Medical Services
We have the options of performing an Endoscopy, Colonoscopy, Hemorrhoid treatment, Colon Cancer Screening, and Endoscopic Ultrasound to identify the appropriate treatment to protect your health. See our complete list below to learn more about the treatment options available from our participating physicians.
We perform the following procedures:
Bravo Capsule
The Bravo capsule is inserted into the esophagus two inches above the stomach junction through an endoscope. The capsule is then attached to the lining of the esophagus by a tiny pin. The endoscope is then used to make sure the capsule is in place. The capsule is a small gel cap, it contains a radio transmitter that sends the pH values to a monitor worn by the patient on his/her wrist of carried in a pocket.
After this procedure, patients go home and resume normal day to day activity. The monitor also has a symptom botton, that the patient will be told to press when heartburn, chest pain, or regurgitation is felt. This capsule monitors the patients pH for 48 hours. The doctor then downloads the data and uses the data to confirm or rule out GERD.
The capsule does not need to be removed, it will detach from the esophagus in a few days after placing, and will pass through the gastrointestinal tract to be eliminated.
Capsule Endoscopy
A capsule Endoscopy is used to check the small bowel. If both an Endoscopy and a colonoscopy are completed and they show no abnormalities but pain persists a capsule Endoscopy is ordered by the referring physician. The capsule is used to also detect not only abdominal pain but also sources of anemia and intestinal absorption problems. For this procedure, the day before a clear liquid diet is kept and a small bottle of Citroma is consumed to clean the bowels. The day of the procedure, a capsule with a built in camera is swallowed, this capsule follows the digestive tract and is excreted about 8 hours after it is swallowed. A monitor is worn the whole time to make sure the capsule is moving, and the patient can eat a small lunch that day to help monitor regular activities of the digestive tract. The capsule is disposable and will be passed.
Colonoscopy
This procedure is used to examine the appearance of colon using a thin, flexible viewing tube (colonoscope), which is attached to a viewing monitor. Colonoscopies are used when symptoms appear that suggest colon diseases. This procedure is your best alternative in order to evaluate the cause of blood in the stool, abdominal pain, diarrhea, change in bowel habits and abnormalities found during x-rays or CAT Scan. Some patients that have a family history of colon disease may be recommended to schedule regular colonoscopies because they are at a greater risk of developing polyps or colon cancer.
Before the procedure it is necessary that all fecal matter be removed from the colon. The presence of any fecal matter may affect the effectiveness and duration of the exam. Therefore, the patient is put on a liquid diet and given cleansing enemas before the procedure. Additional medication may be given to help empty the bowels.
In general, medications should not be discontinued during a colonoscopy; however, certain medications such as blood thinners may affect the effectiveness of the exam. Therefore, discuss any medications you are taking with your physician before the exam, in addition to making him/her aware of any allergies or pre-existing conditions. Also, let your physician know if you have been given antibiotics before any other medical or dental surgery.
During the procedure, the patient is given an IV and the heart blood pressure and oxygenation of blood are monitored. A sedative or other pain relief medications may also be administered. The patient may experience bloating, cramping and pressure during the procedure; yet, these effects will be minimal with the medications. The patient will then lie on their left side or back while the colonoscope is slowly inserted through the anus and into the colon. The lining and integrity of the colon is monitored as it is inserted and retracted. Abnormalities such as polyps and bleeding can be tended during this portion of the procedure. A biopsy (tissue sample) may also be taken to be analyzed for cancer. This procedure lasts about 15-60 mins.
The patient will be in observation for about 1-2 hours while the medication wear off. Afterwards, a driver may take the patient home. The patient should not drive or operate machinery for the entire day even if they feel alert, since sedatives have been administered. Side effects include cramping and gas; these will be relieved shortly after the procedure with the passing of gas. Diet and activities may be restricted if polyps were removed during biopsy.
Complications from colonoscopy are very rare. They include: bleeding at site of biopsy (which can be tended to without surgery or transfusion), reaction to sedatives, irritation of vein through which sedatives were administered, and complications resulting from pre-existing heart and lung diseases. If you experience any of the following side effects you should contact your physician immediately: severe abdominal pain, fever, chills or rectal bleeding.
EGD (Esophagogastroduodenoscopy)
This procedure is performed by a gastroenterologist and uses a small, flexible, viewing tube (endoscope), inserted through the mouth, to view the organs of the upper gastrointestinal (GI) tract including: the stomach, esophagus and duodenum (top portion of small intestine).
EGD is used to evaluate possible problems with the upper GI and evaluate possible symptoms such as abdominal pain, nausea, vomiting, reflux, dysphagia and anemia. This procedure is more effective than a x-ray and has the added advantage of being able to perform biopsy (removal of tissue samples) and cytology (removal of cell samples). During EGD, the endoscope can also be used to perform other minor procedures such as stretching of narrowed areas (strictures), removal of polyps or accidentally swallowed objects, or treatment of GI bleeding.
Before the procedure, the throat may be sprayed with a numbing solution and a mild sedative and pain reliever may be administered. Discomfort is minimal and most patients sleep right through the procedure.
After the EGD is done, there is a possibility that you may feel a light sore throat or distention. These symptoms will go away after a few hours. You can resume your normal diet after a few hours as well. Once the medications have worn off, which takes a few hours, you will be allowed to go home with a driver. Because sedatives are administered, patients are not allowed to drive themselves home and are required to have driver. It is recommended that you do not drive or operate machinery for the rest of the day following this procedure.
Complications from EGD are rare. They include: irritation of vein used to administer sedatives or medication, reaction to sedative or medication administered, complications resulting from pre-existing heart/lung/liver conditions, bleeding at site or biopsy or poly removal (bleeding would be minimal and rarely requires surgery or transfusion), or perforation (which is also very rare, but would require surgery to repair). Be sure to discuss any pre-existing medical conditions or health concerns with your physician before the procedure in order to reduce complications.
Endoscopic Ultrasound
Endoscopic Ultrasound (EUS)- combines Endoscopy (EGD) and ultrasound, a long flexible endoscope is inserted through the mouth, down the esophagus, into the stomach, and through a small portion of the duodenum. The ultrasound (high frequency sound waves that produce images) enhances the depth of the skin tissue, muscle tissue, lymph nodes, blood vessels, and outlines structures inside the body, such as gallbladder, pancreas, liver, etc. A EUS also allows your physician to obtain tissue samples by passing a needle through the endoscope into enlarged masses, and suspicious tumors. This procedure is called a fine needle aspiration (FNA).
An EUS is suggested for the following situations:
Determining the stage of Esophageal, Stomach, Pancreatic, Rectal Cancer
Evaluating pancreatitis
Evaluating the Gall Bladder, Liver, Bile Ducts
Evaluating the reasons for fecal inconsistency
Evaluating other submucosal lesions, bumps, masses, etc that may be hiding behind normal appearing intestinal walls.
To prepare for a EUS, one must not each from 12 midnight, and not drink 4 hours before the procedure. Plan for your care and recovery after the operation. Allow for time to rest and try to find people to help you with your day-to-day duties.
Follow any instructions your doctor may give you.
Once you are awake after the procedure, the doctor will discuss with you, your results. Someone should be available to accompany you home. Light meals and fluids are allowed unless otherwise instructed.
Complications from EUS are rare. They include: irritation of vein used to administer sedatives or medication, reaction to sedative or medication administered, complications resulting from pre-existing heart/lung/liver conditions, bleeding at site or biopsy or poly removal (bleeding would be minimal and rarely requires surgery or transfusion), or perforation (which is also very rare, but would require surgery to repair). Be sure to discuss any pre-existing medical conditions or health concerns with your physician before the procedure in order to reduce complications.
Hemorrhoidectomy
What is a hemorrhoidectomy?
Hemorrhoids are veins in the tissues at the opening of the anus that become enlarged. They can cause pain, bleeding, and/or itching. If you have hemorrhoids, you may have clots forming in the hemorrhoid tissue. Your bowel may treat the clots like stool and try to push them out of your body.
A hemorrhoidectomy is a procedure in which the doctor removes hemorrhoid tissue to remove clots and promote healing.
When is it used?
Hemorrhoidectomy is one method of treating hemorrhoids. Examples of alternatives to this procedure are:
To use a laser to remove the hemorrhoids.
To place tight bands around the hemorrhoids.
To use a fluid to harden the hemorrhoids.
To freeze the hemorrhoids.
To try anesthetic ointments and/or sitz baths.
To choose not to have treatment, recognizing the risks of your condition.
You should ask your doctor about these choices.
How do I prepare for this procedure?
Plan for your care and recovery after the operation. Allow for time to rest and try to find people to help you with your day-to-day duties.
Follow instructions provided by your doctor. Eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.
What happens during the procedure?
You are given either spinal or general anesthesia. The spinal anesthetic will make you feel temporarily numb from the chest down so that you have no pain during the procedure. The general anesthetic relaxes your muscles, makes you feel as if you are in a deep sleep, and prevents you from feeling pain.
The doctor will put an anoscope (tubelike instrument for examining the lower rectum and anal canal) into your anus and expose the affected hemorrhoids. The doctor will cut the inflamed parts of the hemorrhoids and remove them.
The doctor may also try to trim the lining of the rectum by removing some extra tissue. He or she will check for any bleeding. The doctor may sew the wounds closed or leave them open to heal.
What happens after the procedure?
You may go home that day or may stay in the hospital 1 to 3 days, depending how fast you recover. You will need to take sitz baths, use stool softeners, and apply ointments to the area. Avoid all heavy lifting for 2 to 3 weeks. You may return to work in a few days or weeks, depending on the type of work. You may have trouble passing urine and controlling gas and bowel movements for a few days after this operation.
Ask your doctor what other steps you should take and when you should come back for a checkup.
What are the benefits of this procedure?
You will be relieved of the itching, painful, and bleeding hemorrhoids.
What are the risks associated with this procedure?
There are some risks when you have general anesthesia. Discuss these risks with your doctor.
Spinal anesthesia may not numb the area quite enough, and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. Spinal anesthesia is considered safer than general anesthesia.
You may have trouble urinating.
The wound may scar and leave a smaller opening in the rectum, making it difficult to pass stools.
The remaining hemorrhoids may become inflamed.
The hemorrhoids could recur.
There is a risk of infection or bleeding.
You should ask your doctor how these risks apply to you.
When should I call the doctor?
Call the doctor immediately if:
You develop substantial bleeding.
You cannot urinate.
You develop a fever.
You cannot pass bowel movements.
Call the doctor during office hours if:
You have questions about the procedure or its results.
You want to make an appointment for a follow-up office visit.
Sigmoidoscopy
This procedure is used to examine the rectum and lower colon (sigmoid colon). The viewing instrument, a sigmoidoscope, is 60 cm. long and the thickness of a finger. It is inserted through the anus and slowly worked through the rectum and into the lower colon. This procedure is a simple method for evaluating the cause of rectal bleeding, change in bowel habits, rectal pain and diarrhea. Sigmoidoscopy can also be used to perform biopsies (removal of tissue samples) for polyp removal and cancer screening.
Before the procedure, the bowel and rectum must be clear of fecal matter. Therefore, the physician may prescribe a liquid diet and a few cleansing enemas. A laxative may also be necessary to remove any additional fecal matter. You should inform your physician of any medications you are taking, and if you have heart valve abnormalities or hip/knee prostheses. In these cases, antibiotics may be needed before the procedure in order to avoid infection.
During the procedure, the patient will feel only mild discomfort including bloating, pressure and cramping. While lying on his/her left side, the sigmoidoscope will be inserted into the rectum and lower colon. A view of these organs will be shown on a TV monitor. The physician will carefully examine the lining of the colon and rectum when retracting the sigmoidoscope. The procedure lasts 5-15 mins.
Complication are very rare but include perforation of the colon lining, which requires surgery to repair, and bleeding from the site of biopsy. If you experience any of the following side effects you should contact your physician immediately: severe abdominal pain, fever, chills or rectal bleeding.
Enteroscopy
Enteroscopy is a procedure used to examine the small intestine (small bowel). A thin, flexible tube (endoscope) is inserted through the mouth or nose and into the upper gastrointestinal tract. During a double-balloon enteroscopy, balloons attached to the endoscope can be inflated to allow the doctor to view a large part of the small intestine.