Gastrointestinal Procedures

Abdominal Sonogram

An abdominal sonogram is a diagnostic imaging test that helps physicians diagnose and treat potential maladies within the abdominal area. Unlike other ionizing-type wave imaging systems, sonograms capture images in real-time, allowing the technician and the patient to view the results immediately while the machine is imaging.

During an abdominal sonogram, a soft gel is spread across the abdomen, which helps the sound waves travel between the machine and the body. While the imaging itself is completely painless, the patient may experience discomfort if the area to be imaged was tender beforehand. No downtime is required after an abdominal sonogram; regular activities can be resumed immediately afterwards.

Colonoscopy

A colonoscopy is a diagnostic procedure performed to examine the inside of the colon and rectum. The colonoscopy procedure can aid in determining the cause of changes in bowel activity, abdominal pain, rectal bleeding, as well as detect early signs of cancer. A colonoscopy may be recommended as an option for people who are at risk of developing cancer of the colon and rectum, known as colorectal cancer, or CRC.

Patients will be given a set of written instructions to follow. A clear liquid diet should be followed for 1 to 3 days prior to the procedure. Depending on the instructions provided, a laxative or enema may be required. Patients may need to drink a special bowel cleansing solution, the day before the procedure. Most medications can still be taken, although some such as aspirin or blood thinners may require special instructions.

Before the colonoscopy procedure, an intravenous, or IV, with a light sedative will be used to make the patient comfortable. Vital signs will be monitored throughout the procedure. The patient will lie on their left side as the colonoscope is inserted into the anus and guided to the opening of the small intestine. The colonoscope is then slowly withdrawn from the colon and the lining of the colon is examined carefully by the physician. The removal of polyps, or growths, for biopsy may also be conducted during the procedure. The colonoscopy procedure usually takes between 30-60 minutes to perform.

After the procedure, patients will be kept under observation for up to 2 hours, until the sedative used for the procedure wears off. Reflexes and judgment may be impaired and driving is not permitted for 24 hours after the procedure. Some people may experience pressure, bloating and cramping in the abdomen after the procedure, but these effects are temporary.

Fecal Occult Blood Test

The fecal occult blood test is a type of test performed on the stool to determine the possible presence of colorectal cancer. The sample is treated with chemicals to check for small quantities of blood that can signal the incidence of disease. If blood is found in the fecal occult blood test, other forms of testing will be recommended to diagnose its source, which may be hemorrhoids, colitis, ulcers or several other conditions.

Flexible Sigmoidoscopy

A flexible sigmoidoscopy is a diagnostic procedure performed to examine the sigmoid, the last one-third of the colon, also known as the descending colon. A flexible sigmoidoscopy procedure can aid in determining the cause of changes in bowel activity, abdominal pain, rectal bleeding, as well as detect early signs of cancer. A flexible sigmoidoscopy may be recommended as an option for people over the age of 50 who are at risk of developing colon or rectal cancer.

During a flexible sigmoidoscopy, a long, thin, flexible tube with a camera mounted on the end of the tube, called a sigmoidoscope, is inserted into the sigmoid part of the colon through the anus. Images of the rectum and sigmoid colon are displayed on a screen for the doctor to examine and detect any abnormalities. The removal of polyps, or growths, for biopsy may also be conducted during the procedure. A sigmoidoscopy usually takes 20 minutes to perform. Some people may experience pressure, bloating and cramping in the abdomen after the procedure, but these effects are temporary. If certain symptoms, such as colon polyps, are found, a more thorough examination of the colon may be required.

Hemorrhoid Coagulation Treatment

Hemorrhoids should only be treated if they are painful or cause complications. One of the methods of treatment of hemorrhoids is coagulation, with either infrared or laser light or heat. During the procedure, the hemorrhoid is exposed to warm, painless infrared or laser light or an electrical current over a series of treatment sessions. This process causes the swollen veins to contract and recede. There is little to no risk of complications associated with this procedure, and no more discomfort than a quick perception of heat in the treatment area.

Lower GI Endoscopy

A lower endoscopy is a minimally invasive diagnostic procedure performed to examine the lower portion of the gastrointestinal tract. The procedure can aid in the diagnosis of conditions such as cancer, polyps or inflammation, as well as determine the cause of bleeding or other abnormalities. The procedure may be performed as either a colonoscopy or sigmoidoscopy.

During a lower endoscopy, a thin, flexible tube is passed through the anus into the lower gastrointestinal tract. Intravenous sedation may be administered to help relieve anxiety or discomfort. Images of the gastrointestinal tract are displayed on a screen for the doctor to examine and detect any abnormalities. The removal of polyps, or growths, for biopsy may also be conducted during the procedure. The procedure usually takes about 20 minutes to perform. Some people may experience pressure, bloating and cramping in the abdomen after the procedure, but these effects are temporary.

Upper Endoscopy

An esophagogastroduodenoscopy, also known as an EGD or upper endoscopy, is a diagnostic procedure that examines and treats certain conditions of the upper gastrointestinal tract, which includes the esophagus, stomach and upper part of the small intestine, with an endoscope. An EGD is able to aid in the diagnosis of conditions affecting the upper digestive tract issues, including nausea, vomiting, heartburn, abdominal pain and ulcers. During the EGD procedure, tissue samples can be obtained for biopsy, objects can be removed and therapeutic procedures may be performed.

Patients with a weakened immune system may need to take antibiotics before the procedure. Four to eight hours before the EGD, patients are not allowed to eat, drink, smoke or chew gum, with the exception of medication, which can be taken with a small sip of water. Driving is not permitted up to 24 hours after the procedure and the patient will need to arrange for transportation home.

The EGD is performed either as an outpatient procedure at the hospital or at an outpatient clinic. After the EGD, the patient will be monitored in a recovery area for about half an hour. A sore throat is common right after an EGD, but it can be soothed with lozenges. With the doctor's approval, regular activities can usually be resumed the very next day.

Results are usually available after an EGD and will be discussed with the patient after the sedative has worn off. If a biopsy was performed during the procedure, the results will be available after the sample has been sent to a pathology lab for more detailed testing.

Valerie Heron MD

Patient Education