Procedures
Colonoscopy
A Colonoscopy is using a flexible, lighted, fiberoptic scope to permit visualization of the colon. It allows the physician to look inside your entire large intestine, from the rectum, all the way up through the colon to the beginning of the small intestine. The procedure is used to diagnose the causes of unexplained changes in bowel habits, such as inflamed tissue, abnormal growths, ulcers, bleeding, and muscle spasms. It is also used to look for early signs of cancer in the colon and rectum.
For the procedure, you will lie on your left side on the exam table. You will probably be given pain medication and a mild sedative to keep you comfortable and to help you relax during the exam. Some patients fall asleep, but most patients will have amnesia and feel comfortable. The physician will insert the scope into your rectum and slowly guide it into your colon. The scope transmits an image of the inside of the colon to the monitor, so the physician can carefully examine the lining of the colon. The scope bends, so the physician can move it around the curves of your colon. You may be asked to change position occasionally to help the physician move the scope. The scope also blows air into your colon, which inflates the colon and helps the physician see better. You may experience some cramping but will be able to pass this air rectally and be encouraged to do so in recovery.
If anything unusual is in your colon, like a polyp or inflamed tissue, the physician can remove a piece of it using tiny instruments passed through the scope. That tissue (biopsy) is then sent to a lab for testing. If there is bleeding in the colon, the physician can pass an electrical probe, or inject special medicines, through the scope and use it to stop the bleeding.
Bleeding and puncture of the colon are possible complications of colonoscopy. However, such complications are uncommon. Colonoscopy can take anywhere form 15 to 60 minutes. The sedative and pain medicine should keep you from feeling much discomfort during the exam. You will need to remain at the Center at least 30 minutes post sedation.
Preparation - Your colon must be completely empty for the colonoscopy to be adequate and safe. To prepare for the procedure you may have to follow a liquid diet 1 day prior or ½ day prior to procedure. A liquid diet means bouillon or broth, Jell-O®, strained fruit juice, water, plain coffee, plain tea, or soda. Depending on the prep given to you, you may need to take laxatives before the procedure. Also, you must arrange for someone to take you home afterward--you will not be allowed to drive because of the sedatives. Your physician may give you other special instructions.
Upper Endoscopy
Upper endoscopy is also called EGD, which stands for esophagogastroduodenoscopy. Upper endoscopy is a procedure where a flexible, lighted fiberoptic scope enables the physician to look inside the esophagus, stomach, and duodenum (first part of the small intestine). The procedure assists the physician in evaluating persistent upper abdominal pain, nausea, vomiting or difficulty swallowing.
Your stomach and duodenum must be empty for the procedure to be adequate 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.
You will receive pain medicine and a sedative to help you relax during the exam. A mouthpiece will be placed in your mouth to protect your teeth and the endoscope. You will be instructed to swallow the endoscope when it reaches the back of your throat. The instrument will slide through to the esophagus and transmit an image of the inside of the esophagus, stomach, and duodenum to the monitor, so the physician can carefully examine the lining of these organs.
The physician will be able to observe abnormalities, like ulcers, that do not visualize 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. Some people may have a mild sore throat after the procedure.
The procedure can take anywhere of 5 minutes - 20 minutes. Because you will be sedated, you will need to rest at the Center at least 30 minutes post sedation.
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Paracentesis
Paracentesis is a medical procedure involving needle drainage of fluid from a body cavity, most commonly the abdomen. It is used for a number of reasons:
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to relieve abdominal pressure from ascites
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to diagnose spontaneous bacterial peritonitis and other infections (e.g. abdominal TB)
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to diagnose metastatic cancer
The procedure is often done in doctors office or an out-patient clinic. In an expert's hands, it is very safe, although there is a very small risk of introducing an infection, causing excessive bleeding or perforating a loop of bowel.
During the procedure, patients are asked to lie down and expose their abdomen. After cleaning the side of abdomen with an antiseptic solution, physicians will numb a small area of skin and then insert a fairly large-bore needle (along with a plastic sheath) 2 to 5 cm to reach the peritoneal (ascetic) fluid. The needle is then removed, leaving the plastic sheath behind to allow drainage of the fluid. The fluid can be drained by gravity or by connection to a vacuum bottle. Up to 10 liters of fluid may be drained during the procedure.
The procedure generally is not painful; patients require no sedation. As long as they are not very dizzy and maintain their blood pressure after the procedure, they can go home afterwards.
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Peg Tubes
A percutaneous endoscopic gastrostomy (PEG) is an endoscopic procedure for placing a tube into the stomach through the abdominal wall to provide a means of nutrition either long term or short term for patients who cannot productively take food orally. They are inserted with the use of the EGD scope into the stomach, so the stomach must be empty and follow the same guidelines as the EGD procedure. They provide a method of feeding by intermittent bolus feedings or by continuous pump.
The PEG-Tubes can be easily changed in a physicians office or even by a home health nurse in the same gastric opening. If the tube is pulled out, it can also be replaced easily, within the same gastric opening, if replaced within 24 hours. The average lifespan for the tubes are about 6 months.
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*procedure descriptions are generalized & taken from Wikipedia.