Reasons For The Exam

Colonoscopy is the visual examination of the large intestine (colon) using a lighted, flexible video endoscope.  The colon begins in the right- lower abdomen and looks like a big question mark as it moves up and around the abdomen, ending in the rectum.  It is 5 to 6 feet long.  The colon has a number of functions including withdrawing water from the liquid stool that enters it so that a formed stool is produced.

Equipment

The flexible colonoscope is a remarkable piece of equipment that can be directed and moved around the many bends in the colon.  Video endoscopes have a tiny, optically sensitive computer chip at the end.  Electronic signals are then transmitted up the scope to a computer which displays the image on a large video screen.  An open channel in these scopes allows other instruments to be passed through in order to perform biopsies, remove polyps or inject solutions.

There are many types of problems that can occur in the colon.  The medical history, physical exam, laboratory tests and x-rays can provide information useful in making a diagnosis.  Directly viewing the inside of the colon by colonoscopy is usually the best exam.  Colonoscopy is used for:

• Colon cancer — a serious but highly curable malignancy

• Polyps — fleshy tumors which usually are the forerunners of colon cancer

• Colitis (Ulcerative or Crohn’s) - chronic, recurrent inflammation of the colon

• Diverticulosis and Diverticulitis — pockets along the intestinal wall that develop over time and can become infected

• Bleeding lesions — bleeding may occur from different points in the colon

• Abdominal symptoms, such as pain or discomfort, particularly if associated with weight loss or anemia

• Abnormal barium x-ray exam

• Chronic diarrhea, constipation, or a change in bowel habits

• Anemia

Preparation

To obtain the full benefits of the exam, the colon must be clean and free of stool.  The patient receives instructions on how to do this.  It involves drinking a solution which flushes the colon clean or taking laxatives and enemas.  Usually the patient drinks only clear liquids and eats no food the day before the exam.  The physician advises the patient regarding the use of regular medications during that time.

The Procedure

Colonoscopy is usually performed on an outpatient basis.  The patient is sedated, the endoscope is inserted through the anus and moved gently around the bends of the colon.  If a polyp is encountered, a thin wire snare is used to lasso it.  Electrocautery (electrical heat) is applied to painlessly remove it.  Other tests can be performed during colonoscopy, including biopsy to obtain a small tissue specimen for microscopic analysis.

The procedure takes 15 to 30 minutes and is seldom remembered by the sedated patient.  A recovery area is available to monitor vital signs until the patient is fully awake.  It is normal to experience mild cramping or abdominal pressure following the exam.  This usually subsides in an hour or so.

Results

After the exam, the physician explains the findings to the patient and family.  If the effects of the sedatives are prolonged, the physician may suggest an appointment at a later date.  If a biopsy has been performed or a polyp removed, the results of these are not available for three to seven days.

Benefits

A colonoscopy is performed to identify and/or correct a problem in the colon.  The test enables a diagnosis to be made and specific treatment can be given if a polyp is found during the exam, it can be removed at that time, eliminating the need for a major operation later.

Preparation

If a bleeding site is identified, treatment can be administered to stop the bleeding.  Other treatments can be given through the endoscope when necessary.

Alternative Testing

Alternative tests to colonoscopy include a barium enema or other types of x-ray exams that outline the colon and allow a diagnosis to be made.  Study of the stools and blood can provide indirect information about a colon condition.  These exams, however, do not allow direct viewing of the colon, removal of polyps, or the completion of biopsies.

Side Effects and Risks

Bloating and distension typically occur for about an hour after the exam until the air is expelled.  Serious risks with colonoscopy, however, are very uncommon.  One such risk is excessive bleeding, especially with the removal of a large polyp.  In rare instances, a tear in the lining of the colon (perforation) can occur.  These complications may require hospitalization and, rarely, surgery.  Quite uncommonly a diagnostic error or oversight may occur.

Due to the mild sedation, the patient must not drive or operate machinery following the exam.  For this reason, someone must be available to drive the patient home.

Summary

Colonoscopy is an outpatient exam that is performed with the patient lightly sedated.  The procedure provides significant information used to determine which specific treatment will be given.  In certain cases, therapy can be administered directly through the endoscope.  Serious complications rarely occur from colonoscopy.  The physician can answer any questions the patient has.

 

Note: the information in this section is provided as a supplement to information discussed with your healthcare provider.  It is not intended to serve as a complete description of a particular topic or substitute for a clinic visit.

 

Upper GI endoscopy, sometimes called EGD (esophagogastroduodenoscopy), is a visual examination of the upper intestinal tract using a lighted, flexible fiberoptic or video endoscope.  The upper gastrointestinal tract begins with the mouth and continues with the esophagus (food tube) which carries food to the stomach.  The J-shaped stomach secretes a potent acid and churns food into small particles.  The food then enters the duodenum, or small bowel, where bile from the liver and digestive juices from the pancreas mix with it to help the digestive process.

Equipment

The flexible endoscope is a piece of equipment that can be directed and moved around the many bends in the gastrointestinal tract.  Electronic signals are then transmitted up the scope to the computer which then displays the image on a large video screen.  An open channel in these scopes allows other instruments to he passed through in order to take tissue samples, remove polyps and perform other exams.

Reasons for the Exam

Due to factors related to diet, environment and heredity, the upper GI tract is the site of numerous disorders, These can develop into a variety of diseases and/or symptoms.  Upper GI endoscopy helps in diagnosing and often in treating these conditions:

• ulcers—which can develop in the esophagus, stomach, or duodenum; occasionally ulcers can be malignant

• tumors of the stomach or esophagus

• difficulty in swallowing

• upper abdominal pain or indigestion

• intestinal bleeding—hidden or massive bleeding can occur for various reasons

• esophagitis and heartburn—chronic inflammation of the esophagus due to reflux of stomach acid and digestive juices

• gastritis—inflammation of the lining of the stomach

Preparation

It is important not to eat or drink anything for at least six hours before the exam.  The physician instructs the patient about the use of regular medications, including blood thinners, before the exam.

The Procedure

Upper GI endoscopy is usually performed on an outpatient basis.  Intravenous sedation is usually given to relax the patient, deaden the gag reflex and cause short-term amnesia.  For some individuals who can relax on their own and whose gagging can be controlled, the exam is done without intravenous medications.  The endoscope is then gently inserted into the upper esophagus.  The patient can breathe easily throughout the exam.  Other instruments can be passed through the endoscope to perform additional procedures if necessary.  For example, a biopsy can be done in which a small tissue specimen is obtained for microscopic analysis.  A polyp or tumor can be removed using a thin wire snare and electrocautery (electrical heat).  The exam takes from 15 to 30 minutes, after which the patient is taken to the recovery area.  There is no pain with the procedure and patients seldom remember much about it.

Results

After the exam, the physician will explain the results to the patient and family.  If the effects of the sedatives are prolonged, the physician may suggest an interview at a later date when the results can be fully understood.  If a biopsy has been performed or a polyp removed, the results are not available for three to seven days.

Benefits

An upper GI endoscopy is performed primarily to identify and/or correct a problem in the upper gastrointestinal tract.  This means the test enables a diagnosis to be made upon which specific treatment can be given.  If a bleeding site is identified, treatment can stop the bleeding, or if a polyp is found, it can be removed without a major operation.  Other treatments can be given through the endoscope when necessary,

Alternative Testing

Alternative tests to upper GI endoscopy include a barium x-ray and ultrasound (sonogram) to study the organs in the upper abdomen.  Study of the stools, blood and stomach juice can provide indirect information about a gastrointestinal condition.  These exams, however, do not allow for a direct viewing of the esophagus, stomach and duodenum, removing of polyps or taking of biopsies.

Side Effects and Risks

A temporary, mild throat irritation sometimes occurs after the exam, Serious risks with upper GI endoscopy, however, are very uncommon.  One such risk is excessive bleeding, especially with removal of a large polyp.  In extremely rare instances, a perforation, or tear, in the esophagus or stomach wall can occur.  These complications may require hospitalization and, rarely, surgery.  Quite uncommonly, a diagnostic error or oversight may occur.  Due to the mild sedation, the patient should not drive or operate machinery following the exam.  For this reason, someone else should be available to drive the patient home.

Summary

Upper GI endoscopy is a simple outpatient exam that is often performed with the patient lightly sedated.  The procedure provides significant information upon which specific treatment can be given.  In certain cases, therapy can be administered directly through the endoscope.  Serious complications rarely occur from upper GI endoscopy.  The physician can answer any question the patient has.

 

Note: the information in this section is provided as a supplement to information discussed with your healthcare provider.  It is not intended to serve as a complete description of a particular topic or substitute for a clinic visit.

 

ERCP stands for endoscopic retrograde cholangiopancreatography. As hard as this is to say, the actual exam is fairly straight forward. A dye is injected into the bile and pancreatic ducts using a flexible, video endoscope. Then x-rays are taken to outline the bile ducts and pancreas.

The liver produces bile, which flows through the ducts, passes or fills the gallbladder and then enters the intestine (duodenum) just beyond the stomach. The pancreas, which is six to eight inches long, sits behind the stomach. This organ secretes digestive enzymes that flow into the intestine through the same opening as the bile. Both bile and enzymes are needed to digest food.

Equipment

The flexible endoscope is a remarkable piece of equipment that can be directed and moved around the many bends in the upper gastrointestinal tract. Images are transmitted through the scope to a video screen. An open channel in the scope allows instruments to be passed to perform biopsies, make small incisions, inject solutions, or place stents.

Reasons for the Exam

Due to factors related to diet, environment and heredity, the bile ducts, gallbladder and pancreas are the seat of numerous disorders. These can develop into a variety of diseases and/or symptoms.

ERCP helps in diagnosing and often in treating the condition.

ERCP is used for:

• Gallstones, which are trapped in the main bile duct

• Blockage of the bile duct

• Yellow jaundice, which turns the skin yellow, stool light, and the urine dark

• Undiagnosed upper-abdominal pain

• Cancer of the bile ducts or pancreas

• Pancreatitis (inflammation of the pancreas)

Preparation

The only preparation needed before an ERCP is to not eat or drink for eight hours prior to the procedure. You may be asked to stop certain medications such as aspirin before the procedure. Antibiotics are sometimes given before the procedure. Check with the physician.

The Procedure

An ERCP requires x-ray films and is performed in an x-ray room. Patients usually lie on their stomach or left side. The throat is anesthetized with a spray or solution, and the patient is mildly sedated. The endoscope is then gently inserted into the upper esophagus. The patient breathes easily throughout the exam, with gagging rarely occurring. A thin tube is inserted through the endoscope to the main bile duct entering the duodenum. Dye is then injected into this bile duct and/or the pancreatic duct and x-ray films are taken. If a gallstone is found, steps may be taken to remove it. Electrocautery (electrical heat) is sometimes used to make a small incision to help remove stones, place stents, or improve the flow bile or pancreatic fluid. Additionally, it is possible to widen narrowed ducts and to place small tubes, called stents, in these areas to keep them open. The exam takes from 20 to 40 minutes, after which the patient is taken to the recovery area.

Results

After the exam, the physician explains the results. If the effects of the sedatives are prolonged, the physician may suggest an appointment for a later date when the patient can fully understand the results.

Benefits

An ERCP is performed primarily to identify and/or correct a problem in the bile ducts or pancreas. This means the test enables a diagnosis be made upon which specific treatment can be given. If a gallstone is found during the exam, it often be removed, eliminating the need for major surgery. If a blockage in the bile duct causes yellow jaundice or pain, it can be relieved.

Alternative Testing

Alternative tests to ERCP include certain types of x-rays (CAT scan, MRI) and sonography (ultrasound) to visualize the pancreas and bile ducts. In addition, dye can be injected into the bile ducts by placing a needle through the skin and into the liver. Small tubing can then be threaded into the bile ducts. Study of the blood also can provide some indirect information about the ducts and pancreas.

Side Effects and Risks

A temporary, mild sore throat sometimes occurs after the exam. Serious risks with ERCP, however, are uncommon. The most common complication of ERCP is called pancreatitis, an inflammation of the pancreas. It does occur in 3-5% of cases. In certain patients this risk can be higher. It results in abdominal pain and, usually, the need for hospitalization. Another risk is excessive bleeding, especially when electrocautery used to open the lower bile duct, In rare instances, a perforation or tear in the intestinal wall can occur. Surgery can be required under these circumstances.

Due to the mild sedation, the patient should not drive or operate machinery for six hours following the exam. For this reason, a driver should accompany the patient to the exam.

Summary

ERCP is an outpatient exam that is performed with the patient sedated. The procedure provides significant information upon which specific treatment can be given. In certain cases, therapy can be administered directly through the endoscope. Serious complications rarely occur from an ERCP. In each case, the physician will consider all factors and make the decision that is in the best interest of the patient.

 

Note: the information in this section is provided as a supplement to information discussed with your healthcare provider.  It is not intended to serve as a complete description of a particular topic or substitute for a clinic visit.

 

Endoscopic ultrasound (EUS) is a medical exam using an instrument that combines a tiny ultrasound unit with an endoscope.  Ultrasound uses sound waves that are passed into the body tissues and which then echo back to a sensor.  The sensor creates a visual image on a screen that can be evaluated by the physician.

EUS is an ultrasound test of the digestive tract.  The ultrasound probe is placed on the end of the endoscope.  An endoscope is a lighted, flexible tube that the physician can pass through the esophagus (the tube through which food passes to the stomach).  Endoscopes may also be passed through the rectum.  With a standard endoscopy, the physician can directly view the inside surface of the digestive tract.  With EUS, the ultrasound creates an image of the underlying area.  Thus, the physician can get a view of the tissues and organs beneath the intestinal surface.

Purpose of the EUS

The digestive tract, also called the gastrointestinal or GI tract, includes the mouth, throat, esophagus, stomach, intestines, and rectum.  Other organs like the gallbladder and pancreas which contribute to the digestion of foods are also part of the digestive system.  When a patient is having discomfort and symptoms that suggest a problem in the GI system, the physician will order tests to help with the diagnosis.  Stomach ulcers and intestinal polyps are examples of conditions that clearly show on the inside lining of the intestine.  In these cases a standard endoscopy is all that is needed.  However, sometimes the physician wants to see deeper into the underlying tissues or the surrounding area.  EUS may be used to evaluate the following:

• Blood vessels

• Gallstones within the gallbladder and bile duct

• Pancreas

• Abnormalities of the rectum

• Tumors and lymph nodes that lie beneath the intestinal wall

• Growth of known tumors

• Tumor removal or recurrence

• Follow-up of benign appearing tumors

Biopsy of tumors can also be done through the EUS scope.

Preparing for the EUS

The physician should be informed of all medications the patient is taking.  The patient should also check with the physician before stopping any medications.  When the test is done on the upper GI tract, the patient does not eat or drink anything for a period of eight hours before the exam.  When EUS is done through the rectum, the colon (lower intestine) must be cleansed.  Normally, the patient uses a liquid diet along with laxatives or enemas to cleanse the lower bowel.  If biopsies are anticipated, the physician advises the patient about any blood thinning medications.  These include aspirin and Coumadin (warfarin), which are usually stopped for up to five days before the exam.  These medications may increase the risk of excessive bleeding from a biopsy.

Performing the EUS

EUS is usually performed as an outpatient exam in an area of the hospital set aside for GI procedures.  The patient lies on the left side and is given a sedative to produce a drowsy, sleepy state.  The EUS scope is then inserted through the mouth or rectum, and eased through to the area to be examined.  An EUS scope is flexible and can be easily moved around the various bends in the digestive tract.  When the scope is in position, the ultrasound mechanism produces the images needed for the examination.  These images are carried electronically into a computer system that displays them on a video screen for the physician to view.

Permanent photographs of the video images are made to verify what has been found, and to use for later study and comparison.  In general, it takes 20 to 40 minutes to complete the exam.  The patient is then taken to a recovery area for observation until sedation wears off.  While most of the needed information is available to the physician immediately, a biopsy report will require several days.  A follow-up appointment is then necessary to review the results.

Side Effects and Risks

During the procedure, patients are routinely monitored to be sure that there are no complications from medications.  Following the procedure, the patient may have a mild sore throat for a few hours.  Because of the sedation, patients should not drive, operate heavy machinery, or make important decisions for up to six hours following the procedure.  Therefore, someone should be available to drive the patient home.

The ability of EUS to get so close to an area to be examined makes this test reliable and preferable to more invasive techniques.  In general, EUS is a very safe procedure.  There is a very slight risk of the endoscope tearing the intestinal tract, which would require surgery.  Rarely, excessive bleeding may occur with a biopsy.

Summary

EUS is an effective way of examining the digestive tract, and the tissues and organs that lie outside it.  This exam may be used with other studies to give a life-like picture of conditions in the GI tract.  Serious complications are very uncommon.  EUS allows the physician a high degree of accuracy in making a diagnosis, so that an effective form of therapy can usually be provided.

 

Note: the information in this section is provided as a supplement to information discussed with your healthcare provider.  It is not intended to serve as a complete description of a particular topic or substitute for a clinic visit.

 

The esophagus is the long, narrow food tube that carries food and liquid from the mouth to the stomach.  It can become blocked or injured in a variety of ways.  Esophageal dilatation is the technique used to stretch or open a narrowed portion of the esophagus.

Causes of Esophageal Blockage

There are several causes of blockage or stricture of the esophagus.  They all can make swallowing food and/or fluids difficult.  The physician’s first job is to find the reason for the stricture or narrowing.  The answer can usually be provided by the medical history, physical exam, x-rays, and endoscopy which is a visual exam of the esophagus using a flexible fiberoptic tube.

Acid Peptic Stricture - This condition is very common.  The stomach produces acid which, in turn, can reflux into the esophagus.  This event is usually made worse by the presence of a hiatal hernia.  Over time, the acid and peptic stomach juices injure the esophagus, causing inflammation and then scarring.  The fibrous scar then contracts and narrows the esophageal opening.

Schatzki’s Ring - This is a narrow ring of benign fibrous tissue constricting the lower esophagus.  Physicians still do not know how it develops.

Achalasia - This condition is uncommon and quite fascinating to physicians.  The problem is a persistent and marked spasm of the lower esophageal muscle.  This spasm just does not open up to allow food and fluid through.  The result is a persistent blockage with subsequent slow trickling of the esophageal contents into the stomach.

Ingestion of Caustic Agents - Children are particularly prone to swallowing liquid lye and other agents which can severely burn the esophagus, leaving it narrowed.

Tumors - Various forms of tumors, benign and malignant, can block the esophagus.  This condition is obviously very important to diagnose and treat promptly.

Heredity - The esophagus may be partially or completely blocked at birth.

Methods of Esophageal Dilatation

In most instances, the problem is a mechanical one with an obstruction acting like a dam across a stream.  Therefore, the treatment must be mechanical.  The dam must be broken.  After a diagnosis is made, the physician determines the best method of treatment.  The physician has a variety of techniques available.  Each has benefits and is appropriate in specific cases.  The physician will always discuss these options with the patient.

Simple Dilators (Bougies) - These are a series of flexible dilators of increasing thickness.  One or more of these are passed down through the esophagus at a time.  The bougie is the simplest and quickest method of opening the esophagus.

Guided Wire Bougie - In most instances, the physician performs endoscopy and places a flexible wire across the stricture.  The endoscope is removed and the wire left in place.  A dilator with a hole through it from end to end is guided down the esophagus and across the stricture.  One or more of these dilators are passed over the wire.  At the end of the exam, the wire is removed.  This type of treatment may be performed in the x-ray department under fluoroscopy.

Balloon Dilators - Flexible endoscopy allows the physician to directly view the stricture.  Deflated balloons are placed through the endoscope and across the stricture.  When inflated, they stretch and break the stricture.

Achalasia Dilators - Achalasia is a special situation which requires a larger, balloon-type dilator.  The procedure is frequently done under x-ray control.  In this situation, the spastic muscle fibers in the lower esophagus are stretched and broken, which in turn allows easier passage of food and liquid into the stomach.

The Procedure

As mentioned, there are a number of dilating techniques available to the physician.  Simple bougie dilatation may be done in the office, in a sitting position, and with only an anesthetic spray of the throat.  If endoscopy is performed at the same time, then it will be done in the endoscopy suite, usually under sedation.  If x-ray fluoroscopy equipment is needed, the procedure is performed in the x-ray unit.  Simple bougie dilatation may take only a few minutes.  The other techniques require 20 to 30 minutes.  Recovery is usually quick and the patient can soon begin eating and drinking to test the effectiveness of the treatment.  Depending on the type of narrowing, several dilation procedures may be required to achieve the desired results.

Complications

Esophageal dilatation is usually performed effectively and without problems.  However, some complications can occur.  A small amount of bleeding almost always happens at the treatment site.  At times, it can be excessive, requiring evaluation and treatment.  An uncommon but known complication is perforation of the esophagus.  The wall of the esophagus is thin and, despite the best efforts of the physician, can tear.  An operation may be required to correct this problem.

Alternative Treatments

The alternative treatment options are to do nothing or to undergo major chest surgery.

Summary

Narrowing or stricture of the esophagus is a very common problem.  The physician can almost always uncover the specific cause of the stricture.  And there are a variety of treatment options available for the physician.  Complications are rare and, in most instances, a satisfactory outcome occurs with complete clearing of or improvement in the swallowing problem.

 

Note: the information in this section is provided as a supplement to information discussed with your healthcare provider.  It is not intended to serve as a complete description of a particular topic or substitute for a clinic visit.

 

The liver is the largest organ in the body.  It is found high in the right upper abdomen, behind the ribs.  It has many important functions, including making many proteins, eliminating waste products, and participating in the general metabolism and nutrition of the body.  It even has the power to regenerate itself.  However, there are many different problems that can occur in the liver and some can cause permanent damage.  These conditions include virus infections, reactions to drugs or alcohol, tumors, hereditary conditions, and problems with the body’s immune system.

Evaluating a Liver Condition

The physician will always take a medical history and perform a physical exam.  Blood studies, known as liver function tests (LFT), give an overview of the health of the liver.  If LFT results are persistently abnormal, the physician will then perform additional medical studies to determine the exact cause of the problem.

Finding the cause is important because there are now effective treatments for many liver disorders.  Finally, the physician will want to know not only the specific cause of the problem, but also how severe the condition may be.  The liver biopsy helps answer these questions.

What is a Biopsy?

A biopsy is a tiny sample of body tissue—in this case, liver tissue.  The tissue is prepared and stained in a laboratory, so the physician can view it under a microscope.  This usually helps the physician make a specific diagnosis and determine the extent and seriousness of the condition.  It is vital information for determining treatment.

The Procedure

The liver biopsy is usually performed on an outpatient basis.  A mild sedative may be given to the patient prior to the procedure.  An ultrasound or echo machine is used to identify the best location to make the biopsy.  The patient lies quietly on the back or slightly to the left side.  That area of the skin where the biopsy will be done is carefully cleaned.  Then, a local anesthetic agent is used to numb the skin and tissue below.  A specially designed thin needle is inserted through the skin.  At this point, the physician will tell the patient how to breathe.  The needle is advanced into and out of the liver.  This takes only 1 or 2 seconds.  A slender core of tissue is removed with the needle, and is then processed through the laboratory.  The entire procedure from start to finish lasts only 15 to 20 minutes.

The patient is kept at rest for several hours following the exam.  Medical personnel check the heart rate and blood pressure during this time.  There may be some discomfort in the chest or shoulder, however, this is usually temporary.  Medication is available for this discomfort, if needed.  Before being discharged, the patient is given instructions about returning to normal activities and about eating.  Activity is restricted for a day or so after the biopsy.  However, the procedure does not require a long recovery period.

Complications

In most instances, a liver biopsy is obtained quickly with no problems.  As noted, there is occasionally some fleeting discomfort in the right side or shoulder.  Internal bleeding can sometimes occur, as can a leak of bile from the liver or gallbladder.  These problems are rare and can usually be handled without the need for surgery.

Summary

A liver biopsy is a simple, rapid method of obtaining a sample of liver for analysis.  It provides important information for evaluating and treating liver disorders.  While some complications can occur, they are unusual.  The benefits of the exam most often outweigh the risks.  Early, specific, and effective therapy can often prevent irreversible liver damage.

 

Note: the information in this section is provided as a supplement to information discussed with your healthcare provider.  It is not intended to serve as a complete description of a particular topic or substitute for a clinic visit.

 

What is Capsule Endoscopy?

Capsule Endoscopy lets your doctor examine the lining of the middle part of your gastrointestinal tract, which includes the three portions of the small intestine (duodenum, jejunum, ileum).  Your doctor will use a pill sized video capsule called an endoscope, which has its own lens and light source and will view the images on a video monitor.  You might hear your doctor or other medical staff refer to capsule endoscopy as small bowel endoscopy, capsule enteroscopy, or wireless endoscopy.

Why is Capsule Endoscopy Done?

Capsule endoscopy helps your doctor evaluate the small intestine.  This part of the bowel cannot be reached by traditional upper endoscopy or by colonoscopy.  The most common reason for doing capsule endoscopy is to search for a cause of bleeding from the small intestine.  It may also be useful for detecting polyps, inflammatory bowel disease (Crohn’s disease), ulcers, and tumors of the small intestine.

As is the case with most new diagnostic procedures, not all insurance companies are currently reimbursing for this procedure.  You may need to check with your own insurance company to ensure that this is a covered benefit.

How Should I Prepare for the Procedure?

An empty stomach allows for the best and safe examination, so you should have nothing to eat or drink, including water, for approximately twelve hours before the examination.  Your doctor will tell you when to start fasting.

Tell your doctor in advance about any medications you take including iron, aspirin, bismuth subsalicylate products and other “over-the-counter” medications.  You might need to adjust your usual dose prior to the examination.  Discuss any allergies to medications as well as medical conditions, such as swallowing disorders and heart or lung disease.  Tell your doctor of the presence of a pacemaker, previous abdominal surgery, or previous history of obstructions in the bowel, inflammatory bowel disease, or adhesions.

What Can I Expect During Capsule Endoscopy?

Your doctor will prepare you for the examination by applying a sensor device to your abdomen with adhesive sleeves (similar to tape).  The 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.

Most patients consider the test comfortable.  The capsule endoscope is about the size of a large pill.  After ingesting the capsule and until it is excreted, you should not be near an MRI device or schedule an MRI examination.

What Happens After Capsule Endoscopy?

You will be able to drink clear liquids after two hours and eat a light meal after four hours following the capsule ingestion unless your doctor instructs you otherwise.  You will have to avoid vigorous physical activity such as running or jumping during the study.

Your doctor generally can tell you the test results within the week following the procedure; however, the results of some tests might take longer.

What are the Possible Complications of Capsule Endoscopy?

Although complications can occur, they are rare when doctors who are specially trained and experienced in this procedure perform the test.  Potential risks include complications from obstruction.  This usually relates to a stricture (narrowing) of the intestine from inflammation, prior surgery, or tumor.  It’s important to recognize early signs of possible complications.  If you have evidence of obstruction, such as unusual bloating, pain, and/or vomiting, call your doctor immediately.  Also, if you develop a fever after the test, have trouble swallowing or experience increasing chest pain, tell your doctor immediately.  Be careful not to prematurely disconnect the system as this may result in loss of image acquisition.

 

Note: the information in this section is provided as a supplement to information discussed with your healthcare provider.  It is not intended to serve as a complete description of a particular topic or substitute for a clinic visit.