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MAINE DIGESTIVE HEALTH CENTER
Common Procedures

Colonoscopy
Colonoscopy is a diagnostic test used to detect abnormalities, such as polyps, ulcers or cancerous changes, in the large intestine.  A few days prior to the test, the patient is asked to eat a clear liquid diet, including things such as ginger ale, plain tea and coffee, gelatin, ginger ale and water. The night before the procedure, the patient is given a bowel prep to empty the contents of the large intestine. On the day of the test, the patient is given sedating medication and monitored for changes in heart rhythm and vital signs. Pain medication is also given. A flexible, lighted scope is inserted into the rectum, and advanced the length of the colon. If anything abnormal is seen, a biopsy may be taken. Polyps may be removed if found. After the test is complete, and the patient is awake from the sedating medication, he may return home.

  

Flexible Sigmoidoscopy
Flexible sigmoidoscopy is a diagnostic test used to detect abnormalities, such as polyps, ulcers or cancerous changes, in the rectum and sigmoid colon of the large intestine.  This test may be performed to find the cause of diarrhea, constipation or abdominal pain. A few days prior to the test, the patient is asked to eat a clear liquid diet, including things such as ginger ale, plain tea and coffee, gelatin, ginger ale and water. The night before the procedure, the patient is given a bowel prep to empty the contents of the large intestine. On the day of the test, the patient is given sedating medication and monitored for changes in heart rhythm and vital signs. Pain medication is also given. A flexible, lighted scope is inserted into the rectum, and advanced the length of the sigmoid colon. If anything abnormal is seen, a biopsy may be taken. Polyps may be removed if found. After the test is complete, and the patient is awake from the sedating medication, he may return home.

  

Upper GI Endoscopy
Prior to this test, the patient will have received directions from his physician not to have anything to eat or drink for eight to twelve hours. This test may be done due to GERD symptoms or Barrett's esophagus. Once at the test, the patient will receive sedating medication. Vital signs and heart rhythm will be monitored for changes. A lighted, flexible tube is inserted into the mouth and after local anesthesia, passed down the throat, into the esophagus, stomach and duodenum, beginning of the small intestine. Abnormalities, such as bleeding, polyps or ulcers are searched for. Polyps can be removed and biopsies can be taken, if needed. Once the test is complete, and the patient is awakened from the sedating medication, he can go home.

  

ERCP (Endoscopic Retrograde Cholangiopancreatography)  
Prior to this test, the patient will have received directions from his physician not to have anything to eat or drink for eight to twelve hours. This test is when done looking for problems in the liver, gallbladder, pancreas or bile ducts. Once at the test, the patient will receive sedating medication. Vital signs and heart rhythm will be monitored for changes. After local anesthesia, the flexible endoscope is passed down the patient's throat, into the stomach and duodenum. Dye is then injected into the pancreatic ducts and x-rays are taken to look for abnormalities, such as gallstones, inflammation or cancer. A stent may be placed if there is a blockage. Gallstones may be removed, if necessary. A tissue biopsy may be taken if cancer is questioned. Once the test is complete, and the patient is awakened from the sedating medication, he can go home.

 

Liver Biopsy
This diagnostic test allows testing on a small piece of tissue from your liver. This test may be done to diagnose hepatitis, liver cancer or some other liver disorder. Any blood thinners, including aspirin, the patient may be on should be stopped about a week prior to the biopsy. Blood tests for blood clotting times should be completed. On the day of the test, the patient will receive sedating medication and pain medication. A local anesthesia will be injected into the patient's right side, where the biopsy will be performed. The physician will then use ultrasound and guide a biopsy needle to the liver and obtain a sample of tissue. Following the procedure, the patient must remain in bed, with pressure to the biopsy site for a few hours to control any potential bleeding.

  

Endoscopic Ultrasound (EUS)
Endoscopic ultrasound, or EUS, allows your doctor to use sound waves from ultrasound to see lining and and walls of the upper and lower GI tract, as well as some of the internal organs close to the GI tract, such as the pancreas and gall bladder. This procedure is done by a specially trained gastroenterologist, and is used to diagnose digestive disease symptoms, evaluate possible growths in the digestive tract, as well as aid in the staging of digestive cancers.

A Doppler probe can be used to study blood flow within the digestive tract. A fine needle aspiration (FNA) may be done during the procedure to collect a tissue sample from a tumor, lymph nodes or a fluid collection, and will be sent to pathology for review. Sedation and/or pain medication is usually given during the procedure for comfort. EUS is frequently performed in conjunction with ERCP.

The following are some common conditions EUS is used to help diagnose:

  • Anal sphincter and incontinence
  • Barrett's esophagus with high-grade dysplasia
  • Neuroendocrine tumors
  • Common bile duct stones
  • Esophageal cancer
  • Pancreatic cancer
  • Pancreatitis
  • Cystic neoplasms of the pancreas
  • Rectal cancer
  • Rectal fistulas
  • Smooth muscle tumors
  • Enlarged lymph nodes
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Maine Medical Center | 22 Bramhall Street | Portland, Maine 04102-3175 | (207) 662-0111