How to prepare for GI procedures

There are many gastrointestinal (GI) procedures performed by gastroenterologists. These include esophagogastroduodenoscopy (EGD), colonoscopy, balloon enteroscopy, capsule endoscopy, endoscopic ultrasound (EUS),  endoscopic retrograde cholangiopancreatography (ERCP), Bravo PH study, Smart pill motility capsule study, esophageal PH-Impedance study, esophageal manometry, anorectal manometry, and hydrogen breath test.

Who is a gastroenterologist?

According to the American College of Gastroenterology (ACG), a  gastroenterologist is a physician with dedicated training and unique experience in the management of diseases of the gastrointestinal tract and liver.

Conditions treated by a gastroenterologist

  • Difficulty swallowing (dysphagia).
  • Heartburn and regurgitation.
  • Acid reflux disease.
  • Barrett’s esophagus.
  • Cancer such as esophageal cancer, stomach cancer, liver cancer, pancreatic cancer, and colon cancer.
  • Polyps.
  • Ulcers.
  • Helicobacter pylori infection.
  • Celiac disease.
  • Fatty liver disease.
  • Liver cirrhosis.
  • Pancreatitis
  • Inflammatory bowel disease (ulcerative colitis and Crohn’s disease).
  • Diverticulitis.
  • Hemorrhoids

 

How to prepare for gastroenterologist GI procedures

Esophagogastroduodenoscopy (EGD)

An upper endoscopy is otherwise known as an esophagogastroduodenoscopy or EGD for short. This is an examination of the inside of your esophagus (food pipe), stomach, and duodenum using a fiber optic flexible tube (gastroscope or endoscope) that has light and camera at the end.

For information on how to prepare for the GI procedure known as EGD , click HERE.

Percutaneous endoscopic gastrostomy (PEG tube)

PEG stands for percutaneous endoscopic gastrostomy. It is a feeding tube that is placed through your abdomen into your stomach using an endoscope. A gastroenterologist is the specialist that usually perform this procedure. Feeding tubes can also be placed by an interventional radiologist or a surgeon.

For information on how to prepare for the GI procedure known as PEG tube, click HERE.

Colonoscopy

Colonoscopy is a procedure that utilizes a flexible tube with light and camera at the end to look at the inner lining of a person’s large intestine (colon). It can be used to diagnose and treat diseases of the colon. It is the gold standard for screening for colorectal cancer because it is the only test that gives us the ability to remove precancerous polyps. Colon cancer usually grow from colon polyps. 

For information on how to prepare for the GI procedure known as Colonoscopy , click HERE.

Balloon enteroscopy

The enteroscope (endoscope) is a flexible tube with light and camera at the end. It is longer than the gastroscope. The small intestine is about 20 feet long and very floppy. It is difficult to navigate the small intestine with a regular endoscope due to its length and floppiness.

To solve this problem, an over-tube with balloon is attached to the endoscope and the small intestine is pleated over the over-tube.  Single balloon has one balloon while double balloon has 2 balloons.

For information on how to prepare for the GI procedure known as Balloon enteroscopy , click HERE.

Capsule endoscopy

Capsule endoscopy is a camera that is swallowed to examine the small intestine. It is recommended for patients with obscure gastrointestinal bleeding, iron deficiency anemia, Celiac disease, and Crohn’s disease . It is usually done after an upper endoscopy and a colonoscopy.

For information on how to prepare for the GI procedure known as Capsule endoscopy , click HERE.

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.

For information on how to prepare for the GI procedure known as EUS, click HERE.

Endoscopic retrograde cholangiopancreatography (ERCP)

This is a special procedure that uses a flexible tube called an endoscope with special features to examine and treat diseases of the bile duct and pancreas. The doctor inserts wires and catheters through the endoscope. Dye (contrast material) is injected and X-rays are taken. The doctor looks for any abnormality in the bile duct and pancreatic duct. If abnormalities are found, special procedures can be done to diagnose or treat the problem.

For information on how to prepare for the GI procedure known as ERCP , click HERE.

Bravo PH study

The Bravo PH study is a wireless way to assess and monitor acid reflux. During the procedure, a camera is attached to the esophagus. The camera sends information to a recorder that will be given to you. The camera records the PH (acid level) in your esophagus.

For information on how to prepare for the GI procedure known as Bravo PH study , click HERE.

Smart pill motility capsule study

A Smart Pill is a capsule that is swallowed to measure the pressure, acidity (PH), and temperature of the gastrointestinal tract as it passes through the body. It is designed to evaluate symptoms such as nausea, vomiting, bloatingconstipation and abdominal pain.

It measures gastric emptying time (GET), small bowel transit time (SBTT), colon transit time (CTT) and whole gut transit time (WGTT).  A gastric emptying time of 4 hours or more is used to diagnose gastroparesis. A colon transit time of 59 hours or more is used to diagnose slow transit constipation.

For information on how to prepare for the GI procedure known as Smart pill motility capsule study , click HERE.

Esophageal PH Impedance study

24 hour PH Impedance is a test to measure acid reflux and non acid reflux. A flexible tube (catheter) is passed through your nostril into the esophagus. You may be asked to swallow or drink water to help with the passage. The outer end of the catheter is taped to your cheek and wrapped over your ear. The end is then attached to a small portable recorder.

For information on how to prepare for the GI procedure known as Esophageal PH-Impedance study , click HERE.

Esophageal manometry

Esophageal manometry measures the strength and function of the muscles of the esophagus. The esophagus is an 8-10 inches tube that connects the mouth to the stomach. The muscles of the esophagus through well-coordinated muscular contractions move food and water from the mouth to the stomach.

If these muscular contractions are abnormal, swallowing problem starts. In addition to difficulty swallowing, chest pain, heartburn and regurgitation can occur.

For information on how to prepare for the GI procedure known as Esophageal manometry, click HERE.

Anorectal manometry

Anorectal manometry measures pressures of the anal sphincter muscles, the sensation in the rectum, and the reflexes that are necessary for normal bowel movements. The test is done for patients with chronic constipation and fecal incontinence.

For information on how to prepare for the GI procedure known as Anorectal manometry, click HERE.

Hydrogen breath test

Breath test is the measurement of gases produced in the intestine and expired through the lungs. Intestinal gases come from four sources. These are swallowed air and air mixed with food, gases from the blood to the intestine, chemical reaction in the gut, and gases from gut bacteria. Normal people have 30-200 cc (100 cc on average) of Intestinal gas.

These gases are hydrogen (H2), carbon dioxide (CO2), methane (CH4), oxygen (O2), nitrogen (N2), hydrogen sulfide (H2S), indole, skatole and ammonia (NH3). Hydrogen and methane are produced only through gut bacteria metabolism. They are the gases measured during hydrogen breath test.

For information on how to prepare for the GI procedure known as Hydrogen breath test , click HERE.

 

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