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A colonoscopy is a minimally-invasive examination of the colon. During a colonoscopy, a long, flexible, narrow tube with a light and tiny camera on one end is used to look inside the rectum and entire colon. A colonoscopy can show irritated and swollen tissue, ulcers, and polyps - extra pieces of tissue that grow on the lining of the intestines.

A colonoscopy is performed to help diagnose:

• changes in bowel habits
• abdominal pain
• bleeding from the anus
• weight loss
• cancer

Watch our 'Preparing for your colonoscopy' video to help you prepare for your procedure in the comfort of your home. There is valuable information about what you need from the store, what food to eat and how to make the preparation for your procedure as easy as possible.

Our physicians also perform colonoscopies as a screening test for colon cancer. A colonoscopy is the most effective colon cancer screening tool available.

Colon Cancer Screening Saves Lives

Approximately 150,000 new cases of colorectal cancer are diagnosed every year in the United States and nearly 50,000 people die from the disease. Estimates indicate that increased awareness and screening would save at least 30,000 lives each year. The good news is that colorectal cancer is highly preventable and can be detected by testing even before there are symptoms. The American Society for Gastrointestinal Endoscopy encourages everyone over 50, or those under 50 with a family history or other risk factors, to be screened for colorectal cancer.

Colorectal cancer almost always develops from precancerous polyps in the colon or rectum. Screening tests can find precancerous polyps, so that they can be removed before they turn into cancer. Screening tests can also find colorectal cancer early, when treatment is most effective

When to begin colonoscopy screening

You should begin screening for colorectal cancer soon after turning 50, then continue getting screened at regular intervals. However, you may need to be tested earlier than 50 or more often if:

• You or a close relative have had colorectal polyps or colorectal cancer.
• You have inflammatory bowel disease, Crohn's disease, or ulcerative colitis.
• You have genetic syndrome such as familial adenomatous polyposis or hereditary non-polyposis colorectal cancer or Lynch syndrome

Know the facts

Colonoscopies are the "Gold Standard" of screening. This is because they can both find potentially precancerous growths called polyps and remove them, while other screening tests may only find cancer or polyps. Since most cases of colon cancers start as polyps, colonoscopies essentially allow you to stop colon cancer before it even starts!

Benefits of colonoscopy

• "Gold Standard" Colonoscopies are the most complete screening method available. They allow us to identify and remove polyps in one session.
• Colonoscopies Save Lives Did you know that colorectal cancer is the second-most common cause of cancer deaths in the U.S., but with a regular screening the cancer is almost completely preventable? Or did you know that according to a study published in New England Journal of Medicine, colonoscopies can reduce the risk of dying from colon cancer by 53 percent?
• Procedure is Painless Patients are sedated so you won't feel a thing. Essentially you get to take a 30-minute nap.
• It Doesn't Take Long A colonoscopy appointment may take an hour total if you add up waiting time, consulting time, and of course your procedure/nap time.
• Screening is good for eight to 10 years After you've had your screening, if everything checks out well, you won't have to come back for another eight to 10 years.

For more information

• Colon Surgery
• Colon Cancer

Why choose us?

The Riverside Gastroenterology Specialists team is dedicated to making you as comfortable as possible. We offer complimentary one-on-one preparation appointments, even from the comfort of your own home through a Virtual Visit. We take the time to assess your health history, and walk you through the preparation process for your colonoscopy.

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An Upper Endoscopy allows a physician to examine the lining of the upper part of the gastrointestinal tract, which includes the esophagus, stomach and duodenum which is the first portion of the small intestine. Our physicians use a thin, flexible tube called an endoscope, which has its own lens and light source, to view the images on a video monitor.

It is used to view the interior of the stomach and small intestine to detect abnormalities and obtain tissue samples for analysis.

This test can be used to diagnose:

• abdominal pain
• nausea
• vomiting
• swallowing difficulties
• gastric reflux
• unexplained weight loss
• anemia
• bleeding in the upper GI tract

An endoscopy is also used to perform certain procedures, such as controlling gastrointestinal bleeding, removing polyps and other growths, and taking biopsies or samples.

How to prepare for upper GI endoscopy

The upper GI tract must be empty before upper GI endoscopy. Generally, no eating or drinking is allowed for 4 to 8 hours before the procedure. Smoking and chewing gum are also prohibited during this time.

Patients should tell their doctor about all health conditions they have, especially heart and lung problems, diabetes, and allergies. Whey should also tell them about all medications they are taking. Patients may be asked to temporarily stop taking medications that affect blood clotting or interact with sedatives, which are often given during upper GI endoscopy.

Medications and vitamins that may be restricted before and after an upper GI endoscopy include:

• nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen (Advil), and naproxen (Aleve)
• blood thinners
• blood pressure medications
• diabetes medications
• antidepressants
• dietary supplements

Driving is not permitted for 12 to 24 hours after an upper GI endoscopy to allow sedatives time to completely wear off. Before the appointment, patients should make plans for a ride home.

Why choose us?

The endoscopy center at Riverside Gastroenterology Specialists has successfully met the requirements to be recognized as a facility that promotes quality in endoscopy through the ASGE Endoscopy Unit Recognition Program. This indicates that our facility and physicians have achieved the highest quality measures in endoscopic care, as established by the American Society of Gastrointestinal Endoscopy.

Our physicians have national above-average rates for detecting adenoma, or polyps. Regular screening can often find colorectal cancer early, when it is most likely to be curable. In many people, screening can also prevent colorectal cancer altogether. This is because some polyps, or growths, can be found and removed before they have the chance to turn into cancer.

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Flexible sigmoidoscopy is a procedure similar to colonoscopy in which a doctor examines the inside of the last third of the colon, known as the sigmoid colon, and rectum instead of the full colon.

Flexible sigmoidoscopy is used to:

• detect inflamed tissue, abnormal growths and ulcers
• look for early signs of cancer
• help doctors diagnose unexplained changes in bowel habits, abdominal pain, bleeding from the anus and weight loss.

Colonoscopy is the preferred screening method for cancers of the colon and rectum; however, flexible sigmoidoscopy usually requires less preparation time, so some patients choose this option.

How to prepare for a flexible sigmoidoscopy

To prepare for a flexible sigmoidoscopy, one or more enemas are performed about two hours before the procedure to remove all solids from the sigmoid colon. An enema is performed by flushing water, laxative or sometimes a mild soap solution into the anus using a special wash bottle.

In some cases, the entire gastrointestinal tract must be emptied by following a clear liquid diet for one to three days before the procedure, similar to the preparation for colonoscopy. Patients should not drink beverages containing red or purple dye.

A laxative or an enema may also be required the night before a flexible sigmoidoscopy. A laxative is medicine that loosens stool and increases bowel movements. Laxatives are usually swallowed in pill form or as a powder dissolved in water.

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ERCP is a specialized technique used to study the ducts of the gallbladder, pancreas and liver. ERCP combines the use of X-rays and an endoscope, a long, flexible, lighted tube, through which a physician can view the inside of the stomach, duodenum, and ducts in the biliary tree and pancreas. ERCP may be used to discover the underlying cause of jaundice, upper abdominal pain, or unexplained weight loss.

ERCP is used when it is suspected a person's bile or pancreatic ducts may be narrowed or blocked due to:

• tumors
• gallstones that form in the gallbladder and become stuck in the ducts
• inflammation due to trauma or illness, such as pancreatitis - inflammation of the pancreas
• infection
• valves in the ducts, called sphincters, that won't open properly
• scarring of the ducts, called sclerosis
• pseudocysts, which are accumulations of fluid and tissue debris

How to prepare for ERCP

The upper GI tract must be empty. Generally, no eating or drinking is allowed eight hours before ERCP. Smoking and chewing gum are also prohibited during this time.

Patients should tell their health care provider about all health conditions they have, especially heart and lung problems, diabetes, and allergies. Patients should also tell their health care provider about all medications they take. Patients may be asked to temporarily stop taking medications that affect blood clotting or interact with sedatives, which are usually given during ERCP to help patients relax and stay comfortable.

Medications and vitamins that may be restricted before and after ERCP include:

• nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen (Advil), and naproxen (Aleve)
• blood thinners
• high blood pressure medication
• diabetes medications
• antidepressants
• dietary supplements

Driving is not permitted for 12 to 24 hours after ERCP to allow the sedatives time to completely wear off.
Before the appointment, patients should make plans for a ride home.

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Percutaneous endoscopic gastronomy is a procedure that provides nutritional support for patients who cannot take food orally. During a percutaneous endoscopic gastrostomy a tube is placed through the abdominal wall and into the stomach through which nutritional liquids can be infused.

The purpose of a percutaneous endoscopic gastronomy is to feed patients who have difficulty swallowing food. Irrespective of the age of the patient or their medical condition, the purpose of percutaneous endoscopic gastronomy is to provide fluids and nutrition directly into the stomach.

How is percutaneous endoscopic gastrostomy performed?

An endoscope is passed through the mouth, throat and esophagus, then into the stomach. The physician then makes a small incision in the skin of the abdomen over the stomach and pushes a needle through the skin.

 

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An esophageal pH test measures and records the pH in your esophagus to determine if you have gastroesophageal reflux disease. The test can also be done to determine the effectiveness of medications or surgical treatment for GERD.

How does the Bravo esophageal pH test work?

A small capsule, about the size of a gel cap, is temporarily attached to the wall of the esophagus during an upper endoscopy. The capsule measures pH levels in the esophagus and transmits readings by radio telecommunications to a receiver. The receiver has several buttons on it that you will press to record symptoms of GERD such as heartburn. You will be asked to maintain a diary to record certain events such as when you start and stop eating and drinking, when you lie down, and when you get back up. This will be explained by the nurse.

Benefits of Bravo esophageal pH test

Bravo provides a more tolerable and convenient way to evaluate your heartburn symptoms when compared to catheter-based pH monitoring systems.

A catheter-free test allows you to engage in your usual activities during the test period:

• Eat normally
• Bathe and sleep comfortably
• Maintain your daily life

How to prepare for a Bravo pH test

Please let us know if you have a pacemaker or implantable heart defibrillator, a history of bleeding problems, dilated blood vessels, and any other previously known problems with your esophagus.

• Seven days before the monitoring period, do not take proton pump inhibitors such as omeprazole (Prilosec®), lansoprazole (Prevacid®), rabeprazole (Aciphex®), pantoprazole (Protonix®), esomeprazole (Nexium®)
• Two days before the monitoring period, do not take the H2 blockers ranitidine (Zantac®), cimetidine (Tagamet®), famotidine (Pepcid®), nizatidine (Axid®);or the promotility drug, metoclopramide (Reglan®)
• Six hours before the monitoring period, do not take antacids (such as Alka-Seltzer®, Gaviscon®, Maalox®, Milk of Magnesia®, Mylanta®, Phillips®, Riopan®, Tums® or any other brands)
• Four to 6 hours before your appointment do not eat or drink

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Esophageal manometry is a test that gauges how well your esophagus works. During a esophageal manometry we measure the rhythmic muscle contractions, also called peristalsis, that occur in your esophagus when you swallow. Esophageal manometry also measures the coordination and force exerted by the muscles of your esophagus.

During esophageal manometry, a thin, flexible tube (catheter) that contains sensors is passed through your nose, down your esophagus and into your stomach.

When is esophageal manometry used?

We may recommend esophageal manometry if you're experiencing symptoms that could be related to an esophageal disorder. Those symptoms may include:

• Difficulty swallowing (dysphagia)
• Pain when swallowing (odynophagia)

Esophageal manometry may be used to help diagnose a number of conditions:

• Swallowing problems (dysphagia)
• Achalasia
• Scleroderma

How to prepare for an esophageal manometry

We may ask you to avoid eating and drinking for a certain length of time before esophageal manometry. Your doctor will give you specific instructions. Also, tell your doctor about any medications you're taking. You may be asked not to take some medications before the test.

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Capsule endoscopy, or pill cam, is a procedure that uses a tiny wireless camera to take pictures of your digestive tract. The camera sits inside a vitamin-sized capsule that you swallow. As the capsule travels through your digestive tract, the camera takes thousands of pictures that are transmitted to a recorder.

The images saved on the recorder are transferred to a computer with special software that strings the images together to create a video.

Generally, patients can resume normal activities while the camera pill passes through your digestive tract. You may be asked to avoid repetitive movements that could disrupt the recorder.

When is capsule endoscopy used?

Capsule endoscopy our doctors see inside your small intestine - an area that isn't easily reached with conventional endoscopy.

 

We may use capsule endoscopy to diagnose or treat:

• Obscure gastrointestinal bleeding
• Inflammatory bowel diseases
• Cancer
• Celiac disease
• Polyps

How to prepare for a Capsule Endoscopy

It is very important to follow your doctor's instructions to ensure a successful procedure

 

To prepare for capsule endoscopy, your doctor may ask that you:

• Restrict your diet. Only consume clear liquids for 24 hours before the procedure to ensure that the camera captures clear images.
• Stop or delay taking certain medications, to prevent them from interfering with the camera.
• Avoid strenuous exercise or heavy lifting after the procedure.

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Riverside's long-standing commitment to technological innovation means that our Gastroenterology Department utilizes the most advanced medical technology. We use the latest endoscopic instruments with high-definition images and narrow-band image capability for improved detection and diagnosis of GI disorders. Our sophisticated digital fluoroscopy and radiology equipment delivers the highest-quality images, with the lowest radiation exposure. At Riverside we combine state-of-the-art technology with gentle care to provide patients with the best digestive health, colonoscopy and endoscopy services possible.

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