Most of our colonoscopy and endoscopy procedures are scheduled in our Ambulatory Surgery Center located at 2807-2 Capital Medical Blvd, Tallahassee, FL 32308 although some procedures may be performed at Tallahassee Memorial Hosptial out of medical neccessity.
The procedure information has been provided by the the American Gastroenterological Association. For more information, go to www.gastro.org.
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 Procedure?
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 colonoscopy.
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.
What Can You Expect During a Colonoscopy?
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 Your Colonoscopy?
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 you home.
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 directly.
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 Procedure?
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 substances.
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 cause vomiting.
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 information!
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 doctor.
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 know.
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 activity.
Occasionally, minor problems may persist, such as mild sore throat, bloating, or cramping; these should disappear in 24 hours or less.
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.
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 from sedatives.
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.
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.