Pinehurst Imaging

Gastroenterology & Endoscopy Procedures and Services

The following is a list of some of the common services and procedures offered by our gastroenterologists.

To learn more about a service or a procedure, click on the appropriate link below.


Endoscopies are used by a variety of specialists. GI endoscopies refer to the following:

First, what is an endoscope?

Flexible sigmoidoscopy – rectum to lower colon

Colonoscopy – entire colon, from rectum to the lower end of the small intestine

Virtual Colonoscopy – uses x rays and computers to produce two- and three-dimensional images of the colon (large intestine) from the lowest part, the rectum, all the way to the lower end of the small intestine and display them on a screen

Capsule Endoscopy – looks at the small bowel

Upper Endoscopy (EGD) – esophagus, stomach, duodenum

Endoscopic ultrasonography (EUS) – esphagus, stomach lining, and upper/lower gastrointestinal tract

Endoscopic Retrograde Cholangiopancreatography Test (ERCP) – liver, gall bladder, pancreas, bile ducts

Liver Biopsy – GI procedure. Not an endoscopy, but performed in the GI endoscopy unit

Transit Study – GI procedure. Not an endoscopy, but performed in the GI endoscopy unit

Gastroenterology Health Questionnaire – Please print, fill out and bring to your appointment.


Endoscope

An Endoscope is a medical instrument that enables gastroenterologists to see organs within the body that are usually hidden from view. The endoscope may be inserted through the mouth or rectum. The endoscope is a long tube with an optic viewing system on the end. The physician uses a TV monitor to view what the endoscope sees.

The endoscope can be used as a treatment tool by passing tiny surgical instruments through this tube; the gastroenterologist can remove polyps, take biopsy samples, or remove gallstones.


Flexible sigmoidoscopy

This procedure enables the physician to look at the inside of the large intestine from the rectum through the lower part of the colon, called the sigmoid colon. Physicians may use this procedure to find the cause of diarrhea, abdominal pain, or constipation. They also use sigmoidoscopy to look for early signs of cancer in the colon and rectum. With sigmoidoscopy, the physician can see bleeding, inflammation, abnormal growths, and ulcers.

For the procedure, you will lie on your left side on the examining table. The physician will insert a short, flexible, lighted tube into your rectum and slowly guide it into your colon. The tube is called a Sigmoidoscopy. The scope transmits an image of the inside of the rectum and colon, so the physician can carefully examine the lining of these organs. The scope also blows air into these organs, which inflates them and helps the physician see better.

If anything unusual is in your rectum or colon, like a polyp or inflamed tissue, the physician can remove a piece of it using instruments inserted into the scope. The physician will send that piece of tissue (biopsy) to the lab for testing.

Bleeding and perforation of the colon are possible complications of sigmoidoscopy. However, such complications are uncommon.

Sigmoidoscopy takes 10 to 20 minutes. During the procedure, you might feel pressure and slight cramping in your lower abdomen. You will feel better afterwards when the air leaves your colon.

The colon and rectum must be completely empty for sigmoidoscopy to be thorough and safe, so the physician will probably tell you to drink only clear liquids for 12 to 24 hours beforehand. A liquid diet means fat-free bouillon or broth, Jello, not red, strained fruit juice, water, plain coffee, plain tea, or diet soda. The night before or right before the procedure, you may also be given an enema, which is a liquid solution that washes out the intestines. Your physician may give you other special instructions



Colonoscopy

The procedure is used to diagnose the causes of unexplained changes in bowel habits. It is also used to look for early signs of cancer in the colon and rectum. Colonoscopy enables the physician to see inflamed tissue, abnormal growths, ulcers, bleeding, and muscle spasms.

For this traditional procedure, you will lie on your left side on the examining table. You will probably be given pain medication to keep you comfortable. The physician will insert a long, flexible, lighted tube into your rectum and slowly guide it into your colon. The tube is called a colonoscope. The scope transmits an image of the inside of the colon, so the physician can carefully examine the lining of the colon. The scope bends, so the physician can move it around the curves of your colon. You may be asked to change position occasionally to help the physician move the scope. The scope also blows air into your colon, which inflates the colon and helps the physician see better.

If anything unusual is in your colon, like a polyp or inflamed tissue, the physician can remove a piece of it using tiny instruments passed through the scope. That tissue (biopsy) is then sent to a lab for testing. If there is bleeding in the colon, the physician can pass a laser, heater probe, or electrical probe, or inject special medicines, through the scope and use it to stop the bleeding.

Bleeding and perforation of the colon are possible complications of colonoscopy. However, such complications are uncommon.



Virtual Colonoscopy

Virtual Colonoscopy(or CT colonography) is a rapid CT examination of the abdomen to examine the air-filled colon for masses or polyps. It offers the advantages of less invasiveness, no sedation, and incidental imaging of the other abdominal organs. Despite its many advantages, virtual colonoscopy still requires a cathartic colon prep, and is not able to remove polyps or biopsy abnormalities. In addition, it is not yet accepted as an option for screening for colorectal cancer outside of clinical trials.



Capsule Endoscopy

Capsule Endoscopy lets your doctor examine the lining of the middle part of your gastrointestinal tract, which includes the three portions of the small intestine (duodenum, jejunum, ileum). Your doctor will use a pill sized video capsule called an endoscope, which has its own lens and light source and will view the images on a video monitor. You might hear your doctor or other medical staff refer to capsule endoscopy as small bowel endoscopy, capsule enteroscopy, or wireless endoscopy.

Capsule endoscopy helps your doctor evaluate the small intestine. This part of the bowel cannot be reached by traditional upper endoscopy or by colonoscopy. The most common reason for doing capsule endoscopy is to search for a cause of bleeding from the small intestine. It may also be useful for detecting polyps, inflammatory bowel disease (Crohn’s disease), ulcers, and tumors of the small intestine.

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Upper Endoscopy

An Upper GI endoscopy or EGD (esophagoastoduodenoscopy) is an examination of the lining of the upper digestive tract through a flexible tube (endoscope). This allows a specially trained physician to directly view the esophagus (food tube), stomach and duodenum (first portion of the small intestine) and identify any problems.



Endoscopic ultrasonography (EUS)

Endoscopic ultrasonography (EUS) allows your doctor to examine your esophageal and stomach linings as well as the walls of your upper and lower gastrointestinal tract. The upper tract consists of the esophagus, stomach and duodenum; the lower tract includes your colon and rectum. EUS is also used to study other organs that are near the gastrointestinal tract, including the lungs, liver, gall bladder and pancreas.

Endoscopists are highly trained specialists who welcome your questions regarding their credentials, training and experience. Your endoscopist will use a thin, flexible tube called an endoscope that has a built-in miniature ultrasound probe. Your doctor will pass the endoscope through your mouth or anus to the area to be examined. Your doctor then will use the ultrasound to use sound waves to create visual images of the digestive tract.

Why is EUS done?

EUS provides your doctor with more information than other imaging tests by providing detailed images of your digestive tract. Your doctor can use EUS to diagnose certain conditions that may cause abdominal pain or abnormal weight loss.

EUS is also used to evaluate known abnormalities, including lumps or lesions, which were detected at a prior endoscopy or were seen on x-ray tests, such as a computed tomography (CT) scan. EUS provides a detailed image of the lump or lesion, which can help your doctor determine its origin and help treatment decisions. EUS can be used to diagnose diseases of the pancreas, bile duct and gallbladder when other tests are inconclusive or conflicting.

Why is EUS used for patients with cancer?

EUS helps your doctor determine the extent of spread of certain cancers of the digestive and respiratory systems. EUS allows your doctor to accurately assess the cancer’s depth and whether it has spread to adjacent lymph glands or nearby vital structures, such as major blood vessels. In some patients, EUS can be used to obtain a needle biopsy of a lump or lesion to help your doctor determine the proper treatment.



Endoscopic Retrograde Cholangiopancreatography Test (ERCP)

Endoscopic retrograde cholangiopancreatography (ERCP) enables the physician to diagnose problems in the liver, gallbladder, bile ducts, and pancreas. The liver is a large organ that, among other things, makes a liquid called bile that helps with digestion. The gallbladder is a small, pear-shaped organ that stores bile until it is needed for digestion. The bile ducts are tubes that carry bile from the liver to the gallbladder and small intestine. These ducts are sometimes called the biliary tree. The pancreas is a large gland that produces chemicals that help with digestion.

ERCP may be used to discover the reason for jaundice, upper abdominal pain, and unexplained weight loss. ERCP combines the use of x-rays and an endoscope, which is a long, flexible, lighted tube. Through it, the physician can see the inside of the stomach, duodenum, and ducts in the biliary tree and pancreas.



Liver Biopsy

Liver biopsy is the only certain way to confirm certain types of liver disease. Liver biopsy requires taking a small amount of tissue from the liver. The physician may use ultrasound, CAT scan or a laparoscope to look at the liver and find the best places from which to remove tissue samples. The samples are then sent to a pathology lab, where they are analyzed and a diagnosis can be made. Liver biopsy is often performed as an outpatient procedure.



Transit Study

This is the most helpful test to find the cause of constipation. This test measures how long it takes food residues to travel through the gut. This is done by having you swallow tiny soft rubber rings in a capsule about 1/2 inch across and then taking an x-ray 5 days later to see how many of the rings are left.

In the illustration of the lower intestines at your right, (1) indicates Sitzmarks showing the movement of the contents of your intestines, and (2) shows the location of your rectum.