FAQ’s

A colonoscopy is a diagnostic procedure performed to examine the inside of the colon 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. A colonoscopy may be recommended as an option for people who are at risk of developing cancer of the colon and rectum, known as colorectal cancer, or CRC.

Patients will be given a set of written instructions to follow. A clear liquid diet should be followed for 1 to 3 days prior to the procedure. Depending on the instructions provided, a laxative or enema may be required. Patients may need to drink a special bowel cleansing solution, the day before the procedure. Most medications can still be taken, although some such as aspirin or blood thinners may require special instructions.

Before the colonoscopy procedure, an intravenous, or IV, with a light sedative will be used to make the patient comfortable. Vital signs will be monitored throughout the procedure. The patient will lie on their left side as the colonoscope is inserted into the anus and guided to the opening of the small intestine. The colonoscope is then slowly withdrawn from the colon and the lining of the colon is examined carefully by the physician. The removal of polyps, or growths, for biopsy may also be conducted during the procedure. The colonoscopy procedure usually takes between 30-60 minutes to perform.

After the procedure, patients will be kept under observation for up to 2 hours, until the sedative used for the procedure wears off. Reflexes and judgment may be impaired and driving is not permitted for 24 hours after the procedure. Some people may experience pressure, bloating and cramping in the abdomen after the procedure, but these effects are temporary.

Complications of a colonoscopy are rare. If they do occur, complications can include fever, abdominal pain, dizziness, bleeding from a biopsy site, perforation of the bowel wall or a reaction to the medication used in the IV.

During normal ingestion and digestion, food travels from the mouth through a tube of muscle called the esophagus to the stomach, where it remains until it moves into the intestine. Muscles in the lower part of the esophagus, known as the lower esophageal sphincter, or LES, tighten keeping food and digestive acids in the stomach. For patients who have gastroesophageal reflux disease, the LES muscles are loose allowing acid to escape, or reflux, into the esophagus, damaging or burning the sensitive esophageal lining.

Prolonged acid reflux, known as gastroesophageal reflux disease, or GERD, reduces the ability of the LES muscle to contract, causing acid to remain in the esophagus longer, leading to extended complications. These complications include scarring, nerve damage, tightening of the esophagus, the formation of ulcers, and bleeding.

The primary symptom of GERD is heartburn, which occurs as the stomach acid travels through the esophagus and stimulates the nerve fibers. Heartburn is felt as a burning pain in the middle of the chest. It can stretch from the abdomen to the neck and can even extend into the back. Heartburn from acid reflux occurs most often after eating or while lying down, when reflux is more likely to occur. Symptoms can be triggered by spicy foods, caffeine or alcohol. Other more common symptoms of GERD may include the following:

• Regurgitation
• A dry cough
• Nausea
• Trouble swallowing
• Ulcers
• A hoarseness or change in the voice
• Sore throat
• Burping

Heartburn affects almost everyone at some point in their lives. Heartburn that is experienced several times in a 24-hour period, that occurs many times a month, or that causes hoarseness, coughing, bleeding or swallowing difficulties, is not normal and should be examined.

GERD is a chronic condition that cannot be cured. There are numerous treatment options that may reduce the severity and frequency of the symptoms of GERD. They include lifestyle changes, such as:

• Diet modification
• Cessation of smoking and alcohol consumption
• Eating small, frequent meals
• Stress reduction techniques
• Loss of excess weight
• Avoidance of tight clothing and frequent bending
• Sleeping with the head of the bed elevated.

Medications are also helpful in reducing acid production or relieving the symptoms of GERD. These medications include antacids, foaming agents, H2 blockers. proton pump inhibitors and pro-motility drugs. A combination of medications that work to address different symptoms may help to relieve the symptoms of GERD.

Testing for the presence of GERD include the following:

• X-ray
• Esophagogastroduodenoscopy
• Esophageal manometry
• Esophageal acid testing
• Biopsy

A laparoscopic Nissen fundoplication is a surgical procedure to tighten the lower sphincter muscle of the esophagus. A Nissen fundoplication is used in the treatment of gastrointestinal reflux disease, also known as GERD. During the procedure the top of the stomach, known as the fundus, is wrapped around the lower esophagus to strengthen the barrier between the stomach and esophagus.

During a laparoscopic Nissen fundoplication three to four small incisions are made in the patient’s abdomen where a laparoscope and tiny surgical instruments are inserted. With video guidance, the physician is able to repair the valve. Most patients see an improvement in their GERD symptoms after this procedure, and are less likely to need daily medication for their condition.

Patients usually return home in a day or two and can resume normal activities within a week.

A laparoscopic Nissen fundoplication is considered safe for most patients, yet there are certain risks associated with any kind of surgical procedure. Some of these risks may include the following:

• Recurring heartburn
• Infection
• Bleeding
• Bloating
• Difficulty swallowing
• Esophagus sliding out of place