ESA Central Jersey Bariatrics, LLC

Colonoscopy

Colonoscopy enables Dr. Washington to examine the lining of your colon (large intestine) for abnormalities by inserting a flexible tube as thick as your finger into your anus and slowly advancing it inot the rectum and colon. To help you relax and better tolorate any discomfort, Dr. Washington might give you a sedative.

You will lie on your side or back while Dr. Washington slowly advances a colonoscope through your large intestine to examine the lining. He will examine the lining again as he slowly withdraws the colonscope. The procedure itself usually takes 15 to 60 minutes, although you should plan on two to three hours for waiting, preparation and recovery.

In some cases, Dr. Washington cannot pass the colonoscope through the entire colon to where it meets the small intestine. Although another examination might be needed, Dr. Washington might decide that the limited examination is sufficient.

If Dr. Washington thinks an area needs further evaulation, he will pass an instrument through the colonscope to obtain a biopsy to be analyzed. If colonoscopy is being performed to identify sites of bleeding, Dr. Washington might control the bleeding through the colonoscope by injecting medications or by coagulation (sealing off bleeding vessels with heat treatment). Dr. Washington might also find polyps during colonoscopy, and he will most likely remove them during the examination. These procedures don't usually cause any pain.

Upper Endoscopy

Upper endoscopy helps Dr. Washington evaluate symptoms of persistent upper abdominal pain, nausea, vomiting or difficulty swallowing. It's an excellent test for finding the cause of bleeding from the upper gastrointestinal tract. It's also more accurate than X-ray films for detecting inflammation, ulcers and tumors of the esophagus, stomach and duodenum.

Your doctor might use upper endoscopy to obtain a biopsy (small tissue samples). A biopsy helps your doctor distinguish between benign and malignant (cancerous) tissues. Remember, biopsies are taken for many reasons, and your doctor might order one even if he or she does not suspect cancer. For example, your doctor might use a biopsy to test for Helicobacter pylori, bacterium that causes ulcers.

Your doctor might also use upper endoscopy to perform a cytology test, where he or she will introduce a small brush to collect cells for analysis.

Upper endoscopy is also used to treat conditions of the upper gastrointestinal tract. Your doctor can pass instruments through the endoscope to directly treat many abnormalities with little or no discomfort. For example, your doctor might stretch a narrowed area, remove polyps (usually benign growths) or treat bleeding.

Flexible Sigmoidoscopy

Flexible sigmoidoscopy lets your doctor examine the lining of the rectum and the lower portion of the colon (large intestine) by inserting a flexible, slim, lighted tube called a sigmoidoscope into the anus and slowly advancing it into the rectum and lower part of the colon.

If Dr. Washington sees an area that needs further evaluation, he might take a biopsy (sample of the colon lining) to be analyzed. Biopsies are used to identify many conditions, and your doctor might order one even if he or she doesn't suspect cancer.

If Dr. Washington finds polyps, he might take a biopsy of them as well. Polyps, which are growths from the lining of the colon, vary in size and types. Polyps known as "hyperplastic" might not require removal, but benign polyps known as "adenomas" are potentially pre-cancerous. Dr. Washington will likely ask you to have a colonoscopy (a complete examination of the colon) to remove any large polyps or any small adenomas.

Endoscopic Ultrasonography (EUS)

EUS allows your doctor to examine your stomach lining as well as the walls of your upper and lower gastrointestinal tract. The upper tract is the esophagus, stomach and duodenum; the lower tract includes your colon and rectum. EUS is also used to study internal organs that lie next to the gastrointestinal tract, such as the gall bladder and pancreas.

Dr. Washington will pass an endoscope through your mouth or anus to the area to be examined. He will then turn on the ultrasound attachment to produce sound waves that create visual images of the digestive tract.

EUS provides your doctor with more information than other imaging tests by providing more detailed pictures of your digestive tract. Dr. Washington can use EUS to diagnose the cause of conditions such as abdominal pain or abnormal weight loss. Or if Dr. Washington has ruled out certain conditions, EUS can confirm your diagnosis and give you a clean bill of health.

EUS is also used to evaluate an abnormality, such as a lump, that was detected at a prior endoscopy. EUS provides a picture of the lump, which can help Dr. Washington determine its nature and help him decide the best treatment.

In addition, EUS can be used to diagnose diseases of the pancreas, bile duct and gallbladder when other tests are inconclusive.