, is important in the digestion and absorption of fats. Bile is carried from the liver through a system of tubes, known as bile ducts.  Depending on the individual, ERCP can be done as an outpatient procedure or may require hospitalization. During the procedure, you may feel drowsy from the sedative, but will remain awake and able to cooperate. Patients should not feel any pain, but may feel a sense of fullness because air might be introduced to help advance the scope. You should not eat or drink anything for at least six hours, prior to the ERCP or after midnight if the procedure is scheduled first thing in the morning. Patients should inform the doctor of all current medications, including aspirins, aspirin containing drugs or blood thinners. Be sure to tell your physician about any allergic reactions to drugs, especially antibiotics or pain medications.  ERCP does have a five to ten percent risk of complications, such as inflammation of the pancreas. Following the procedure, you may feel drowsy. Patients experiencing bleeding from the rectum, severe abdominal pain, dizziness or any other problems should consult the doctor

EUS – Endoscopic Ultrasound

This minimally invasive procedure combines endoscopy with ultrasound. It can be used to diagnose chronic pancreatitis and esophageal, stomach and rectal cancers. It can also be used to treat abdominal pain associated with chronic pancreatitis and pancreatic cancer.  An ultrasound transducer is placed at the end of an endoscope and advanced into the intestine. A transducer is a device that receives a signal in the form of one type of energy and converts it to another form.

The ultrasound transducer produces a high-resolution image of the gastrointestinal lining and other structures located beyond the gastrointestinal wall. Complications such as perforation are rare. The patient should not eat or drink anything for at least 6 hours prior to the procedure.