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When you visit your physician, he may recommend a specialist or specialty area for you that you may not know much about. San Juan Endoscopy specializes in digestive health and we often hear certain questions from our customers. Check out a few of them below and hopefully, they will answer some of your questions.

What is an Upper Endoscopy?

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Upper endoscopy, also known as esophagogastroduodenoscopy (EGD), is a procedure used to examine the lining of the esophagus (swallowing tube), stomach, and upper part of the small intestine (duodenum). The doctor may perform this procedure to diagnose and treat when possible certain disorders of the upper GI tract. Often it is used to investigate symptoms of abdominal pain, difficulty swallowing, prolonged nausea & vomiting, heartburn, unexplained weight loss, anemia, or blood in your bowel movements.

How do I Prepare for an Upper Endoscopy?

It is important to have an empty stomach for this test, so you should not have anything to eat or drink (except a small sip of water to take any oral medications with) for at least 6 hours prior to your procedure. Your physician will provide a list of guidelines as medications to take the morning of your procedure. Do not take any antacids, aspirin, or ibuprofen (Advil, Motrin, or Aleve).

How is upper endoscopy procedure performed?

The procedure may start by spraying your throat with a local anesthetic. Then you will have a small plastic bite block placed in your mouth to aid the insertion of the instrument. Before you are given medications for sedation, you will be positioned on your left side. Once you’re sedated, the physician passes the endoscope through your mouth and into your esophagus, stomach and duodenum. Air inflates the upper GI tract. The air may cause some belching after the test is completed. The endoscope does not interfere with your breathing. Discomfort, if any, is minimal during the procedure.

What are some of the finding from an upper Endoscopy?

A diagnosis can be made when abnormalities are discovered while performing the procedure. However, it is usually necessary to take a small biopsy (sample of tissue) to aid in or confirm a diagnosis. These specimens are obtained with special biopsy forceps. You should not feel any discomfort when biopsies are taken. Special brushes can collect other cell samples from the lining of the upper GI tract for cytology examination. If inflammation or erosion of the esophagus (esophagitis), stomach (gastritis), or duodenum (duodenitis) is noted, biopsies can be helpful in determining the origin. If found bacteria, such as, Helicobacter pylori can be treated with antibiotics. Similarly, if any nodules (bumps), masses, or tumors are found, biopsies can help determine if they are benign (non-cancerous) or malignant (cancerous). Sometimes biopsies are taken of the lining of the upper GI tract to look for microscopic evidence of diseases of the gut.

What should I expect when recovering from an Upper Endoscopy?

After the procedure, the nurses will monitor you closely. Your throat may feel a little sore, and the air can cause bloating and belching. These are minor and temporary conditions. You will be able to eat shortly after the procedure unless the physician instructs you otherwise. The physician will explain the results of the examination to you. However, the biopsy results will follow at a later time. The biopsy will be examined by a pathologist. Afterward, the physician will notify you with the results, treatment, and follow-up.

What are the risks?

Although upper endoscopy is a frequently used modality for diagnosing and treating a number of GI disorders, no medical technique is completely safe. There are potential complications with upper endoscopy. There is a small risk of having a reaction to the medications used for sedation or antibiotics that may be given prior to the procedure. You will be monitored closely during and after the procedure. There is a small risk of infection. This risk is so small that antibiotics are not routinely given prior to the procedure. There is a small risk of bleeding from the procedure. Rarely is it necessary to give a blood transfusion or other treatments such as surgery. Bleeding is usually controlled through the endoscope. Another rare complication from EGD is perforation. This occurs when the tip of the endoscope goes through a weakened part of the gut wall resulting in a hole. This almost always requires surgery to correct but is a very uncommon complication of EGD.

*Since there are a number of variables involved, it is difficult to generalize about the exact risks of EGD in various settings, so it is very important to talk to your doctor about your specific risks before you have any procedure. If after an EGD you experience any severe abdominal pain, fever, increased blood in your stools or vomit, extreme dizziness/ lightheadedness you should not hesitate to call your doctor since early recognition of post procedure complications greatly improves your outcome. If you’ve received sedation or anesthesia for the procedure, you MUST have a responsible friend or relative drive you home and stay with you. Even if you feel alert, your judgment and reflexes may be impaired for the rest of the day.

What is a colonoscopy?

colonoscopeA Colonoscopy is a procedure used to examine the large intestine. A flexible camera, called a colonscope, is used to identify and correct a problem in the colon. The colonoscope will take a video of the procedure and help the physician look for irregularities. An open channel through the scope will allow for other instruments to be passed through it, allowing the doctor to remove polyps, perform biopsies and inject fluids when needed.
The test is helpful in determining:
• Colon cancer- a serious, highly curable cancer
• Polyps, which are usually the initiation of colon cancer
• Evaluating chronic diarrhea, constipation, blood in the stool, abdominal pain or change in bowl movements
• Evaluating unexplained anemia
• Detect the type and extent of inflammatory bowel disease (ulcerative colitis and Crohn’s disese)

How to prep for a colonoscopy?

YOU MAY NOT EAT ANY SOLID FOODS THE DAY BEFORE YOUR PROCEDURE. The best results come from a colon free from feces. You will be expected to drink a lot of clear liquids the day before your scheduled procedure. We ask you not to take any Aspirin or NSAIDS, such as, Motrin, ibuprofen, Advil, Aleve, Naproxyn. If you must take a pain reliever take Tylenol. Your doctor will give you a prescription for a solution to drink that will clean out your colon. Follow the written instructions that are given to you at the doctor’s office that will be performing to the procedure. These instructions will guide you as to how to take your prep, as well as, what medications that you can take the day of your procedure.

What happens before your procedure?

You will be instructed to arrive 30-45 minutes before your scheduled time in order to properly prepare for the procedure. Once you are registered, you will read and sign any needed paperwork, such as, consent for the procedure. After your health history is reviewed an IV catheter will be placed in an arm or hand vein. Your physician will go over your procedure with you, The physician will answer any questions that you may have and the sedation process with begin.

What happens during the procedure?

The colonoscope will be inserted through the rectum and guided to the beginning of the colon. Your physician may instill water or air into the colon to help with visualization. Areas of abnormal tissue will be biopsied, and photos of the area will be obtained. Polyps are commonly seen during colonoscopy. When a polyp is removed or a biopsy is taken your physician will go over this with you. It is important to remember not to take aspirin or NSAIDS for several days afterwards. Most patients tolerate the procedure well with little memory of the actual procedure.

What happens after the procedure?

After your procedure, you will be monitored and allowed to recover from the sedation. The recovery typically takes 30 minutes to an hour. Your abdomen may be sore, along with cramping, along with possible bloating and cramping, after the procedure. This is due to the air that was placed in your abdomen during the procedure. You will be instructed to expel the air to relieve this discomfort. With rare exceptions, most patients can resume a normal diet immediately afterwards.

Additional Questions:

How often should I have a colonoscopy?

You should have a baseline colonoscopy at the age of 50. When you should return for a repeat colonoscopy will depend on what is found, your family history and personal history. Your physician will be able to direct you to the appropriate time frame for your personal health.

On the preparation instruction for my procedure, it states that I should not drink anything red or purple when I am on a clear liquid diet, why?

Food or drink containing red or purple dyes may temporarily cause discoloration of the lining of the GI tract, making it harder for the physician to identify potential problems.

How long will my procedure take?

Once you are taken into the procedural area, the actual procedure only takes 30-45 minutes.

Will my menstrual cycle affect having a colonoscopy?

No, you will still be able to have the procedure, we do ask that you to inform the nurse when you are being prepared for procedure.

When will I know the results of my procedure?

Immediately following the procedure the physician will tell you if anything was found. You will go home with a discharge instructions, as well as, information about the findings. If a biopsy was taken, it will be reviewed by a pathologist. Within a week or so, you will receive a letter in the mail pertaining to the findings along with any required follow-up from the doctor’s office.

What are the possible complications of a colonoscopy?

Colonoscopy is generally safe and complications are rare. There is a small risk that biopsies or removal of polyps will cause bleeding which could require transfusions. You should not take aspirin or NSAIDS, or any other blood thinners for several days after a biopsy. Your doctor will inform you when you can resume these types of medications.
Irritation may occur at the vein where medications are given, sometimes leaving a tender lump lasting for several weeks. Apply hot moist towels may help relieve discomfort.
A rare, but possible complication during a colonoscopy is a tear in the wall of the colon. This complication could require hospitalization, emergency surgery, and/or death.
Also, there is a small possibility of a splenic tear or rupture.
Other rare risks include a reaction to the anesthetics or sedatives used.
**Since there are a number of variables involved, it is difficult to generalize about the exact risks of colonoscopy in various settings, so it is very important to talk to your doctor about your specific risks before you have any procedure. Please call you doctor or go the emergency department if after the procedure you develop fever, significant pain or bleeding.
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