GI Lower

Flexible Sigmoidoscopy

The flexible sigmoidoscopy is an endoscopic procedure that allows a physician to look at the inside of the large intestine from the rectum to the sigmoid or descending colon.

Overview
This procedure is performed to help find the cause of lower gastrointestinal symptoms including diarrhea, rectal bleeding,or constipation, as well as evaluate for early signs of cancer in the lower colon and rectum.

What to expect
During the procedure, the physician will insert a sigmoidoscope, which is a short, lighted tube, into your rectum and slowly guide it into your colon. Using air to inflate the colon and a monitor, the doctor can visualize the inside of the rectum and the lower colon. Simple therapeutic objectives, including biopsies, removal of polyps or cauterization can be performed.

Preparation
If your physician has ordered a flexible sigmoidoscopy, follow these instructions beginning the day before your procedure.

Clear liquid Diet
Flexible sigmoidoscopy prep
Flexible Sigmoidoscopy Tap Water prep

One of the best ways to ensure a successful procedure is to strictly follow your Physicians’s instructions and to contact us if you have any questions at all.

Hemorrhoidal Banding
Hemorrhoidal banding is a simple, painless, and effective method to eradicate hemorrhoids as an alternative to traditional surgical methods.

Overview
The procedure uses a non-surgical device for the treatment and removal of hemorrhoids, which can be performed comfortably without sedation. For optimal results, three treatments are scheduled at least 10 days apart.

What to expect
The physician will place a tiny rubber band around the internal hemorrhoids to cut off the blood supply. The hemorrhoid then shrinks and falls off within a short time, usually without you noticing. In most cases, patients can return to work immediately after the procedure.

Colonoscopy
A colonoscopy is an endoscopic procedure investigating the colon (large intestine) for evaluation of lower gastrointestinal symptoms including bleeding, abdominal pain, change in bowel habits or anemia. It is also the most reliable preventative exam to screen for colon cancer.

Overview
The procedure allows a physician to look inside the entire large intestine by inserting a small flexible endoscopic tube (colonoscope) into the rectum and gently pushing it through the large intestine. The procedure is done with sedation which keeps a patient very comfortable during the procedure. During the procedure, the physician can visualize the inside of the large intestine on a high definition screen. Biopsies, removal of polyps and control of bleeding lesions can be safely done through the colonoscope during this procedure.

What to expect

During the procedure, everything will be done to ensure your comfort. After the initial history and physical questionnaire, you will change into a procedure gown, and an intravenous (IV) line will be administered to sedate you during the procedure. Our centers employ Certified Nurse Anesthetists working together with our physicians to provide sedation with utmost concern for your comfort and safety. You will be monitored closely during the procedure using state of the art technology. Once you are fully asleep, your doctor will proceed with the exam.
After your colonoscopy is complete you will be cared for in a recovery area until the effects of the sedation have worn off. Your doctor will give you the results of your colonoscopy and provide any additional information you may request. You’ll also be given discharge instructions regarding how soon you can eat and drink, plus other guidelines for resuming your normal routine.

Preparation
The success of the colonoscopy depends on the quality of the preparation. This requires both the experience and dedication of our staff to explain the preparation, as well as our patients’ commitment to following the preparation instructions. One of the best ways to ensure a successful colonoscopy is to strictly follow your doctor’s instructions and to contact us if you have any questions at all.
Depending on your medical history, your doctor will prescribe one of several colonoscopy preparations.

Click on the links below to download the instructions for each preparation.
Clear Liquid Diet
Miralax prep
HalfLytely Prep
MoviPrep
Nulytely or Trilytely prep
Suprep

Endoscopic Retrograde Cholangiopancreatography (ERCP)

Overview
An Endoscopic Retrograde Cholangiopancreatography (ERCP) is a procedure in which the physician uses an endoscope to see the inside of the stomach and duodenum. Dyes are injected into the ducts in the biliary tree and pancreas so they can be seen on X Ray. ERCP may be useful in diagnosing and treating problems causing jaundice (a yellowing of the whites of the eyes) or abdominal pain. For example, an ERCP can be helpful when there is a blockage of the bile ducts by gallstones, tumors, scarring or other conditions that cause obstruction or narrowing (stricture) of the ducts. Similarly, blockage of the pancreatic ducts from stones, tumors, or stricture can also be evaluated or treated by an ERCP. This procedure is useful in assessing causes of pancreatitis (inflammation of the pancreas). Problems with the bile ducts or pancreas may first show up as jaundice or pain in the abdomen, although not always. Also, there may be changes in blood tests that show abnormalities of the liver or pancreas. Other special exams that take pictures using X-rays or sound waves may provide important information for use along with that obtained from ERCP.

What to expect
Your comfort and safety are of utmost importance to us. This procedure is done in the hospital in cooperation with a team of highly trained physician of anesthesiologists, anesthetists, nurses, surgical and radiology technicians. The procedure is now done under general anesthesia to provide the safest environment for our physician’s to perform this procedure.

In the duodenum, the physician positions the instrument near the papilla, the point at which the main bile and pancreatic ducts empty into the intestine. A small tube known as a cannula is threaded down through the endoscope and can be directed into either the pancreatic or common bile duct. The cannula allows a dye to be injected into the ducts to help with diagnosis and to direct treatment. The physician then uses x-ray equipment to examine and take pictures of the dye outlining the ducts.

Some of the problems identified during ERCP can also be treated through the endoscope. For example, if a stone is blocking the pancreatic or common bile duct, it is usually possible to remove it. Stents and biopsies can also be done through the endoscope. Some of our physicians can insert a smaller camera (called Spyglass) into the bile duct in order to perfrom a more in depth evaluation and treatment.

Preparation
Aftercare
When your ERCP is completed on an outpatient basis, you will need to remain under observation until your Physician releases you. In some cases, it may be necessary to admit you.
You will not be released unless you have someone to drive you home. You should also avoid operating machinery for a day and not drink any alcohol.

Your Physician will tell you when you can take fluids and meals. Usually, it is within a few hours after the procedure.

Because of the air used during ERCP, you may continue to feel full and pass gas for some time, and it is not unusual to have either soft stool or other brief changes in bowel habits. However, if you notice bleeding from your rectum or black, tarry stools, please call your Physician immediately.

You should also report vomiting, severe abdominal pain, weakness or dizziness, and fever over 100 degrees. Fortunately, these problems are not common.