The surgery center allows our doctors to evaluate the intestines including the stomach and the colon in a painless comfortable manner.
- Colonoscopy
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Colonoscopy is an examination of the large intestine, or colon, using a long flexible instrument called a colonoscope. This test may be done for a variety of reasons. Commonly it is done to investigate the finding of blood in the stool, diarrhea, abdominal pain, a change in bowel habits, or an abnormality noted on a colon x-ray or barium enema.What Happens During the Procedure?
An intravenous (IV) will be started in your arm. Just before and during the procedure the nurse anesthetist will carefully monitor you and give you medication which will keep you pain free and unaware during the colonoscopy.
The examination is performed while you are lying on your left side. The doctor will examine your rectum first with a finger and then the colonoscope will be gently inserted. The colonoscope will be carefully passed through the colon and then slowly withdrawn.If any abnormalities are found, small pieces of tissue may be taken for examination by a pathologist (biopsies). Small growths (polyps) may also be found in the colon and can usually be removed safely. Small bleeding sites are often cauterized (burned) or injected to stop bleeding. This is a very safe procedure and in many cases eliminates the need for major surgery.This examination may last anywhere from 20 minutes to an hour depending on how long it takes to pass the scope around the colon and treat any abnormalities which are found.
After the Procedure You will be observed for about 30 minutes before going home. You will not be allowed to drive for the rest of the day.
Following the colonoscopy, the doctor will talk with you and your family and give them a preliminary report of the test findings. A follow-up visit may also be scheduled so the test results can be explained to you when you are fully awake.Risks
This is a very safe examination, but there is a small risk of complications which occur in less than 1% of patients. Reaction to the medications given for sedation are also uncommon, but include allergic reactions, difficulty breathing, or irritation of the vein used to give the medication. Bleeding is a possibility, and can sometimes occur several days after the procedure, especially if a polyp has been removed. Perforation or puncture of the colon may occur. A perforation is a serious problem and in most cases requires hospitalization and surgery in order to repair the perforation of the colon. Fortunately, this complication is quite rare. We continuously monitor blood pressure, pulse, and oxygen levels during the procedure to minimize the risk of any complications related to sedation.If you experience severe pain, bleeding, or any problems after the procedure, please contact our office immediately.
Alternatives Colonoscopy is the best test available to detect and treat abnormalities inside the colon. However, like any other medical test, it is not 100% accurate.Barium enema is a somewhat less accurate X-ray test that can detect many abnormalities in the colon. However, it misses abnormal findings in the colon more often than colonoscopy, and if an abnormality is found, colonoscopy often must be done to biopsy or remove the abnormality.Preparation
Complete cleansing of the colon is very important so that a thorough examination of your colon can be performed. Your doctor will chose a laxative preparation for you. Please carefully follow the instructions.Iron preparations and fiber supplements should not be taken for 4 days before colonoscopy.If your procedure is scheduled in the morning, you are not to eat, drink, or chew anything after midnight until your procedure is completed. On the day of your procedure, important medications (such as those for high blood pressure or heart disease) should be taken with a small amount of clear liquid early in the morning, at least 3 hours before the procedure. Other medications can be taken after the procedure.If your procedure is scheduled after noon, you may have one cup of clear liquids of your choice in the early morning and then nothing to eat, drink or chew until after your procedure is completed. You may take your regular prescription medications in the early morning.If you are a diabetic or taking Coumadin, you will be given specific instructions regarding these medications.
Please let your doctor know if there is any chance you might be pregnant at the time of any procedure. - Gastroscopy - EGD
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SOME THINGS YOU SHOULD KNOW...
What is Gastroscopy?
Gastroscopy is a test done to examine the inside of the stomach.
The formal name of the procedure is esophagogastroduodenoscopy [EGD].In other words, the procedure involves looking at the esophagus, stomach, and part of the small intestine (duodenum) with a long, slender tube passed through the mouth.What Happens During the Procedure?
An intravenous (IV) will be started in your arm. Just before and during the procedure the nurse anesthetist will carefully monitor you and give you medication which will keep you pain free and unaware during the EGD.The doctor will insert the gastroscope through your mouth and examine your esophagus, stomach, and duodenum. If there are any areas which are abnormal, small pieces of tissue may be taken for examination by a pathologist (biopsies). Certain conditions may also be treated through the gastroscope. Small growths may be removed. Small bleeding sites may also be burned by electrocautery or laser to stop bleeding. A special type of bleeding which occurs in patients with severe liver disease may be treated by either Banding or injecting medicine into large veins which are causing the bleeding. This is called "sclerotherapy". If the esophagus or the outlet of the stomach is narrowed, it can be stretched open with a balloon or a tapered plastic tube.In general, this examination is very brief and takes perhaps 10 to 15 minutes. Because medication is given, the procedure is painless. Many people are totally unaware that the procedure has been done.After the Procedure
You will be observed for about 30 minutes before going home. You will not be allowed to drive for the rest of the day.
Following the gastroscopy, the doctor will talk with you and your family and give them a preliminary report of the test findings. A follow-up visit may also be scheduled so the test results can be explained to you when you are fully awake.Risks
The examination is very safe and the risk of complications is extremely low. The major risks of the procedure are: reaction to medications, which might take the form of either an allergic reaction or difficulty in breathing; bleeding, which might occur after a biopsy is taken; or perforation, creating a tear in the gut. Serious complications are quite rare. A mild sore throat may occur. Medications given through the IV may cause irritation of the vein. We continuously monitor blood pressure, pulse, and oxygen levels during the procedure to minimize the risk of any complications related to sedation.Is There Any Alternative to Gastroscopy?
Gastroscopy is the best test available to diagnose (and, sometimes treat) abnormalities of the esophagus, stomach and duodenum. An X-ray test called an upper GI series can also detect some abnormalities of these organs, but generally gastroscopy is better at detecting problems.Only gastroscopy allows taking biopsies to diagnose infection with Helicobacter or other organisms, or to look for abnormal cells or tumors, treatment of bleeding sites, or stretching of narrowed portions of the upper digestive tract.Preparation
If your procedure is scheduled in the morning, you are not to eat, drink, or chew anything after midnight until your procedure is completed. On the day of your procedure, important medications (such as those for high blood pressure or heart disease) should be taken with a small amount of clear liquid early in the morning, at least 3 hours before the procedure. Other medications can be taken after the procedure.If your procedure is scheduled after noon, you may have one cup of clear liquids of your choice in the early morning and then nothing to eat, drink or chew until after your procedure is completed. You may take your regular prescription medications in the early morning.If you are a diabetic or on Coumadin, you will be given specific instructions regarding these medications. Please let your doctor know if there is any chance you might be pregnant at the time of any procedure. - Dilation
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ESOPHAGEAL DILATION
SOME THINGS YOU SHOULD KNOW...
Dilation is a procedure used to stretch open a narrowed area in the esophagus or other part of the gastrointestinal tract. Narrowing or constriction of the esophagus usually causes difficulty swallowing. Food or liquid may become lodged in the chest or neck. When this occurs, it is a most distressing sensation and can cause pain and a feeling of choking. Esophageal dilation usually will relieve these symptoms if they are due to a narrowing. Dilation may also relieve chest pain and swallowing difficulty in patients who suffer from esophageal spasm. How is it performed?
Esophageal dilation is usually performed after examining the esophagus with a gastroscope (see our pamphlet on gastroscopy). Gastroscopy is necessary in order to clearly see what is causing the problem and to exclude serious conditions such as cancer. Most strictures are treated with Maloney dilators. These are tapered rubber tubes which are passed gently down the throat and through the stricture. A series of dilators of gradually larger sizes are passed in order to enlarge the narrowed area. In some cases, Maloney dilators cannot be used to safely dilate a stricture. For these patients we use other techniques.Balloon Dilation
Balloon dilators are long, sausage shaped balloons which are passed through the scope and then inflated under pressure within the stricture. This process is similar to what is done with coronary angioplasty wherein small balloons are used to stretch open narrowed areas in the coronary arteries.Wire guided dilators (Savary dilators)
These dilators are tapered and shaped like Maloney dilators. The scope is used to pass a guide-wire through the stricture. The scope is then removed and the Savary dilators are passed over the guide-wire through the stricture. The dilators have a small passageway through the center which allows them to slide over the wire. These are used when strictures are too firm or too narrow to be dilated with Maloney dilators.Reaction to Medication
Medication given for sedation can cause slowing of the breathing and lowering of oxygen levels. We monitor oxygen levels continuously in order to identify and treat this problem immediately if it should occur. Monitoring is also performed in order to identify any drops in blood pressure or changes in the pulse or heart rhythm.Bleeding
Bleeding may occur during or after the dilation. If you experience vomiting of blood or passage of black stool or become weak, dizzy and pale, please notify our office immediately or go directly to the emergency room.Esophageal Perforation
This is the most serious complication of esophageal dilation. It often requires major surgery for correction. Fortunately, it is quite uncommon. Symptoms suggesting esophageal perforation would include severe chest pain, abdominal pain, fever or shortness of breath after dilation. If the physician suspects the possibility of an esophageal perforation, then x-rays will be obtained to identify this complication.Sore Throat
About ten percent of patients undergoing endoscopy and/or dilation may experience some mild sore throat. If this occurs, Chloraseptic spray can be used to relieve the discomfort. This generally resolves in a matter of a day or two. Please notify our office if you are having any severe pain or swelling in the neck. - Bravo pH
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48 Hour Ambulatory pH Monitoring
Bravo is the world's first catheter-free pH monitoring system that allows one to maintain their regular diet and activities without the embarrassment and discomfort associated with traditional pH catheter systems.
How are Heartburn and GERD Diagnosed?
The traditional way to measure pH levels in the esophagus is to place a catheter, which is connected to a monitoring device on the patients' belt, down the nose and into the esophagus. Many patients complain of nasal discomfort and are embarassed to go out with the catheter in their nose. Bravo is a more patient-friendly pH test for determining heartburn and GERD. This test allows your doctor to evaluate your heartburn symptoms to determine the frequency and duration of acid refluxing into your esophagus. Your doctor uses the pH data from the Bravo Receiver and clinical evidence to confirm your condition.
The test involves a miniature pH capsule, approximately the size of a gelcap that is attached to your esophagus.
How the Bravo System Works
Throughout the test period, The Bravo pH capsule measures the pH in the esophagus and transmits the information to a pager sized receiver worn on your belt or waistband just like a pager or mobile phone. You will be given a diary to write down the times when you have reflux symptoms (for example, coughing, heartburn, regurgitation,) when eating or lying down.
After the test is completed, you return the diary and the Bravo receiver to your doctor. The test data is then uploaded and analyzed by your doctor to diagnose your condition.
Your doctor will have the test results within a few days