Endoscopy

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What is a Colonoscopy?

Colonoscopy enables your doctor to look at the liner of your colon (large intestine) for abnormalities by inserting a versatile tube as thick as your finger into your anus and slowly advancing it into the rectum and colon. If your doctor has recommended a colonoscopy, this brochure will provide you with a basic understanding of the procedure - how it's performed, how it can help, and what side effects you might experience. It can't answer all of your questions since much depends on the individual patient and also the doctor. Please ask your doctor about anything you don't understand.

What preparation is required?

Your doctor will tell you what dietary restrictions to follow and what cleansing routine to use. In general, the preparation consists of either consuming an oversized volume of a special cleansing solution or clear liquids and special oral laxatives. The colon must be completely clean for the procedure to be accurate and complete, so be sure to follow your doctor's instructions carefully.

Can I take my current medications?

Most medications can be continued as usual, but some medications can interfere with the preparation or the examination. Inform your doctor about medications you are taking, particularly aspirin products, arthritis medications, anticoagulants (blood thinners), insulin, or iron products. Also, make sure to say allergies you've got to medications.

Alert your doctor if you need antibiotics before dental procedures, because you would possibly need antibiotics before a colonoscopy also.

What happens during colonoscopy?

Colonoscopy is well-tolerated and rarely causes much pain. You might feel pressure, bloating, or cramping during the procedure. Your doctor might provide you with a sedative to assist you to relax and better tolerate any discomfort.

You will lie on your side or back while your doctor slowly advances a colonoscope through your bowel to look at the lining. Your doctor will examine the lining again as he or she slowly withdraws the colonoscope. The procedure itself usually takes 15 to 60 minutes, although you should plan on two to three hours for waiting, preparation and recovery.

In some cases, the doctor cannot pass the colonoscope through the complete colon to where it meets the little intestine. Although another examination may be needed, your doctor might decide that the limited examination is sufficient.

What if the colonoscopy shows something abnormal?

If your doctor thinks a region needs further evaluation, he or she might pass an instrument through the colonoscope to get a biopsy (a sample of the colon lining) to be analyzed. Biopsies are used to identify many conditions, and your doctor might order one even though he or she doesn't suspect cancer. If colonoscopy is being performed to spot sites of bleeding, your doctor might control the bleeding through the colonoscope by injecting medications or by coagulation (sealing off bleeding vessels with heat treatment). Your doctor may additionally find polyps during colonoscopy, and he or she's going to possibly remove them during the examination. These procedures don't usually cause any pain.

What are polyps and why are they removed?

Polyps are abnormal growths within the colon lining that are usually benign (noncancerous). They vary in size from a little dot to many inches. Your doctor can't always tell a benign polyp from a malignant (cancerous) polyp by its outer appearance, so he or she might send removed polyps for analysis. Because cancer begins in polyps, removing them is a very important means of preventing colorectal cancer.

How are polyps removed?

Your doctor might destroy tiny polyps by fulguration (burning) or by removing them with wire loops called snares or with biopsy instruments. Your doctor might use a technique called "snare polypectomy" to remove larger polyps. That technique involves passing a wire loop through the colonoscope and removing the polyp from the intestinal wall using an electrical current. You should feel no pain during the polypectomy.

What happens after a colonoscopy?

Your physician will explain the results of the examination to you, although you'll probably have to wait for the results of any biopsies performed.

If you've got been given sedatives during the procedure, someone must drive you home and stick with you. Even if you are feeling alert after the procedure, your judgment and reflexes may be impaired for the remainder of the day. You might have some cramping or bloating owing to the air introduced into the colon during the examination. This should disappear quickly when you pass gas.

You should be ready to eat after the examination, but your doctor might restrict your diet and activities, especially after polypectomy.

What are the possible complications of colonoscopy?

Colonoscopy and polypectomy are generally safe when performed by doctors who are specially trained and are experienced in these procedures.

One possible complication is a perforation, or tear, through the bowel wall that could require surgery. Bleeding might occur at the positioning of biopsy or polypectomy, but it has always minor. Bleeding can stop on its own or be controlled through the colonoscope; it rarely requires follow-up treatment. Some patients might need a reaction to the sedatives or complications from heart or lung disease.

Although complications after colonoscopy are uncommon, it is important to acknowledge early signs of possible complications. Contact your doctor if you notice severe abdominal pain, fever and chills, or rectal bleeding over one-half cup. Note that bleeding can occur several days after the procedure.

What is flexible sigmoidoscopy?

Flexible sigmoidoscopy lets your doctor examine the liner of the rectum and some of the colon (large intestine) by inserting a versatile tube about the thickness of your finger into the anus and slowly advancing it into the rectum and lower a part of the colon.

What preparation is required?

Your doctor will tell you what cleansing routine to use. In general, preparation consists of one or two enemas prior to the procedure but could include laxatives or dietary modifications as well. However, in some circumstances your doctor might advise you to forgo any special preparation. Because the rectum and lower colon must be completely empty for the procedure to be accurate, it is important to follow your doctor's instructions carefully.

Should I continue my current medications?

Most medications can be continued as usual. Inform your doctor about medications that you are taking - particularly aspirin products or anticoagulants (blood thinners like warfarin or heparin), or clopidogrel, likewise as any allergies you have to medications.

What can I expect during flexible sigmoidoscopy?

Flexible sigmoidoscopy is usually well-tolerated. You might experience a sense of pressure, bloating or cramping during the procedure. You will lie on your side while your doctor advances the sigmoidoscope through the rectum and colon. As your doctor withdraws the instrument, your doctor will carefully examine the lining of the intestine.

What if the flexible sigmoidoscopy finds something abnormal?

If your doctor sees a region that needs further evaluation, your doctor might take a biopsy (tissue sample) to be analyzed. Obtaining a biopsy doesn't cause any pain or discomfort. Biopsies are used to identify many conditions, and your doctor might order one even though he or she doesn't suspect cancer.

If your doctor finds polyps, he or she might take a biopsy of them likewise. Polyps, which are growths from the lining of the colon, vary in size and kinds. Polyps referred to as "hyperplastic" may not require removal, but benign polyps called "adenomas" have any low risk of becoming cancerous. Your doctor will likely ask you to have a colonoscopy (a complete examination of the colon) to get rid of any large polyps or any small adenomas.

What happens after a flexible sigmoidoscopy?

Your doctor will explain the results to you when the procedure is finished. You might feel bloating or some mild cramping due to the air that was passed into the colon during the examination. This will disappear quickly when you pass gas. You should be ready to eat and resume your normal activities after leaving your doctor's office or the hospital, assuming you probably did not receive any sedative medication.

What are possible complications of flexible sigmoidoscopy?

Flexible sigmoidoscopy and biopsy are safe when performed by doctors who are specially trained and experienced in these endoscopic procedures. Complications are rare, but you need to acknowledge early signs of possible complications. Contact your doctor if you notice severe abdominal pain, fevers, and chills, or rectal bleeding. Note that rectal bleeding can occur several days after the exam.

What is a therapeutic ERCP?

Endoscopic retrograde cholangiopancreatography, or ERCP, could be a study of the ducts that drain the liver and pancreas. Ducts are drainage routes into the bowel. The ones that drain the liver and gallbladder are called bile or biliary ducts. The one that drains the pancreas is named the duct . The bile and pancreatic ducts join together just before they drain into the upper bowel, about 3 inches from the stomach. The drainage opening is called the papilla. The papilla is surrounded by a circular muscle, called the sphincter of Oddi. Diagnostic ERCP is when X-ray contrast dye is injected into the common bile duct , the duct , or both. This contrast dye is squirted through atiny low tube called a catheter that matches through the ERCP endoscope. X-rays are taken during ERCP to urge pictures of those ducts. That is called diagnostic ERCP. However, most ERCPs are literally finished treatment and not just photography . When an ERCP is completed to permit treatment, it's called therapeutic ERCP.

Percutaneous Endoscopic Gastrostomy (PEG)

Percutaneous endoscopic gastrostomy, or PEG, maybe a procedure during which an endoscope assists the location of a versatile feeding tube through the wall and into the stomach. The PEG procedure is for patients who have difficulty swallowing, problems with their appetite, or an inability to require enough nutrition through the mouth. It allows nutrition, fluids, and/or medications to be put directly into the stomach, bypassing the mouth and esophagus.

IIn this procedure, the endoscopist uses a lighted, flexible tube called an endoscope to guide the creation of a little opening through the skin of the abdomen and directly into the stomach. This allows the doctor to position and secures a feeding tube into the stomach. Patients generally receive a sedative and native anesthesia, and an antibiotic is given by vein before the procedure. Patients can usually go home the day of the procedure or the next day.

A PEG does not prevent a patient from eating or drinking, but depending on the medical condition and situation, the doctor might decide to limit or completely avoid eating or drinking.

PEG tubes can last for months or years. However, because they will break down or become clogged over extended periods of your time, they may get replaced. The doctor can remove or replace a tube without sedatives or anesthesia, although he or she might choose to use sedation and endoscopy in some cases. PEG sites close quickly once the tube is removed, so accidental dislodgment requires immediate attention.