Endoscopic Procedures

Endoscopic Procedures

The most commonly performed gastrointestinal endoscopic procedures are: EGD, Colonoscopy, Flexible Sigmoidoscopy, and ERCP. For details, please click on the name of the respective procedure you’re interested in learning more about to the left.

Endoscopic procedures are used by gastroenterologists for diagnosis and treatment of a variety of gastrointestinal disorders. A contemporary endoscope looks like a long, black, flexible tube, with a diameter of 7 to 14 mm (0.27 to 0.59 inch) and length up to 6 feet (some specialized endoscopes are even longer). At its tip, the endoscope has got an image sensor, similar to those found in high-end digital cameras. It also has got a light source and channels through which the endoscopist may thread flexible instruments as well as collect tissue and fluid samples. The contemporary video endoscope is a sophisticated device, designed to minimize patients discomfort and risk for complications.

Upper Endoscopy (EGD – Esophagogastroduodenoscopy)

EGD is a relatively short and painless procedure. For added comfort and for minimizing the anxiety, most patients are sedated with use of short-acting intravenous medications.

EGD (Upper GI Endoscopy) is a procedure during which upper digestive tract could be examined using a lighted, flexible video endoscope. The upper digestive tract begins with the mouth and continues with the esophagus (food pipe), stomach and duodenum (the initial segment of the small bowel). EGD is performed for diagnostic reasons (detecting diseases) as well as therapeutic reasons (treating diseases). The most common indications for EGD include gastroesophageal reflux disease (GERD), abdominal pain, intractable nausea and vomiting, difficulties and/or pain with swallowing, peptic ulcers of the stomach and duodenum, esophageal and gastric cancer, and upper gastrointestinal bleeding.

EGD is a relatively short and painless procedure. For added comfort and for minimizing the anxiety, most patients are sedated with use of short-acting intravenous medications. Some patients prefer not to be sedated and usually tolerate the procedure well. In opposite to colonoscopy, no cleansing of the intestine is necessary before EGD. However, you should not eat or drink after midnight the night before your procedure (minimum 6 hours prior to EGD).

At least a week prior to EGD, you should notify the physician performing the procedure (or his nurse) if taking medications for diabetes (oral or injectable) and/or anticoagulants (“blood thinners”) such as Coumadin (Warfarin), Heparin, Lovenox (Enoxaparin), Plavix (Clopidogrel), Pradaxa (Dabigatran) or Ticlid (Ticlopidine). Also, you should notify your physician of taking Aspirin, Ibuprofen, Advil, Naprosyn, Voltaren, and other similar anti-inflammatory medications.

For details concerning the technique, risks of the procedure, and indications for EGD please click on this link to the American Gastroenterological Association Web site.

Colonoscopy

A Colonoscopy is a relatively short and safe procedure. As opposite to some beliefs, the procedure is rarely painful but it may be uncomfortable.

A colonoscopy is an endoscopic procedure performed by Dr. Janecki during which the interior of the colon (large bowel) is visually examined by a physician performing the test. The colon begins in the right lower abdomen and looks like a big question mark as it moves up and around the abdomen, ending in the rectum. The procedure is performed with you lying on your left side.

A Colonoscopy is a relatively short and safe procedure. As opposite to some beliefs, the procedure is rarely painful but it may be uncomfortable. For this reason, most patients prefer to be sedated during colonoscopy. After intravenous administration of a sedative, the flexible video endoscope is gently inserted through the anus and moved around the bends of the colon.

Colonoscopy is performed for many different indications. These include screening for colorectal cancer, looking for and removing colonic polyps which are frequently precancerous, looking for the source of an intestinal bleeding or abdominal pain, evaluation of colonic diseases like ulcerative colitis and Crohn’s disease, and many more. Before the procedure, the colon must be purged using one of the several available methods of cleaning the organ from stool and debris. The methods used in our practice are described in details in the Colon Cleansing section on this Website.

At least a week prior to colonoscopy, you should notify the physician performing the procedure (or his nurse) if taking medications for diabetes (oral or injectable) and/or anticoagulants (“blood thinners”) such as Coumadin (Warfarin), Heparin, Lovenox (Enoxaparin), Plavix (Clopidogrel), Pradaxa (Dabigatran) or Ticlid (Ticlopidine). Also, you should notify your physician of taking Aspirin, Ibuprofen, Advil, Naprosyn, Voltaren, and other similar anti-inflammatory medications.

For details concerning colonoscopic technique, risks of the procedure, and multiple potential benefits of colonoscopy, please click on this link to the American Gastroenterological Association Web Site.

Flexible Sigmoidoscopy

A Flexible Sigmoidoscopy is usually performed without sedation.

A flexible sigmoidoscopy is an endoscopic procedure similar to colonoscopy, which is also performed by Dr. Janecki. The major difference is that the endoscope used for flexible sigmoidoscopy is much shorter than that used for colonoscopy. The procedure is, therefore, easier to perform and generally shorter. However, only about one-third of the colon (so-called distal colon) is evaluated and, therefore, many proximal lesions are missed. Moreover, the procedure is usually performed without sedation and may, therefore, result in some discomfort and pain.

Flexible sigmoidoscopy may be used for evaluation of distal colonic disorders like rectal bleeding or rectal/anal pain. It may also be used for screening for colorectal cancer. For this purpose, however, it must be combined with other methods. Generally, the ability of flexible sigmoidoscopy to evaluate the patient for risk for colon cancer is much poorer than that of colonoscopy.

ERCP

During an endoscopic retrograde cholangiopancreatography (ERCP) patients are sedated with intravenous medications.

An endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic procedure which enables the physician to evaluate the biliary tree, the gallbladder, and the pancreatic ducts. Dr. Janecki performs ERCP procedures regularly. The biliary tree is a system of ducts draining bile from the liver into the duodenum (an initial segment of the small bowel). Bile is a dark yellow liquid which helps in digestion of fat. The gallbladder is a small organ connected to the biliary tree, and it serves as a storage container for bile. Pancreatic ducts drain the juice produced by the pancreas into the duodenum. Pancreatic ducts are connected to the biliary tree. Pancreatic juice contains substances which are essential for digestion of food in the small bowel.

An ERCP is used primarily to diagnose and treat diseases of the biliary tree and pancreatic ducts, including gallstones, inflammatory strictures (narrowing of the ducts), leaks (from injury or surgery), and cancer. ERCP combines the use of X- rays and an endoscope, which is an instrument similar to the one used for EGD and colonoscopy. Through the endoscope, the physician can see the inside of the stomach and duodenum and can inject dyes into the ducts of the biliary tree and pancreas so they can be seen on X-rays.

During the procedure, patients are sedated with intravenous medications. The risks of ERCP are higher than those of EGD or colonoscopy and include pancreatitis (inflammation of the pancreas), bleeding, perforation of the intestine or biliary tree, and infection.

At least a week prior to ERCP, you should notify the physician performing the procedure (or his nurse) if taking medications for diabetes (oral or injectable) and/or anticoagulants (“blood thinners”) such as Coumadin (Warfarin), Heparin, Lovenox (Enoxaparin), Plavix (Clopidogrel), Pradaxa (Dabigatran) or Ticlid (Ticlopidine). Also, you should notify your physician of taking Aspirin, Ibuprofen, Advil, Naprosyn, Voltaren, and other similar anti-inflammatory medications.

For details concerning the technique and indications for ERCP, as well as risks of the procedure, please click on this link to the American Gastroenterological Association Web Site.

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