Endoscopic Ultrasound: How to Prepare

An Endoscopic Ultrasound (EUS) is a procedure for assessing and producing images of the digestive system with an endoscope. It is also used as a modality to treat certain gastrointestinal disorders through fine-needle aspiration (FNA). Follow along for an overview of EUS. 

When an Endoscopic Ultrasound is used

An EUS can help doctors determine the source of chest pain, abdominal discomfort, and other symptoms. It can also help them evaluate the extent of disease spread in your digestive tract, and evaluate findings from other diagnostics like MRIs or CT scans. It can help evaluate conditions including Barrett’s Esophagus, Lymphoma, and various cancers. 

There are many different therapeutic procedures that can be performed during an EUS. These include celiac plexus neurolysis (EUS-CPN), pseudocyst drainage, biliary drainage (EUS-BD) and liver biopsy. Each of these treatments has a unique set of steps involved. Below, we will take a look at some general steps and approaches involved with the various diagnostics and treatments performed through an Endoscopic Ultrasound. 

Preparing for an EUS

The way you need to prepare for an EUS depends on the specifics of the procedure and any therapeutic treatments in your case. In general, you often need to fast starting the midnight before the procedure. This helps empty your stomach. You may also need to discuss any medications you are taking with your doctor before the procedure. It is especially important to stop taking any blood-thinning medications leading up to the procedure. These medications can increase the risk of severe bleeding during the Endoscopic Ultrasound. If the EUS is being performed in the rectal area, you may need to undergo a cleansing routine to prepare your bowels. This usually consists of taking a liquid laxative and sticking to a liquid diet for a day before the procedure. 

During the procedure

On the day of your Endoscopic Ultrasound procedure, you will first go to a pre-op area where your medical information will be taken and you will be given an IV. You will also discuss sedation used during the procedure with an anaesthesiologist. 

Depending on the location in your GI tract that doctors will examine or treat, they will advance an endoscope through your mouth or a colonoscope through your anus. You will be on your left side and may be sedated as this happens. Your doctor will advance the scope to the site or sites of interest and then perform any diagnostics or treatments. This can include tissue biopsies, pain-relieving injections, pseudocyst drainage, and bile duct drainage, depending on your situation. Your doctor will be able to see your GI tract through a camera at the end of the scope, and will pass any necessary instruments through the scope to perform the procedure. Most EUS examinations take under an hour, but the exact time will vary depending on what diagnostics or treatments your doctor is administering. 

After an Endoscopic Ultrasound

After your procedure, you will go to a post-op area where you will recover from any sedation and be monitored for side effects of the procedure. Once you are recovered, your doctor will share results with you. Some biopsy results may take longer to return. Given sedation side effects, you should not operate machinery, drive, or make important decisions for 24 hours following the procedure. 

Endoscopic Ultrasounds have a relatively low risk for complications. If you underwent Celiac Plexus Neurolysis to provide pain relief for tumors, you may experience abdominal pain for a few hours and diarrhea for a few days. More rarely, bleeding, infection, and paralysis can occur. If you underwent Pseudocyst Drainage, there is a small risk of bleeding, infection, and pancreatitis. Additionally, in under one percent of cases, perforations occur, requiring surgery to repair. If you underwent Biliary Drainage, there is a 10-20% chance of mild complications associated with bile drainage. These include bleeding, infection, and bile leakage in the abdominal cavity. If you underwent a Liver Biopsy, complications are very rare, and include a small risk of bleeding and infection. In general, if you were sedated during your procedure, there are a few uncommon complications including aspiration, adverse reactions to sedative medication, and complications from lung and heart diseases. 

Our experienced team at GHP has years of experience performing Endoscopic Ultrasounds. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Endoscopic Mucosal Resection (EMR): An Overview

Endoscopic Mucosal Resection, or EMR, is a therapeutic technique that helps remove precancerous and early stage cancer lesions during an upper endoscopy or colonoscopy. This technique is a less-invasive alternative to surgery. Here’s what you need to know if you are preparing for an EMR.

When is an Endoscopic Mucosal Resection Used?

EMRs are used to remove abnormal tissues in the digestive tract. The procedure can help treat a variety of conditions including Barrett’s Esophagus, colorectal cancer, and colon polyps. This is a less invasive option than surgery for removing abnormal tissues in the digestive tract. While EMRs are often used to treat disease, your doctor may also collect tissue samples during the procedure. They can examine tissue they collect to determine a diagnosis and the scope of disease spread. 

Preparing for an EMR

There are several important steps you need to follow prior to an Endoscopic Mucosal Resection. Your physician will discuss each of these with you leading up to the procedure. First, you may need to stop taking certain medications. These include blood-thinning medications like aspirin, Plavix (clopidogrel), Xarelto (rivaroxaban), Lovenox (enoxaparin), Pradaxa (dabigatran), Coumadin (warfarin), and Eliquis (apixaban). Blood-thinners increase your risk of excessive bleeding during the procedure. Also, if you use insulin, you may need to adjust your dosage and timing before the procedure. Make sure you discuss all medications you use with your doctor. 

Additionally, you will need to follow a clear liquid diet the day before the procedure, and stay hydrated. You will also need to fast beginning the midnight before your procedure. For EMRs performed through a colonoscopy, you will also need to undergo a cleansing routine. This involves taking a liquid laxative the day before your EMR to prepare your bowels. 

During the procedure

EMRs are performed through either an upper endoscopy or a colonoscopy, depending on the location of the diseased tissue. When you arrive for your procedure, you will go to a pre-op area where nurses will take your medical information and place an IV. You will also speak with an anaesthesiologist about the sedation they will use for the procedure. 

You then will go to the procedure room and be connected to monitors that will measure your vitals during the EMR. You’ll be sedated at this point. If the procedure is done through an upper endoscopy, you will be placed on your left side and given a bite block so the endoscope can pass through your mouth safely. If it is done through a colonoscopy, you will also be placed on your left side so the colonoscope can pass through your anus and advanced into the colon. 

Your doctor will be identifying and removing lesions during the EMR. There are several ways to remove lesions. Your doctor may inject a liquid into the submucosal layer under the lesion, which acts as a pillow that lifts the lesion for easy removal. They may also use a suction or a rubber band to help lift the lesion. After the lesion is lifted, it will be captured with a snare and the removal site will be cauterized. The procedure takes around 20 to 60 minutes.  

After the Endoscopic Mucosal Resection

Following your EMR, you will move to a post-op area to recover from sedation and monitor for any complications. Once you have recovered, your doctor will talk to you about the findings and give you post-op recovery instructions. You should not drive or make important decisions for 24 hours following the EMR due to sedative effects. You should follow a clear liquid diet immediately following the procedure, and can later transition to bland foods and a more regular diet. 

Complications from an EMR are uncommon. This includes bleeding, which occurs in 5-10% of cases. Your doctor can usually stop bleeding during the procedure if they recognize it. However, bleeding can become severe if it is delayed and may require follow-up care. In other rare cases (1-2% of the time), perforation of the intestine can occur. This is often managed through antibiotics, bowel rest, and hospitalization. It may require surgery as well. Additionally, some patients have reactions to sedative medication in uncommon cases. Always contact your doctor if you have any severe symptoms like abdominal pain, a fever, or excessive rectal bleeding after the procedure, as they may indicate a severe complication. 

Our experienced team at GHP has years of experience performing EMRs. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Hemorrhoid Banding: What to Expect

Hemorrhoids are swollen veins in the lower rectum or anus. They can cause bleeding, itching, and pain. While most hemorrhoids resolve with home treatment, some can be harder to get rid of. There are several non-invasive treatments for hemorrhoids. In cases of highly symptomatic hemorrhoids, banding is one approach that can help. Here’s what you need to know about hemorrhoid banding.

When Hemorrhoid Banding is used

As mentioned above, in cases of highly symptomatic hemorrhoids, hemorrhoid banding (sometimes called rubber band ligation) may be used. These symptoms include severe pain, severe bleeding, prolapsing (protrusion through the anus), and hemorrhoids with blood clots. Hemorrhoid banding is a non-invasive, non-surgical procedure that cuts off the hemorrhoid’s blood supply. Eventually, the hemorrhoid falls off as a loss of blood supply.

Before the Procedure

In the days leading up to the procedure, your doctor may ask you to stop taking certain medications. These include ibuprofen, aspirin, or any other drug that makes it difficult for blood to clot. Your doctor may also perform some diagnostics prior to the procedure to identify the hemorrhoid and its state. This may include a physical examination, a rectal examination, a sigmoidoscopy, or an anoscopy.

During the Hemorrhoid Banding Procedure

The entire hemorrhoid banding procedure only takes about five minutes. During the procedure, your doctor will place a tube-like instrument in your anus so they can examine the hemorrhoid. They will then put a tight rubber band around the base of the hemorrhoid. This cuts off the blood supply. You may experience some discomfort during the procedure.

After the procedure

After your doctor performs the hemorrhoid banding, your doctor will advise you regarding recovery and may schedule a checkup or another appointment. You may need multiple bandings to remove a hemorrhoid. Hemorrhoids may take around a week to fall off after a successful banding procedure.

In the days following your procedure, you may have some difficulty with controlling bowel movements and passing gas. Fortunately, there are a few things you can do at home to help with this. For one, make sure you move your bowels right when you feel the urge to do so. Do not sit on the toilet for long periods of time, and don’t strain during bowel movements. To avoid constipation and straining, eat lots of fiber, stay hydrated, and exercise. Additionally, you should avoid heavy lifting for two or three weeks.

While serious complications are rare with this procedure, there are a few signs to look out for after your hemorrhoid banding. These include any signs of infection (like fever or chills), passing a lot of blood, having uncontrollable pain, having trouble urinating, and developing an aching feeling between the rectum and genitals. Call your doctor if any of these symptoms develop.

Our experienced team at GHP has years of experience performing hemorrhoid banding. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Breath Testing

Breath testing is a noninvasive method doctors can use to diagnose gastrointestinal conditions. Here’s what you need to know about breath testing. 

Breath Testing 

Breath testing gives doctors a noninvasive way to diagnose several conditions. They can analyze your breath to detect amounts of particular gases, making diagnosis quick and simple. Typically, there are a few pre-testing steps you will need to follow, including consuming particular liquids and avoiding certain activities before or during breath testing. The specifics for each type of breath testing are discussed in the following sections. 

Bacterial Overgrowth Breath Test

This test is used to figure out if there is too much bacteria growth in the small intestine. This sort of overgrowth can prevent your body from absorbing nutrients properly. In the day prior to this test, you will need to limit your consumption of slow-digesting foods like beans and pasta. You will also need to fast for 12 hours before testing, and should not sleep, smoke, or exercise vigorously directly before or during the test. Additionally, you should avoid chewing gum, having mints, using mouthwash, or brushing your teeth the morning of. Stop using probiotics for the two weeks leading up to testing as well. You need to reschedule the testing if you have been taking antibiotics within 48 hours. Finally, you may consume water up until the time of testing, but you can’t eat or drink during the test. 

During Bacterial Overgrowth Breath testing, you will first breathe into a small machine. Then, you’ll consume a lactulose solution (this may cause abdominal pain or diarrhea for some people). 90 minutes later, you will breathe into the machine again. Last, you will wait an additional 30 minutes and breathe into the small machine. 

Fructose Breath Test

Fructose testing helps determine whether you may have trouble absorbing fructose. Symptoms like gas, bloating, diarrhea, and cramping can be a sign of fructose malabsorption. Fructose is a sugar that is in many plants you may consume, like onions, artichokes, and pears.

Preparation for this test is similar to the aforementioned testing. The day before the test, you need to limit consumption of slow-digesting foods. Stop taking medications leading up to the test. You must fast for 12 hours before testing, and shouldn’t smoke, sleep, or exercise vigorously right before or during testing. Also, you should not chew gum, use mouthwash, brush your teeth, or have mints the morning of testing. You may consume water up until the time of testing, but you can’t eat or drink during the test. Finally, you should let your doctor know if you have taken antibiotics recently or if you have been having diarrhea. 

Three hours prior to the testing, you will need to consume 12oz of Coca-Cola. When you arrive for the test, you will breathe into a machine that will measure for hydrogen gas. You will breathe into the machine in 30 minute intervals for three hours. 

Pylori Breath Test

H. Pylori breath testing helps doctors detect the presence of H. Pylori bacteria in your stomach or small intestine. This bacteria can cause diseases and increase your risk of gastric cancer. Two common conditions associated with the bacteria are gastritis and gastric ulcers. 

To prepare for H. Pylori breath testing, you should stop taking proton pump inhibitors like Prilosec OTC or Nexium. These can lead to false readings. You will also need to stop taking antibiotics two weeks before testing. Additionally, you should stop taking Sucralfate, Pepto-Bismol, and Carafate. Finally, you will need to fast for the hour leading up to the test. 

During testing, you will first give a breath sample. Then, you will drink a Pranactin-Citric solution and give another breath sample 15 minutes later. 

Lactose Breath Test

Lactose breath testing helps diagnose lactose intolerance. This intolerance prevents you from being able to digest lactose (a sugar found in milk) properly. Common symptoms of this intolerance are bloating, gas, cramping, and diarrhea after consuming dairy products. 

Preparation for this testing is similar to preparing for a Bacterial Overgrowth or Fructose test. The day before testing, you will need to limit consumption of slow-digesting foods like beans and pasta. You also need to fast for 12 hours before testing, and should not sleep, smoke, or exercise vigorously directly before or during the test. Additionally, you should avoid chewing gum, having mints, using mouthwash, or brushing your teeth the morning of. You will need to be off of any antibiotics for two weeks before testing. You may consume water up until the time of testing, but you can’t eat or drink during the test. Tell your doctor if you have had any recent diarrhea, as this can affect testing. 

Three hours before the test, you will need to consume 12oz of skim or fat-free milk. During the test, you will need to drink a beverage with lactose. This can cause intolerance symptoms. After this, every fifteen minutes, you will blow into inflatable bags that will be tested for hydrogen levels. An elevated hydrogen level means that lactose is not digested properly. 

Our experienced team at GHP has years of experience performing breath testing. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

 

GI Luminal Stenting

GI Luminal Stenting is a procedure that inserts a stent in the GI tract to relieve obstruction. Here’s everything you need to know about the procedure. 

When it’s used

GI Luminal Stents can relieve obstructions in the GI tract. Obstructions are caused by numerous diseases, like GI cancers. They can cause blockages of food, fluid, and waste, and lead to symptoms like vomiting, nausea, and severe abdominal pain. This can be life-threatening in some cases. Surgery used to be the only option to relieve obstructions. Fortunately, stents now provide a less invasive method. 

Preparing for GI Luminal Stenting

To prepare for stenting, there are a few pre-operative steps you may need to take. For lower GI stenting, you will need to adhere to a cleansing routine leading up to the procedure. This consists of a liquid laxative you will take the day before the procedure, preparing your bowels. You will also be instructed to consume only clear liquids the day before, and drink lots of fluids in general. For upper GI stenting, you may be asked to stop eating the midnight before the procedure.

You will also need to discuss any medications you are prescribed with your doctor. It’s especially important to mention any blood-thinners you are taking. These increase the risk of excessive bleeding, and you will need to stop taking them before the procedure. Additionally, if you use insulin, you will need to adjust your dosage and timing leading up to the procedure. 

During the procedure

Directly before your procedure, you will go to a pre-operation area where nurses will place an IV and take your medical information. You will also talk with an anaesthesiologist about the sedation used during the procedure. Machines will monitor your vitals throughout the stenting procedure. 

Your doctor will place the stent by using an endoscope. Depending on if the stent is being placed in the upper or lower GI tract, an endoscopy or colonoscopy will first be performed to evaluate the area. Once the blocked section is examined, the stent will be placed through the endoscope. 

Stents are simply hollow tubes made of flexible wire that is tacked to a mesh. The stent will be advanced through the endoscope with a guide wire. When it is positioned, your doctor will expand the stent to help open the obstruction. 

After GI Luminal Stenting

You will go to a post-operation area following the procedure. There, nurses will monitor you for any signs of complications from the sedation or procedure. Once you are recovered, your doctor will discuss preliminary findings with you. Some findings (like those from biopsies) may take several days to come back. 

You shouldn’t drive, operate machinery, or make important decisions for 24 hours following the procedure due to potential lingering sedative effects. You should also follow a clear liquid diet for a few days following the procedure, eventually transitioning to a bland diet. You’ll formally receive all of these instructions before you leave. 

Complications from GI Luminal Stenting are rare. Perforation occurs in less than 5% of cases, and requires surgery to repair. Stents can also migrate on rare occasion. When this happens, patients experience obstruction symptoms again, and should contact their doctor to remove or replace the stent. 

Our experienced team at GHP has years of experience performing GI Luminal Stenting. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

 

Single Balloon Enteroscopy: A Closer Look

Single Balloon Enteroscopy is a procedure that allows doctors to examine the small intestine. Follow along for everything you need to know about the procedure.

When Single Balloon Enteroscopy used

A Single Balloon Enteroscopy is used to examine, diagnose, and treat diseases in both the upper and lower GI tract. The advantage of the procedure is that it gives access to the entire small intestine, which is around 20 feet long on average. Other procedures cannot provide reach to effectively examine or treat the small intestine. The Single Balloon Enteroscopy lets doctors get access and live imaging of parts of the GI tract that are otherwise inaccessible. This is important for examining sources of GI bleeding, taking biopsies, removing polyps or foreign objects, and enlarging strictures.

Preparing for the procedure

There are a few important pre-operative steps you need to take prior to a Single Balloon Enteroscopy. You will need to discuss any medications you are taking with your doctor. Certain blood-thinning medications can pose risks of excessive bleeding during the procedure. Additionally, if you take insulin, you may need to adjust timing and dosage leading up to the procedure.

You will need to adhere to a clear liquid diet the day before the procedure. You will also be asked to refrain from eating starting the midnight before the procedure. In addition to these steps, you will need to use a cleansing routine the day before your procedure. This entails a liquid laxative that clears and prepares your bowels for examination. Your doctor will give clear instructions for all of these important steps leading up to your Single Balloon Enteroscopy.

During Single Balloon Enteroscopy

On the day of your procedure, you will first check in to a pre-op area where nurses will place an IV and take medical information. You will also meet with an anaesthesiologist to discuss sedation during the procedure.

The procedure takes around 60-75 minutes total. Your doctor will use a balloon system consisting of a flexible endoscope with a camera, an overtube, and an attached inflatable balloon at the tip of the overtube. They first insert the endoscope down your throat and into your intestine (you will have a mouthguard to protect your teeth and the endoscope). They will inflate the balloon to anchor the overtube, and then advance the endoscope further into your small intestine. Cyclically, they can then deflate the balloon, advance the overtube, reinflate the balloon, withdraw the overtube to shorten and straighten your small intestine, and advance the endoscope further. This pleats the small intestine over the overtube, shortening the small intestine’s length.

The endoscope is also able to inflate your intestine, rinse it with water, and guide biopsy and cautery instruments. Since you will be sedated, given pain medications, and given a local oral anaesthetic, the procedure is pain-free.

After the procedure

Following the procedure, you will return to a post-op area to recover from sedation. Nurses will monitor you for potential complications. After recovery, your doctor will discuss findings with you, although some results for biopsies and polyp removal can take a few more days to be finalized). You should not drive, make important decisions, or operate machinery for 24 hours after the procedure due to sedative effects.

You may feel bloated for a few hours after the procedure, which is normal. There are few severe complications and risks associated with Single Balloon Enteroscopy. On rare occasions, the procedure can cause perforation, excessive bleeding, and complications from sedation. If you experience excessive rectal bleeding, severe abdominal pain, or a fever, contact your doctor immediately.

Our experienced team at GHP has years of experience performing Single Balloon Enteroscopies We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Radiofrequency Ablation: What You Should Expect

Radiofrequency ablation (RFA) is a procedure that utilizes radio waves to destroy diseased tissue. Here’s what you need to know if you are preparing for the procedure. 

When it’s used

Radiofrequency ablation can be used during an upper endoscopy to treat Barrett’s esophagus. People with Barrett’s esophagus have an increased risk of esophageal cancer, and RFA can eliminate this risk by destroying pre-cancerous tissue in the esophagus. Patients with both high and low grade dysplasia should almost always pursue radiofrequency ablation. It has an 80-90% success rate in removing Barrett’s esophagus long-term. There is a chance that Barrett’s can develop again after a successful procedure. However, repeat treatments are effective and often able to eliminate abnormal tissues entirely. 

Preparing for Radiofrequency Ablation

To prepare for RFA, your physician will discuss preoperative steps with you. First, you will need to talk to them about medications you are taking that could be a risk factor. For example, blood-thinning medications can increase the risk of excessive bleeding during the procedure. Additionally, if you use insulin, you may need to adjust dosage or timing leading up to the RFA. Your doctor will also ask you about any allergies to medications. You will be instructed to stop eating at midnight the day before the procedure. 

During the procedure

Before the procedure, you will be on an IV and will give your medical information in a pre-op area. An anaesthesiologist will then discuss sedation for the procedure. Then, you will go to the procedure room. Doctors will connect you to monitors that measure your heart rate, blood pressure, and blood oxygen levels.

Your doctor will perform radiofrequency ablation during an upper endoscopy. You will be on your left side. A bite block will be in your mouth to prevent damage to your teeth or the endoscope. You will be under sedation for the duration of the procedure. 

Your doctor will advance the endoscope into your esophagus and examine the Barrett’s esophagus. If they see any visible abnormalities, they may perform an endoscopic mucosal resection. This involves either injecting or banding any identified lesions and then using a snare device to capture, cut, and remove them. If this is not necessary, your doctor will perform RFA. They will inflate a balloon-catheter to make contact with the targeted area and apply heat energy for a second or so. 

After the Radiofrequency Ablation

Afterwards, you will wait in a post-op area where you can recover from the sedation while being monitored for any complications. Once you have recovered, your doctor will discuss their findings with you. Some results may take days or weeks to return. They will also give you information on any follow-up appointments. 

For the first 24 hours after the procedure, you should not drive or make important decisions due to sedative effects. Your doctor will also recommend a clear liquid diet for a few days following the treatment. 

Patients commonly feel some chest discomfort and have difficulty swallowing for a few days after the procedure. Your doctor will be prescribe medications to help with any pain or nausea. You will also need to take a proton pump inhibitor twice a day for 30 days. 

Complications

There are a few complications that can occur from the procedure. In around 6% of cases a stricture or narrowing of scar tissue develops in the esophagus. Doctors can treat this with dilation during an upper endoscopy. Another more rare complication is a tear in the esophagus, which occurs less than .02% of the time. 

Our experienced team at GHP has years of experience performing radiofrequency ablation. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Capsule Endoscopy: What You Need to Know

A Capsule Endoscopy is a procedure that allows doctors to examine the middle part of the gastrointestinal tract. Patients swallow a pill that contains a video camera, battery, and light source. The camera takes pictures as it travels through the GI tract, which allow doctors to examine the GI tract. 

Here’s what you need to know about the procedure. 

When it’s used

Capsule Endoscopies are used to examine the small intestine, which is not easily reached with other endoscopy procedures that involve passing an endoscope through the throat or anus. Specifically, the procedure can help doctors investigate causes of bleeding in the area, polyps, tumors, inflammatory bowel disease, and ulcers. 

Preparing for a Capsule Endoscopy

There are a few important steps to take to prepare for a Capsule Endoscopy. Your doctor will give you specific instructions leading up to the procedure. A cleansing routine is at the core of the preparations. You should stop eating and drinking 12 hours before the procedure, and may need to follow a clear liquid diet prior to that. You may also need to take a laxative to flush out your small intestine. All of this can help improve picture quality from the procedure. Additionally, you will need to discuss your medical history and medications with your doctor. 

During the procedure

The procedure begins with you swallowing the camera capsule with water. A monitor is attached to your abdomen to record images obtained from the camera. You are then able to leave the office and go about your day. Some restrictions apply as the camera records, like strenuous activity. 

As the camera in the capsule passes through your digestive tract, it will take thousands of color pictures. The images are saved and transferred to a computer, where they are then strung together into a video format. This is what your doctor will view to examine your digestive tract. Getting results back can take a week or two. 

After the Capsule Endoscopy

Around two hours after the procedure, you can start drinking clear liquids again. After four hours, you can have a light lunch or snack. The procedure is over after eight hours or when you see the capsule after a bowel movement, whichever occurs first. Since everyone’s digestive system varies, you may pass the capsule in a few hours or in a few days. At that point, you can remove the monitor, pack it up, and follow the equipment return instructions given by your doctor. You can flush the camera capsule. If you have not seen the capsule pass within two weeks, you should contact your doctor. 

Complications from a Capsule Endoscopy are rare. In some cases, the capsule can get stuck in the digestive tract, especially where there is a stricture from surgery, a tumor, or inflammation. Symptoms of obstruction include vomiting, abdominal pain, and unusual bloating. It’s important to recognize the signs of an obstruction early on. Contact your doctor if you experience any of these symptoms after the procedure. 

Our experienced team at GHP has years of experience performing Capsule Endoscopies. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

 

Preparing for an Upper Endoscopy

An Upper Endoscopy (EGD) is an outpatient procedure in which an endoscope is passed through the throat to examine the lining of the upper GI or digestive tract. There are a few things you should know about an EGD if you are preparing for one. Here’s an overview of the Upper Endoscopy: 

When it’s used

The Upper Endoscopy allows gastroenterologists to examine the upper digestive system. Doctors can use the procedure to diagnose or treat conditions affecting the stomach, esophagus, and duodenum (beginning of the small intestine). It can help determine the cause of digestive symptoms like vomiting, trouble swallowing, gastrointestinal bleeding, and abdominal pain. The procedure also allows doctors to collect tissue samples to test for specific conditions or diseases like anemia or cancer. They can even use the procedure to treat some conditions; doctors can clip off polyps, treat bleeding, remove foreign objects, and widen a narrow esophagus during the procedure. 

Preparing for an Upper Endoscopy

To prepare for an Upper Endoscopy, there are a few steps you need to take. Your doctor will discuss these with you. You should abstain from eating or drinking starting around six hours before the procedure. This is helpful because an empty stomach allows for a safer and more effective examination. Your doctor will give you specific guidance on timing for starting to fast, as it can vary case-to-case. 

Additionally, you should discuss any medications you are taking with your doctor. You may need to adjust the dosage of medication leading up to the procedure; in particular, blood-thinners can cause excessive bleeding during the procedure, so these should be addressed. If you take insulin, you will need to adjust your dosage or timing before the procedure as well. Last, you and your doctor will need to discuss any allergies to medication that you have. 

During the procedure

An Upper Endoscopy is an outpatient procedure, meaning that you will be able to leave the location of your procedure the same day it occurs. Directly before an EGD, you will enter a pre-op area where nurses will place an IV and record your medical history. An anaesthesiologist will also discuss how sedation will be used during the procedure.

After, once you have been taken to a procedure room, you will be connected to monitors that track your heart rate, blood oxygen levels, and blood pressure. You will be under sedation for the procedure’s duration, which takes around 10-15 minutes. During the procedure, a bite block is inserted in your mouth to prevent damage to your teeth or the endoscope. As you are on your left side, the doctor will pass the endoscope through your mouth and into your upper digestive tract. Depending on your situation, they will then examine, diagnose, or treat as needed. 

After the Upper Endoscopy

After an EGD, you are taken to a post-op room to be monitored for any potential complications. Your blood pressure, breathing, and pulse will be monitored for stability. Your doctor will discuss initial findings with you after you have recovered. Results from biopsies will take several more days to come back. Because of the sedative effects, you will need someone to drive you home. Additionally, you should avoid operating machinery or making important decisions for 24 hours. Your diet may return to normal, unless otherwise indicated by your doctor. It’s normal to feel gassy or bloated following the procedure, and mild cramping or sore throat is common for a brief time post-op. 

Though uncommon, there are some more severe complications to be on the lookout for following the procedure. If you notice tarry stools, severe abdominal pain, fever and chills, or difficulty swallowing after the procedure, contact your doctor immediately. These can be signs of complications like excessive bleeding from a biopsy, a perforated intestine, or a reaction to sedation. In general, these severe complications are very uncommon, and are far outweighed by the general safety and health benefits of an upper endoscopy. 

Our experienced team at GHP has years of experience performing EGDs. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

 

Colonoscopy: What to Expect

A colonoscopy is a procedure that allows a physician to examine a patient’s colon. Colonoscopies are often used to evaluate GI disorders and screen for colon cancer. Here’s what you need to know if you are preparing for a colonoscopy.  

When it’s used

There are a few reasons your doctor may recommend a colonoscopy. The procedure is commonly used as a screening tool for colon cancer, which starts from polyps in the colon. A colonoscopy can help your doctor examine your colon for any polyps and other warning signs of colon cancer. You may also need a colonoscopy if you have previously had polyps. In this case, your doctor will likely look for more polyps and remove any, as a preventative measure against colon cancer. Last, you may need a colonoscopy if you have any GI pain or distress that your doctor needs to identify and diagnose through examination. 

Preparing for a Colonoscopy

There are a few important pre-procedure steps you need to take leading up to a colonoscopy. You will be asked to adhere to a cleansing routine the day before the procedure. This typically consists of taking a liquid laxative the day before to empty your bowels, and switching to a clear liquid diet. You may be asked to drink plenty of liquids as well. Following the instructions on laxative use is a crucial step to properly prepare for the exam, so always be diligent in this regard. 

In addition to the cleansing routine, you should also discuss any medications you use with your doctor. You may have to stop use of some medications like blood-thinners prior to the procedure. This is because some of these medications can increase the risk of excessive bleeding. If you use insulin, you may need to adjust dosage and timing the day of the procedure. Your doctor will also want to know about any allergies to medication you have. 

What to Expect During the Procedure

A colonoscopy takes about 20-30 minutes in total. You will be sedated for the entire procedure, so there is no discomfort during it. Your doctor will monitor your heart rate, blood oxygen levels, and blood pressure throughout the process as well. During the procedure, your doctor will insert a colonoscope (a thin, flexible tube with a light and camera) in your anus while you lay on your side and advance it to the end of your colon. The camera and light allow your doctor to fully examine the colon lining. 

If your doctor sees anything they want to analyze further, they may take a small tissue sample (biopsy) for later analysis. In the case that they see any bleeding during the examination, they can feed instruments through the colonoscope to medicate, cauterize, or clip affected areas and control bleeding. If they find any polyps, they can use an instrument threaded through the colonoscope to remove them. None of these techniques cause discomfort during the procedure. 

After the Procedure

It typically takes around an hour to mostly recover from the sedation after a colonoscopy. As such, you should always have someone take you home afterwards. The effects can linger to an extent for the next 24 hours, so you should avoid driving, making important decisions, or working for that period of time as well. If any polyps were removed during the procedure, you may be prescribed a temporary special diet. It’s common to pass gas and feel bloated for a few hours after the exam. Walking can help ease some of this discomfort. 

You may see a small amount of blood in your stool during your first bowel movement post-procedure; this is not cause for alarm most of the time. However, if bleeding persists or you develop a fever or consistent bowel pain within a week or two of the procedure, you should contact your doctor. 

Our experienced team at GHP has years of experience performing colonoscopies. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.