ENDOSCOPYENDOSCOPY Endoscopy is a nonsurgical Endoscopy is a nonsurgical

procedure used to examine a procedure used to examine a person's digestive tract. Using person's digestive tract. Using an endoscope, a flexible tube an endoscope, a flexible tube with a light and camera with a light and camera attached to it, your doctor can attached to it, your doctor can view pictures of your digestive view pictures of your digestive tract on a color TV monitor. tract on a color TV monitor.

The GI endoscopy procedure may The GI endoscopy procedure may be performed on either be performed on either an outpatient or an outpatient or inpatient basisinpatient basis

Through the endoscope, a Through the endoscope, a doctor can evaluate several doctor can evaluate several problems, such as ulcers problems, such as ulcers or muscle spasms. These or muscle spasms. These concerns are not always seen on concerns are not always seen on other imaging tests other imaging tests

LOWER GI ENDOSCOPYLOWER GI ENDOSCOPY

COLONOSCOPYCOLONOSCOPY SIGMOIDDOSCOPYSIGMOIDDOSCOPY ENTEROSCOPYENTEROSCOPY

ColonoscopyColonoscopy   colonoscopy is a test to colonoscopy is a test to

look at the inside of look at the inside of your colon. The colon is your colon. The colon is the large intestine and the the large intestine and the last part of your digestive last part of your digestive system. Its job is to dry, system. Its job is to dry, process, and eliminate the process, and eliminate the waste left after the small waste left after the small intestine has absorbed the intestine has absorbed the nutrients in food. The colon nutrients in food. The colon is about 3-5 feet long. It is about 3-5 feet long. It travels from the lower right travels from the lower right corner of your corner of your abdomen (where the abdomen (where the small intestine ends) up to small intestine ends) up to your liver, across your body your liver, across your body to the spleen  in the upper to the spleen  in the upper left corner and then down to left corner and then down to form your rectum and anus. form your rectum and anus.

The doctor will use an instrument The doctor will use an instrument called the colonnoscope to perform a called the colonnoscope to perform a colonoscopy. It is a long (about 3 colonoscopy. It is a long (about 3 ft), thin (about 1 in), flexible ft), thin (about 1 in), flexible fiberoptic camera that allows the fiberoptic camera that allows the doctor to visualize your entire doctor to visualize your entire colon. colon.

Your doctor may order a colonoscopy Your doctor may order a colonoscopy to investigate many different to investigate many different diseases of the colon.diseases of the colon.

Colonoscopy may be used to find the Colonoscopy may be used to find the place and cause of bleeding as well place and cause of bleeding as well as to check areas for irritation or as to check areas for irritation or sores in your colon. sores in your colon. 

These colon problems can cause These colon problems can cause unexplained changes in bowel habits. unexplained changes in bowel habits. 

Pain, bloody diarrhea, Pain, bloody diarrhea, and weight loss can be caused and weight loss can be caused by inflammation of the bowel, by inflammation of the bowel, which may be the result which may be the result of Crohn disease or ulcrative of Crohn disease or ulcrative collitiscollitis

These inflammatory digestive These inflammatory digestive diseases tend to occur in young diseases tend to occur in young adults and, if undetected, can adults and, if undetected, can produce chronic symptoms and produce chronic symptoms and increase the risk of colon increase the risk of colon cancer.cancer.

SigmoidoscopySigmoidoscopy

Sigmoidoscopy is a procedure in Sigmoidoscopy is a procedure in which a doctor looks in which a doctor looks in your large intestine. A length your large intestine. A length of flexible tube connected to a of flexible tube connected to a fiberoptic camera is used. A fiberoptic camera is used. A light is transmitted through light is transmitted through the scope to the tip by a the scope to the tip by a bundle of light fibers. The bundle of light fibers. The doctor uses this light to look doctor uses this light to look at your intestine through an at your intestine through an eyepiece or video screen.eyepiece or video screen.

ENTEROSCOPYENTEROSCOPY

The use of a The use of a flexible instrument flexible instrument (a "scope") to (a "scope") to examine the small examine the small intestine, a very intestine, a very long hollow tube long hollow tube located between the located between the stomach and colon stomach and colon (large intestine) (large intestine) and made up of the and made up of the duodenum, jejunum, duodenum, jejunum, and ileum. and ileum.

RISKRISK Upper GI endoscopy (Upper GI endoscopy (EGDEGD))

    Esophagogastroduodenoscopy. Esophagogastroduodenoscopy.

bleeding and puncture of your esophagus  or bleeding and puncture of your esophagus  or stomach walls are possible during EGD.stomach walls are possible during EGD.

Severe irregular heartbeatSevere irregular heartbeat

Pulmonary aspiration - When material, either Pulmonary aspiration - When material, either particulate (food, foreign body) or fluid particulate (food, foreign body) or fluid (gastric contents, blood, or saliva), enters (gastric contents, blood, or saliva), enters from your throat into your windpipe   from your throat into your windpipe  

Respiratory depression, a decrease in the rate Respiratory depression, a decrease in the rate or depth of breathing, in people with severe or depth of breathing, in people with severe lung diseases or vagus nerve system to the lung diseases or vagus nerve system to the sedatives sedatives 

Infections and fever that come and go Infections and fever that come and go

Lower GI endoscopy (colonoscopy,Lower GI endoscopy (colonoscopy,sigmoidoscopysigmoidoscopy, enteroscopy), enteroscopy) possible complications of colonoscopy and sigmoidoscopy include the possible complications of colonoscopy and sigmoidoscopy include the following: following: 

Local Local painpain

DehydrationDehydration (due to excess of laxatives and enemas for bowel  (due to excess of laxatives and enemas for bowel preparation)preparation)

Cardiac arrhythmiasCardiac arrhythmias

Bleeding and Bleeding and infectioninfection

Hole in your colonHole in your colon

Explosion of combustible gases in your colon (certain gases are Explosion of combustible gases in your colon (certain gases are produced within the bowel) during removal of polypsproduced within the bowel) during removal of polyps

Respiratory depression usually due to oversedation in people Respiratory depression usually due to oversedation in people with chronic lung diseasewith chronic lung disease

Gastrointestinal Endoscopy PreparationGastrointestinal Endoscopy Preparation

Upper endoscopyUpper endoscopy  

The doctor will explain the test to you, including the possibility of The doctor will explain the test to you, including the possibility of biopsybiopsy and risks such as the need to remove polyps or other surgical  and risks such as the need to remove polyps or other surgical procedures. procedures. 

The doctor will ask you to sign a consent form agreeing to the The doctor will ask you to sign a consent form agreeing to the procedure. At the same time, you must inform the endoscopy team of any procedure. At the same time, you must inform the endoscopy team of any medications you may be taking and any allergies or bad reactions you medications you may be taking and any allergies or bad reactions you have had to previous tests. have had to previous tests. 

Wear clothing that is easily removed. Wear clothing that is easily removed. 

Remove all dentures and eyeglasses prior to beginning an upper Remove all dentures and eyeglasses prior to beginning an upper endoscopy. For colonoscopy, dentures can be left in.endoscopy. For colonoscopy, dentures can be left in.

EGDEGD  

Stop taking any medications, such asStop taking any medications, such asaspirinaspirin and  and sucralfatesucralfate (Carafate), used to treat ulcers, that could cause false  (Carafate), used to treat ulcers, that could cause false readings on tests. readings on tests. 

People who have had cardiac valve replacement or blood vessel People who have had cardiac valve replacement or blood vessel graft should receive graft should receive antibioticsantibiotics to prevent infection.  to prevent infection. 

Do not eat or drink anything for 8-10 hours before your Do not eat or drink anything for 8-10 hours before your examination to allow a valid examination of the upper GI examination to allow a valid examination of the upper GI tract and to lower the risk of vomiting. tract and to lower the risk of vomiting. 

You will be given a topical anesthetic before the test to You will be given a topical anesthetic before the test to numbnumb your throat to prevent gagging. your throat to prevent gagging.

Colonoscopy or sigmoidoscopy Colonoscopy or sigmoidoscopy  Your rectum and colon should be cleaned of all fecal matter. Even Your rectum and colon should be cleaned of all fecal matter. Even

a small amount of feces can reduce reliability of the test. a small amount of feces can reduce reliability of the test. 

You will change your diet prior to the test-no fibers or foods You will change your diet prior to the test-no fibers or foods with small seeds for 5-6 days before the examination. You will with small seeds for 5-6 days before the examination. You will drink liquids such as tea, fruit juices, and clear broth. drink liquids such as tea, fruit juices, and clear broth. 

You may be given laxatives 12-15 hours before the test. You will You may be given laxatives 12-15 hours before the test. You will be asked to drink up to 4 liters (about 4 qt) of a special be asked to drink up to 4 liters (about 4 qt) of a special cleansing solution to clean out the colon. Several medications are cleansing solution to clean out the colon. Several medications are available for bowel cleansing, including available for bowel cleansing, including polyethylene glycol 3350polyethylene glycol 3350 (GoLYTELY, NuLYTELY). Other laxatives to cleanse the bowel, such  (GoLYTELY, NuLYTELY). Other laxatives to cleanse the bowel, such as as magnesium magnesium citratecitrate(Citroma) or (Citroma) or sennasenna (X-Prep), may also be  (X-Prep), may also be prescribed. prescribed. 

You may be given 1 or 2 little enemas 2-3 hours before the You may be given 1 or 2 little enemas 2-3 hours before the procedure. procedure. 

The doctor may perform a The doctor may perform a rectalrectal examination to detect narrowings,  examination to detect narrowings, polyps or abnormal growth, or hidden bleeding from your lower polyps or abnormal growth, or hidden bleeding from your lower intestineintestine

During the ProcedureDuring the Procedure

Upper GI endoscopy Upper GI endoscopy 

You will be placed on your left side and have a plastic mouthpiece placed between your teeth You will be placed on your left side and have a plastic mouthpiece placed between your teeth to keep your to keep your mouthmouth open and make it easier to pass the tube.  open and make it easier to pass the tube. 

The doctor lubricates the endoscope, passes it through the mouthpiece, then asks you to swallow it. The doctor guides the endoscope under direct visualization through your stomach into the small intestine

Any saliva you have will be cleared using a small suction tube that is removed quickly and easily after the test. 

The doctor inspects portions of the linings of your esophagus, stomach, and the upper portion of your small intestine and then reinspects them as the instrument is withdrawn. 

If necessary, biopsies and removal of foreign bodies and polyps may be performed. 

The procedure usually is completed within 10-15 minutes. Any surgical procedures will require several minutes, depending on the type.

Lower GI endoscopy Lower GI endoscopy 

You will be placed on your left side with your hips back, You will be placed on your left side with your hips back, flexed beyond your abdominal wall. flexed beyond your abdominal wall. 

The doctor lubricates the endoscope and inserts it into The doctor lubricates the endoscope and inserts it into your anus and advances it under direct vision. your anus and advances it under direct vision. 

You may be asked to change position during the procedure to You may be asked to change position during the procedure to assist moving the endoscope. The doctor will study your colon assist moving the endoscope. The doctor will study your colon and rectum walls and reinspect them as the endoscope is and rectum walls and reinspect them as the endoscope is withdrawn. If necessary, surgeries may be performed. withdrawn. If necessary, surgeries may be performed. 

You may feel uneasiness and abdominal pain. The procedure You may feel uneasiness and abdominal pain. The procedure usually takes 15-20 minutes. Any surgeries will require usually takes 15-20 minutes. Any surgeries will require additional time, depending on the type.additional time, depending on the type.

After the ProcedureAfter the Procedure

If you have been sedated, you will be moved to a recovery If you have been sedated, you will be moved to a recovery area to wake up.area to wake up.

Once sedation has worn off, before you are discharged from Once sedation has worn off, before you are discharged from medical center, you will be given instructions and told to medical center, you will be given instructions and told to call your doctor if complications develop.call your doctor if complications develop.

You should have someone there to take you home. You should You should have someone there to take you home. You should not drive a car or use other machinery or drink alcohol for not drive a car or use other machinery or drink alcohol for at least a day. You may feel drowsy.at least a day. You may feel drowsy.

At home, it would be best to have a light meal and rest for At home, it would be best to have a light meal and rest for the remainder of the day.the remainder of the day.

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