- Upper Endoscopy
- DIRECT ACCESS COLONOSCOPY
- Flexible SIGMOIDOSCOPY
- SMALL BOWEL WIRELESS CAPSULE ENDOSCOPY
Upper GI endoscopy is a procedure that uses a lighted, flexible endoscope to see inside the upper GI tract. The upper GI tract includes the esophagus, stomach, and duodenum—the first part of the small intestine.
- Upper gastrointestinal (GI) endoscopy is a procedure that uses a lighted, flexible endoscope to see inside the upper GI tract.
- To prepare for upper GI endoscopy, no eating for 6 hours and no drinking for 2 hours before the procedure. Smoking and chewing gum are also prohibited.
- Patients should tell their doctor about all health conditions they have and all medications they are taking.
- Driving is not permitted for 12 hours after upper GI endoscopy to allow the sedative time to wear off. Before the appointment, patients should make plans for a ride home.
- Before upper GI endoscopy, the patient will receive a local anesthetic to numb the throat.
- An intravenous (IV) needle is placed in a vein in the arm if a sedative will be given.
- During upper GI endoscopy, an endoscope is carefully fed into the upper GI tract and images are transmitted to a video monitor.
- Special tools that slide through the endoscope allow the doctor to perform biopsies, stop bleeding, and remove abnormal growths.
- After upper GI endoscopy, patients may feel bloated or nauseated and may also have a sore throat.
- Unless otherwise directed, patients may immediately resume their normal diet and medications.
- Possible risks of an upper GI endoscopy include abnormal reaction to sedatives, bleeding from biopsy, and accidental puncture of the upper GI tract.
Upper GI endoscopy can detect
- abnormal growths
- precancerous conditions
- bowel obstruction
- hiatal hernia
When is upper GI endoscopy used?
Upper GI endoscopy can be used to determine the cause of
- abdominal pain
- swallowing difficulties
- gastric reflux
- unexplained weight loss
- bleeding in the upper GI tract
Upper GI endoscopy can be used to remove stuck objects, including food, and to treat conditions such as bleeding ulcers. It can also be used to biopsy tissue in the upper GI tract. During a biopsy, a small piece of tissue is removed for later examination with a microscope.
How is upper GI endoscopy performed?
Upper GI endoscopy is conducted at our Endoscopy Center.
During the procedure, patients lie on their back or side on an examination table. An endoscope is carefully fed down the esophagus and into the stomach and duodenum. A small camera mounted on the endoscope transmits a video image to a video monitor, allowing close examination of the intestinal lining. Air is pumped through the endoscope to inflate the stomach and duodenum, making them easier to see. Special tools that slide through the endoscope allow the doctor to perform biopsies, stop bleeding, and remove abnormal growths.
Recovery from Upper GI Endoscopy
After upper GI endoscopy, patients are moved to a recovery room where they wait about an hour for the sedative to wear off. During this time, patients may feel bloated or nauseated. They may also have a sore throat, which can stay for a day or two. Patients will likely feel tired and should plan to rest for the remainder of the day. Unless otherwise directed, patients may immediately resume their normal diet and medications.
Some results from upper GI endoscopy are available immediately after the procedure. The doctor will often share results with the patient after the sedative has worn off. Biopsy results are usually ready in a few days.
What are the risks associated with upper GI endoscopy?
Risks associated with upper GI endoscopy include
- abnormal reaction to sedatives
- bleeding from biopsy
- accidental puncture of the upper GI tract
Patients who experience any of the following rare symptoms after upper GI endoscopy should contact their doctor immediately:
Colonoscopy is a procedure used to see inside the colon and rectum. Colonoscopy can detect inflamed tissue, ulcers, and abnormal growths. The procedure is used to look for early signs of colorectal cancer and can help doctors diagnose unexplained changes in bowel habits, abdominal pain, bleeding from the anus, and weight loss.
- Colonoscopy is a procedure used to see inside the colon and rectum.
- All solids must be emptied from the gastrointestinal tract by following a clear liquid diet for 1 to 3 days before colonoscopy.
- During colonoscopy, a sedative, and possibly pain medication, helps keep patients relaxed.
- A doctor can remove polyps and biopsy abnormal-looking tissues during colonoscopy.
- Driving is not permitted for 12 hours after colonoscopy to allow the sedative time to wear off.
Routine colonoscopy to look for early signs of cancer should begin at age 50 for most people—earlier if there is a family history of colorectal cancer, a personal history of inflammatory bowel disease, or other risk factors. The doctor can advise patients about how often to get a colonoscopy.
How is colonoscopy performed?
Examination of the Large Intestine
During colonoscopy, patients lie on their left side on an examination table. In most cases, a light sedative, and possibly pain medication, helps keep patients relaxed. Deeper sedation may be required in some cases. The doctor The doctor inserts a long, flexible, lighted tube called a colonoscope, or scope, into the anus and slowly guides it through the rectum and into the colon. The scope inflates the large intestine with carbon dioxide gas to give the doctor a better view. A small camera mounted on the scope transmits a video image from inside the large intestine to a computer screen, allowing the doctor to carefully examine the intestinal lining. The doctor may ask the patient to move periodically so the scope can be adjusted for better viewing.
Once the scope has reached the opening to the small intestine, it is slowly withdrawn and the lining of the large intestine is carefully examined again. Bleeding and puncture of the large intestine are possible but uncommon complications of colonoscopy.
Removal of Polyps and Biopsy
A doctor can remove growths, called polyps, during colonoscopy and later test them in a laboratory for signs of cancer. Polyps are common in adults and are usually harmless. However, most colorectal cancer begins as a polyp, so removing polyps early is an effective way to prevent cancer.
The doctor can also take samples from abnormal-looking tissues during colonoscopy. The procedure, called a biopsy, allows the doctor to later look at the tissue with a microscope for signs of disease.
The doctor removes polyps and takes biopsy tissue using tiny tools passed through the scope. If bleeding occurs, the doctor can usually stop it with an electrical probe or special medications passed through the scope. Tissue removal and the treatments to stop bleeding are usually painless.
Colonoscopy usually takes 30 to 60 minutes. Cramping or bloating may occur during the first hour after the procedure. The sedative takes time to completely wear off. Patients may need to remain at the clinic for 1 to 2 hours after the procedure. Full recovery is expected by the next day. Discharge instructions should be carefully read and followed.
Patients who develop any of these rare side effects should contact their doctor immediately:
DIRECT ACCESS COLONOSCOPY
A Direct Access Colonoscopy is done on healthy patients. These patients do not come in for a pre-procedure visit, they will be sent info on all aspects of the procedure by mail, fax or internet. Patients who meet certain health related criteria qualify for this service.
Screening, or testing, is done while you are feeling well – to detect, or find, any abnormalities early, before signs and symptoms of disease occur. Screening for colorectal cancer allows for the early detection of cancer when it is highly curable, as well as the detection of growths, or polyps, that could become pre-cancer.
Colorectal cancer is the second leading cancer killer in the U.S., and 90% of colorectal cancer deaths are preventable.
We offer "Direct Access Colonoscopy" to healthy patients who are eligible for colorectal cancer screening. For your convenience, a separate consultation visit at the physician’s office is no longer required, saving you time, effort and money. In addition, we will schedule your colonoscopy at the date and time that best fits your schedule.
Direct access colonoscopy is for asymptomatic patients between 50 and 70 years old, who are in generally good health (as defined below), who have not been previously screened, or who were screened more than 10 years ago. Any patient who wishes to meet with the physician prior to the date of the procedure is encouraged to make a brief (15 minute) appointment, but those patients who do not feel it is necessary may call us and schedule a screening colonoscopy directly.
Please be aware that some insurance plans do not cover preventive health screenings. Patients covered by such plans will not have insurance coverage for the procedure unless it is being done to evaluate a specific medical condition/diagnosis. These patients will need to be seen in the physician’s office prior to their colonoscopy. HMO patients require pre certification and therefore, are not eligible for Direct access colonoscopy
Eligible patients should meet the following criteria:
• Age 50-70 (age 40-49 IF they have a first-degree relative with colon cancer at age 50 or younger)
• No previous problems with anesthesia or conscious sedation
• No anticoagulant/antiplatelet drugs (coumadin, plavix, etc.). Aspirin (even 81 mg) and gingko biloba should be stopped one week prior to the procedure to reduce the risk of bleeding. No valvular heart disease, including mitral valve prolapse (with murmur).
• No disease of the cardiovascular, pulmonary, hepatic, or renal systems requiring active medical treatment. No uncontrolled endocrine (e.g. diabetes) or psychiatric disease (includes active alcohol abuse).
• No chronic use of narcotics, benzodiazepines, or other sedatives.
• No gastrointestinal symptoms (a formal consultation in the physician’s office is indicated in patients with symptoms, although colonoscopy may eventually be part of the evaluation.
Anoscopy is a diagnostic test that is characterized by the insertion of a scope into the anus to view the inner lining of the rectum and anus directly. This is done to look for abnormal growths (like tumors or polyps), inflammation, bleeding, ulcers, hemorrhoids, piles.
How is Anoscopy performed?
A short rigid hollow tube called an anoscope is used to look into the anal canal. The tube has an in built light source and can help the doctor look at least two inches into the anal canal. This can be done at any time as it does not require any preparation like enema to empty the colon.
Anoscopy helps to detect problems related to the anus and rectum. It is usually performed to investigate symptoms such as bleeding from the rectum, chronic diarrhea, constipation, passage of blood or pus in the stools, or rectal pain. This procedure may be followed by surgical removal of polyps or piles and is then done every few months to monitor their growth. This can also be used as a screening test for inflammatory bowel disease and cancer of the rectum
Flexible sigmoidoscopy is a procedure used to see inside the sigmoid colon, (the last one-third of the colon.) and rectum. Flexible sigmoidoscopy can detect inflamed tissue, abnormal growths, and ulcers. The procedure is used to look for early signs of cancer and can help doctors diagnose unexplained changes in bowel habits, abdominal pain, bleeding from the anus, and weight loss.
- Flexible sigmoidoscopy is a procedure used to see inside the sigmoid colon and rectum.
- One or more enemas are performed about 2 hours before the procedure to remove all solids from the sigmoid colon.
- Nothing to eat 2 hours before the procedure.
- In some cases, the entire gastrointestinal tract must be emptied—similar to the preparation for colonoscopy.
- A sigmoidoscope transmits a video image from inside the colon to a computer screen.
- A doctor can biopsy abnormal-looking tissues during a flexible sigmoidoscopy.
- Polyps can be removed using special tools passed through the sigmoidoscope.
- If polyps or other abnormal tissues are found, the doctor may suggest examining the rest of the colon with a colonoscopy.
- A flexible sigmoidoscopy takes about 10 minutes.
Colonoscopy allows the doctor to see the entire colon. and is the preferred screening method for cancers of the colon and rectum; however, to prepare for and perform a flexible sigmoidoscopy usually requires less time.
How is a flexible sigmoidoscopy performed?
Examination of the Sigmoid Colon
During a flexible sigmoidoscopy, patients lie on their left side on an examination table. The doctor inserts a long, flexible, lighted tube called a sigmoidoscope, or scope, into the anus and slowly guides it through the rectum and into the sigmoid colon. The scope inflates the colon with air to give the doctor a better view. A small camera mounted on the scope transmits a video image from inside the colon to a computer screen, allowing the doctor to carefully examine the tissues lining the sigmoid colon and rectum. The doctor may ask the patient to move periodically so the scope can be adjusted for better viewing.
When the scope reaches the transverse colon, the scope is slowly withdrawn while the lining of the colon is carefully examined again.
Biopsy and Removal of Colon Polyps
The doctor can remove growths, called polyps, during flexible sigmoidoscopy using special tools passed through the scope. Polyps are common in adults and are usually harmless. However, most colon cancer begins as a polyp, so removing polyps early is an effective way to prevent cancer. If bleeding occurs, the doctor can usually stop it with an electrical probe or special medications passed through the scope.
During a flexible sigmoidoscopy, the doctor can also take samples from abnormal-looking tissues. Called a biopsy, this procedure allows the doctor to later look at the tissue with a microscope for signs of disease.
Tissue removal and the treatments to stop bleeding are usually painless. If polyps or other abnormal tissues are found, the doctor may suggest examining the rest of the colon with a colonoscopy.
A flexible sigmoidoscopy takes about 10 minutes. Recovery takes about 5-10min. Cramping or bloating may occur during the first hour after the procedure. Bleeding and puncture of the large intestine are possible but uncommon complications. Discharge instructions should be carefully read and followed.
Patients who develop any of these rare side effects should contact their doctor immediately:
The capsule endoscope, utilizes a wireless video camera, small enough to swallow, to perform painless endoscopic imaging of the small intestine. The capsule contains a camera, light source, radio transmitter, and battery. Patients can simply swallow the capsule and the camera takes and transmits about two images per second as it travels the entire length of the gastrointestinal tract. Thousands of video images are transmitted by sensors attached to the patient’s abdomen. These images are stored on a data recorder worn by the patient and later downloaded onto a computer for viewing by the physician.
WHY IS CAPSULE ENDOSCOPY OF THE SMALL BOWEL PERFORMED?
Capsule endoscopy assists in diagnosing gastrointestinal conditions such as bleeding, malabsorption, abdominal pain, tumors, Crohn’s Disease, infectious enteritis, celiac sprue and drug-induced ulceration. Capsule endoscopy can help your physician determine the cause for recurrent or persistent symptoms such as diarrhea, bleeding or anemia. In certain chronic gastrointestinal diseases, this method can also help to evaluate the extent to which your small intestine is involved or monitor the effect of therapy. The physician can also use capsule endoscopy to obtain motility data such as gastric or small bowel passage time.
WHAT CAN I EXPECT DURING CAPSULE ENDOSCOPY?
When the patient arrives, the procedure will be fully explained, a consent form signed and instructions for the day’s activities will be given. The patient will then have the sensor leads attached to the abdomen and a halter belt will be put on which holds the data recorder. The capsule is swallowed with a glass of water and the patient is then free to leave and pursue their regular activity. The patient is then instructed on dietary guidelines for the day and what time to return the same afternoon. Upon completion of the allotted time the patient will return to our office and the halter and the sensors will be removed and the patient is free to go. Results of the capsule endoscopy will be available within seven to ten days.
A rare complication is that the capsule stays in the small intestine rather than being expelled with stooling. You will need to have an X-ray about a week later to determine if the capsule has finally passed.