Gastrointestinal Endoscopy

You have been scheduled for gastrointestinal endoscopy also called esophagogastroduodenoscopy (EGD). The purpose of this test is to identify any abnormalities in your esophagus, stomach and/or duodenum by passing a flexible fiberoptic tube through your mouth and down the back of the throat into the esophagus. The results obtained from this test may explain the cause of symptoms such as abdominal pain, nausea, reflux, or difficulty swallowing.

HOW DO I PREPARE FOR THE EXAM?
Do not have anything to eat or drink after midnight the night prior to the exam. Please notify our office immediately if you are taking any blood thinners (coumadin, plavix, aggrenox) or diabetic medications. Please follow the enclosed instructions.

WHAT OCCURS DURING THE EXAMINATION?
Prior to beginning the examination the nurse may spray the throat with a numbing medication. The physician will give you medication to sedate you for the exam. Please notify our office of any medication allergies. The physician will use a small, lighted flexible fiberobtic tube, thinner that most of the food you swallow to examine the lining of the upper digestive tract. The procedure does not obstruct breathing passages. The physician may biopsy (take tissue samples) during the examination. The specimens will be sent to the pathologist for examination under the microscope. Biopsies are not painful.

ARE THERE ANY POSSIBLE COMPLICATIONS?
EGD is safe and is associated with a very low risk. Complications can occur but are rare. Possible complications include: hemorrhage (bleeding), perforation (tearing) of the esophagus or stomach, pneumonia, or an adverse reaction to the medications used for sedation.

WHAT CAN I EXPECT AFTER THE PROCEDURE?
Do not eat or drink anything for one hour after your exam. You may feel sleepy for several hours after the examination. Do not plan to return to work, drive or sign any legal documents for the remainder of the day. You may experience a mild sore throat lasting one or two days after the exam. You may use throat lozenges for relief.
If a biopsy is taken during your examination, our office will call you with your pathology results in 5-7 business days.

Flexible Sigmoidoscopy

Flexible sigmoidoscopy is the visual examination of the lining of the lower intestine (sigmoid colon) and rectum. The lower intestine is 5-6 feet long. In the procedure, only the latter part (1-2 feet) of the lower intestine is examined. The purpose of the exam is to identify any abnormalities by inserting a flexible fiberoptic tube into the anus. The tube, which is about the thickness of your finger, is slowly passed into the rectum and sigmoid colon.
The results obtained from sigmoidoscopy may help explain the cause of symptoms such as rectal bleeding, pain, or diarrhea,

HOW DO I PREPARE FOR THE EXAM?
The rectum and colon must be thoroughly clean in order for the exam to be accurate and complete. Usually, this is accomplished by administering two enemas. Please follow the enclosed instructions.

WHAT HAPPENS DURING THE FLEXIBLE SIGMOIDOSCOPY?
While lying on your left side with your knees bent, the physician will perform a finger exam of the anus and rectum. The sigmoidoscope will be inserted, and the physician will be able to visualize the bowel wall.
As air is inflated into the bowel, you may experience slight cramping or gas. You may also feel lower abdominal pressure as the instrument is moved through the lower bowel. The exam usually takes 5-15 minutes and generally does not require sedation.
A small tissue specimen (biopsy) may be taken from the lining of the colon for microscopic analysis. This will not cause any discomfort. If there is an abnormal growth (polyp), a sample of it may be taken or your physician may schedule you to come back for a more extensive exam.

WHAT CAN I EXPECT AFTER THE EXAM?
You can expect to feel bloating for about 30-60 minutes afterwards. This sensation will be relieved as gas is passed.
Your physician will discuss the findings of the exam and provide you with instructions to follow when you return home.

ARE THERE ANY POSSIBLE COMPLICATIONS?
Flexible sigmoidoscopy is safe and is associated with very low risk. Complications that could occur, but are rare, include perforation (rupture) of the sigmoid colon, and bleeding if a biopsy is taken.

Please contact our office if you have any family history of colon cancer or colon polyps, as a more extensive exam may be necessary.

Colonoscopy

Colonoscopy is the visual examination of the lining of the colon. The colon is about 5-6 feet long. The purpose of the exam is to identify any abnormalities by inserting a flexible fiberoptic tube into the anus. The tube, which is about the thickness of your finger, is slowly passed through the length of the colon to the cecum.
The results obtained from the colonoscopy may help explain the cause of symptoms such as rectal bleeding, pain, or diarrhea. A screening colonoscopy is recommended for anyone age 50 or older.

HOW DO I PREPARE FOR THE EXAMINATION?
The colon must be thoroughly clean in order for the exam to be accurate and complete. Please follow the enclosed preparation instructions.

WHAT SHOULD I EXPECT DURING THE EXAMINATION?
While lying on your left side with your knees bent, the physician will perform a finger exam of the anus and rectum. The colonoscopy is done by inserting a long flexible lighted tube into the rectum and beyond. In many cases, the instrument can be inserted throughout the entire extent of the large intestine, permitting a complete examination. The patient during the course or the examination usually experiences abdominal cramps. However, you will be sedated with medications, which will help the cramps. Be sure and tell us if you are allergic to any medications.

WHAT IS A POLYP?
A polyp is a growth that is attached to the inside of the colon. Most of these growths are benign but their removal is strongly recommended so that the polyp may be examined under the microscope, permitting an exact diagnosis to be made. In addition, benign polyps at times may become malignant with the passage of time. Therefore, we believe they should be removed. At times, a polyp is discovered unexpectedly during the course of a colonoscopy examination, which is being done for other reasons. We recommend that all patients give us permission ahead of time to remove polyps if they are discovered.

WHAT HAPPENS IF A POLYP IS DISCOVERED?
If a polyp is discovered, a thin snare wire is passed through the colonoscope and the polyp is encircled. The snare is tightened and an electric current is passed through the wire, which cuts off the polyp. The polyp is then brought out of the colon and sent to the pathologist for further examination.

ARE THERE ANY POSSIBLE COMPLICATIONS?
The possible complications of colonoscopy and polypectomy (polyp removal) include perforation (rupture) of the colon, hemorrhage from the colon and side effects due to the medications (sedatives) which are given. In very rare circumstances, death could result from a complication.

Please notify the physician if you are taking any blood thinners (coumadin, aggrenox, plavix). Please review all of your medications with the office as well as any medication allergies.

WHAT CAN I EXPECT AFTER THE EXAM?
You can expect to feel bloating for about 30-60 minutes after the exam. This sensation will be relieved as gas is passed. You may feel sleepy for several hours after the exam from the medications given prior to the exam. Do not plan to return to work, drive or sign any legal documents for the remainder of the day.
If the physician removes polyps or takes a tissue biopsy during your examination, our office will contact you in 5-7 business days with the pathology results.

Reviewed CBM 4/19/07