Gastroenterology

GastroenterologyColonoscopy

During colonoscopy, the physician will look inside of the entire colon and rectum for polyps, small growths that over time can become cancer. A colonoscope — a thin, flexible, hollow, and lighted tube that has a tiny video camera —is gently eased into the colon by the physician gently, and sends pictures to a TV screen. Small amounts of air are puffed into the colon to keep it open and let the physician see clearly. The exam takes about 30 minutes. Patients are usually given medicine to help them relax and sleep while it is performed.

Flexible sigmoidoscopy

During sigmoidoscopy, a physician closely looks only at the lower part of the colon and the rectum for signs of cancer or polyps. Because the scope used is only about two feet long, the physician is able to see the entire rectum but less than half of the colon with this exam. The physician uses a thin (about the thickness of a finger), flexible, hollow, lighted tube that has a tiny video camera on the end called a sigmoidoscope. The sigmoidoscope is gently eased inside the colon and sends pictures to a TV screen. Small amounts of air are puffed into the colon to keep it open and let the physician see clearly.

Removing polyps can help prevent colorectal cancer from ever starting. Cancers found in an early stage, while they are small and before they have spread, are more easily treated. Nine out of 10 people whose colon cancer is discovered early will be alive five years later, according to The American Cancer Society. And many will live a normal life span.

Upper Endoscopy

Upper endoscopy lets your physician examine the lining of the upper gastrointestinal tract, which includes the esophagus, stomach and duodenum and helps to evaluate symptoms of upper abdominal pain, nausea, vomiting or difficulty swallowing. It's the best test for finding the cause of bleeding from the upper GI tract. It's also more accurate than X-ray films for detecting inflammation, ulcers and tumors of the esophagus, stomach and duodenum. The physician uses a thin, flexible tube called an endoscope, which has its own lens and light source, and views the images on a video monitor.

Your physician might use upper endoscopy to obtain a biopsy to distinguish between benign and malignant (cancerous) tissues. Biopsies are taken for many reasons, and your physician might order one even if he or she does not suspect cancer. For example, your physician might use a biopsy to test for Helicobacter pylori, the bacterium that causes ulcers.

Upper endoscopy is also used to treat conditions of the upper gastrointestinal tract. Your physician can pass instruments through the endoscope to directly treat many abnormalities — this will cause you little or no discomfort.

Endoscopic Ultrasonography

The combination of endoscopy and ultrasound, endoscopic ultrasonography, allows physicians to "microscopically" examine tissue within and surrounding the digestive tract. Like endoscopy, EUS uses a flexible tube called an endoscope, to photograph and videotape the internal organs. EUS is similar to a regular endoscopy, although it takes more time because it is more precise, and because there are more details for the physician to examine and interpret. The high frequency of EUS reveals the full extent of abnormalities not detectable by most other means, including information that is critical to accurate diagnosis and optimum care.

Endoscopic Retrograde Cholangiopancreatography

Endoscopic retrograde cholangiopancreatography, or ERCP, is a specialized technique used to study the bile ducts, pancreatic duct and gallbladder. Ducts are drainage routes; the drainage channels from the liver are called bile or biliary ducts. The pancreatic duct is the drainage channel from the pancreas.

During ERCP, your physician will pass an endoscope through your mouth, esophagus and stomach into the small intestine. After your physician sees the common opening to the ducts from the liver and pancreas, called the major duodenal papilla, your physician will pass a narrow plastic tube called a catheter through the endoscope and into the ducts. Your physician will inject a dye into the pancreatic or biliary ducts and will take X-rays.

GI Pill Camera

Capsule endoscopy lets your physician examine the lining of the middle part of your gastrointestinal tract, which includes the three portions of the small intestine (duodenum, jejunum, ileum) with a pill sized video camera for you to swallow. This camera has its own light source and takes pictures of your small intestine that are set to a small recording device on your body. The small intestine is unable to be viewed by colonoscopy or upper endoscopy. Bleeding from the small intestine is the most common reason to do capsule endoscopy.

The pill-sized capsule endoscope is swallowed and passes naturally through your digestive tract while transmitting video images to a data recorder worn on your belt for approximately eight hours. At the end of the procedure you will return to the office and the data recorder is removed so that images of your small bowel can be put on a computer screen for physician review.

BARRX Radiofrequency Ablation for the Treatment of Barrett's Esophagus

Radiofrequency ablation (RFA) therapy involves the use of radiofrequency energy (radio waves) delivered through a catheter to the esophagus to remove diseased tissue while minimizing injury to healthy esophagus tissue. This is called ablation, which means the removal or destruction of abnormal tissue.

While you are sedated, a device is inserted through the mouth into the esophagus and delivers a controlled level of energy and power to remove a thin layer of diseased tissue. The ability to provide a controlled amount of heat to diseased tissue is one reason this therapy has a lower rate of complications than other forms of ablation therapy. Larger areas of Barrett’s tissue are treated with the balloon-mounted catheter. Smaller areas are treated with the endoscope-mounted catheter. The RFA treatment is usually performed in an outpatient setting and no incisions are involved.

How does the balloon-mounted ablation system work?

  • A sizing balloon is inserted into your esophagus to measure its diameter
  • A correctly sized ablation balloon is then inserted and inflated close to the Barrett’s tissue
  • A rapid burst of radiofrequency energy (less than one second) heats and removes a very thin layer of the diseased esophagus
  • The tissue removal is tightly controlled with the intent to minimize unintended injury to underlying healthy tissue
  • The procedure takes about 25 minutes

How does the endoscope-mounted ablation system work?

  • Using an endoscope, the physician directs the electrode to the diseased area of your esophagus
  • A short burst of radiofrequency energy (less than one second) heats and removes a very thin layer of the diseased esophagus
  • The procedure takes about 15 minutes and is performed without incisions using conscious sedation in an outpatient setting
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