Diagnosing and Treating Your Digestive Problem

Our specialists diagnose and treat a wide range of digestive problems using procedures that include endoscopy and colonoscopy.

To diagnose your digestive problem, first discuss your symptoms with one of our gastroenterologists. They will ask about your medical history and give you a physical exam. Some patients need laboratory tests, imaging tests and/or endoscopic procedures to help doctors diagnose the problem.

Our advanced Endoscopy Lab is equipped with advanced technology, such as an endoscopic laser, to help diagnose and treat digestive problems.

Colonoscopy and Other Endoscopic Procedures

About 70 percent of our diagnostic procedures involve colonoscopy, in which a doctor uses a long, flexible, lighted tube called a colonoscope to view your colon (large intestine).

To prepare for a colonoscopy, you must clear out your colon. A day or two before the procedure, you begin a liquid diet and take laxatives in liquid or pill form. The colonoscopy is done under mild anesthesia to relieve any anxiety you may be feeling. The doctor inserts the colonoscope into your rectum and moves it into your large intestine or colon. The colonoscope sends images to a computer.

Because colonoscopy allows the doctor to view the entire length of the large intestine, it can help identify abnormal growths, inflamed tissue, ulcers and bleeding. If your doctor finds an abnormal growth (polyp), it can be removed and tested for cancer.

Depending upon the location of your digestive problem, doctors may use other endoscopic procedures such as:

• Sigmoidoscopy—It examines a smaller portion of the colon using a shorter telescope (sigmoidoscope). This test doesn’t require anesthesia and is helpful in identifying the causes of diarrhea, abdominal pain, constipation, abnormal growths and bleeding. But it misses some polyps that a colonoscopy will see.
• Upper Endoscopy (EGD or esophagogastroduodenoscopy)—It examines the inside of the esophagus, stomach, and the first part of your small bowel (duodenum) by inserting an endoscope into the mouth.
• Endoscopic retrograde cholangiopancreatography (ERCP)—It diagnoses and treats problems in the liver, gallbladder, bile ducts, and pancreas. An endoscope is guided from your mouth into the stomach, and dye is injected to provide an image of internal organs on an X-ray.

Additional Therapy

During endoscopic procedures, different therapeutic procedures also can be performed to help treat the problem. These treatments include:

• Esophageal manometry—measures the strength and muscle coordination of the esophagus
• Anorectal manometry—helps determine the strength of the muscles in the rectum and anus using a small tube in the rectum
• Gastric Manometry—measures electrical and muscular activity in the stomach as it digests foods and liquids
• Biopsy—removes and examines tissue to detect cancer cells
• Ablation—burns tumors or abnormal tissue
• Stenting—increases GI tract flow and contraction of the gastrointestinal muscles
• Rectal and anal ultrasounds—This imaging technique uses high-frequency sound waves and a computer to view the rectum
• Feeding tube placement for swallowing disorders
• Removal of gallstones
• Sphincterotomy—prevents tears or fissures in the anus
• Wireless capsule endoscopy—provides a more precise image inside the bowel to locate bleeding, cancer or other abnormalities
• PH monitoring—measures the acidity inside of the esophagus using a thin, plastic tube that is inserted through the nostrils.

Other diagnostic tests may include laboratory tests to check for blood in the stool or the presence of abnormal bacteria in the digestive tract. In some imaging tests, doctors will give you a metallic, chalky liquid called barium to coat the inside of your organs so they can see them on an X-ray. Imaging tests using X-rays help specialists watch the inside of the stomach and other organs as digestion occurs.

We also have one of the nation's few doctors specially educated in interventional pulmonology to perform flexible bronchoscopy. This procedure was traditionally used to evaluate the airways after chest X-rays and CT scans find an abnormality in the lungs. Now we use bronchoscopy treat air passage tumors, helping lung cancer patients breathe more easily and handle treatments better.

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