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Endoscopic Procedures for Colorectal Disease

The following endoscopic procedures may be used to diagnose your digestive symptoms and determine if they are due to a colorectal disease: 

Colonoscopy: Colonoscopy is a procedure that allows the doctor to view the entire length of the large intestine (colon), and can often help identify abnormal growths, inflamed tissue, ulcers, and bleeding. It involves inserting a colonoscope, a long, flexible, lighted tube, in through the rectum up into the colon. The colonoscope allows the doctor to see the lining of the colon, remove tissue for further examination, and possibly treat some problems that are discovered.

Endoscopic retrograde cholangiopancreatography (ERCP): ERCP is a procedure that allows the doctor to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. The procedure combines X-ray and the use of an endoscope, a long, flexible, lighted tube. The scope is guided through the patient's mouth and throat, then through the esophagus, stomach, and duodenum (the first part of the small intestine). The doctor can examine the inside of these organs and detect any abnormalities. A tube is then passed through the scope, and a dye is injected that will allow the internal organs to appear on an X-ray.

Esophagogastroduodenoscopy (also called EGD or upper endoscopy):
 An EGD (upper endoscopy) is a procedure that allows the doctor to examine the inside of the esophagus, stomach, and duodenum with an endoscope, which is guided into the mouth and throat, then into the esophagus, stomach, and duodenum. The endoscope allows the doctor to view the inside of this area of the body, as well as to insert instruments through the scope for the removal of a sample of tissue for biopsy (if necessary).

Sigmoidoscopy: A sigmoidoscopy is a diagnostic procedure that allows the doctor to examine the inside of a portion of the large intestine, and is helpful in identifying the causes of diarrhea, abdominal pain, constipation, abnormal growths, and bleeding. A short, flexible, lighted tube, called a sigmoidoscope, is inserted into the intestine through the rectum. The scope blows air into the intestine to inflate it and make viewing the inside easier. This procedure is most often performed in a physician’s office.

Capsule endoscopy:
 A capsule endoscopy helps doctors examine the small intestine. Because traditional procedures, such as an upper endoscopy or colonoscopy, cannot reach this part of the bowel, capsule endoscopy may be helpful in identifying causes of bleeding, detecting polyps, inflammatory bowel disease, ulcers, and tumors of the small intestine. A a tiny camera contained in a capsule is swallowed. The capsule passes naturally through the digestive tract while transmitting video images to a data recorder worn on a belt. Images of the small bowel are downloaded to a computer from the data recorder. The images are reviewed by a doctor on a computer screen. Normally, the capsule passes through the colon and is eliminated in the stool within 24 hours.

Anorectal manometry: This test helps determine the strength of the muscles in the rectum and anus. These muscles normally tighten to hold in a bowel movement and relax when a bowel movement is passed. Anorectal manometry is helpful in evaluating anorectal malformations and Hirschsprung's disease, among other problems. A small tube is placed into the rectum to measure the pressures exerted by the sphincter muscles that ring the canal.

Esophageal manometry: This test helps determine the strength of the muscles in the esophagus. It is useful in evaluating gastroesophageal reflux and swallowing abnormalities. A small tube is guided into the nostril, then passed into the throat, and finally into the esophagus. The pressure the esophageal muscles produce at rest is then measured.

Esophageal pH monitoring:
 An esophageal pH monitor measures the acidity inside of the esophagus. A thin, plastic tube is placed into a nostril, guided down the throat, and then into the esophagus. The tube stops just above the lower esophageal sphincter, which is at the connection between the esophagus and the stomach. At the end of the tube inside the esophagus is a sensor that measures pH, or acidity. The other end of the tube outside the body is connected to a monitor that records the pH levels for a 24- to 48-hour period. Normal activity is encouraged during the study, and a diary is kept of symptoms experienced, or activity that might be suspicious for reflux, such as gagging or coughing, and any food intake by the patient. It is also recommended to keep a record of the time, type, and amount of food eaten. The pH readings are evaluated and compared to the patient's activity for that time period.

Bravo study: Similar to the pH monitoring, this uses a capsule that is attached to the attached to the lining of the esophagus. It transmits a signal to a small monitor that is worn for about 48 to 96 hours. The capsule sloughs off from the esophageal lining and is excreted through the digestive tract.

Endoscopic Ultrasound:
A procedure in which an endoscope is inserted into the body. An endoscope is a thin, tube-like instrument that has a light and a lens for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves (ultrasound) off internal organs to make a picture (sonogram). Also called endoscopic ultrasound and endosonography.