Endoscopy Procedures

What is a Colonoscopy?

A colonoscopy is a life-saving procedure for the prevention and detection of colon cancer. As well as , an important test for patients with diarrhea, bleeding in their stool and various conditions of the large intestine.

Who needs a Colonoscopy?

For the screening of colon cancer, an individual should have a colonoscopy starting at age 45. However, certain individuals who have family history of colon cancer or other conditions may require colonoscopy at an earlier age. Talk to your gastroenterologist about your need and timing to have a colonoscopy.

Why Would a Colonoscopy Be Necessary?

Gastroenterologists may perform them in persons with various ailments or symptoms in their lower gut. Remember, a colonoscopy is a routine test doctors perform safely and comfortably, even at an outpatient center, like the San Antonio Gastroenterology Endoscopy Center.

If you are experiencing symptoms, such as rectal bleeding or blood in your stool, a colonoscopy may be a necessary next step to determine what is going on inside your body. Talking to your primary care physician or a gastroenterologist can help you assess your symptoms to determine what treatments or procedures you may need to protect your health.

What is Colonoscopy Prep?

Colonoscopy prep (also known as a bowel or colon prep), which cleans out your colon, is required before the procedure. Colonoscopy prep varies by physician but in most cases requires 1 to 2 days of modification to your standard eating and drinking habits.

Many people consider the prep to be the worst part of the experience. The clear liquid diet leaves many people feeling hungry and the required bowel prep can be uncomfortable. You should plan to stay home when prepping for your colonoscopy as you will need to use the bathroom frequently and experience loose stools and diarrhea. This process is necessary to completely empty and cleanse your colon for the procedure.

Your gastroenterologist will provide you with specific instructions on how to prepare for your colonoscopy. Failure to follow the prep instructions exactly as indicated may require you to reschedule your procedure.

What is a Upper Endoscopy?

An upper endoscopy is a procedure gastroenterologists perform to look at the lining of the upper digestive tract which includes the esophagus (food pipe), stomach and 1st portion of the intestine otherwise known as the duodenum. It is done using an endoscope, which is long tube with a light source and camera at the end.

Who Needs an Upper Endoscopy?

An upper endoscopy is performed to help diagnose causes of symptoms such as abdominal pain, nausea, vomiting, reflux, difficulty swallowing etc. It is also very useful to obtain tissue samples, stop bleeding, treat cancer, widen a narrowed esophagus, and retrieve food that is stuck as well as foreign bodies.

What is the Prep for and Upper Endoscopy?

To prepare for an upper endoscopy, your gastroenterologist will need to refrain from eating or drinking anything for approximately 8 hours before the examination. Your stomach will need to be completely empty. Your gastroenterologist will give you very specific instructions regarding when to begin fasting based on when your procedure is scheduled.

What is a Sigmoidoscopy?

A flexible sigmoidoscopy is a diagnostic procedure that a doctor uses to the inner lining of your rectum and the lower portion of the colon.

Who Needs a Flexible Sigmoidoscopy?

A flexible sigmoidoscopy is something doctors recommend for individuals who may be suffering from certain gastrointestinal symptoms. Some of which include abdominal pain, rectal bleeding, or unusual changes in bowel habits. Doctors may also use it to assess risk of colon or rectal cancer.

What is the Prep for a Sigmoidoscopy?

To prepare for a sigmoidoscopy, your bowel must be fully clean. Your doctor will recommend specific instructions regarding preparation. This may include use of any enema to empty out your rectum and lower intestine for clear viewing of the intestinal walls.

What is Esophageal Banding?

Esophageal banding is a life-saving procedure to stop bleeding from esophageal varices. Esophageal varices are veins in the esophagus that have become wider and larger due to blockage in the flow of blood to the liver and or spleen. Varices usually form because the liver has scars and allows little blood to flow through it. This results in an increase in pressure in the vessels that carry blood to the liver and an eventual “backing-up” of blood flow. Often, the blood “backs up” to the veins of the lower esophagus, forming esophageal varices. Esophageal banding is done by putting little rubber bands on the varices using an upper endoscope, hence effectively tying them off to prevent further bleeding.

What is Esophageal Manometry?

Esophageal manometry is a procedure to measure the movement or function of the esophagus. Doctors perform this test mostly in patients with swallowing problems. When doctors perform the test they examine the lower esophageal sphincter, and the esophagus muscles via esophageal manometry. This determines the esophageal sphincter’s ability to restrict backflow of gastric acid into the esophagus, as well as if the esophagus is capable of pushing food down to the stomach properly.

Who Needs an Esophageal Manometry?

Individuals who have trouble swallowing or consistently experience heartburn or nausea after eating may need an esophageal manometry to determine the cause of these symptoms. An Esophageal manometry allows your gastroenterologist to determine if the esophagus is contracting and relaxing properly.

What is ERCP?

ERCP, or endoscopic retrograde cholangiopancreatography, examines the bile ducts, gallbladder, and pancreatic ducts. Bile is an alkaline fluid that aids in digestion of food. Bile ducts funnel bile from the liver to the gallbladder and small intestines. An ERCP is an endoscopic procedure in which an endoscope analyzes the bile ducts for stones, tumors, or narrowed regions. Patients are sedated during an ERCP, while a doctor inserts an endoscope into the mouth, and through the esophagus, until it reaches the uppermost part of the small intestine. A catheter is then inserted through the endoscope, and guided into the papilla, a diminutive duct located in between the liver and pancreas. The catheter releases a contrast solution for x-rays that helps gastroenterologists determine how bile ducts are functioning.

Who needs an ERCP?

ERCP is a treatment procedure for patients with jaundice (yellowing of the skin or whites of eyes) stomach/abdominal pain caused by pancreatic or bile duct issues.

What is Endoscopic Ultrasound?

Endoscopic ultrasound (EUS) uses sound waves (ultrasound) to produce high quality images of the lining of the upper digestive tract (esophagus, stomach, and 1st part of the small intestine); as well other organs that are near it such as the liver, gallbladder, pancreas, and surrounding lymph nodes.

It can be combined with a procedure called fine needle aspiration (FNA) where a needle advances from the probe to the target organs and a small sample aspirated through the needle. The sample can then be sent to the lab to be analyzed.

EUS can also be used to provide a minimally invasive way of draining pseudocysts from the pancreas. Pseudocysts are fluid-filled sacs that appear like a true cyst. However, the sac is not composed of a specific lining of cells that are common to a true cyst.

What is Hemorrhoid Banding?

Hemorrhoid banding is a simple, safe procedure doctors conduct strictly for internal hemorrhoids via rubber band ligation. The hemorrhoid is tied at the base with rubber bands to cut off its blood supply. The lack of blood flow to the hemorrhoid causes it to shrink and eventually fall off. Within a week or two the hemorrhoid will detach, leaving a scar. The procedure is confined to 1 or 2 hemorrhoids per visit. A gastroenterologist may treat hemorrhoids at once with general anesthesia, or over 4 to 6 week periods.

Who Needs Hemorrhoid Banding?

Individuals suffering from internal hemorrhoids that are causing discomforts such as rectal bleeding and itching can benefit from endoscopic hemorrhoid band ligation, or hem banding.

What is pH PROBE?

Gastroenterologists use pH probe studies to diagnose, and treat chronic acid reflux by implanting a thin tube into the esophagus. Over 24 hours, Doctors monitor the frequency or acid reflux into the esophagus objectively. Typically, pH probe studies are used to help substantiate the diagnosis of GERD or to distinguish the cause of various symptoms, such as heartburn or chronic cough.

Who Needs a pH Probe Study?

Doctors typically use pH probe studies to help substantiate the diagnosis of GERD or to distinguish the cause of various symptoms, including:

• Heartburn , mainly in patients who have had a routine endoscopy, yet failed medical treatment, or in cases which the patient may be considered as a candidate for surgery
• Uncommon symptoms of GERD (gastroesophageal reflux disease), such as chest pain, persistent dry cough or chronic cough, asthma and other throat symptoms

pH probe studies may also be done to assess the effectiveness of current treatments for heartburn or reflux. It is often advised for those whose symptoms are not improving with medications.

What is Capsule Endoscopy?

Capsule endoscopy allows a gastroenterologist to evaluate the small intestine in detail. Capsule endoscopy photographs the digestive tract with a wireless camera located within an easy to swallow, pill-sized capsule. As the camera moves through the small intestine, it captures thousands of images, and transfers them to an apparatus fastened to the waist. Gastroenterologists are able to assess the images for irregularities in the digestive tract.

Who Needs a Capsule Endoscopy?

Traditional upper endoscopy and colonoscopy may not be able to reach a large portion of the small intestine. The most common reason for doing capsule endoscopy is to search for a cause of bleeding occurring in the small intestine. A capsule endoscopy may also be appropriate for detecting polyps, inflammatory bowel disease (IBD), ulcers, and tumors of the small intestine.

A gastroenterologist may choose capsule endoscopy to detect polyps, Crohn’s disease, ulcers, and other abnormalities.

What is the prep for a Capsule Colonoscopy?

For the most accurate, secure inspection, gastroenterologists usually request patients to refrain from eating or drinking anything twelve hours prior to the exam. Your gastroenterologist will inform you of when to begin fasting. Before your capsule colonoscopy, your gastroenterologist may require a bowel prep, or cleansing.

Tell your gastroenterologist any prescriptions, OTC medications, or supplements you currently take. Alert your gastroenterologist of any medication allergies, health conditions, or prior history of gastrointestinal obstructions or disorders. Additionally, if you have a pacemaker or defibrillator let your gastroenterologist know.