Common Endoscopic Procedures
Colonoscopy is a procedure to evaluate the large intestines or colon. A gastroenterologist uses a colonoscope which is a flexible instrument with a small camera on its tip. The colonoscope is inserted through the anus and advanced gently into the colon. In a clean colon, the gastroenterologist can visualize the walls of the colon, remove polyps, and obtain biopsies. Screening with colonoscopy can prevent colon cancer. Colonoscopy may also be performed to evaluate and treat various conditions include bleeding from the colon, unexplained chronic diarrhea, and look for other causes of lower abdominal pain.
Patients will be required to clean their colon by drinking a bowel preparation solution. The bowel preparation will naturally result in diarrhea to purge the colon of stool. A clean colon will facilitate a safe and effective colonoscopy. During the procedure, a patient is usually given sedatives in order to be comfortable. A patient is required to refrain from driving or operating machinery after colonoscopy due to any lingering effect of the sedation.
Flexible sigmoidoscopy is similar to colonoscopy, however, this instrument can only reach the last segment of the colon, called the sigmoid. This exam is ideal for the evaluation and treatment of conditions that affect the sigmoid only.
EGD or Upper Endoscopy
EGD stands for esophagogastroduodenoscopy. Its long name came from the fact that it is a procedure to examine the esophagus, stomach, and the duodenum. Various conditions could be diagnosed and treated with EGD.
EGD can be performed to obtain biopsies of the upper gastrointestinal tract, to check for inflammation, and other precancerous lesions. EGD can be performed to deliver treatment for bleeding ulcers, stretch narrowing, and event put stents to relieve an obstruction in the upper gastrointestinal tract.
Similar to other endoscopic procedures, a patient is made comfortable during the procedure using sedatives. EGD may be recommended for patients with upper abdominal pain, worsening reflux, difficulty or painful swallowing, bleeding ulcers, obstruction from a suspected stricture, or mass in the upper digestive tract.
Endoscopic Retrograde Cholangiopancreatography (ERCP)
Endoscopic retrograde cholangiopancreatography or ERCP is a specialized endoscopic procedure to evaluate and treat diseases of the bile ducts and pancreas. Not every gastroenterologist is able to perform this advanced endoscopic procedure. ERCP usually requires further training and certification.
ERCP is the ideal procedure for the treatment of bile duct stones, cholangitis (infection in the bile duct) or obstruction in either the pancreas or bile ducts.
ERCP is often performed in conjunction with x-rays to visualize the bile ducts during the procedure. While the patient is sedated, the ERCP endoscope is inserted into the mouth and gently advanced to the opening of the bile duct in the small intestines. Various small devices can be passed through the ERCP endoscope to remove stones, obtain biopsies, and deploy stents in order to improve bile flow from the liver.
Endoscopic Ultrasound (EUS)
Endoscopic ultrasonography (EUS) combines endoscopic procedures with ultrasound technology to evaluate the gastrointestinal organs, obtain biopsies using minimally-invasive techniques, and treat complicated pancreatic and biliary problems. A EUS procedure can confirm the presence of certain medical conditions not visible in standard endoscopy or remains indeterminate on CT scan or MRI. EUS has a wide variety of applications and is specifically valuable in the diagnosis and staging of gastrointestinal cancers.
Your healthcare provider may also recommend EUS if you have: pancreatitis, pancreatic cysts, pancreatic fluid collections, jaundice, suspected bile duct stones, mass, gastrointestinal lymph nodes, and for the diagnosis & staging of gastrointestinal cancers. Not every gastroenterologist is able to perform this advanced endoscopic procedure. EUS usually requires further training and certification.
Small Bowel Enteroscopy
The examination of the small intestines is often challenging due its length. The average length of the small intestines is about 3 to 5 meters; and it often increases with the patient’s height. There are several conditions that can affect the small intestines, including bleeding, polyps, ulcers, strictures, and tumors. Video capsule endoscopy is often the preliminary exam that is performed to evaluate the small intestines. In cases where the gastroenterologist is required to obtain biopsies and provide treatment to the small bowel, a gastroenterologist can perform enteroscopy to inspect and treat the small bowel. These procedure can be performed either with using a longer endoscope or a modified endoscope fitted with inflatable balloons to pleat the small bowel in order to reach the desired area for biopsy or treatment.
Video Capsule Endoscopy
Video capsule endoscopy is a unique examination using a small pill with a miniature camera. After the pill or capsule is swallowed, its camera captures thousands of images of the small intestines. These images are electronically transmitted to an apparatus fastened to the waist. Gastroenterologists are able to view these images for irregularities in the small bowel. After sometime, the pill is usually excreted with the stools. There is no need to retrieve the pill camera. The video capsule endoscopy is an ideal test for check for bleeding in the small bowel, otherwise not reachable by a regular endoscope.