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Click on the title below to learn more about each procedure.

Uses:
Anoscopy is a procedure used to diagnose anal fissures (tears in the lining of the anus), hemorrhoids, and some cancers.

Procedure:
This test is performed by using a small, tubular instrument called an anoscope. The anoscope is lubricated and gently inserted into the anus to evaluate problems of the anal canal and lower rectum.

Uses:
Capsule Endoscopy is a procedure used to diagnose diseases of the small intestine. This part of the digestive tract is quite long and cannot be easily examined using standard upper endoscopy or colonoscopy.

Procedure:
Capsule endoscopies utilize a video capsule the size of a large pill that contains a miniature camera. After the capsule is swallowed, it transmits images of the lining of the small intestine that are recorded on a small monitor worn by the patient throughout the procedure.

After the study is completed, a physician can review the images on a computer screen. This procedure is used to diagnose problems of the small intestine such as bleeding, ulcers, Crohn's disease, tumors and Celiac sprue.

Uses:
A colonoscopy is an examination of the large intestine, also known as the colon.

In patients with gastrointestinal bleeding, a colonoscopy can be used to identify and treat the source of the bleeding.

Preparation:
Prior to the procedure, the patient ingests a potent laxative preparation to evacuate all stool from the colon.

Procedure:
After proper sedation to ensure patient comfort, a long, flexible instrument is inserted into the rectum and carefully advanced to the beginning of the colon called the cecum. As the instrument is slowly withdrawn, the lining of the colon is carefully inspected by the physician using images transmitted by the colonoscope to a television monitor.

Any abnormalities can be biopsied for further analysis. Precancerous growths called polyps can be removed using a wire loop known as a snare.

Colonoscopies typically takes 30 minutes to complete. Complications are rare but may include perforation of the intestine or bleeding after removal of polyps.

Uses:
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a procedure to examine and treat diseases of the drainage system of the liver and gall bladder (bile ducts) and the pancreas (pancreatic duct). This procedure can be used to diagnose and treat problems such as gallstones trapped in the bile ducts, benign or cancerous strictures (a narrowing) of the ducts, and complications of pancreatic inflammation.

Procedure:
After the patient is deeply sedated, the physician passes a flexible tube (endoscope) through the mouth, esophagus, and stomach, and into the beginning of the small intestine called the duodenum.

At this location, the bile and pancreatic ducts drain into the intestine through a small nipple-like opening called the papilla. A plastic tube called a catheter is then passed through the scope, into the papilla and up into either the bile duct or pancreatic duct. Contrast material is then injected into the ducts and images are obtained using an X-ray machine.

Although generally safe, ERCP can cause complications such as pancreatitis, infection, and intestinal perforation or bleeding.

Uses:
Endoscopic Ultrasound (EUS) is a procedure to evaluate, diagnose, and treat abnormalities that lie in the wall beneath the lining of the gastrointestinal tract or in tissue outside of, but adjacent to, the digestive system.

This procedure is used to diagnose and treat benign and malignant conditions of the esophagus, stomach, duodenum, colon and rectum, gallbladder, and pancreas.

Procedure:
After adequate patient sedation, a thin flexible instrument (called an endoscope) is passed though either the mouth or anus to the desired location in the digestive tract.

Using a small ultrasound probe attached to the end of the scope, the physician can image abnormalities arising beneath the gastrointestinal lining or in the structures next to it. These areas cannot be seen during a standard endoscopic procedure such as upper endoscopy or colonoscopy, and may not be as well seen on a traditional ultrasound, CT scan, or MRI scan.

By passing a needle through the scope, tissue biopsy samples can be obtained for further analysis.

Uses:
Esophageal motility study is a procedure to assess the motor or muscle function of the esophagus.

The muscles in the wall of the esophagus contract and relax in an organized fashion to propel food from the mouth into the stomach. Abnormal muscle function can cause difficulty swallowing and sometimes even chest pain.

Procedure:
During the procedure, a very thin, flexible tube is passed through the nose into the esophagus. The motor function of the esophagus can then be investigated as the patient swallows.

Uses:
Esophageal pH monitoring is a test to diagnose the abnormal reflux of acidic stomach contents back up into the esophagus. This condition, known as GERD, is a common cause of heartburn, indigestion, and sometimes unusual symptoms such a chest pain, cough, sore throat, or laryngitis.

Procedure:
During this procedure, the acid level (pH) in the esophagus is measured over 24 to 48 hours by either a probe attached to the lining of the esophagus during an upper endoscopy procedure (Bravo pH capsule), or a long, thin tube inserted through the nose.

The information is transmitted to a recording device worn by the patient during the procedure. The patient is also asked to record symptoms during the test. The physician analyzing the data can then determine if the patient's symptoms are related to GERD.

Uses:
Esophagogastroduodenoscopy (EGD/Upper Endoscopy) is a procedure to examine the esophagus, stomach, and first part of the small intestine (duodenum).

EGD is typically performed to investigate symptoms such as heartburn, difficulty swallowing, abdominal pain, nausea, or vomiting. In patients with gastrointestinal bleeding, EGD can be used to identify and treat the source of bleeding.

Procedure:
After proper sedation to ensure patient comfort, a flexible instrument is inserted into the mouth and carefully advanced into the esophagus, stomach, and duodenum. The linings of these organs are carefully inspected by the physician using images transmitted by the scope to a television monitor. Any abnormalities can be biopsied for further analysis.
This procedure typically takes 15 minutes to perform.

Uses:
Gastrostomy (PEG) tube placement is a procedure performed to place a small flexible feeding tube through the abdominal wall into the stomach.

Procedure:
After proper sedation to ensure patient comfort, a flexible instrument (called an endoscope) is inserted through the mouth and esophagus and into the stomach. Using the endoscope, the physician locates an area where the stomach lies just below the skin in the left upper portion of the abdomen. The tube is then inserted through a small incision in the abdominal wall.

A feeding tube is typically inserted if the patient is unable to safely pass food from the mouth through the esophagus and into the stomach. This may be due to a stroke or other neurologic disorder or a cancerous growth in the throat or esophagus. The feeding tube can subsequently be removed if the patient recovers and is able to eat and drink normally.

Uses: Hemorrhoid banding, or rubber band ligation (RBL), is a non-surgical approach to hemorrhoid treatment. It reduces the size of the internal hemorrhoids, which in turn decreases symptoms of rectal bleeding, itching, and pain.

Procedure: Hemorrhoid banding is a quick procedure that is done in the office. A disposable ligator is inserted into the rectum to create a soft, gentle suction that pulls the appropriate tissue into it. Then a rubber band is placed around the base of the hemorrhoid, where no pain causing nerve endings are present. The average procedure time is about 5 minutes. There is no sedation required.

Uses:
Paracentesis is a procedure to evaluate and remove an abnormal collection of fluid in the abdominal cavity known as ascites. Ascites fluid most often accumulates in the abdomen as a complication of cirrhosis of the liver, congestive heart failure or cancer.

Procedure:
An appropriate site for fluid removal is chosen by either physical examination or by using an ultrasound machine. The skin and abdominal wall are numbed with an injection of Novocain.

A small plastic tube is then inserted through an incision into the abdominal cavity. Fluid can then be removed for diagnostic testing.
A large volume of fluid can also be removed to relieve symptoms such as bloating or abdominal pressure.