med-health

Gastroenterology

Gastroenterology Specialties Endoscopy

An upper endoscopy, also known as an EGD, is a procedure in which a thin flexible scope, with a light and camera at its tip, is used to look inside the upper digestive tract – the esophagus, stomach, and first part of the small intestine, called the duodenum. This procedure is commonly used to help identify causes of heartburn, abdominal pain, bleeding, and any swallowing problems.

The EGD procedure can also help identify any inflammation in the stomach lining, any ulcers, or tumors. In providing comprehensive care to ensure optimal outcome for our bariatric patients,this procedure is recommended prior to any weight loss surgery.

The medical term for an upper endoscopy is an Esophagogastroduodenoscopy. But it can also be known as an upper EGD for short. An endoscopy is a minimally-invasive diagnostic medical procedure in which a flexible tube is used to examine the inside of the body. The lighted flexible instrument, which is called an endoscope, contains a camera at the very tip with which allows the physician to visualize and inspect the internal organs on a larger TV-like screen or monitor. The physician will insert the tube through your mouth and gently thread it down into your stomach. The physician can also insert instruments into the endoscope to take tissue samples for further testing or to treat internal bleeding. The procedure is short, usually lasting thirty minutes or less.

An upper EGD is most commonly used to examine areas of the gastrointestinal tract, including the esophagus, stomach, and areas of the intestine. Reasons for performing an endoscopy include symptoms such as bleeding, stomach pain. This procedure can identify the cause of symptoms such as swallowing difficulty, nausea, vomiting, or reflux. Other conditions that might be investigated through endoscopy are indigestion and abdominal or chest pain.

During an upper endoscopy, the patient receives a numbing agent to prevent gagging when the endoscope is inserted in the throat. Often, patients are given pain medication and sedatives through an IV, as well. As the scope also forces air into the stomach, it allows the physician to see the folds of tissue inside the stomach and, therefore, make a more careful analysis.

PREPARING FOR THE PROCEDURE: You may not have anything to eat or drink after midnight the evening prior to your surgery. It is important that you arrange for a responsible adult to take you to and from the surgery center. For your safety, a responsible adult should also be available to stay with you during your first night at home. If you take blood pressure medications, you may continue to take those meds with a small sip of water the morning of your surgery. Your physician will determine what other medications you may continue to take and which ones you will need to discontinue prior to your procedure.

POST-OPERATIVE CARE: Immediately after the procedure, you will be transferred to the Post Anesthesia Care Unit where you will be monitored closely for approximately 30 minutes to one hour. Breathing treatments will be administered as needed. It is normal to feel a little drowsy and/or nauseous after waking up from the procedure. This is can be an effect of the anesthesia and medications administered to sedate you. Simply inform your nurse and he/she will treat your nausea with medications ordered by your anesthesia provider.

Once you arrive home, you may begin with light soup. If you are not nauseated, you may slowly advance your diet to thicker and heavier foods as you can tolerate. You may not drive or operate any heavy machinery for up to 24 hours.

RISKS ASSOCIATED WITH THE PROCEDURE: Abnormal reaction to sedatives; bleeding from biopsy; accidental puncture of the upper GI tract.

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Gastroenterology Specialties Colonoscopy

A colonoscopy is an outpatient procedure in which the inside of the large intestine (colon and rectum) is examined. A colonoscopy is commonly used to evaluate gastrointestinal symptoms, such as rectal and intestinal bleeding, abdominal pain, or changes in bowel habits. Colonoscopies are also performed in indivduals without symptoms to check for colorectal polyps or cancer. A screening colonoscopy is recommended for anyone 50 years of age and older, and for anyone with parents, siblings, or children wih a history of colorectal cancer or polyps.

WHAT HAPPENS DURING A COLONOSCOPY: A colonoscopy is a minimally-invasive diagnostic medical procedure in which a colonoscope (a long, flexible tube approximately ½ inch in diameter) is used to examine the inside of the body, specifically, the lining of the colon. The lighted colonoscope contains a camera at the very tip with which allows the physician to visualize and inspect the internal organs on a larger TV-like screen or monitor. The physician will insert the tube through your anus and gently thread it upwards into your large intestine. The physician can also insert instruments into the colonoscope to take tissue samples for further testing or to treat internal bleeding. These small amounts of tissue can be removed for analysis (a biopsy), and polyps can be identified and entirely removed. In many cases, a colonoscopy allows accurate diagnosis and treatment of colorectal problems without the need for a major operation.

PREPARING FOR THE PROCEDURE
To complete a successful colonoscopy, the bowel must be clean so that the physician can clearly view the colon. It is very important that you read and follow all of the instructions given to you for your bowel preparation well in advance of the procedure. Without proper preparation, the colonoscopy will not be successful and the test may have to be repeated.

You may not have anything to eat or drink after midnight the evening prior to your surgery. It is important that you arrange for a responsible adult to take you to and from the surgery center. For your safety, a responsible adult should also be available to stay with you during your first night at home. If you take blood pressure medications, you may continue to take those meds with a small sip of water the morning of your surgery. Your physician will determine what other medications you may continue to take and which ones you will need to discontinue prior to your procedure.

POST-OPERATIVE CARE: Immediately after the procedure, you will be transferred to the Post Anesthesia Care Unit where you will be monitored closely for approximately for one hour. Breathing treatments will be administered as needed. It is normal to feel a little drowsy and/or nauseous after waking up from the procedure. This is can be an effect of the anesthesia and medications administered to sedate you. Simply inform your nurse and he/she will treat your nausea with medications ordered by your anesthesia provider. You may feel some cramping or a sensation of having gas, but this quickly passes.

DIET AND ACTIVITY: Unless otherwise instructed, you may immediately resume your normal diet. If you are not nauseated, you may slowly advance your diet to thicker and heavier foods as you can tolerate. We recommend you wait until the day after your procedure to resume normal activities. You may not drive or operate any heavy machinery for up to 24 hours.

MEDICATIONS: If polyps were removed or a biopsy was taken, avoid taking aspirin, products containing aspirin, or anti-inflammatory drugs for two (2) weeks after the procedure to help decrease the risk of bleeding; you may take acetaminophen (such as Tylenol®) if needed.

If you are taking Coumadin®, Plavix®, Ticlid®, or Agrylin®, the physician performing your colonoscopy will advise you when it is safe to resume your blood thinners

BLEEDING: If a biopsy was taken or a polyp was removed, you may notice light rectal bleeding for one to two days after the procedure; large amounts of bleeding, the passage of clots, or abdominal pain should be immediately reported.

RISKS ASSOCIATED WITH THIS PROCEDURE: Though rare, there is potential for the colonoscope to injure the intestinal wall, causing perforation, infection, or bleeding.

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