DDHS offers an assortment of minimally invasive, non-surgical procedures for the diagnosis and treatment of gastrointestinal disorders. Some of these procedures use leading-edge imaging technology—a video endoscope with high-definition video display—to illuminate and visually examine the hollow organs of the digestive system. They include:
This test is performed to evaluate patients with constipation or incontinence of the bowel. A small pressure catheter the size of a thermometer is inserted into the rectum to measure the pressure of the sphincter muscle and the neural reflexes that are needed for normal bowel movements.
A colonoscopy is a medical procedure that uses a long, flexible and lighted video instrument (a colonoscope) to visually inspect the rectum and large intestine for the polyps that can cause colorectal cancer. If a suspicious polyp is found, it can be removed through the colonoscope for further testing. This test can also be used to check for other diseases of the bowel, such as ulcerative colitis and Crohn’s disease.
A new and highly advanced test, capsule endoscopy uses a miniature capsule containing a video camera that is swallowed by the patient to record images of the digestive tract. This test is ideal for visualizing the small intestine, which is not easily reached by an endoscope or colonscope. Because the capsule travels the entire length of the digestive system, it takes longer than other tests such as colonoscopy or traditional endoscopy.
With this test, a video endoscope is used to inject dye into the bile and pancreatic ducts. Then, x-rays are taken to look for blockages, or the leakage of bile into the abdominal cavity. ERCP can be used to locate and remove gallstones in the bile duct, check for cancer or cirrhosis of the liver, evaluate jaundice and investigate otherwise unexplained abdominal pain.
This test uses a special endoscope (a long, flexible instrument with a light and video camera) that has an ultrasound device attached to the end of it that emits sound waves. It can be used to visualize the size and depth of cancers of the esophagus, stomach and rectum and obtain biopsies if necessary. It can also be used to visualize organs outside of the GI tract such as the liver, gallbladder and pancreas in greater detail when needed.
Also known as “upper endoscopy,” this test uses an endoscope (a long, flexible instrument with a light and video camera) to visually inspect the esophagus, stomach and part of the small intestine for abnormalities. If a problem is found, certain therapies can be performed during the procedure, such as the widening of a constricted esophagus or halting the bleeding of an ulcer.
People who do not respond to normal medical treatment for GI problems may be advised to have a 24-hour ambulatory pH test, in which a special monitor is placed in the esophagus that records acid reflux over a period of time. The test will show how frequently acid refluxes into the esophagus, the activities that cause the reflux, how long the acid remains in the esophagus and the symptoms that occur during the reflux.
This test uses an endoscope (a long, flexible instrument with a light and video camera) to visually inspect the esophagus. When a stricture or narrowing of the esophagus is found, we can “stretch” the scar tissue with a balloon or dilator to open the narrowing back up. This is generally a very well tolerated procedure. Strictures may need to be dilated more than once, especially if they are very narrow to start.
When the esophagus is not functioning properly, several tests can be used to assist in providing an accurate diagnosis. Manometry is used to check the ability of the esophageal muscles for their ability to contract properly. Esophageal pH monitoring measures changes in the acidity of the esophagus, which is especially useful when evaluating heartburn or gastroesophageal reflux disease (GERD). Multichannel intraluminal impedance testing is a new technique to measure how far up the esophagus acid or alkaline from the stomach travels.
This test is used to measure the function of the valve in the lower esophagus that prevents the reflux of gastric acid from the stomach into the esophagus. It measures the pressure in the lower esophageal sphincter (LES) as well as any signs of abnormal muscle contractions in the main part of the esophagus.
A flexible sigmoidoscopy is a medical procedure that uses a flexible and lighted video instrument (a sigmoidoscope) to visually inspect the rectum and sigmoid colon for various abnormalities including hemorrhoids, polyps and inflammation (such as that seen with ulcerative colitis and Crohn’s disease). Polyp removal and biopsies can be obtained during this procedure just like they can with a colonoscopy. It does not visualize the entire colon however and therefore has more limited use.
This is a procedure performed by our colleagues in the Interventional Radiology department at Rose Medical Center. We may request this if blood work suggests inflammation of the liver without a clear cause or to assess the degree of inflammation and scarring in patients with chronic liver disease.
Commonly known as “tube feeding,” PEG is a procedure for patients who have a functional digestive tract, but who are unable to consume enough calories to meet their body’s demands. During this procedure, a flexible, lighted instrument called an endoscope is inserted into the stomach through the mouth to assist in the placement of a tube passed through the abdomen.
Also known as “EGD,” this test uses an endoscope (a long, flexible instrument with a light and video camera) to visually inspect the esophagus, stomach and part of the small intestine for abnormalities. If a problem is found, certain therapies can be performed during the procedure, such as the widening of a strictured esophagus or halting the bleeding of an ulcer.
In some cases, endoscopy allows minor surgery and biopsy to be performed (such as colon polyp removal) without invasive surgical techniques.
When additional testing or treatment is needed, including ultrasound or CT tests, we are conveniently located at the Rose Medical Center campus, where comprehensive radiology testing services and emergency health services are offered.
