how to prepare for EUS

To prepare for endoscopic ultrasound (EUS), you need to stop solid food for eight hours or more. You may need to stop blood thinners before the test. You can take your essential medications like those for blood pressure the morning of your test. EUS is used to examine the lining of the esophagus, stomach, duodenum, anus, rectum, colon. It is also used to examine organs close to gastrointestinal tract like liver, gall bladder, bile ducts, pancreas, and lungs.

What is an endoscopic ultrasound (EUS)?

This is a special procedure that uses a flexible tube called an endoscope with an ultrasound probe to examine the lining of the esophagus, stomach, duodenum, anus, rectum, colon. It is also used to examine organs close to gastrointestinal tract like liver, gall bladder, bile ducts, pancreas, and lungs.

Sound waves from the ultrasound probe are converted into images and read by the doctor. Apart from capturing images, tissue and fluids can be obtained during the procedure.

Why do you need an EUS?

  • Evaluate lumps and bumps of the gastrointestinal tract.
  • Evaluate and stage cancers of the gastrointestinal tract.
  • Evaluate submucosal nodules or tumors.  These are tumors below the surface.
  • Evaluate lymph nodes of the mediastinum (chest) and non small cell lung cancer.
  • Diagnose stones in the gall bladder, bile duct and pancreas.
  • Diagnose pancreatic cancer.
  • Diagnose cancer of the bile duct.
  • Drain the gall bladder.
  • Drain fluid collection around pancreas.
  • Celiac plexus neurolysis to control chronic pain due to chronic pancreatitis and cancer in the abdomen.

What are the risks of EUS

Risks of EUS include reaction to sedation, breathing problems, nausea, vomiting, abdominal pain, headaches, heart problems, bleeding, perforation, pancreatitis and death. The risks and benefits are discussed during consent before the test.

What are the alternatives to an EUS?

Alternatives to endoscopic ultrasound (EUS) include CT scan, MRI, ultrasound, surgery and special procedures by radiology.

How do I prepare for my test

What do I do 1 week before the EUS?

  • Discuss all your medications with your provider.
  • You may need to stop your antiplatelet or anticoagulants such as Coumadin, Plavix.
  • You may continue to take your aspirin.
  • Arrange for a driver to take you home after the procedure.

What do I do 2-3 days before the EUS?

  • You may need to stop anticoagulants like Eliquis, Pradaxa, and Xarelto 2-3 days before your EUS.

What do I do a day before the EUS?

  • Confirm your transportation with a responsible adult driver.
  • No solid food 8 hours prior to your procedure.
  • For lower GI EUS, you need a bowel preparation. Your doctor will tell you how to clean your rectum and colon for the procedure. The type of bowel cleansing agent you use depends on the extent of the exam.  Some people only need Fleet® enema.

What do I do on the day of the EUS?

  • You may take your essential morning medications with a few small sips of water, at least 4 hours before your procedure, unless as directed by your physician.
  • For lower GI EUS, complete your bowel cleansing based on the specific instruction, you’ve been given.
  • Nothing by mouth at least 4 hours prior to your procedure including gum, hard candies, mints, tobacco.
  • Leave your valuables at home.
  • Bring your ID, insurance cards, and any co-pay with you.


What to expect during the procedure

You will be given medicines to make you sleepy. Most people do not remember the test. You will be given oxygen and monitored throughout the test. Your doctor will insert the endoscope through your mouth.

For lower GI endoscopic ultrasound (lower GI EUS), the endoscope is passed through the bottom (anus) into the rectum and colon.

For most people, the procedure lasts about 30-60 minutes.

What to expect after the procedure

You will be monitored until you are awake. You may eat or drink once you are awake. Your doctor may discuss your result with you and whomever came with you. You may be given a copy of your report. If biopsies are taken, it may take a few days for those results to come from the pathologist. Someone should drive you home.

If you develop severe abdominal pain, belly distention, fever, chills, vomiting or feel very sick after the procedure, contact your doctor immediately.

Suggested Reading