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Procedures
24-hour pH Monitoring
Upper Endoscopy BarrX Photodynamic Therapy (PDT) Esophageal Manometry Colonoscopy FEES Study In order to better understand a procedure that you have been scheduled for, please follow the links below. These links will also include instructions on preparing for the procedure. 24-hour pH Monitoring This test involves a GI nurse inserting a small tube into the esophagus that will stay there for 24 hours. Placement of the tube takes ½ to 1 hour. After placement, you will be able to leave the hospital. While you go about your normal activities, the device measures acid that comes up into your esophagus. If your physician recommends 24-hour pH impendence monitoring, the device will also measure any movement in your esophagus, including non-acid reflux. During the 24 hours, you will keep a diary to record meal times, symptoms, and time spent lying down. This diary helps your physician see correlations between symptoms and reflux episodes. You will return to the hospital the following day to have the tube removed. Top Upper Endoscopy Upper endoscopy, also called esophagogastroduodenoscopy (EGD) enables the physician to look inside the esophagus, stomach, and duodenum (first part of the small intestine). This procedure can be recommended in a variety of situations, including reflux, bleeding, and routine monitoring of conditions like Barrett's Esophagus. Prior to the procedure, you may receive throat numbing medication and a sedative to help you relax. The physician will have you swallow a flexible tube with a light on the end (called an endoscope). The endoscope is connected to a computer and will transmit an image of the inside of your esophagus, stomach, and duodenum for the physician to view. The physician can view abnormalities, such as bleeding and erosions, that cannot be examined with other tests. The physician may insert other instruments into the scope to treat abnormalities or to obtain samples of tissue for testing. Possible complications of upper endoscopy include bleeding and tearing of the stomach lining, but these complications are rare. Mild sore throat is common after the procedure. The procedure takes 20 to 30 minutes. Because you will be sedated, you will need to rest at the endoscopy facility for at least 1/2 hour until the medication wears off. Your stomach and duodenum must be empty for the procedure, so you will not be able to eat or drink anything for at least 6 hours before. Also, you must arrange for someone to come to the procedure with you and take you home. Your physician may give you other special instructions regarding medications. Top BarrX BarrX is an ablation procedure used to treat Barrett's Esophagus. The procedure is performed through the endoscope during an upper endoscopy. An ablation catheter is inserted into your esophagus through the endoscope, and electrodes on the catheter are positioned on the desired treatment area. Energy is delivered to the electrodes and underlying tissue, and the catheter can then be repositioned to treat other areas. The amount of energy is controlled to remove the diseased tissue, and to reduce risk of injury to healthy tissue layers. After the procedure, it is important that patients follow the discharge instructions provided by the physician or the nursing staff to ensure proper healing of the esophagus. It is also important that patients attend follow up visits to receive additional BarrX treatment sessions, if necessary, and to ensure proper healing. The BarrX procedure does not cure GERD, so it is important that patients continue to control reflux symptoms as recommended by their physician. Top Photodynamic Therapy (PDT) Photodynamic therapy (PDT) is a treatment for esophageal cancer. PDT combines a light source and a photosensitizing agent (a drug that is activated by light) to destroy cancer cells. The photosensitizing agent (porfimer sodium, also called photofrin) collects in cancer cells and normal cells, but more so in cancer cells. Photofrin is given through a vein, and travels through the blood stream to cells in the body. After a couple days, the photofrin remains only in the cancer cells and skin cells. During an upper endoscopy, the portion of the esophagus affected with cancer is exposed to light from a laser. The light causes a chemical change, and this change can kill the cancer cells, and only slightly damage nearby normal cells. PDT can be repeated may need to be repeated in some cases. The two major side effects associated with this treatment include reactions to bright light or sunlight, and swelling in the treated area. It is important that patients protect their skin and eyes from sunlight and other bright light after photofrin has been injected and for 30 days after the injection. A reaction to bright light or sunlight (such as sunburn, swollen skin, and blistering) can occur very quickly, so the eyes and skin must be protected at all times. Swelling in the treated area may cause nausea, chest pain, abdominal pain, fever, difficulty breathing, and difficulty swallowing. Patients may additionally experience vomiting, constipation, or infection. When side effects occur, they should be reported to the physician right away. Top Esophageal Manometry Esophageal manometry is a test performed to measure pressure in the esophagus. This test may also be called an esophageal motility study, and is usually recommended to determine if a swallowing problem is due to improperly working muscles in your esophagus. When the muscles in the esophagus do not work properly, patients may experience difficulty swallowing, heartburn, esophageal spasms, and possibly pneumonia. During the test, a thin tube is inserted through your nose or mouth and into your esophagus. The tube measures pressure in your esophagus as you swallow to determine if there is any abnormality. The test generally takes less than one hour. Side effects from this test are rare, but may include some gagging during the exam or mild sore throat after the exam. To prepare for esophageal manometry, patients should not eat or drink anything for 8 hours prior to the test. In some cases, your physician will give you special instructions about medications that cannot be taken prior to the test. There are many possible findings from esophageal manometry tests, and your physician will discuss your results with you. Top Colonoscopy A colonoscopy is a procedure that allows a physician to look inside the large intestine to determine if inflamed tissue, abnormal growths, or ulcers are present. The procedure is recommended to look for early signs of colon or rectal cancer, and also to look for causes of unexplained rectal bleeding, weight loss, abdominal pain, or other symptoms. You will be given specific instructions to prepare for this exam, which include a strict diet in the few days before your exam. Your colon must be completely empty for the test to be useful and safe. Your physician may also ask you to stop using certain medications prior to the exam. You will be given pain medication and a sedative to help you relax during the exam, and you will be asked to turn on your left side. The physician will then insert a long, flexible tube with a light into your rectum and then colon. The tube is called a colonoscope, and it transmits an image of the inside of the colon onto a video screen for careful examination of the colon lining. Most abnormal growths in your colon, like a polyp, can be removed during the procedure. Polyps, which are growths in the lining of the bowel, are often not cancerous, but they must be sent to the lab for testing. Removing polyps will help prevent cancers from forming. The doctor can also obtain samples of tissue to test for other diseases of the colon. The procedure lasts about 30 to 60 minutes. You may feel mild cramping during and after the procedure, but this generally goes away within an hour. You must remain at the endoscopy facility until the sedative from the exam wears off. However, you will not be allowed to drive, so you must have a responsible person check in with you and drive you home following the procedure. Top FEES Study A FEES study is used to evaluate swallowing. During the exam, a flexible tube is inserted into the throat to see what happens during a swallow. You may be asked to eat foods of different consistencies colored with dyes. This allows the physician to observe movement of food from the back of the mouth, through the throat and into the esophagus. Top This material is not intended as a substitute for professional medical care. Please consult with your physician on any matters regarding your health. |