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is a Colonoscopy?
The term "colonoscopy" means looking inside the colon. It is a procedure
performed by a gastroenterologist, a well-trained subspecialist.
The colon, or large bowel, is the last portion of your digestive or GI
tract. It starts at the cecum, which attaches to the end of the small intestine,
and it ends at the rectum and anus. The colon is a hollow tube, about five
feet long, and its main function is to store unabsorbed food products prior
to their elimination.
The main instrument that is used to look inside the colon is the colonoscope,
which is a long, thin, flexible tube with a tiny video camera and a light
on the end. By adjusting the various controls on the colonoscope, the gastroenterologist
can carefully guide the instrument in any direction to look at the inside
of the colon. The high quality picture from the colonoscope is shown on
a TV monitor, and gives a clear, detailed view.
Colonoscopy is more precise than an X-ray. This procedure also allows
other instruments to be passed through the colonoscope. These may be used,
for example, to painlessly remove a suspicious-looking growth or to take
a biopsy-a small piece for further analysis. In this way, colonoscopy may
help to avoid surgery or to better define what type of surgery may need
to be done.
A shorter version of the colonoscope is called a sigmoidoscope, an instrument
used to screen the lower part of the large bowel only. The colonoscope,
however, is long enough to inspect all of the large bowel and even part
of the small intestine.
Colonoscopy is a safe and effective way to evaluate problems such as blood
loss, pain, and changes in bowel habits such as chronic diarrhea or abnormalities
that may have first been detected by other tests. Colonoscopy can also
identify and treat active bleeding from the bowel.
Colonoscopy is also an important way to check for colon cancer and to
treat colon polyps - abnormal growths on the inside lining of the intestine.
Polyps vary in size and shape and, while most are not cancerous, some may
turn into cancer. However, it is not possible to tell just by looking at
a polyp if it is malignant or potentially malignant. This is why colonoscopy
is often used to remove polyps, a technique called a polypectomy.
How Do I Prepare for the
There are important steps that you must take to prepare for the procedure.
First, be prepared to give a complete list of all the medicines you are
taking, as well as any allergies you have to drugs or other substances.
Your medical team will also want to know if you have any other medical
conditions that may need special attention before, during, or after the
You will be given instructions in advance that will outline what you should
and should not do in preparation for colonoscopy. Be sure to
read and follow these instructions. One very critical step is
to thoroughly clean out the colon, which, for many patients, can be the
most trying part of the entire exam. It is essential that you complete
this step carefully, because how well the bowel is emptied determines the
success of the procedure.
Various methods can be used to help cleanse the bowel. Often, a liquid
preparation designed to stimulate bowel movements is given by mouth, which
may cause bloating. Other laxative preparations, such as castor oil, may
also be used. Additional approaches include special diets or the use of
enemas. Whatever method or combination of methods that is recommended for
you, be sure to follow instructions as directed.
And remember, you should not consume anything within eight to ten hours
before your colonoscopy.
Colonoscopy can be done in either a hospital or outpatient office. You’ll
be asked to sign a form that gives your consent to the procedure and states
that you understand what is involved. If there is anything you don’t understand,
ask for more information or click the attached link,
What Can You Expect During a
During the procedure, everything will be done to ensure your comfort.
An intravenous, or IV, line will be inserted to give you medication to
make you relaxed and drowsy. The drug will enable you to remain awake and
cooperative, but it may prevent you from remembering much of the experience.
Once you are fully relaxed, your doctor will do a rectal exam with a gloved,
lubricated finger; then the lubricated colonoscope will be gently inserted.
As the scope is slowly and carefully passed, you may feel as if you need
to move your bowels, and because air is introduced to help advance the
scope, you may feel some cramping or fullness. Generally, however, there
is little to no discomfort.
What are the Possible
Complications from a Colonoscopy?
Although colonoscopy is a safe procedure, complications can sometimes
occur. These include perforation - a puncture of the colon walls, which
could require surgical repair.
When polyp removal or biopsy is performed, hemorrhage (heavy bleeding)
may result and sometimes require blood transfusion or reinsertion of the
colonoscope to control the bleeding. Be sure to discuss any specific concerns
you may have about the procedure with your doctor.
The time needed for colonoscopy will vary, but on the average, the procedure
takes about 30 minutes. Afterwards, you’ll be cared for in a recovery area
until the effects of the medication have worn off. At this time, your doctor
will inform you about the preliminary results of your colonoscopy and provide
any additional information that you need to know. You’ll also be given
instructions about how soon you can eat and drink, plus other guidelines
for resuming your normal routine.
What Can You Expect After
Occasionally, minor problems may persist, such as bloating, gas, or mild
cramping. These symptoms should disappear in 24 hours or less. By the time
you’re ready to go home, you’ll feel stronger and more alert. Nevertheless,
rest for the remainder of the day. Have a family member or friend take
A day or so after you’re home, you might speak with a member of the colonoscopy
team for follow-up, or you may have questions you want to ask the doctor
What is Upper
The term "endoscopy" refers to a special technique for
looking inside a part of the body. "Upper GI" is the portion of the
gastrointestinal tract, the digestive system, that includes the esophagus, the
swallowing tube leading to the stomach, which is connected to the duodenum, the
beginning of the small intestine. The esophagus carries food from the mouth for
digestion in the stomach and duodenum.
Upper GI endoscopy is a procedure performed by a
gastroenterologist, a well-trained subspecialist who uses the endoscope to
diagnose and, in some cases, treat problems of the upper digestive system.
The endoscope is a long, thin, flexible tube with a tiny
video camera and light on the end. By adjusting the various controls on the
endoscope, the gastroenterologist can safely guide the instrument to carefully
examine the inside lining of the upper digestive system.
The high quality picture from the endoscope is shown on a TV
monitor; it gives a clear, detailed view. In many cases, upper GI endoscopy is a
more precise examination than X-ray studies.
Upper GI endoscopy can be helpful in the evaluation or
diagnosis of various problems, including difficult or painful swallowing, pain
in the stomach or abdomen, and bleeding, ulcers, and tumors.
How Do I Prepare for the
Regardless of the reason upper GI endoscopy has been
recommended for you, there are important steps you can take to prepare for and
participate in the procedure. First, be sure to give your doctor a complete list
of all the medicines you are taking and any allergies you have to drugs or other
Your medical team will also want to know if you have heart,
lung, or other medical conditions that may need special attention before,
during, or after upper GI endoscopy. You will be given instructions in advance
that will outline what you should and should not do in preparation for the upper
GI endoscopy. Be sure to read and follow these instructions.
One very important step in preparing for upper GI endoscopy
is that you should not eat or drink within eight to ten hours of your procedure.
Food in the stomach will block the view through the endoscope, and it could
Upper GI endoscopy can be done in either a hospital or
outpatient office. You’ll be asked to sign a form that verifies that you consent
to having the procedure and that you understand what is involved.
If there is anything you don’t understand, ask for more
What Can You Expect During an
Upper GI Endoscopy?
During the procedure, everything will be done to help you be
as comfortable as possible. Your blood pressure, pulse, and the oxygen level in
your blood will be carefully monitored. Your doctor may give you a sedative
medication; the drug will make you relaxed and drowsy, but you will remain awake
enough to cooperate.
You may also have your throat sprayed or be asked to gargle
with a local anesthetic to help keep you comfortable as the endoscope is passed.
A supportive mouthpiece will be placed to help you keep your mouth open during
the endoscopy. Once you are fully prepared, your doctor will gently maneuver the
endoscope into position.
As the endoscope is slowly and carefully inserted, air is
introduced through it to help your doctor see better. During the procedure, you
should feel no pain and it will not interfere with your breathing.
Your doctor will use the endoscope to look closely for any
problems that may require evaluation, diagnosis, or treatment.
In some cases, it may be necessary to take a sample of
tissue, called a biopsy, for later examination under the microscope. This, too,
is a painless procedure. In other cases, this endoscope can be used to treat a
problem such as active bleeding from an ulcer.
What are the Possible
Complications From an Upper GI Endoscopy?
Years of experience have proved that upper GI endoscopy is a
safe procedure. Typically, it takes only 15-20 minutes to perform.
Complications rarely occur. These include perforation - a
puncture of the intestinal wall, which could require surgical repair, and
bleeding, which could require transfusion. Again, these complications are
unlikely. Be sure to discuss any specific concerns you may have with your
When your endoscopy is completed you’ll be cared for in a
recovery area until most of the effects of the medication have worn off.
Your doctor will inform you about the preliminary results of
the procedure and provide any additional information you need to
What Can I Expect After My
Upper GI Endoscopy?
You will be given instructions regarding how soon you can
eat and drink, plus other guidelines for resuming your normal
Occasionally, minor problems may persist, such as mild sore
throat, bloating, or cramping; these should disappear in 24 hours or
By the time you’re ready to go home, you’ll feel stronger
and more alert. Nevertheless, you should plan on resting for the remainder of
the day. This means not driving, so you’ll need to have a family member or
friend take you home.
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What is Esophageal
Esophageal dilation is a procedure that allows your doctor to dilate,
or stretch, a narrowed area of your esophagus [swallowing tube]. Doctors
can use various techniques for this procedure. Your doctor might perform
the procedure as part of a sedated endoscopy. Alternatively, your doctor
might apply a local anesthetic spray to the back of your throat and then
pass a weighted dilator through your mouth and into your esophagus.
Why is Esophageal Dilation Done?
The most common cause of narrowing of the esophagus, or stricture, is
scarring of the esophagus from reflux of stomach acid occurring in patients
with heartburn. Patients with a narrowed portion of the esophagus often
have trouble swallowing; food feels like it is “stuck” in the chest region,
causing discomfort or pain. Less common causes of esophageal narrowing
are webs or rings (which are thin layers of excess tissue), cancer of the
esophagus, scarring after radiation treatment or a disorder of the way
the esophagus moves [motility disorder].
How Should I Prepare for the Procedure?
An empty stomach allows for the best and safest examination, so you should
have nothing to drink, including water, for at least six hours before the
examination. Your doctor will tell you when to start fasting.
Tell your doctor in advance about any medications you take, particularly
aspirin products or anticoagulants (blood thinners such as warfarin or
heparin), or clopidogrel. Most medications can be continued as usual, but
you might need to adjust your usual dose before the examination. Your doctor
will give you specific guidance. Tell your doctor if you have any allergies
to medications as well as medical conditions such as heart or lung disease.
Also, tell your doctor if you require antibiotics prior to dental procedures,
because you might need antibiotics prior to esophageal dilation as well.
What Can I Expect during Esophageal Dilation?
Your doctor might perform esophageal dilation with sedation along with
an upper endoscopy. Your doctor may spray your throat with a local anesthetic
spray, and then give you sedatives to help you relax. Your doctor then
will pass the endoscope through your mouth and into the esophagus, stomach
and duodenum. The endoscope does not interfere with your breathing. At
this point your doctor will determine whether to use a dilating balloon
or plastic dilators over a guiding wire to stretch your esophagus. You
might experience mild pressure in the back of your throat or in your chest
during the procedure. Alternatively, your doctor might start by spraying
your throat with a local anesthetic. Your doctor will then pass a tapered
dilating instrument through your mouth and guide it into the esophagus.
Your doctor may also use x-rays during the esophageal dilation procedure.
What Can I Expect after Esophageal Dilation?
After the dilation is done, you will probably be observed for a short
period of time and then allowed to return to your normal activities. You
may resume drinking when the anesthetic no longer causes numbness to your
throat, unless your doctor instructs you otherwise. Most patients experience
no symptoms after this procedure and can resume eating the next day, but
you might experience a mild sore throat for the remainder of the day.
If you received sedatives, you probably will be monitored in a recovery
area until you are ready to leave. You will not be allowed to drive after
the procedure even though you might not feel tired. You should arrange
for someone to accompany you home, because the sedatives might affect your
judgment and reflexes for the rest of the day.
What are the Potential Complications of Esophageal Dilation?
Although complications can occur even when the procedure is performed
correctly, they are rare when performed by doctors who are specially trained.
A perforation, or hole, of the esophagus lining occurs in a small percentage
of cases and may require surgery. A tear of the esophagus lining may occur
and bleeding may result. There are also possible risks of side effects
It is important to recognize early signs of possible complications. If
you have chest pain, fever, trouble breathing, difficulty swallowing, bleeding
or black bowel movements after the test, tell your doctor immediately.
Will Repeat Dilations be Necessary?
Depending on the degree and cause of narrowing of your esophagus, it is
common to require repeat dilations. This allows the dilation to be performed
gradually and decreases the risk of complications. Once the stricture,
or narrowed esophagus, is completely dilated, repeat dilations may not
be required. If the stricture was due to acid reflux, acid-suppressing
medicines can decrease the risk of stricture recurrence. Your doctor will
advise you on this.
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Capsule Endoscopy (Pill Cam)
The M2A Capsule is easily swallowed, travels painlessly through the digestive
tract, and is naturally passed from the body. On its journey the M2A captures
and transmits video images to a recorder worn comfortably by the patient.
When the test is complete, the data is downloaded from the recorder to
a computer workstation where a physician can view the results.
- M2A is the only non-invasive means of seeing inside the full length of
the 21-foot-long small intestine.
- This technology allows for complete freedom of movement: patients are
no longer confined and can freely go about their daily activities
- It is particularly useful in helping physicians pinpoint the cause of
previously undiagnosed small intestine disorders.
The M2A Capsule is part of the
Given Diagnostic System, which is intended for the visualization of
the small bowel mucosa. Capsule endoscopy is a standard test for the detection
of small bowel abnormalities. This diagnostic is usually appropriate only
after standard diagnostic results are negative. This procedure is not a
replacement for a colonoscopy or upper endoscopy.
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