Colonoscopy | EGD | Capsule Endscopy | ERCP

Colonoscopy

What is a colonoscopy?
Under light, but adequate sedation, a flexible tube with a light on the end is passed into the rectum and advanced so that the entire colon (large intestine) is visualized. It is essential that the colon be very clean so that all polyps or other abnormalities will be seen. If polyps are found they can usually be removed at the same time. Polyps are important to remove because they can transform into cancer.

Will I be in pain?
Despite what you might have heard, the majority of people have very little difficulty with a colonoscopy. Discomfort comes from air introduced into the colon and from stretching the colon with the scope as it turns corners. The pain is similar to cramping. The preparation is usually the most unpleasant part of the experience. We use sedation to help with pain and anxiety. This is not general anesthesia and you will be breathing on your own. Some people choose to have no sedation! Remember, this is to prevent the far greater pain of colon cancer.

Do I need someone to drive me?
YES!!! Since you will be receiving sedation you may not drive until the day after your procedure. Unless you are accompanied by a responsible adult, leaving the endoscopy center in a bus or taxi cab is not allowed. This is for your safety. It is the policy of the facility that you have a responsible adult accompany you home after the procedure or you procedure will be cancelled.

Important instructions regarding medications:

  • If you take Coumadin, Warfarin, Plavix, Plental, Ticlid, or any other blood thinner, make this known to your Gastroenterologist ahead of time, or consult with your Cardiologist about stopping your blood thinning medication ahead of time.
  • If you are diabetic: Do not take your pill or insulin the morning of the day of your colonoscopy. If you have questions please contact your physician.

What time should I be there?
Please arrive one hour before your scheduled time. At this time important paper work is completed and your i.v. catheter will be placed.

Insurance pre-authorization
If not already done by our office, please check with your insurance company on coverage and to see if pre-authorization is required. Do not assume this procedure is automatically covered. It is always better to check with your insurance company.

Preparation Instructions

EGD

Introduction
An Upper Endoscopy (also known as esophagogastroduodenoscopy or EGD) is a procedure used to diagnose various conditions of the esophagus, stomach and small intestine. The examination can be used to diagnose and/or treat conditions such as gastroesophageal reflux disease, Barrett’s esophagus, swallowing difficulties, and peptic ulcer disease.

The Procedure
Upper endoscopy involves inserting a lighted, flexible instrument into the upper intestinal tract. An upper endoscopy is performed by a gastroenterologist at a special facility with specially trained nurses so it can be performed safely and comfortably. After arriving at the facility, a nurse will meet with you and review your medical history, medicines and allergies. The nurse will also place a small needle in your vein for the duration of the test. You will then be brought to an examination room and meet with your doctor before beginning the test. At the start of the test, you will receive medications for sedation. The majority of people feel very little discomfort during the exam. The endoscope will be passed through your mouth into your upper intestinal tract and will not interfere with your breathing. Biopsies can be obtained during the examination. The exam will last approximately 10 minutes.

After your Endoscopy
After the examination, you will rest in the recovery area. Your doctor will review the results of the examination with you and you will receive a written report. You will need a ride home and we ask that you do not drive for the rest of the day. Buses and taxis are prohibited. You may return to your usual activities the next day. You may resume your normal diet as you wish. You should allow 2-3 hours for the entire appointment.

Preparing for your Endoscopy
Do not eat or drink after midnight the night before your procedure. You may take only essential medications in the morning with tiny sips of water only. It is best to wait until after the procedure. If your procedure is in the afternoon you may drink clear liquids until 4 hours before your procedure. Clear liquids include water, coffee and tea with no cream, clear fruit juice, clear pop, Gatorade, and Jell-O but nothing Red or Purple. Do not drink any oily liquids such as broth. You may be asked to stop certain medications as well such as warfarin (coumadin) and clopidogrel (Plavix).

Capsule Endoscopy

Introduction
Capsule endoscopy is a procedure used to diagnose various conditions of the small intestine. The most common reason for performing a capsule endoscopy is to search for a cause of bleeding from the small intestine. It is also useful for detecting Crohn’s disease, polyps, ulcers and tumors of the small intestine.

The Procedure
You will arrive at the office and meet with one of our staff. A sensor device will be placed on your abdomen with an adhesive sleeve and a recording device will be worn as a belt. You will then swallow a pill sized video capsule that has its own lens and light source. The capsule will pass naturally through your digestive tract while transmitting images to the data recorder. At the end of the procedure or after approximately 8 hours, you will return to the office, the data recorder will be removed, and the study will be downloaded to a computer.

After your Capsule Endoscopy
The capsule should pass naturally out of your gastrointestinal tract. You may resume your normal diet. The physician will review the images on a computer and contact you with the results.

Preparing for Capsule Endoscopy
An empty stomach allows for the best examination so you should not eat or drink anything for 12 hours prior to the examination. You may begin to eat a clear liquid diet 4 hours after ingesting the capsule.

ERCP

Introduction
ERCP or endoscopic retrograde cholangiopancreatography is a procedure performed at a hospital. The liver, gallbladder and pancreas share ducts or drainage routes into the small intestine. An ERCP combines the use of x-rays and endoscopy to enter the ducts and diagnose and treat conditions related to the liver, gallbladder, bile ducts or pancreas. These conditions include gallstones, scarring, leaks and cancer.

The Procedure
After receiving sedation through an IV, a flexible, lighted instrument is passed through the mouth, esophagus, and stomach into the small intestine. After reaching the small intestine, the doctor will find the opening to the ducts and will pass a narrow plastic tube, or catheter, through the endoscope and into the ducts. Contrast material can then be injected into the ducts to obtain x-ray images and other maneuvers can then be performed to diagnose or treat disorders. The examination will last between 30-90 minutes.

After your ERCP
After the examination, you will be observed in the recovery area. You may generally go home the same day and resume your diet as instructed. You will need a ride home and you will not be able to drive for the rest of the day.

Preparing for your ERCP
In order to prepare for the test, you will be asked to not eat or drink anything for six hours prior to the examination. You may be asked to stop certain medications prior to the examination.