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Digestive and Liver Center of Florida
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SUBMITTING THIS FORM DOES NOT MAKE AN APPOINTMENT.
YOU WILL BE CONTACTED BY OUR OFFICE
BY PHONE TO MAKE THE APPOINTMENT
Digestive and Liver Center of Florida
Please remember to bring your insurance card to your appointment.
Use this form for routine appointments only. If you have an urgent issue, please call our office; for emergencies, dial 911.
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Digestive and Liver Center of Florida specializes in the following procedures, many of which can be performed on-site at the Endo-Surgical Center. If you are scheduled for a colonoscopy, upper endoscopy or capsule endoscopy, please watch the videos on this page.
GI Tract Dilation
The esophagus is the long, narrow food tube (gullet) 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 the blocked 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.
Causes of Dysphagia
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 hiatus 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 condition is really exactly that, 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 some instances, the physican 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 become sausage shaped, 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.
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.
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.
The alternative treatment options are to do nothing or to undergo major chest surgery. The latter is recommended only if dilatation is ineffective.
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.
Esophagitis and Stricture
Upper GI Endoscopy (EGD)
Capsule Endoscopy enables your doctor to examine the three portions of your small intestine. Your doctor will use a vitamin-pill sized video capsule as an endoscope, which has its own camera and light source. While the video capsule travels through your body, images are sent to a data recorder you will wear on a waist belt. Most patients consider the test comfortable. Afterwards, your doctor will view the images on a video monitor.
Why Is Capsule Endoscopy Performed?
Capsule Endoscopy helps your doctor determine the cause for recurrent or persistent symptoms such as abdominal pain, diarrhea, bleeding or anemia, in most cases where other diagnostic procedures failed to determine the reason for your symptoms. In certain chronic gastrointestinal diseases, the method can also help to evaluate the extent to which your small intestine is involved or monitor the effect of therapeutics. Your doctor might use Capsule Endoscopy to obtain data such as gastric or small bowel passage time.
How Should I Prepare for the Procedure?
You will receive accurate preparation instructions the day before the examination. An empty stomach allows optimal viewing conditions, so you should have nothing to eat or drink, including water, for approximately ten hours before the examination. Your doctor will tell you when to start fasting. Tell your doctor in advance about any medications you take; you might need to adjust your usual dose for the examination. Tell your doctor of the presence of a pacemaker, previous abdominal surgery, swallowing problem or previous history of obstructions in the bowel.
What Can I Expect During Capsule Endoscopy?
Your doctor will prepare you for the examination by applying a sensor array to your abdomen with adhesive sleeves. The capsule endoscope is ingested and passes naturally through your digestive tract while transmitting video images to a data recorder worn on a belt for approximately eight hours. You will be able to eat after four hours following the capsule ingestion unless your doctor instructs otherwise.
What Happens After Capsule Endoscopy?
At the end of the procedure, you will need to return to the office to return the data recorder and sensor array. The images acquired during your exam will be downloaded to a workstation for physician review. After ingesting the capsule and until it is excreted, you should not have a Magnetic Resonance Imaging (MRI) examination or be near an MRI device.
How will I Know the Results of the Capsule Endoscopy?
After you return the equipment (waist belt, data recorder, battery pack and sensor array), your doctor will process the information from the data recorder and will view a color video of the pictures taken from the capsule. After the doctor has looked at this video, you will be contacted with the results.
Upper endoscopy enables the physician to look inside the esophagus, stomach, and duodenum (first part of the small intestine). The procedure might be used to discover the reason for swallowing difficulties, nausea, vomiting, reflux, bleeding, indigestion, abdominal pain, or chest pain. Upper endoscopy is also called EGD, which stands for esophagogastroduodenoscopy (eh-SAH-fuh-goh-GAS-troh-doo-AH-duh-
For the procedure you will swallow a thin, flexible, lighted tube called an endoscope (EN-doh-skope). Right before the procedure the physician will spray your throat with a numbing agent that may help prevent gagging. You may also receive pain medicine and a sedative to help you relax during the exam. The endoscope transmits an image of the inside of the esophagus, stomach, and duodenum, so the physician can carefully examine the lining of these organs. The scope also blows air into the stomach; this expands the folds of tissue and makes it easier for the physician to examine the stomach.
The physician can see abnormalities, like ulcers, through the endoscope that don't show up well on x-rays. The physician can also insert instruments into the scope to remove samples of tissue (biopsy) for further tests.
Possible complications of upper endoscopy include bleeding and puncture of the stomach lining. However, such complications are rare. Most people will probably have nothing more than a mild sore throat after the procedure.
The procedure takes 20 to 30 minutes. Because you will be sedated, you will need to rest at the physician's office for 1 to 2 hours until the medication wears off.
Your stomach and duodenum must be empty for the procedure to be thorough and safe, so you will not be able to eat or drink anything for at least 6 hours beforehand. Also, you must arrange for someone to take you home--you will not be allowed to drive because of the sedatives. Your physician may give you other special instructions.
What Is A Colonoscopy?
A colonoscopy (koh-luh-NAH-skuh-pee) allows a doctor to look inside the entire large intestine. The procedure enables the physician to see things such as inflamed tissue, abnormal growths, and ulcers. It is most often used to look for early signs of cancer in the colon and rectum. It is also used to look for causes of unexplained changes in bowel habits and to evaluate symptoms like abdominal pain, rectal bleeding, and weight loss.
What is the colon?
The colon, or large bowel, is the last portion of your digestive tract, or gastrointestinal tract. The colon is a hollow tube that starts at the end of the small intestine and ends at the rectum and anus. The colon is about 5 feet long, and its main function is to store unabsorbed food waste and absorb water and other body fluids before the waste is eliminated as stool.
You will be given instructions in advance that will explain what you need to do to prepare for your colonoscopy. Your colon must be completely empty for the colonoscopy to be thorough and safe. To prepare for the procedure you will have to follow a liquid diet for 1 to 3 days beforehand. The liquid diet should be clear and not contain food colorings, and may include
fat-free bouillon or broth
strained fruit juice
Thorough cleansing of the bowel is necessary before a colonoscopy. You will likely be asked to take a laxative the night before the procedure. In some cases you may be asked to give yourself an enema. An enema is performed by inserting a bottle with water and sometimes a mild soap in your anus to clean out the bowels. Be sure to inform your doctor of any medical conditions you have or medications you take on a regular basis such as
vitamins that contain iron
The medical staff will also want to know if you have heart disease, lung disease, or any medical condition that may need special attention. You must also arrange for someone to take you home afterward, because you will not be allowed to drive after being sedated.
For the colonoscopy, you will lie on your left side on the examining table. You will be given pain medication and a moderate sedative to keep you comfortable and help you relax during the exam. The doctor and a nurse will monitor your vital signs, look for any signs of discomfort, and make adjustments as needed.
The doctor will then insert a long, flexible, lighted tube into your rectum and slowly guide it into your colon. The tube is called a colonoscope (koh-LON-oh-skope). The scope transmits an image of the inside of the colon onto a video screen so the doctor can carefully examine the lining of the colon. The scope bends so the doctor can move it around the curves of your colon.
You may be asked to change positions at times so the doctor can more easily move the scope to better see the different parts of your colon. The scope blows air into your colon and inflates it, which helps give the doctor a better view. Most patients do not remember the procedure afterwards.
The doctor can remove most abnormal growths in your colon, like a polyp, which is a growth in the lining of the bowel. Polyps are removed using tiny tools passed through the scope. Most polyps are not cancerous, but they could turn into cancer. Just looking at a polyp is not enough to tell if it is cancerous. The polyps are sent to a lab for testing. By identifying and removing polyps, a colonoscopy likely prevents most cancers from forming.
The doctor can also remove tissue samples to test in the lab for diseases of the colon (biopsy). In addition, if any bleeding occurs in the colon, the doctor can pass a laser, heater probe, electrical probe, or special medicines through the scope to stop the bleeding. The tissue removal and treatments to stop bleeding usually do not cause pain. In many cases, a colonoscopy allows for accurate diagnosis and treatment of colon abnormalities without the need for a major operation.
During the procedure you may feel mild cramping. You can reduce the cramping by taking several slow, deep breaths. When the doctor has finished, the colonoscope is slowly withdrawn while the lining of your bowel is carefully examined. Bleeding and puncture of the colon are possible but uncommon complications of a colonoscopy.
A colonoscopy usually takes 30 to 60 minutes. The sedative and pain medicine should keep you from feeling much discomfort during the exam. You may feel some cramping or the sensation of having gas after the procedure is completed, but it usually stops within an hour. You will need to remain at the colonoscopy facility for 1 to 2 hours so the sedative can wear off.
Rarely, some people experience severe abdominal pain, fever, bloody bowel movements, dizziness, or weakness afterward. If you have any of these side effects, contact your physician immediately. Read your discharge instructions carefully. Medications such as blood-thinners may need to be stopped for a short time after having your colonoscopy, especially if a biopsy was performed or polyps were removed. Full recovery by the next day is normal and expected and you may return to your regular activities.
Sigmoidoscopy (SIG-moy-DAH-skuh-pee) enables the physician to look at the inside of the large intestine from the rectum through the last part of the colon, called the sigmoid colon. Physicians may use this procedure to find the cause of diarrhea, abdominal pain, or constipation. They also use sigmoidoscopy to look for early signs of cancer in the colon and rectum. With sigmoidoscopy, the physician can see bleeding, inflammation, abnormal growths, and ulcers.
For the procedure, you will lie on your left side on the examining table. The physician will insert a short, flexible, lighted tube into your rectum and slowly guide it into your colon. The tube is called a sigmoidoscope (sig-MOY-duh-skope). The scope transmits an image of the inside of the rectum and colon, so the physician can carefully examine the lining of these organs. The scope also blows air into these organs, which inflates them and helps the physician see better.
If anything unusual is in your rectum or colon, like a polyp or inflamed tissue, the physician can remove a piece of it using instruments inserted into the scope. The physician will send that piece of tissue (biopsy) to the lab for testing.
Bleeding and puncture of the colon are possible complications of sigmoidoscopy. However, such complications are uncommon.
Sigmoidoscopy takes 10 to 20 minutes. During the procedure, you might feel pressure and slight cramping in your lower abdomen. You will feel better afterwards when the air leaves your colon.
The colon and rectum must be completely empty for sigmoidoscopy to be thorough and safe, so the physician will probably tell you to drink only clear liquids for 12 to 24 hours beforehand. A liquid diet means fat-free bouillon or broth, Jell-Oﾮ, strained fruit juice, water, plain coffee, plain tea, or diet soda. The night before or right before the procedure, you may also be given an enema, which is a liquid solution that washes out the intestines. Your physician may give you other special instructions.
Endoscopic Retrograde Cholangiopancreatography
Endoscopic retrograde cholangiopancreatography (en-doh-SKAH-pik REH-troh-grayd koh-LAN-jee-oh-PANG-kree-uh-TAH-gruh-fee) (ERCP) enables the physician to diagnose problems in the liver, gallbladder, bile ducts, and pancreas. The liver is a large organ that, among other things, makes a liquid called bile that helps with digestion. The gallbladder is a small, pear-shaped organ that stores bile until it is needed for digestion. The bile ducts are tubes that carry bile from the liver to the gallbladder and small intestine. These ducts are sometimes called the biliary tree. The pancreas is a large gland that produces chemicals that help with digestion.
ERCP may be used to discover the reason for jaundice, upper abdominal pain, and unexplained weight loss. ERCP combines the use of x-rays and an endoscope, which is a long, flexible, lighted tube. Through it, the physician can see the inside of the stomach, duodenum, and ducts in the biliary tree and pancreas.
For the procedure, you will lie on your left side on an examining table in an x-ray room. You will be given medication to help numb the back of your throat and a sedative to help you relax during the exam. You will swallow the endoscope, and the physician will then guide the scope through your esophagus, stomach, and duodenum until it reaches the spot where the ducts of the biliary tree and pancreas open into the duodenum. At this time, you will be turned to lie flat on your stomach, and the physician will pass a small plastic tube through the scope. Through the tube, the physician will inject a dye into the ducts to make them show up clearly on x-rays. A radiographer will begin taking x-rays as soon as the dye is injected.
If the exam shows a gallstone or narrowing of the ducts, the physician can insert instruments into the scope to remove or work around the obstruction. Also, tissue samples (biopsy) can be taken for further testing.
Possible complications of ERCP include pancreatitis (inflammation of the pancreas), infection, bleeding, and perforation of the duodenum. However, such problems are uncommon. You may have tenderness or a lump where the sedative was injected, but that should go away in a few days or weeks.
ERCP takes 30 minutes to 2 hours. You may have some discomfort when the physician blows air into the duodenum and injects the dye into the ducts. However, the pain medicine and sedative should keep you from feeling too much discomfort. After the procedure, you will need to stay at the physician's office for 1 to 2 hours until the sedative wears off. The physician will make sure you do not have signs of complications before you leave. If any kind of treatment is done during ERCP, such as removing a gallstone, you may need to stay in the hospital overnight.
Your stomach and duodenum must be empty for the procedure to be accurate and safe. You will not be able to eat or drink anything after midnight the night before the procedure, or for 6 to 8 hours beforehand, depending on the time of your procedure. Also, the physician will need to know whether you have any allergies, especially to iodine, which is in the dye. You must also arrange for someone to take you home--you will not be allowed to drive because of the sedatives. The physician may give you other special instructions.
Paracentesis is a procedure to remove fluid that has accumulated in the abdominal cavity (peritoneal fluid), a condition called ascites . Ascites may be caused by infection, inflammation, abdominal injury, or other conditions, such as cirrhosis or cancer. The fluid is removed using a needle inserted through the abdominal wall and sent to a lab for analysis to determine the cause of the fluid buildup. Paracentesis also may be done to drain the fluid as a comfort measure in people with cancer or chronic cirrhosis.
The peritoneum is the lining of the abdominal cavity. It supports the organs in the abdomen and helps protect them from infection. The inside surface of the peritoneum produces a very small amount of peritoneal fluid that allows the organs in the abdomen to slide against the peritoneum and each other.
Why It Is Done
Paracentesis may be done to:
• Determine the cause of fluid buildup in the abdominal cavity (ascites).
• Diagnose infection in the peritoneal fluid.
• Detect certain types of cancer, such as liver cancer.
• Remove a large amount of fluid that is causing pain or difficulty breathing or that is affecting the function of the kidneys or the intestines (bowel).
• Evaluate abdominal injury.
How To Prepare
Before you have paracentesis done, tell your doctor if you:
• Are taking any medication.
• Are allergic to any medications, including anesthetics.
• Have had bleeding problems or are taking blood-thinning medications, such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), or warfarin (Coumadin).
• Are or might be pregnant.
Blood tests may be done before a paracentesis to make sure that you do not have any bleeding or clotting problems. Empty your bladder before the procedure because a full bladder can interfere with performing the test.
You may be asked to sign a consent form. Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will indicate.
How It Is Done
This procedure may be done in your doctor's office, an emergency room, the X-ray department of a hospital, or at your bedside in the hospital.
If a large amount of fluid is going to be removed during the procedure, you may lie on your back with your head slightly raised. People who have less fluid removed may be allowed to sit up. The site where your doctor will insert the needle is cleaned with an antiseptic solution and draped with sterile towels.
Your doctor injects a local anesthetic into your abdominal wall to numb the area where the paracentesis needle will be inserted. Once the area is numb, your doctor will gradually insert the paracentesis needle where the fluid is likely to be. If your test is done in the X-ray department, an ultrasound may be used to confirm the location of fluid in your abdomen.
As the paracentesis needle is gradually advanced through the abdominal wall, your doctor will pull back on the syringe to ensure that neither a blood vessel nor the intestine has been punctured. When the abdominal cavity is entered, fluid will flow into the syringe. If a large amount of fluid is present, the paracentesis needle may be connected by a small tube to a vacuum bottle; fluid will then be drained through the needle into the vacuum bottle.
Generally, up to 4 L of fluid is removed. If your doctor needs to remove a larger amount of fluid, intravenous line (IV) fluids may be given through a vein in your arm to prevent low blood pressure or shock. It is important that you remain completely still throughout the procedure, unless you are asked to change positions to help move the fluid.
Once the desired amount of fluid has been removed, the needle is withdrawn and a bandage is placed over the puncture site. After the test, your pulse, blood pressure, and temperature are usually monitored. You may be weighed and the distance around your abdomen may be measured before and after the test.
This procedure usually takes about 20 to 30 minutes. It will take longer if a large amount of fluid is being removed. When it is over, you may resume normal activities unless your doctor tells you otherwise.
How It Feels
You may feel a brief, sharp stinging or burning pain when the local anesthetic is injected. When the paracentesis needle is inserted into the abdominal wall, you may again feel a temporary sharp pain or pressure, similar to having your blood drawn.
You may feel dizzy or lightheaded if a large amount of fluid is withdrawn. Tell your doctor if you do not feel well during the test.
After the procedure, you may notice some clear fluid draining from the needle site, especially if a large amount of fluid was removed from your abdominal cavity. The drainage should subside within 1 to 2 days. A small gauze pad covered by a bandage generally helps absorb the fluid. Ask your doctor how much drainage to expect.
There is a very slight chance that the needle used to withdraw the fluid might puncture the bladder, bowel, or a blood vessel within the abdomen.
If cancer cells are present in the peritoneal fluid, there is a slight risk that the needle used to withdraw the fluid might spread the cancer cells within the abdominal cavity.
If a large amount of fluid is removed, there is a small risk that your blood pressure could drop to a low level, leading to shock. If this occurs, intravenous (IV) fluids or medications, or both, may be given to help return your blood pressure to normal. There is also a small risk that the removal of fluid may decrease your kidney function. If this is a concern, IV fluids may be given during the paracentesis.
After the test
Contact your doctor immediately if you experience:
an 100 F. Severe abdominal pain. Increasing abdominal redness or tenderness. Blood in your urine. Bleeding or excessive drainage from the site where the paracentesis needle was inserted.
Paracentesis is a procedure to remove excess fluid that has accumulated in the abdominal cavity (peritoneal fluid), a condition called ascites . Fluid removed from your abdomen will be sent to a lab to be examined under a microscope. Preliminary results will be available within a few hours.
What Affects the Test
Factors that can interfere with your test and the accuracy of the results include:Use medications and aspirin, which can increase the risk of bleeding. A fluid sample contaminated with blood, bile, urine, or feces. Inability to remain still during the test.Obesity or abdominal adhesions from a previous abdominal surgery.
What To Think About
A paracentesis is often done when signs or symptoms of peritonitis develop. Pregnant women may not have this test done because there is a risk that the needle used to withdraw abdominal fluid could puncture the uterus and injure the baby (fetus).
Abdominal injuries and pain are sometimes evaluated using peritoneal lavage. During this procedure, a doctor uses a needle to inject a saline solution into the abdominal cavity. The fluid is then withdrawn through the same needle. If the fluid withdrawn is bloody, the bleeding is probably being caused by an injury inside the abdomen.
The esophagus is the tube that carries food and liquid from the throat to the stomach. Although it seems like a simple organ, the esophagus is not a rigid tube. The wall of the esophagus contains muscle that rhythmically contracts whenever a person swallows. This contraction occurs as a sweeping wave (peristalsis) carrying food down the esophagus. It literally strips the food or liquid from the throat to the stomach.
Another important part of the esophagus is the lower valve muscle (lower esophageal sphincter, or LES). This is a specialized muscle that remains closed most of the time, only opening when swallowed food or liquid is moved down the esophagus or when a person belches or vomits. This muscle protects the lower esophagus from caustic stomach acid and bile. These substances, of course, cause the discomfort of heartburn and in time can lead to damage and scarring in the esophagus. At times, everyone has heartburn, especially after a large or fatty meal.
Manometry is the recording of muscle pressures within an organ. So esophageal manometry measures the pressure within the esophagus. It can evaluate the action of the stripping muscle waves in the main portion of the esophagus as well as the muscle valve at the end of it.
The equipment for manometry consists of thin tubing with openings at various locations. When this tube is positioned in the esophagus, these openings sense the pressure in various parts of the esophagus. As the esophagus squeezes on the tube, these pressures are transmitted to a computer analyzer that records the pressures on moving graph paper. It is much like an electrocardiogram. The physician can evaluate these wave patterns to determine if they are normal or abnormal.
The C14 urea breath test (UBT) is a diagnostic tool used to diagnose a current infection of Helicobacter pylori (H. pylori). H. pylori is a bacteria that has been found to infect the stomach lining. This bacteria has been linked to many gastrointestinal systems and conditions. It is implicated in the development of duodenal and gastric ulcers. It is treated with antibiotics.
The UBT is performed and processed on site at CDD in a NATA accredited laboratory. The test takes a total of 10 minutes to complete with minimal discomfort experienced by patients.
Patients are required to fast prior to this test with no food or drink for a minimum of 4 hours. The test procedure requires patients to swallow a capsule with water. After several minutes a sample of breath is collected in a foil balloon. This sample is processed with the results sent to the patients referring doctor or GP within days.
To maximize the efficacy of this test it is important that:
• You have nothing to eat or drink for 4 hours prior to the test.
• You cease all forms of antibiotics, pump inhibitors and H2RA's, 4 weeks prior to the test (this includes other antibiotics prescribed by your GP or other Doctor).
• You cease your Losec, Zoton, Somac or Pariet for at least 1 week prior to the test.
Read these instructions at least a week before you come for your procedure.
What is a liver biopsy?
A liver biopsy is a test during which a doctor uses a needle to remove a small piece of tissue from the liver.
This tissue is sent to the laboratory to evaluate the condition of the liver tissue and extent of any liver disease.
How do I get ready?
Within six months of your liver biopsy:
An ultrasound, CT, or MRI of the abdomen must be done to see the size of the liver and see if there are any abnormalities. Talk to your doctor and make sure he/she has had one of these tests done. Your doctor should fax these results to 407-384-7391.
Within six weeks of your liver biopsy:
Blood tests must be done to see how well the blood clots. Talk to your doctor and make sure he/she has had these tests done. Your doctor should fax these results to 407-384-7391.
One week before the biopsy:
• Do not take Aspirin, Advil, Aleve, Ecotrin, Bufferin, Nuprin, Excedrin and/or Ibuprofen for seven days before your biopsy. Ask your doctor if Tylenol (acetaminophen), Celebrex, or Mobic are okay to take.
• If you use Coumadin (Warfarin) or Plavix, contact your doctor about stopping it for 5-7 days.
• If you are a diabetic, contact your doctor about adjusting the dose of insulin or blood sugar pills the day of the biopsy.
Day of the biopsy:
• You may shower as usual the morning of the procedure.
• Do not have any solid foods or milk products after midnight.
• You may have clear liquids until 4 hours before your exam, then nothing at all until after your biopsy. Clear liquids include water, soda, broth, bouillon, coffee, tea, Kool-Aid, clear juices, Gatorade, Jello and popsicles.
• You may take your blood pressure medicine and any heart medicines with a sip of water.
• You may bring mints, gum, or hard candy to keep your mouth moist. Please bring reading materials or radio with headphones to help you pass the time. You will be observed for several hours after your biopsy.
• Bring a list of current medications and medication allergies with you.
• Bring someone with you to drive you home. You will not be allowed to drive the rest of the day.
However, please limit the number of people you bring with you to our waiting room. If you do not have a driver your procedure may be canceled or rescheduled.
Arrive at the hospital one hour before your appointment to allow for parking and registration at radiology department.
• When you arrive at the hospital, walk through the main entrance and ask the hospital receptionist to direct you to the Radiology Department.
• Enter our waiting room and check-in at the reception desk.
• After check-in, you will be called to register.
• After registration, you will be called to the procedure area.
• Please keep in mind that appointments are approximate times. If a delay occurs we will do our best to update you.
What will happen during the biopsy?
• A doctor will explain the benefits and risks of the procedure to you and ask you to sign a consent form giving the doctor permission to perform the biopsy. Ask him/her any questions you might have.
• You will have a needle (IV) put into your arm to give you medicines and fluids during the test.
• During the procedure, you will be asked to lay on your back with your right arm above your head. The doctor will feel for the outline of your liver and select the biopsy site. An ultrasound device may be used to determine the best site for the biopsy. This area will be washed and covered with towels.
• You will receive some numbing medication at this site. This may feel like a bee sting. The doctor will ask you to breathe in and out and then hold your breath. As you hold your breath, a needle will be inserted into the site. You may feel some pressure as the needle is inserted.
What will happen after the biopsy?
• A bandage will be placed over the biopsy site.
• You will be taken to the Recovery Room where you will lie on your right side for 1-4 hours.
• Your blood pressure, pulse and oxygen level will be checked frequently.
• You may feel some discomfort in your right side, mid-abdomen and/or in your right shoulder.
After you leave the DHCOE:
• Your right side may feel sore for a few days.
• The site will be covered with a band-aid.
• You may shower/bathe.
• If you have fever, chills, weakness, dizziness, severe right-sided pain, or pass a black bowel
movement, please go to the nearest emergency room.
What should I do after the biopsy?
• Do not lift heavy objects (greater than five pounds) for at least two days.
• Do not take Aspirin, Advil, Ecotrin, Bufferin, Nuprin, Excedrin, Aleve, or Ibuprofen for seven days.
• You may take acetaminophen (Tylenol) moderately for minor pain if approved by the doctor. Avoid all alcohol during this time.
• You may resume your regular diet.
• A work excuse is available upon request.
The results of your test will be sent to the doctor who referred you for the biopsy in 1-2 weeks. Please contact the physician who ordered your procedure to obtain your test results.
Hemorrhoid and Band Ligation
What are hemorrhoids?
Hemorrhoids, often called piles, are clusters of veins in the anus, just under the membrane that lines the lowest part of the rectum and anus. They occur when veins in your rectum enlarge from straining or pressure. Hemorrhoids are varicose (swollen or dilated) veins located in or around the anus. Internal hemorrhoids are varicose veins that surround the rectum and, when dilated, protrude inside, sometimes extending out of the anus.
Hemorrhoids are dilated (enlarged) veins which occur in and around the anus and rectum. They may be external (outside the anus) or internal and slip to the outside. In both of these instances, the hemorrhoids can be felt and seen as lumps or knots. Hemorrhoids also may remain inside the rectum and so cannot be felt or seen. These are called internal hemorrhoids. Hemorrhoids occur when the veins in the rectum or anus become enlarged; they may eventually bleed. Hemorrhoids may also become inflamed or may develop a blood clot (thrombus). Hemorrhoids that form above the boundary between the rectum and anus (anorectal junction) are called internal hemorrhoids; those that form below the anorectal junction are called external hemorrhoids. Both internal and external hemorrhoids may remain in the anus or protrude outside the anus.
Humans are prone to hemorrhoids because erect posture puts a lot of pressure on the veins in the anal region. Heredity has also been considered a factor, since hemorrhoids tend to run in families. Heredity has also been considered a factor, since hemorrhoids tend to run in families. Chronic constipation is considered a major cause of hemorrhoids. This is because constipated individuals tend to consistently strain to evacuate their bowels, increasing pressure in the rectum. Disturbance from frequent bowel movements associated with diarrhea can also be a cause. Additionally, frequent use of laxative may result in diarrhea, and increase your likelihood of getting hemorrhoids. Increased pressure in the veins of the anorectal area leads to hemorrhoids. This pressure may result from pregnancy, from frequent heavy lifting, or from repeated straining during bowel movements (defecation). Constipation may contribute to straining. In a few people, hemorrhoids develop from increased blood pressure in the portal vein. A doctor can distinguish the dilated, twisted veins that occur in this condition from common hemorrhoids.
What is rubber band ligation?
Rubber band ligation is an outpatient treatment for second-degree internal hemorrhoids. In this procedure, a small band is applied to the base of the hemorrhoid, stopping the blood supply to the hemorrhoidal mass. The hemorrhoid will then
shrivel and die within 7 to 10 days. The shriveled hemorrhoid and band will fall off during normal bowel movements. Rubber band ligation is a popular procedure, as it involves less pain than surgical treatments of hemorrhoids, as well as a shorter recovery period. Its success rate is between 60 and 80%.
Rubber band ligation procedure is as follows:
Pre-treatment diganosis and prescribed medications:
After diagnosis of the second-degree hemorrhoid, antibiotics are often prescribed, especially to patients with immune deficiency or other medical condtions.
The patient is laid down on the left side, with knees drawn up and buttocks projecting over the operating table.
Application of the band:
A proctoscope is inserted into the anal opening. The hemorrhoid is grasped by forceps and maneuvered into the cylindrical opening of the ligator. The ligator is then pushed up against the base of the hemorrhoid, and the rubber band is applied.
More information on hemorrhoids
What are hemorrhoids? - Hemorrhoids are clusters of veins in the anus, just under the membrane that lines the lowest part of the rectum and anus.
What are external hemorrhoids? - External hemorrhoids are those that occur outside of the anal verge. External hemorrhoids are often fairly painful.
What are internal hemorrhoids? - Internal hemorrhoids are those that occur inside the rectum. Untreated internal hemorrhoids can lead to two severe forms of hemorrhoids: prolapsed and strangulated hemorrhoids.
What causes hemorrhoids? - The causes of hemorrhoids include genetic predisposition, excessive time and straining during bowel movements, and chronic bowel straining.
What are the complications of hemorrhoids? - Hemorrhoids can produce several uncomfortable, but non-serious problems. Hemorrhoids can ooze fresh red blood.
What are the symptoms of hemorrhoids? - Symptoms of hemorrhoids include fissures, fistulae, abscesses, or irritation and itching. Hemorrhoids can bleed after a bowel movement.
How are hemorrhoids diagnosed? - Diagnosis of hemorrhoids begins with a visual examination of the anus, followed by an internal examination.
What're the treatments for hemorrhoids? - Treatment of hemorrhoids varies depending on where they are, what problems they are causing, and how serious they are.
What hemorrhoids medications are available? - Local anesthetics temporarily relieve the pain, burning, and itching. Antiseptics inhibit the growth of bacteria and other organisms.
How to relieve hemorrhoids symptoms? - Hemorrhoids can often be effectively dealt with by dietary and lifestyle changes. Exercising, losing excess weight also helps.
What is the hemorrhoids surgery? - Surgery to remove the hemorrhoids may be used if other treatments fail. Rubber band ligation can be used to treat internal hemorrhoids.
What is rubber band ligation? - Rubber band ligation is an outpatient treatment for second-degree internal hemorrhoids. Rubber band ligation is a popular procedure.
What is the alternative treatment for hemorrhoids? - To prevent hemorrhoids by strengthening the veins of the anus, rectum, and colon, they recommend blackberries, blueberries, cherries, vitamin C.
How to prevent hemorrhoids? - Prevention of hemorrhoids includes drinking more fluids, eating more fiber, exercising, practicing better posture, and reducing bowel movement strain and time.
Hemorrhoids during pregnancy - Constipation combined with the increased pressure on the rectum and perineum is the primary reason that pregnant women experience hemorrhoids.
You've been referred to have an endoscopic ultrasonography, or EUS, which will help your doctor, evaluate or treat your condition. This brochure will give you a basic understanding of the procedure - how it is performed, how it can help, and what side effects you might experience. It can't answer all of your questions, since a lot depends on the individual patient and the doctor. Please ask your doctor about anything you don't understand. Endoscopists are highly trained specialists who welcome your questions regarding their credentials, training and experience
What is EUS?
EUS allows your doctor to examine the lining and the walls of your upper and lower gastrointestinal tract. The upper tract is the esophagus, stomach and duodenum; the lower tract includes your colon and rectum. EUS is also used to study internal organs that lie next to the gastrointestinal tract, such as the gall bladder and pancreas. Your endoscopist will use a thin, flexible tube called an endoscope. Your doctor will pass the endoscope through your mouth or anus to the area to be examined. Your doctor then will turn on the ultrasound component to produce sound waves that create visual images of the digestive tract.
Why is EUS done?
EUS provides your doctor more detailed pictures of your digestive tract anatomy. Your doctor can use EUS to diagnose the cause of conditions such as abdominal pain or abnormal weight loss. Or, if your doctor has ruled out certain conditions, EUS can confirm your diagnosis and give you a clean bill of health.
EUS is also used to evaluate an abnormality, such as a growth, that was detected at a prior endoscopy or by x-ray. EUS provides a detailed picture of the growth, which can help your doctor determine its nature and decide upon the best treatment.
In addition, EUS can be used to diagnose diseases of the pancreas, bile duct and gallbladder when other tests are inconclusive.
Why is EUS used for patients with cancer?
EUS helps your doctor determine the extent of certain cancers of the digestive and respiratory systems. EUS allows your doctor to accurately assess the cancer's depth and whether it has spread to adjacent lymph glands or nearby vital structures such as major blood vessels. In some patients, EUS can be used to obtain tissue samples to help your doctor determine the proper treatment.
How should I prepare for EUS?
For EUS of the upper gastrointestinal tract, you should have nothing to eat or drink, not even water, usually six hours before the examination. Your doctor will tell you when to start this fasting.
For EUS of the rectum or colon, your doctor will instruct you to either consume a large volume of a special cleansing solution or to follow a clear liquid diet combined with laxatives or enemas prior to the examination. The procedure might have to be rescheduled if you don't follow your doctor's instructions carefully.
What about my current medications or allergies?
Tell your doctor in advance of the procedure about all medications that you're taking and about any allergies you have to medication. He or she will tell you whether or not you can continue to take your medication as usual before the EUS examination. In general, you can safely take aspirin and nonsteroidal anti-inflammatories (Motrin, Advil, Aleve, etc.) before an EUS examination, but it's always best to discuss their use with your doctor. Check with your doctor about which medications you should take the morning of the EUS examination, and take essential medication with only a small cup of water.
If you have an allergy to latex you should inform your doctor prior to your test. Patients with latex allergies often require special equipment and may not be able to have an EUS examination.
Do I need to take antibiotics?
Antibiotics aren't generally required before or after EUS examinations. But tell your doctor if you take antibiotics before dental procedures. If your doctor feels you need antibiotics, antibiotics might be ordered during the EUS examination or after the procedure to help prevent an infection. Your doctor might prescribe antibiotics if you're having specialized EUS procedures, such as to drain a fluid collection or a cyst using EUS guidance. Again, tell your doctor about any allergies to medications.
Should I arrange for help after the examination?
If you received sedatives, you won't be allowed to drive after the procedure, even if you don't feel tired. You should arrange for a ride home. You should also plan to have someone stay with you at home after the examination, because the sedatives could affect your judgment and reflexes for the rest of the day.
What can I expect during EUS?
Practices vary among doctors, but for an EUS examination of the upper gastrointestinal tract, your endoscopist might spray your throat with a local anesthetic before the test begins. Most often you will receive sedatives intravenously to help you relax. You will most likely begin by lying on your left side. After you receive sedatives, your endoscopist will pass the ultrasound endoscope through your mouth, esophagus and stomach into the duodenum. The instrument does not interfere with your ability to breathe. The actual examination generally takes between 15 to 45 minutes. Most patients consider it only slightly uncomfortable, and many fall asleep during it.
An EUS examination of the lower gastrointestinal tract can often be performed safely and comfortably without medications, but you will probably receive a sedative if the examination will be prolonged or if the doctor will examine a significant distance into the colon. You will start by lying on your left side with your back toward the doctor. Most EUS examinations of the lower gastrointestinal tract last from 10 to 30 minutes.
What happens after EUS?
If you received sedatives, you will be monitored in the recovery area until most of the sedative medication's effects have worn off. If you had an upper EUS, your throat might be sore. You might feel bloated because of the air and water that were introduced during the examination. You'll be able to eat after you leave the procedure area, unless you're instructed otherwise.
Your doctor generally can inform you of the results of the procedure that day, but the results of some tests will take longer.
What are the possible complications of EUS?
Although complications can occur, they are rare when doctors with specialized training and experience perform the EUS examination. Bleeding might occur at a biopsy site, but it's usually minimal and rarely requires follow-up. You might have a sore throat for a day or more. Nonprescription anesthetic-type throat lozenges and painkillers help relieve the sore throat. Other potential, but uncommon, risks of EUS include a reaction to the sedatives used; backwash of stomach contents into your lungs; infection; and complications from heart or lung diseases. One major, but very uncommon, complication of EUS is perforation. This is a tear through the lining of the intestine that might require surgery to repair.
The possibility of complications increases slightly if a deep needle aspiration is performed during the EUS examination. These risks must be balanced against the potential benefits of the procedure and the risks of alternative approaches to the condition.
If you have any questions about your need for EUS, alternative approaches to your problem, the cost of the procedure, methods of billing or insurance coverage, do not hesitate to speak to your doctor or doctor's
The small bowel is approximately 20 feet in length and, until recently, was a relatively inaccessible part of the gastrointestinal tract. Although the advent of the wireless video capsule endoscopy system allowed lesions and abnormalities in the small bowel to be visualized, these could not be biopsied or treated. Balloon assisted enteroscopy was developed to provide non-surgical small bowel therapy. Through this new technique, it is now possible to biopsy tissue, dilate strictures, remove polyps, and stop bleeding from the small bowel. In some instances, therapy with a balloon assisted scope may allow patients to avoid surgical intervention on the small bowel.
The balloon system consists of a 200 cm endoscope and an overtube. There are one or two inflatable balloons attached to the scope and/or overtube. The technique allows the scope to advance through the length of the small bowel via the process of inflating and deflating the balloon(s), which grip the walls of the small intestine. With a series of ‘reductions’ the process pleats the small bowel over the overtube, like a curtain over a rod, and advances the scope. Accessories such as biopsy forceps, dilating devices, and cautery probes can be passed through channels in the scope in order to treat abnormal findings in the small intestine.
Balloon assisted enteroscopy can be performed in an outpatient or inpatient setting and may require several hours, depending on the therapy required. It is often performed with general anesthesia although some patients may require only moderate sedation. Fluoroscopy, or the use of X-ray, is frequently employed during the procedure. Most procedures are performed through the mouth (antegrade) although the retrograde approach, through the rectum, may allow better access to lesions in the lower part of the small bowel.
The risks of the procedure are similar to those for colonoscopy and upper endoscopy (EGD) and include bleeding, perforation, and complications of sedation. Unique to balloon enteroscopy are the risks of ileus (transient slowing of the bowel) and pancreatitis, which occur in less than one percent of procedures.
The indications for balloon assisted enteroscopy include the need for treatment of small intestinal lesions found on other gastrointestinal exams, such as capsule endoscopy or CT scan. The procedure is not used as a first line therapy and is performed only after careful evaluation by a specially trained gastroenterologist. Most procedures are done for bleeding lesions seen on capsule endoscopy, worrisome lesions or masses seen by other modalities, polyps in patients with hereditary syndromes, retained foreign objects, and small bowel strictures.
Therapies include treatment of bleeding lesions such as angioectasias, dilation of strictures using a hydrostatic balloon dilator, removal by snare or biopsy of polyps or small bowel masses, retrieval and removal of foreign objects or retained capsules, and biopsy of abnormal tissue. Balloon assisted enteroscopy has also been used in gaining access to parts of the gastrointestinal tract in patients with surgically altered anatomy.
Patients who are not medically stable should not undergo balloon assisted enteroscopy. Those who have had extensive abdominal surgeries may be poor candidates because of adhesions or altered anatomy which may prevent the scope from advancing.
A tube placed in the esophagus to keep a blocked area open so the patient can swallow soft food and liquids. Esophageal stents are made of metal mesh, plastic, or silicone, and may be used in the treatment of esophageal cancer.
Esophageal cancer is a debilitating disease for patients and symptoms often do not present until late in the disease process. In fact, the majority of esophageal cancer patients present with Stage III and Stage IV cancer at diagnosis. Radiation therapy, chemotherapy, surgery, and metallic stents all play a role in providing palliative treatment to these patients. Surgery, while a viable option in early stages of esophageal cancer, may not be an option for Stage III and Stage IV patients. Radiation and chemotherapy are often used in combination to reduce the size of the tumor and potentially offer hope for a surgical cure.
Metal stents help to relieve dysphagia, allowing the patients to maintain nutritional support perorally versus enteral nutrition. Metal stents are delivered via a small introducer system designed to keep the stent constrained until deployment. Upon endoscopic and fluoroscopic visualization of stent position, the delivery system is released and the stent deploys to its pre-constrained outer diameter.
Since the early 1990's, thousands of doctors have placed endoscopic metal stents to provide symptomatic relief of dysphagia in patients suffering from esophageal malignancy and TE fistula caused by malignancy.
Boston Scientific offers both the Ultraflex™ Esophageal Stent and the WALLSTENT® Esophageal II Endoprosthesis for the management of malignant esophageal strictures. These stents are offered in both covered and non-covered iterations.
HALO: RADIOFREQUENCY ABLATION (RFA)
Radiofrequency ablation (RFA) therapy has been shown to be safe and effective for treating Barrett’s esophagus. Radiofrequency energy (radio waves) is delivered via 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 used to deliver a controlled level of energy and power to remove a thin layer of diseased tissue. Less than one second of energy removes tissue to a depth of about one millimeter. The ability to provide a controlled amount of heat to diseased tissue is one mechanism by which 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. Both are introduced during an upper endoscopy procedure, which is a thin, flexible tube inserted through a patient’s mouth.
Radiofrequency ablation for Barrett's esophagus has been used in more than 60,000 cases and the devices are cleared by the U.S. Food and Drug Administration. The balloon-based catheter has been available commercially since January 2005, the endoscope-mounted catheter since January 2007.
A clinical trial by Fleischer, et al. showed that 98.4% of people were free of Barrett’s at a follow-up exam 30 months8 after two or three RFA treatments. Studies show that when the Barrett’s tissue is removed, it is typically replaced by normal, healthy tissue within three to four weeks. Recent five year follow-up of longer term trials shows that the effects of radiofrequency ablation are durable.
Upper GI Series
The upper gastrointestinal (GI) series uses x rays to diagnose problems in the esophagus, stomach, and duodenum (first part of the small intestine). It may also be used to examine the small intestine. The upper GI series can show a blockage, abnormal growth, ulcer, or a problem with the way an organ is working.
During the procedure, you will drink barium, a thick, white, milkshake-like liquid. Barium coats the inside lining of the esophagus, stomach, and duodenum, and makes them show up more clearly on x rays. The radiologist can also see ulcers, scar tissue, abnormal growths, hernias, or areas where something is blocking the normal path of food through the digestive system. Using a machine called a fluoroscope, the radiologist is also able to watch your digestive system work as the barium moves through it. This part of the procedure shows any problems in how the digestive system functions, for example, whether the muscles that control swallowing are working properly. As the barium moves into the small intestine, the radiologist can take x rays of it as well.
An upper GI series takes 1 to 2 hours. X rays of the small intestine may take 3 to 5 hours. It is not uncomfortable. The barium may cause constipation and white-colored stool for a few days after the procedure.
Your stomach and small intestine must be empty for the procedure to be accurate, so the night before you will not be able to eat or drink anything after midnight. Your physician may give you other specific instructions.
Ileostomy, Colostomy, and Ileoanal Reservoir Surgery
Sometimes treatment for Crohn's disease, ulcerative colitis, and familial adenomatous polyposis involves removing all or part of the intestines. When the intestines are removed, the body needs a new way for stool to leave the body, so the surgeon creates an opening in the abdomen for stool to pass through. The surgery to create the new opening is called ostomy. The opening is called a stoma.
Different types of ostomy are performed depending on how much and what part of the intestines are removed. The surgeries are called ileostomy and colostomy. When the colon and rectum are removed, the surgeon performs an ileostomy to attach the bottom of the small intestine (ileum) to the stoma. When the rectum is removed, the surgeon performs a colostomy to attach the colon to the stoma. A temporary colostomy may be performed when part of the colon has been removed and the rest of it needs to heal.
Ileoanal reservoir surgery is an alternative to a permanent ileostomy. It is usually completed in two surgeries. In the first surgery, the colon and rectum are removed and a pouch or reservoir is constructed from the last 18 inches of the small intestine. This pouch is attached to the anus. In the second surgery, the ileostomy is closed. The muscles surrounding the anus and anal canal are left in place, so the stool in the pouch does not leak out of the anus. People who have this surgery are able to control their bowel movements.
If an ileoanal reservoir is not possible or feasible, a continent ileostomy may be an alternative to using an outside collecting bag. In continent ileostomy, an internal reservoir pouch is created from part of the small intestine. A valve is constructed and a stoma is placed through the abdominal wall. A tube is inserted through the stoma and valve to drain the pouch.
Lower GI Series
A lower gastrointestinal (GI) series uses x rays to diagnose problems in the large intestine, which includes the colon and rectum. The lower GI series may show problems like abnormal growths, ulcers, polyps, diverticuli, and colon cancer.
Before taking x rays of your colon and rectum, the radiologist will put a thick liquid called barium into your colon. This is why a lower GI series is sometimes called a barium enema. The barium coats the lining of the colon and rectum and makes these organs, and any signs of disease in them, show up more clearly on x rays. It also helps the radiologist see the size and shape of the colon and rectum.
You may be uncomfortable during the lower GI series. The barium will cause fullness and pressure in your abdomen and will make you feel the urge to have a bowel movement. However, that rarely happens because the tube used to inject the barium has a balloon on the end of it that prevents the liquid from coming back out.
You may be asked to change positions while x rays are taken. Different positions give different views of the colon. After the radiologist is finished taking x rays, you will be able to go to the bathroom. The radiologist may also take an x ray of the empty colon afterwards.
A lower GI series takes about 1 to 2 hours. The barium may cause constipation and make your stool turn gray or white for a few days after the procedure.
Your colon must be empty for the procedure to be accurate. To prepare for the procedure you will have to restrict your diet for a few days beforehand. For example, you might be able to drink only liquids and eat only nonsugar, nondairy foods for 2 days before the procedure; only clear liquids the day before; and nothing after midnight the night before. A liquid diet means fat-free bouillon or broth, gelatin, strained fruit juice, water, plain coffee, plain tea, or diet soda. To make sure your colon is empty, you will be given a laxative or an enema before the procedure. Your physician may give you other special instructions.
Non Surgical Hemorrhoid Treatment
Our office offers the patented CRH-O’Regan SystemTM for the non-surgical treatment of hemorrhoids. This procedure treats most grades of hemorrhoids and it is best suited to treat grades 1-3. Grade 4 hemorrhoids may require additional treatments. This procedure can be done in our facility, without surgery or pain.
Although a frequently neglected area of healthcare, more than 50% of the population is afflicted with hemorrhoids and while the signs and symptoms may come and go, it is best to treat the underlying source to prevent the condition from worsening. This disposable hemorrhoid removal procedure is safe, painless and takes less than a minute; most patients return to normal activities the same day. Patients typically require 3 treatments at two week intervals, and 99% of patients are able to avoid surgery using this technology.
In the past treatment for hemorrhoids has been painful and not utilized very often, but we are now able to offer this treatment using this new technology to make the procedure quicker and comfortable for our patients.
We perform this procedure at the Endo-Surgical Center of Florida, adjacent to our office. If you have any questions or would like to schedule an appointment, please call us at 407-384-7388.
For more information about this procedure visit http://www.crhsystem.com/
Hemorrhoid Band Ligation
Upper GI Series
Lower GI Series
Hemorrhoid Non Surgical
Main Office 100 North Dean Road • SUITE 101 • Orlando, FL 32825 | 360 Douglas Avenue, Altamonte Springs, FL 32714 | 721 W. Colonial Dr. • Orlando, FL 32804
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