Procedures

Information

Direct visualization of the digestive tract with lighted instruments is referred to as gastrointestinal endoscopy. Your physician has advised you of your need to have this type of examination. The following information is presented to help you understand the reasons for, & possible risks of these procedures. At the time of your examination, the inside lining of the digestive tract will be inspected & possibly photographed. If an abnormality is seen or suspected, a small portion of tissue (biopsy) may be removed for microscopic study, or the lining may be brushed and washed with a solution that can be sent for analysis of abnormal cells (cytology). Small growths can frequently be completely removed (polypectomy), using a wire loop & electrical current. Occasionally during the examination a narrowed portion (stricture) will be stretched to a more normal size (dilatation). Some cancers may be missed by endoscopy. Some cancers can develop and progress in a short period of time.

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Risks

The following are the common risks of these procedures:

• Injury to the lining of the digestive tract by the instrument which may result in perforation (tear) in the wall and leakage into the body cavities; if this occurs, surgical operation to close the leak and drain the region is often necessary.
• Bleeding, if it occurs, usually is a complication of biopsy, polypectomy, or dilatation. Management of this complication may consist only of careful observation or may require blood transfusion or possibly a surgical operation for control.

Other risks include possible drug reactions, complication due to other diseases you may have, or vein irritation caused by medication given into your vein during endoscopy procedure. This vein irritation may cause temporary soreness, numbness, or small bumps due to scar tissue in that arm. You should inform your physician of all your allergies and medical problems.

We ask that all jewelry & body piercings be removed prior to your procedure for your safety. The potential risks of wearing jewelry in the procedure room may include but are not limited to lacerations, pressure injuries, jewelry or tissue damage caused by entanglement of items (such as monitoring cables), and electrocautery burns. It is important to remove jewelry or piercings in or around the mouth or nose to avoid dislocation, injury, or aspiration into the lungs.

ALL OF THESE COMPLICATIONS ARE POSSIBLE BUT OCCUR WITH A VERY LOW FREQUENCY.

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Upper Endoscopic Procedures

• ESOPHAGOGASTRODUODENOSCOPY (EGD):   Also called an Upper Endoscopy is a procedure that allows the physician to look at the inside of the esophagus, stomach, and the duodenum (the site of most ulcers in the small intestine). It involves swallowing a thin, flexible, lighted tube called an endoscope. The endoscope allows the physician to view the inside of this area of the body, as well as to insert instruments through the scope. Biopsy, cytology, specimen collection, polypectomy and dilatation of strictures may be necessary.
• UPPER ENDOSCOPIC VARICEAL LIGATION:    Elastic bands are applied to esophageal or gastric varices to control bleeding.

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Lower Endoscopic Procedures

• FLEXIBLE SIGMOIDOSCOPY:   Sigmoidoscopy is a diagnostic procedure that allows the physician to look at the inside of the lower portion of the large intestine. It is helpful in identifying the causes of diarrhea, abdominal pain, constipation, abnormal growths, and bleeding. A short, flexible, lighted tube called a sigmoidoscope is inserted into the intestine through the rectum.
• COLONOSCOPY:   Colonoscopy is a procedure that allows the physician to view the entire length of the large intestine, and can often help identify abnormal growths, inflamed tissue, ulcers, and bleeding. It involves inserting a colonoscope, a flexible lighted tube, in through the rectum up into the colon. The colonoscope allows the physician to see the lining of the colon, as well as treat some problems that are discovered and remove tissue for further examination.
• LOWER ENDOSCOPIC VARICEAL LIGATION:   Elastic bands are applied to hemorrhoids to control bleeding.

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Other Procedures

• BRAVO pH Monitoring: An EGD procedure is performed and the BRAVO capsule is applied temporarily to the esophageal wall above the lower esophageal sphincter (LES). A small monitor is worn for 48-96 hrs. allowing the capsule to wirelessly transmit information to evaluate how much and often gastric (stomach) reflux is experienced during a normal day. This test helps your doctor make plans for treatment if needed.
   

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• SCHLEROTHERAPY:   The injection of medication into varicose veins of the esophagus and/or stomach, that causes them to shrink or stop bleeding.
• PARACENTESIS:   Paracentesis is a procedure to remove fluid that has accumulated in the abdominal cavity (peritoneal fluid), a condition called ascites. Ascites may be caused by infection, inflammation, abdominal injury, or other conditions, such as cirrhosis or cancer. The fluid is removed using a needle inserted through the abdominal wall and sent to a lab for analysis to determine the cause of the fluid buildup. Paracentesis also may be done to drain the fluid as a comfort measure in people with cancer or chronic cirrhosis. This is not an endoscopic examination.
• P.E.G. (Percutaneous Endoscopic Gastrostomy) TUBE:   This is a tube inserted through the abdominal wall that rests in the stomach and is used to give nutrients to patients who cannot swallow and/or who have the inability to consume enough food or liquids by mouth.

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