Procedures

EGD

During this procedure an endoscope (a thin flexible tube with a camera and a light on the end) is guided down the esophagus under sedation and used to examine the esophagus, stomach, and the duodenum (the first part of the small intestine). Disorders that would be found by an EGD include: problems of the esophagus such as esophagitis from acid reflux, strictures, eosinophilic esophagitis, Barrett's esophagus, and esophageal varices; problems of the stomach such as ulcers and hiatal hernias; and problems of the small intestine such as duodenal ulcers or celiac disease. Esophageal strictures can be dilated to alleviate problems swallowing and esophageal varices can be band ligated. To perform an upper endoscopy the patient must not have eaten solid foods for 8 hrs beforehand, but it doesn't require a clean-out like a colonoscopy.

Colonoscopy

During this procedure a colonoscope (a thin flexible tube with a camera and light on the end) is guided up the rectum and the colon under sedation. This is used to perform a thorough examination of the inside of the entire colon. We can remove colon polyps and/or take biopsies to diagnose any abnormalities. Of any form of colorectal cancer screening, colonoscopy has the best sensitivity for finding colon polyps and is able to prevent colon cancer by removing those precancerous polyps during the procedure. To get a good exam, the colon must be cleaned out with a colon prep prior to the procedure. In addition to colorectal cancer screening, we use colonoscopy to diagnose colonic disorders such as ulcerative colitis, Crohn's disease, and microscopic colitis and to look for causes of rectal bleeding.

ERCP

Under sedation, a side viewing endoscope (a flexible tube with a light and camera) is passed to the duodenum where the bile duct and pancreatic duct exit into the small intestine at the major papilla. Using fluoroscopy (X-ray guidance) we are able to pass a catheter into the bile duct where it can be used to remove stones from the bile duct (usually that have fallen down from the gallbladder), take samples, perform dilations of strictures, or place stents (thin plastic tubes that are temporarily left in place to hold the bile duct open). This procedure is done in a hospital setting (as an inpatient or outpatient) with deep sedation.

Hemorrhoidal Banding

Hemorrhoid banding, or rubber band ligation (RBL), is a fast and non-surgical approach to hemorrhoid treatment. Unlike hemorrhoidectomy, it doesn't require fasting, sedation or post-procedure care. And unlike home remedies that provide temporary relief, it completely removes hemorrhoid symptoms.