A capsule endoscopy is a procedure that uses a pill-sized wireless camera to visually examine the inside lining of the three portions of the small intestine, which includes the duodenum, jejunum and ileum. The camera will take a series of photographs as it passes through the gastrointestinal tract. These photographs are sent wirelessly to a small recording device that is worn on the body. The photographs are then downloaded to a computer about 24 hours after the procedure. The capsule will then be passed through the digestive tract by the patient.
While portions of the intestine can be seen during a colonoscopy or upper endoscopy procedure, these procedures are unable to provide a complete view of the small intestine. The capsule endoscopy is able to provide a view of the small intestine and is helpful in detecting some of the following conditions:
- Intestinal bleeding
- Inflammatory bowel disease
- Celiac disease
While this procedure can provide a more accurate and detailed result than an X-ray, a capsule endoscopy is unable to perform therapy in the area of concern. A capsule endoscopy is a rapidly improving technology that is making conditions of the small intestine much easier to diagnose.
A colonoscopy is a diagnostic procedure performed to examine the inside of the terminal ileum (distal small intestines), colon (large intestines) and rectum. The colonoscopy procedure can aid in determining the cause of changes in bowel activity, abdominal pain, rectal bleeding, as well as detect early signs of cancer or colon polyps. A colonoscopy is recommended for people who are at risk of developing cancer of the colon and rectum, known as colorectal cancer, or CRC.
Endoscopic retrograde cholangiopancreatography, also known as ERCP, is a diagnostic procedure that uses endoscopy and x-ray imaging or fluoroscopy to detect problems in the liver, gallbladder, bile ducts and pancreas including gall stones, strictures or narrowing within the bile duct or pancreas duct and cancer.
An upper endoscopy is a diagnostic test used to examine the upper digestive system - the esophagus, stomach, and first part of the small intestine, known as the duodenum. The procedure is performed by inserting a thin tube with a light and camera at the end through the mouth and into the esophagus. The procedure is used to evaluate problems of the upper digestive tract such as reflux, heartburn, abdominal pain, peptic ulcer and /or celiac disease.
An esophageal dilatation is a procedure performed to resolve an esophageal, stomach or small bowel stricture (a blockage) and restore normal flow by stretching open the blocked area. This procedure is performed by placing a dilating instrument into the esophagus either alone or through an endoscope. Usually performed as an outpatient procedure, with conscious sedation, an endoscope with an instrument for dilation is passed through the mouth into the esophagus, stomach and duodenum to gently enlarge the area of stricture to a given diameter.
pH / Impedance Probe
A pH/impedance probe is a diagnostic technique used to determine the severity of gastroesophageal reflux disease in children and adults. This test is conducted using a special type of catheter known as an esophageal probe to determine if the reflux content is acidic. The pH level is assessed to determine acid concentration, and the amount of both acid and nonacid reflux are measured. Performed as an outpatient procedure, a pH/impedance probe may begin with an esophageal motility test that determines proper placement of the probe. This involves inserting a small catheter into a nostril and guiding it into the esophagus.
The catheter is then slowly removed and the pH/impedance probe is inserted in its place. The probe, which is connected to a small recording device, will remain in the esophagus for 24 hours. The next day, the probe is removed and the results of the test can be assessed. This procedure is considered safe, but some patients experience minor throat irritation or discomfort while the probe is in place.
An esophageal manometry is a diagnostic test used to measure the pressure inside the lower part of the esophagus and determine if it is contracting properly. The esophagus is the tube that leads from the mouth to the stomach. The esophageal manometry test also measures the muscle contractions and coordination within the esophagus when patients swallow. This test can help diagnose swallowing problems, or gastroesophageal reflux. Patients who may be suffering from heartburn, difficulty swallowing, or chest pain may be advised to undergo a esophageal manometry test.
A manometry test is performed by placing a tube through the mouth or nose and down into the stomach. Once in place, patients will be asked to swallow so the muscle contractions can be measured along the tube. A small sensor records each time the patient swallows. An esophageal manometry test also allows the doctor to examine the lower esophageal sphincter, or LES, the muscular valve that connects the esophagus with the stomach.
The procedure usually takes about 20 to 30 minutes and the patient can return to regular diet and activities following the test. Some patients may experience temporary soreness in the throat after the esophageal manometry test.
An anorectal manometry is a diagnostic test to evaluate patients who have chronic constipation or fecal incontinence (inability to control bowel movements causing loss of stool). This procedure measures anal sphincter muscle pressure and rectal sensation. This test also assess nerve reflexes that are needed for normal anal rectal function.
Hydrogen Breath Testing
Hydrogen breath tests are used to diagnose small intestinal bacterial overgrowth and/or dietary carbohydrate intolerance such as lactose, fructose or sucrose intolerance., Lactose intolerance is an inability to properly digest the sugar in dairy products. Prior to undergoing a hydrogen breath test, patients must refrain from eating or drinking anything for at least 8 hours.
At the start of the procedure, the patient will drink a beverage containing lactose. Shortly after consumption of the beverage, the patient is instructed to blow into balloon-like bags every 15 minutes for about two hours. The air within these bags is then tested to measure hydrogen levels. Although hydrogen is normally present in breath, greater amounts are often produced when lactose is not properly digested or bacterial overgrowth exists.
A liver biopsy is a diagnostic procedure used to examine liver tissue and determine the cause of any abnormalities. This procedure is often performed after another test, such as a blood test, indicates a problem within the liver. A liver biopsy can diagnose alcoholic liver disease, hemochromatosis, hepatitis B and C and liver cancer and many other liver disorders.
The biopsy procedure can be performed in several different ways, but generally takes about 20 minutes and may be performed in your doctor's office or in a hospital. A percutaneous biopsy uses local anesthesia and a needle to take samples. Percutaneous biopsies may also be assisted by imaging techniques to properly guide the needle. A short recovery time of a few hours is needed after a liver biopsy.
Fecal Microbiome Transplantation
Fecal microbiome transplantation is also known as a "stool transplant". Fecal transplantation involves transplanting donor stool from a healthy individual to a sick patient. Fecal transplantation is used to treat patients with recurrent Clostridium difficile infection. C. difficile infection is a type of gut infection that causes diarrhea, sometimes very severe. C. difficile occurs when healthy normal human gut bacteria are reduced in number such as during antibiotic therapy, allowing selective colonization of the gut with C. difficile. During fecal transplantation, healthy donor stool is delivered during a colonoscopy examination to a sick patients' colon and has been shown to be highly effective.