- Percutaneous endoscopic gastrostomy
- Flexible sigmoidoscopy
- Colonoscopy and ileoscopy
- Endoscopic sclerotherapy
- Endoscopic band ligation
- Endoscopic polypectomy
- Endoscopic diathermy
- Balloon dilation of gastrointestinal strictures
- PillCam small bowel capsule endoscopy
- Radiofrequency Ablation with HALO-360 & HALO-90
- Endoscopic retrograde cholangio-pancreatography
- Endoscopic biliary stenting for major or minor papilla
- Endoscopic biliary papilla and stricture dilation
- Endoscopic sphincterotomy for biliary papilla
- Biliary stone removal
- Biliary stones mechanical lithotripsy
About Upper Endoscopy
What is Upper Endoscopy?
Upper endoscopy lets your doctor examine the lining of the upper part of your gastrointestinal tract, which includes the esophagus, stomach and duodenum (first portion of the small intestine). Your doctor will use a thin, flexible tube called an endoscope, which has its own lens and light source, and will view the images on a video monitor. You might hear your doctor or other medical staff refer to upper endoscopy as upper GI endoscopy, esophagogastroduodenoscopy (EGD) or panendoscopy. If your doctor has recommended upper endoscopy, this brochure will give you a basic understanding of the procedure – how it’s performed, how it can help, and what side effects you might experience. It can’t answer all of your questions, since a lot depends on the individual patient and the doctor. Please ask your doctor about anything you don’t understand.
Why is Upper Endoscopy done?
Upper endoscopy helps your doctor evaluate symptoms of persistent upper abdominal pain, nausea, vomiting or difficulty swallowing. It’s an excellent test for finding the cause of bleeding from the upper gastrointestinal tract. It’s also more accurate than X-ray films for detecting inflammation, ulcers and tumors of the esophagus, stomach and duodenum.
Your doctor might use upper endoscopy to obtain a biopsy (small tissue samples). A biopsy helps your doctor distinguish between benign and malignant (cancerous) tissues. Remember, biopsies are taken for many reasons, and your doctor might order one even if he or she does not suspect cancer. For example, your doctor might use a biopsy to test for Helicobacter pylori, bacterium that causes ulcers.
Your doctor might also use upper endoscopy to perform a cytology test, where he or she will introduce a small brush to collect cells for analysis.
Upper endoscopy is also used to treat conditions of the upper gastrointestinal tract. Your doctor can pass instruments through the endoscope to directly treat many abnormalities with little or no discomfort. For example, your doctor might stretch a narrowed area, remove polyps (usually benign growths) or treat bleeding.
How should I prepare for the procedure?
An empty stomach allows for the best and safest examination, so you should have nothing to eat or drink, including water, for approximately six hours before the examination. Your doctor will tell you when to start fasting.
Tell your doctor in advance about any medications you take; you might need to adjust your usual dose for the examination.
Discuss any allergies to medications as well as medical conditions, such as heart or lung disease.Also, alert your doctor if you require antibiotics prior to undergoing dental procedures, because you might need antibiotics prior to upper endoscopy as well.
What can I expect during upper endoscopy?
Your doctor might start by spraying your throat with a local anesthetic or by giving you a sedative to help you relax. You’ll then lie on your side, and your doctor will pass the endoscope through your mouth and into the esophagus, stomach and duodenum. The endoscope doesn’t interfere with your breathing. Most patients consider the test only slightly uncomfortable, and many patients fall asleep during the procedure.
What happens after the upper endoscopy?
You will be monitored until most of the effects of the medication have worn off. Your throat might be a little sore, and you might feel bloated because of the air introduced into your stomach during the test. You will be able to eat after you leave unless your doctor instructs you otherwise. Your doctor generally can tell you your test results on the day of the procedure; however, the results of some tests might take several days. If you received sedatives, you won’t be allowed to drive after the procedure even though you might not feel tired. You should arrange for someone to accompany you home because the sedatives might affect your judgment and reflexes for the rest of the day.
What are the possible complications of Upper Endoscopy
Although complications can occur, they are rare when doctors who are specially trained and experienced in this procedure perform the test. Bleeding can occur at a biopsy site or where a polyp was removed, but it’s usually minimal and rarely requires follow-up. Other potential risks include a reaction to the sedative used, complications from heart or lung diseases, and perforation (a tear in the gastrointestinal tract lining). It’s important to recognize early signs of possible complications. If you have a fever after the test, trouble swallowing or increasing throat, chest or abdominal pain, tell your doctor immediately.
What is a Colonoscopy?
Colonoscopy is a procedure that enables the your physician to examine the lining of the colon (large bowel) for abnormalities by inserting a flexible tube that is about the thickness of your finger into the anus and advancing it slowly into the rectum and colon.
What Preparation is Required?
The colon must be completely clean for the procedure to be accurate and complete. Your physician will give you detailed instructions regarding the dietary restrictions to be followed and the cleansing routine to be used. In general, preparation consists of either consumption of a large volume of a special cleansing solution or several days of clear liquids, laxatives and enemas prior to the examination. Follow your doctor’s instructions carefully. If you do not, the procedure may have to be cancelled and repeated later.
What About My Current Medications?
Most medications may be continued as usual, but some medications can interfere with the preparation of the examination. It is therefore best to inform you physician of your current medications as well as any allergies to medications several days prior to the examination. Aspirin products, arthritis medications, anticoagulants (blood thinners), insulin, and iron products are examples of medications whose use should be discussed with your physician prior to this examination. It is also essential that you alert your doctor if you require antibiotics prior to undergoing dental procedures, since you may need antibiotics prior to colonoscopy as well.
What can be Expected During Colonoscopy?
Colonoscopy is usually well tolerated and rarely causes much pain. There is often a feeling of pressure, bloating or cramping at times during the procedure. Your doctor may give you medication through vein to help you relax and better tolerate any discomfort from the procedure. You will be lying on your side or on your back while the colonoscope is advanced slowly through the large intestine. As the colonoscope is slowly withdrawn, the lining is again carefully examined. The procedure usually takes 15 to 60 minutes. In some cases, passage of the colonoscope through the entire colon to its junction with the small intestine cannot be achieved. The physician will decide if the limited examination is sufficient or if other examinations are necessary.
What if the Colonoscopy Shows Something Abnormal?
If your doctor thinks an area of the bowel needs to be evaluated in greater detail, a forceps instrument is passed through the colonoscope to obtain a biopsy (a sample of the colon lining) or a small brush is introduced to collect cells (a cytology test). These specimens are submitted to the pathology laboratory for analysis. If colonoscopy is being performed to identify sites of bleeding, the areas of bleeding may be controlled through the colonoscope by injecting certain medications or by coagulating the bleeding vessels. If polyps are found, they are generally removed. None of these additional procedures produce pain since the colon lining can only sense stretching. Remember, biopsies are taken for many reasons and do not necessarily mean that cancer is suspected.
What are Polyps and Why are They Removed?
Polyps are abnormal growths from the lining of the colon which vary in size from a tiny dot to several inches. The majority of polyps are benign (non-cancerous) but he doctor cannot always tell a benign from a malignant (cancerous) polyp by its outer appearance alone. For this reason, removed polyps are sent for tissue analysis by the pathologist. Removal of colon polyps is an important means of preventing colorectal cancer.
How are Polyps Removed?
Tiny polyps may be totally destroyed by fulguration (burning) but larger polyps are removed by a technique called snare polypectomy. The doctor passes a wire loop (snare) through the colonoscope and sever the attachment of the polyp from the intestinal wall by means of an electrical current. You should feel no pain during the polypectomy. There is a small risk that removing a polyp may cause bleeding or result in perforation to the wall of the colon which could require emergency surgery.
What Happens After Colonoscopy?
After colonoscopy, your physician will explain the results to you. If you have been given medication during the procedure, you will be observed until most of the effects of sedation have worn off (½ to 2 hours). You will need someone to drive you home after the procedures.
You may have some cramping or bloating because of air introduced into the colon during the examination. This should disappear quickly with the passage of flatus (gas). Generally, you should be able to eat after leaving the endoscopy area but your doctor may restrict your diet and activities, especially after polypectomy.