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Pill Capsule Endoscopy

Mon, 26 Jan 2026 22:01:54 GMT

No Wires, Belts or Sedation Required

Common Indications for Capsule Endoscopy

Obscure Gastrointestinal Bleeding

The most common reason that a capsule endoscopy might be performed is to evaluate obscure gastrointestinal (GI) bleeding.

Patients who have unexplained iron deficiency anemia or who are bleeding from the GI tract will typically first be evaluated with a colonoscopy and an upper GI endoscopy (EGD). If neither the colonoscopy nor the EGD are able to identify the source of the bleeding, it is referred to as “obscure GI bleeding” or “suspected small bowel bleeding”.

Once a patient is suspected to have small bowel bleeding, a capsule endoscopy examination may be performed. Approximately 5% of all obscure GI bleeding emanates from the small bowel, these are most caused by small vascular lesions called angioectasias. Other causes of bleeding may include:

Erosions
Hereditary conditions (rare)
Inflammation
Masses
Tumors
Ulcerations

Crohn’s Disease

Capsule endoscopy may also be used in the examine for Crohn’s Disease. Crohn’s disease is a type of inflammatory bowel disease (IBD) that may cause symptoms such as abdominal pain, diarrhea, fever, and weight loss.

Tumors

While less common, small bowel capsule endoscopy is also used to examine the small bowel for tumors.

Celiac Disease

Capsule endoscopy may be used to study patients with celiac disease.

Contraindications

Small bowel obstruction is a contraindication for capsule endoscopy. The CapsoCam Plus video capsule is contraindicated in patients:

Who have known or suspected gastrointestinal obstructions, strictures or fistula
Who are pregnant
Who have gastroparesis
Who have a swallowing disorder

* Documentation and images provided by the CapsoCam website, https://capsovision.com/

IMPORTANT REMINDER: This information is intended only to provide general guidance. It does not provide definitive medical advice. It is very important that you consult your doctor about your specific condition.

For Dr. Matter's prep instructions pre and post procedure, please click here to reference our Prep page.

FibroScan

Fri, 29 Aug 2025 20:13:59 GMT

Painless, Accurate, Noninvasive Way to Assess Liver Health

Why is liver health important?

Situated on the right side, in your upper right-hand part of the tummy, the liver is the largest solid organ in your body and one of the hardest working.

Your liver has 3 main functions:

it cleans your blood
it produces an important digestive liquid called bile
it stores energy in the form of a sugar called glycogen

There are 3 main chronic liver diseases:

non-alcoholic steatohepatitis (NASH) or fatty liver disease
viral hepatitis (HCV and HBV)
alcoholic liver disease

Chronic liver disease is silent and underdiagnosed. Damage to the liver caused by chronic liver diseases can often be reversed by early diagnosis and intervention.

What is FibroScan®?

FibroScan® is the gold standard non-invasive solution for comprehensive management of liver health.

FibroScan® sends a pulse of energy to your liver, which will give your doctor important information about your liver’s health

Why do I need a liver examination with FibroScan®?

Liver health is critically important regardless of your medical needs. As such, the medical staff wants to perform a quick examination to ensure that you do not have liver damage.

How do I prepare?

Wear comfortable clothes that allow access to the right side of your rib cage.

You should be fasting for at least 3 hours before your examination.

What happens during the examination?

• You will lie on your back with your right arm above your head and cross your right leg over your left to help open your rib spaces.

• Gel will be applied and the probe will be placed between your rib spaces.

How long does it take?

A FibroScan® examination typically takes 5-10 minutes to perform.

Does it hurt?

No. FibroScan® is painless. You may feel a slight vibration from the probe as the measurements are taken.

Colonoscopy

Thu, 16 Nov 2023 14:41:27 GMT

What is colonoscopy?

A flexible, lighted tube that is about the thickness of a finger is inserted through the rectum into the large intestine (colon) and allows the physician to carefully examine the lining of the colon.

Abnormalities, which are too small to be seen on x-ray, can be identified, as well as the confirmation of abnormalities suspected on x-ray. A tiny sample of tissue (biopsy) can be taken for examination in the laboratory if indicated. Biopsies are taken for many reasons and do not necessarily imply cancer.

Why is colonoscopy necessary?

Colonoscopy is a valuable tool for the diagnosis and treatment of many diseases of the large intestine. Abnormalities suspected by x-ray can be confirmed and studied in detail. Even when x-rays are negative, the cause of symptoms such as rectal bleeding or change in bowel habits may be found by colonoscopy. It is useful for the diagnosis and follow-up of patients with the inflammatory bowel disease.

The colonoscopy's greatest impact may be in its contribution to the control of colon cancer by polyp removal. Before colonoscopy became available, major abdominal surgery was the only way to remove colon polyps to determine if they were benign or malignant. Now most polyps can be removed easily and safely without surgery.

Periodic colonoscopy is a valuable tool for follow up of patients with previous polyps, colon cancer or a family history of colon cancer. Colonoscopy is a safe and extremely worthwhile procedure, which is very well tolerated. The decision to perform this procedure was based upon assessment of your particular problem.

What happens after colonoscopy?

You will remain at the outpatient area until most of the effects of the sedation have worn off. You may feel bloated after the procedure because of the air that was introduced while examining the colon. Passing flatus (gas) will provide relief and is encouraged.

You will be able to resume your normal diet after the colonoscopy unless you are instructed otherwise (for instance if the polyps were removed).

Due to the sedation, you will not be allowed to drive home following the procedure. You will need to arrange for a companion to drive you home, and remain in the building while you are here. Even through you may not feel tired, your judgment and reflexes may not be normal. You may not drive for the rest of the day or return to work.

Are there any complications from colonoscopy?

Colonoscopy is safe and is associated with very low risk when performed by a physician who has been specially trained and is experienced in this endoscopic procedure.

One possible complication is perforation, a tear in the lining of the colon. This is usually minor and stops on its own or it can be controlled by cauterization through the colonoscope. Rarely, transfusion or surgery is required. Colonoscopy is extremely worthwhile and safe and is invaluable in the diagnosis and proper management of disorders of the colon. The decision to perform this procedure was based upon assessment of your particular problem.

IMPORTANT REMINDER: This information is intended only to provide general guidance. It does not provide definitive medical advice. It is very important that you consult your doctor about your specific condition.

CAT Scan

Wed, 15 Nov 2023 14:35:49 GMT

Diagnostic CT Services

A CAT Scan or CT is a painless procedure that uses digital x-ray images to create a 3D reconstruction of your internal organs. The modern sensitivity of a CT can detect many diseases such as infections, cysts, fractures, stones and tumors. The CT frequently uses the aide of oral contrast drinks and occasionally an intravenous contrast or “x-ray dye,” depending on what the physician needs to visualize.

How Does a CT Scan Work?

A CT scanner emits a series of narrow beams through the human body as it moves through an arc, unlike an x-ray machine which sends just one radiation beam. The final picture is far more detailed than a single x-ray image.

The accuracy and speed of CT scans may be improved with the application of spiral CT. The x-ray beam takes a spiral path during the scanning, gathering continuous data with no gaps between images.

What to Expect During a CT Scan

Patients will need to undress, usually down to their underwear, and put on a gown.

The patient will be asked to lie down on a motorized examination table, which then goes into the giant doughnut-like machine.

Some patients may be given a contrast dye or substance which is either swallowed, given as an enema, or injected. This improves the picture of some blood vessels or tissues.

As metal interferes with the workings of the CT scanner, patients will need to remove all jewelry and metal fastenings. In the majority of cases the patient will lie on his/her back, facing up. But sometimes it may be necessary to lie face-down or sideways.

After the machine has taken one image, the table will move slightly, and then another image is taken, etc. The patient needs to lie very still for best results.

During the scan everybody except for the patient will leave the room. The radiographer will still be able to communicate with the patient, and vice-versa, through an intercom. If the patient is a child, a parent or adult might be allowed to stand or sit nearby. This person will have to wear a lead-lined apron to prevent radiation exposure.

A Pregnancy Test Is Required Prior to the CT Procedure You Are Schedule for if You Are a Female:

Between the ages of 12 and 50 and have NOT had a hysterectomy.

Less than 12 years old and are having menstrual periods.

Over age 50 and having menstrual periods.

Monitored Anesthesia Care (MAC)

Fri, 22 Sep 2023 16:19:38 GMT

Monitored Anesthesia Care (MAC) is the intravenous administration of mild sedatives to help a patient relax and relieve anxiety during minor procedures that do not require general anesthesia. These procedures, such as biopsies and colonoscopies, typically require the injection of a local anesthetic to numb the surgical site.

This is different from general anesthesia because you remain breathing on your own during the procedure and do not have a breathing tube. Your doctor will monitor you throughout the procedure just the same as he or she would during general anesthesia.

What is the purpose?

The purpose of MAC anesthesia is to provide the patient with relief of discomfort and anxiety associated with the procedure. Although you will be able to respond to your doctors and nurses during the procedure, the medicines you receive will likely lead to you not remembering the procedure.

What procedures is it used for?

MAC anesthesia is used for uncomfortable procedures or minor surgeries that do not usually require general anesthesia. Examples of these are upper endocoscopy and colonoscopy, procedures done under radiologic guidance, and minor surgeries for which the patient needs to lie still for more that a few minutes.

What are the benefits?

The medicines used for MAC anesthesia work quickly and also wear off quickly. They allow for you to undergo the procedure in a safe manner. When the procedure is done, most patients are awake quickly afterward and do not get some of the side effects commonly associated with general anesthesia, such as nausea and feeling sleepy.

MAC (Monitored Anesthesia Care) is also referred to as Twilight Sleep.

Conscious Sedation

Fri, 22 Sep 2023 16:11:54 GMT

Conscious sedation is a combination of medicines to help you relax (a sedative) and to block pain (an anesthetic) during a medical or dental procedure. You will probably stay awake but may not be able to speak.

Conscious sedation lets you recover quickly and return to your everyday activities soon after your procedure.

Description

Why the Procedure is Performed?

Conscious sedation is safe and effective for patients who need minor surgery or a procedure to diagnose a condition.

After Conscious Sedation

After conscious sedation, you will feel sleepy and may have a headache or feel sick to your stomach. During recovery, your finger will be clipped to a special device (pulse oximeter) to check the oxygen levels in your blood. Your blood pressure will be checked with an arm cuff about every 15 minutes.

You should be able to go home 1 to 2 hours after your procedure.

When you are home:

Eat a healthy meal to restore your energy.
You should be able to return to your everyday activities the next day.
Avoid driving, operating machinery, drinking alcohol, and making legal decisions for at least 24 hours.
Check with your doctor before taking any medicines or herbal supplements.
If you had surgery, follow your doctor's instructions for recovery and wound care.

Virtual Colonoscopy

Fri, 22 Sep 2023 16:04:08 GMT

What is the difference between the conventional colonoscopy and the virtual colonoscopy?

Virtual colonoscopy is an abdominal CT scan where “pictures” are taken and then the images are reconstructed into a 3D replica of the colon. The images are then read by a trained radiologist to look for pre-cancerous polyps or abnormalities inside and outside your colon. For the optical colonoscopy exam (also known as “conventional” or “traditional” colonoscopy), a flexible tube that has a camera at its end is inserted into the rectum and manually manipulated by a gastroenterologist (GI doctor) all the way to the beginning of the colon called the cecum. On the way back from the cecum, the GI doctor slowly pulls the device out and looks for polyps. If polyps are found, these can be removed using available tools through the flexible tube. Please note that only about 15% of the screening population will actually require removal of pre-cancerous polyps.

Who should have a virtual colonoscopy?

American Cancer Society recommends colon cancer screening for both men and women over the age of 50. For those individuals with a positive family history of colon cancer (family members such as father, mother, brother or sister), the American Cancer Society recommends colon cancer screening starting at the age of 40. Currently, there are several screening methods available but optical colonoscopy (also known as “conventional” or “traditional” colonoscopy) was the only option available for full colon screening exam. Virtual colonoscopy can visualize the entire colon and it is a convenient, non-invasive screening procedure that makes it easy to protect you from colon cancer. In addition, virtual colonoscopy is a good alternative for patients who have a history of incomplete optical colonoscopy, are allergic to IV sedation, or are hesitant to get screened because they perceive optical colonoscopy as invasive, risky, time-consuming or inconvenient.

What is virtual colonoscopy?

Virtual Colonoscopy (VC) uses x-rays and computers to produce two and three dimensional images of the colon (large intestine). The procedure is used to diagnose colon diseases, including polyps, diverticulosis and cancer. VC is performed with computed tomography (CT), sometimes called a CAT scan.

Virtual colonoscopy procedure

While preparations for VC vary, you will usually be asked to take laxatives or other oral agents at home the day before the procedure to clear stool from your colon. You may also be asked to use a suppository.

The examination takes about 10 minutes and does not require sedatives. During the procedure:

You will be asked to lie on your back on the table.
A thin tube will be inserted into your rectum and air will be pumped through the tube to inflate the colon for better viewing.
The table moves through the scanner to produce a series of two-dimension cross-sections along the length of the colon. A computer program puts these images together to create a three-dimensional picture that can be viewed on the video screen.
You will be asked to hold your breath during the scan to avoid distortion on the images.
The scanning procedure is then repeated with you lying on your stomach.

After the examination, the information from the scanner must be processed to create the computer picture or image of your colon. A Radiologist evaluates the results to identify the abnormalities.

You may resume normal activity after the procedure.

Disadvantages of virtual colonoscopy

The doctor cannot take tissue samples or remove polyps during virtual colonoscopy, so conventional colonoscopy must be performed if abnormalities are found. Also, VC does not show as much detail as conventional colonoscopy, so polyps smaller than 10 millimeters in diameter may not show up on the images.

Advantages of virtual colonoscopy

VC is more comfortable than conventional colonoscopy for some people because it does not use a colonoscope. As a result, no sedation is needed and you can return to your usual activities or go home after the procedure without the aid of another person. VC provides clearer, more detailed images than a conventional x-ray using a barium enema, sometimes called lower gastrointestinal (GI) series. it also takes less time than either a conventional colonoscopy or lower GI series.

Flexible Sigmoidoscopy

Fri, 22 Sep 2023 15:51:08 GMT

What is Flexible Sigmoidoscopy?

A flexible, lighted tube that is about the thickness of a finger is inserted through the rectum into the first section of large intestine (colon) and allows the physician to carefully examine the lining of this portion of the colon. A tiny sample of tissue (biopsy) can be taken for examination in the laboratory if indicated. Biopsies are taken for many reasons and do not necessarily imply cancer.

Why is flexible sigmoidoscopy necessary?

Flexible Sigmoidoscopy is a valuable tool for the diagnosis and follow-up of many diseases of the large intestine. Abnormalities suspected by x-ray can be confirmed and studied in detail. It is useful for the diagnosis and follow-up of patients with inflammatory bowel disease and unexplained bleeding in the lower colon. The procedure can also be a valuable screening tool for the prevention of colon cancer.

What should you expect during the procedure?

After admission you will be asked to change into a patient gown. You will then be given a consent form to sign and a nurse will be available to discuss any questions or concerns. You will be lying comfortably on your left side for the examination, which will last approximately ten minutes.

What happens after Flexible Sigmoidoscopy?

If you receive sedation, you will remain at the facility until most of the effects of the sedation have worn off. In this case, you will not be allowed to drive for the rest of the day and cannot return to work until the following day. Even though you may feel awake and alert, your reflexes may not be normal.

You may feel bloated after the procedure because of the air that was introduced while examining the colon. Passing flatus (gas) will provide relief and is encouraged.

Due to sedation, you will not be allowed to drive home following the procedure. You will need to arrange for a companion to drive you home, and who will remain in the building while you are here.

Are there any complications from Flexible Sigmoidoscopy?

Flexible Sigmoidoscopy is safe and is associated with very low risk when performed by a physician who has been specially trained and is experienced in this endoscopic procedure. One possible complication is perforation, a tear in the lining of the colon. This complication usually requires surgery to repair.

Bleeding may occur from the site of the biopsy or polyp removal. This is usually minor and stops on its own, or it can be controlled by cauterization through the endoscope.

Flexible Sigmoidoscopy is extremely worthwhile and safe, and it is valuable in the diagnosis and proper management of some disorders of the colon. The decision to perform this procedure was based upon assessment of your particular problem.

What preparation is required?

The best possible examination requires the lower portion of the colon be completely empty of stool. Therefore, you will be given diet and laxative instructions. It is imperative that you follow these instructions in order to clearly evaluate the colon.

Liver Biopsy

Fri, 22 Sep 2023 15:37:30 GMT

What is Liver Biopsy?

Liver biopsy is a procedure by which a tiny sample of liver tissue is removed through a needle and is evaluated microscopically for liver disease.

Why is Liver Biopsy necessary?

Liver biopsy is necessary to diagnose certain liver diseases. Evidence of these diseases may be seen by enlargement of the liver, jaundice, or elevated liver enzymes.

What preparation is necessary?

Do not eat or drink anything after midnight before the procedure. Some preliminary blood tests will be done to be certain that your blood clots normally. These tests will be done on the morning of the procedure, unless otherwise instructed.

What should I expect during the test?

Upon arrival to the hospital, you will be asked to give the admitting clerk some necessary information. Next, you will be taken to an exam room where a nurse will help you into a gown and complete a brief history and consent form.

A sonogram (ultrasound) of the liver will be obtained just prior to the biopsy. For the biopsy, you will be positioned flat with your right arm extended above your head and the hand resting comfortably under your head. A local medication, similar to that used by your dentist, will be used to numb the area where the needle will be inserted.

What happens after the test?

A bulky dressing will be applied to the site of the biopsy and you will need to lie on your right side for a prescribed amount of time. The liver biopsy is usually performed as an outpatient.

What are the possible complications of Liver Biopsy?

Complications associated with liver biopsy are extremely rare and measures are taken to prevent them. However, the two complications that would most likely be associated with liver biopsy are bleeding and infection.

The liver biopsy is an extremely worthwhile test. It is invaluable in the diagnosis and proper management of certain liver diseases. The decision to perform this procedure was based upon assessment of your particular problem.

If you have any further questions or concerns, your doctor and/or his staff will be happy to discuss them with you.

Hemorrhoid Banding

Fri, 22 Sep 2023 15:24:13 GMT

Hemorrhoid banding is a procedure used to treat painful, swollen hemorrhoids. The procedure is most often done because the hemorrhoids: (1) are bleeding severely, (2) are severely painful, (3) they contain a blood clot (thrombosed hemorrhoid) or, (4) they protrude through the anus (prolapsed hemorrhoids).

What to expect

Post-procedure care:

For a few days, you will have difficulty controlling the passage of gas and bowel movements. When you return home after the procedure, do the following to help ensure a smooth recovery:

Take sitz baths as recommended. Sitz baths will help relieve discomfort and clean the area. For a sitz bath, sit in warm water for 10 – 15 minutes. Pat the area dry. Do not wipe or rub vigorously. You may me advised to take a sitz bath every four hours and after every bowel movement. Devices are available to place on top of the toilet to make the process easier.
Move your bowels as soon as you feel the urge.
Do not strain, bear down, or hold your breath during bowel movements.
Do not sit on the toilet for long periods of time.
To prevent constipation and straining during bowel movements, use a stool softener, exercise, drink plenty of fluids, and eat plenty of high-fiber foods (i.e. fruits, vegetables, beans, and whole grains).
Apply creams or ointments as directed by your physician.
Avoid heavy lifting for two to three weeks.
Be sure to follow your doctor’s instructions.

Expect some bleeding when the hemorrhoid falls off.

After arriving home, contact your doctor if any of the following occurs:

Passing large amounts of blood
Signs of infection, including fever and chills
Pain that you cannot control with the medicines you have been given
Constipation or trouble urinating
Aching feeling develops in the area between your rectum and the genitals

Information provided from Aurora St. Luke’s Medical Center of Wisconsin.

Ileoscopy

Fri, 22 Sep 2023 15:03:12 GMT

What is an ileoscopy?

For an ileoscopy (ill-ee-ah-sco-pee), doctors use a thin, flexible, lighted tube called an endoscope (en-doh-scope) – or "scope" for short – to get a good look at a person's digestive system. For this procedure, the particular part of the digestive system being looked at is the ileum.

The ileum is the last and longest section of your small intestine. The ileum is where most of the nutrients from your food are absorbed before emptying into the large intestine. Ileoscopy is done through a person's ileostomy (ill-ee-ah-sto-mee). An ileostomy is an artificial opening (called a stoma), created in the abdomen by surgeons. The ileum is brought out to the surface of the abdominal wall, allowing waste to drain into a sealed pouch on the outside of the body. Ileostomies are sometimes created as a temporary measure, to allow the intestine a chance to rest and heal after surgery. Surgeons may reconnect the intestine later, when it has healed. In a permanent ileostomy, the entire large bowel is removed before the stoma is made.

ERCP (Endoscopic Retrograde Cholangiopancreatography)

Fri, 22 Sep 2023 14:52:11 GMT

What is ERCP?

ERCP is a procedure by which a flexible, lighted fiberoptic tube is passed through the esophagus (swallowing tube), stomach, and finally into the duodenum (first section of small intestine leading from the stomach). A small plastic tube (cannula) is passed through a tiny muscular opening (sphincter) that leads into the pancreatic and common bile ducts. Dye is injected through the cannula and x-rays are taken in order to study the ductal systems of the pancreas, bile ducts, liver, or gallbladder, depending upon which is being evaluated.

If anything unusual is seen during the procedure, a biopsy (small sample of tissue) can be obtained via the scope and sent to the laboratory for further evaluation. Biopsies are taken for many reasons and do not necessarily imply cancer.

What are the reasons for performing ERCP?

ERCP is a valuable tool for the diagnosis of many diseases of the pancreas, bile duct, liver, and gallbladder. An abnormality suspected by clinical history, blood tests, or x-ray can be confirmed and studied in detail. The cause of an obstruction to the flow of bile may be found in a patient who is jaundiced. The diagnosis may be made in a patient who is not jaundiced when symptoms suggest disease of the bile ducts of the gallbladder. If a blocked duct is found, surgery may be required.

In patients with suspected or known pancreatic disease, ERCP will help to determine the need for surgery and the best type of surgical procedure to perform.

In the event a stone or blockage is found, an extension of ERCP may be performed. This is called Endoscopic Retrograde Sphincterotomy or simply ERS.

What is ERS?

A special cannula that has a cutting wire is passed through the tiny opening (sphincter) that leads into the common bile duct. The opening of this sphincter can be enlarged using this cutting wire. By enlarging the opening to the duct, small stones can pass from the duct and into the small intestine. These will be passed naturally and unnoticed along with the stool. Larger stones may be either crushed with special equipment or removed with a tiny balloon or wire basket.

Occasionally, a small tube (called a stent) will be placed in the bile duct and remain there to allow free drainage of the bile.

What preparation is required?

The best possible examination requires the stomach be completely empty. You should have nothing to eat or drink after midnight (including water) prior to the examination.

What should you expect during the procedure?

After you are admitted you will need to change into a patient gown and will be given a consent form to sign. A nurse will be available to discuss any questions or concerns.

What happens after ERCP?

You will remain in the facility until most of the effects of the sedation have worn off. You may feel bloated and might have a soft bowel movement because of the air and dye that were introduced during the examination.

You will be able to resume your normal diet after the examination, unless otherwise instructed.

Due to the sedation, you will not be allowed to drive home following the procedure. You will need to arrange for a companion to drive you home, and who will remain in the building while you are here. Even though you may not feel tired, your judgment and reflexes may not be normal.

If ERS is necessary, admission to the hospital will be required for observation.

Are there any complications from ERCP?

ERCP is safe and is associated with very low risk when performed by physicians who have been specially trained and are experienced in this highly specialized procedure. Complications can occur but are uncommon.

One possible complication is pancreatitis due to irritation of the pancreatic ducts by the x-ray contrast material (3-4%). Another possible complication is infection, particularly if ERS is performed since a cut has been made.

Other less common risks include perforation (tear) of the bowel, drug reactions, and complications from unrelated diseases such as heart attack or stroke.

Death is extremely rare, but remains a remote possibility.

ERCP is an extremely worthwhile procedure and is well tolerated. The decision to perform ERCP was based upon assessment of your particular problem.

If you have any further questions or concerns, your doctor and/or his staff will be happy to discuss them with you.

Esophageal Dilation

Fri, 22 Sep 2023 14:27:55 GMT

What is Esophageal Dilation?

Esophageal dilation is a procedure that allows your doctor to dilate, or stretch, a narrowed area of your esophagus [swallowing tube]. Doctors can use various techniques for this procedure. Your doctor might perform the procedure as part of a sedated endoscopy. Alternatively, your doctor might apply a local anesthetic spray to the back of your throat and then pass a weighted dilator through your mouth and into your esophagus.

Why is Esophageal Dilation Done?

The most common cause of narrowing of the esophagus, or stricture, is scarring of the esophagus from reflux of stomach acid occurring in patients with heartburn. Patients with a narrowed portion of the esophagus often have trouble swallowing; food feels like it is “stuck” in the chest region, causing discomfort or pain. Less common causes of esophageal narrowing are webs or rings (which are thin layers of excess tissue), cancer of the esophagus, scarring after radiation treatment or a disorder of the way the esophagus moves [motility disorder].

How Should I Prepare for the Procedure?

An empty stomach allows for the best and safest examination, so you should have nothing to drink, including water, for at least six hours before the examination. Your doctor will tell you when to start fasting.

What Can I Expect during Esophageal Dilation?

Your doctor might perform esophageal dilation with sedation along with an upper endoscopy. Your doctor may spray your throat with a local anesthetic spray, and then give you sedatives to help you relax. Your doctor then will pass the endoscope through your mouth and into the esophagus, stomach and duodenum. The endoscope does not interfere with your breathing. At this point your doctor will determine whether to use a dilating balloon or plastic dilators over a guiding wire to stretch your esophagus. You might experience mild pressure in the back of your throat or in your chest during the procedure. Alternatively, your doctor might start by spraying your throat with a local anesthetic. Your doctor will then pass a tapered dilating instrument through your mouth and guide it into the esophagus. Your doctor may also use x-rays during the esophageal dilation procedure.

What Can I Expect after Esophageal Dilation?

After the dilation is done, you will probably be observed for a short period of time and then allowed to return to your normal activities. You may resume drinking when the anesthetic no longer causes numbness to your throat, unless your doctor instructs you otherwise. Most patients experience no symptoms after this procedure and can resume eating the next day, but you might experience a mild sore throat for the remainder of the day.

If you received sedatives, you probably will be monitored in a recovery area until you are ready to leave. You will not be allowed to drive after the procedure even though you might not feel tired. You should arrange for someone to accompany you home, because the sedatives might affect your judgment and reflexes for the rest of the day.

What are the Potential Complications of Esophageal Dilation?

Although complications can occur even when the procedure is performed correctly, they are rare when performed by doctors who are specially trained. A perforation, or hole, of the esophagus lining occurs in a small percentage of cases and may require surgery. A tear of the esophagus lining may occur and bleeding may result. There are also possible risks of side effects from sedatives.

It is important to recognize early signs of possible complications. If you have chest pain, fever, trouble breathing, difficulty swallowing, bleeding or black bowel movements after the test, tell your doctor immediately.

Will Repeat Dilations be Necessary?

Depending on the degree and cause of narrowing of your esophagus, it is common to require repeat dilations. This allows the dilation to be performed gradually and decreases the risk of complications. Once the stricture, or narrowed esophagus, is completely dilated, repeat dilations may not be required. If the stricture was due to acid reflux, acid-suppressing medicines can decrease the risk of stricture recurrence. Your doctor will advise you on this.

*Information obtained from the American Society for Gastrointestinal Endoscopy

EGD with PEG Tube Replacement

Fri, 22 Sep 2023 13:56:04 GMT

Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement

PEG tube placement is a procedure during which a feeding tube will be placed into the stomach during an esophagogastroduodenoscopy (EGD). PEG tube placement requires that a very small incision be made in the abdomen through which the tube will enter the stomach for delivery of nutrition.

What to Expect:

An EGD is done to assist in this procedure. You will receive sedation for the procedure so you will need someone to drive you home, and who will remain in the building while you are here. The feeding tube is placed thru the gastroscope. Local anesthesia will be used at the abdominal site where the tube will exit the skin.

What Happens After:

After the procedure you will be transferred to a recovery area to be monitored. When you are awake and stable you will be discharged home. Post procedure you may have an abdominal binder in place. Instructions will be given to you and your family on how to care for the tube. Your physician will arrange for supplies to be delivered to your home if necessary.

The stomach and abdomen will heal in 5 to 7 days. Moderate pain can be treated with medications. Feedings will start slowly with clear liquids, and increase slowly.

The patient/family will be taught:

How to care for the skin around the tube
Signs and symptoms of infection
What to do if the tube is pulled out
Signs and symptoms of tube blockage
How to empty the stomach through the tube
How and what to feed through the tube
How to hide the tube under clothing
What normal activities can be continued