Radiofrequency Ablation: What You Should Expect

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Radiofrequency ablation (RFA) is a procedure that utilizes radio waves to destroy diseased tissue. Here’s what you need to know if you are preparing for the procedure. 

When it’s used

Radiofrequency ablation can be used during an upper endoscopy to treat Barrett’s esophagus. People with Barrett’s esophagus have an increased risk of esophageal cancer, and RFA can eliminate this risk by destroying pre-cancerous tissue in the esophagus. Patients with both high and low grade dysplasia should almost always pursue radiofrequency ablation. It has an 80-90% success rate in removing Barrett’s esophagus long-term. There is a chance that Barrett’s can develop again after a successful procedure. However, repeat treatments are effective and often able to eliminate abnormal tissues entirely. 

Preparing for Radiofrequency Ablation

To prepare for RFA, your physician will discuss preoperative steps with you. First, you will need to talk to them about medications you are taking that could be a risk factor. For example, blood-thinning medications can increase the risk of excessive bleeding during the procedure. Additionally, if you use insulin, you may need to adjust dosage or timing leading up to the RFA. Your doctor will also ask you about any allergies to medications. You will be instructed to stop eating at midnight the day before the procedure. 

During the procedure

Before the procedure, you will be on an IV and will give your medical information in a pre-op area. An anaesthesiologist will then discuss sedation for the procedure. Then, you will go to the procedure room. Doctors will connect you to monitors that measure your heart rate, blood pressure, and blood oxygen levels.

Your doctor will perform radiofrequency ablation during an upper endoscopy. You will be on your left side. A bite block will be in your mouth to prevent damage to your teeth or the endoscope. You will be under sedation for the duration of the procedure. 

Your doctor will advance the endoscope into your esophagus and examine the Barrett’s esophagus. If they see any visible abnormalities, they may perform an endoscopic mucosal resection. This involves either injecting or banding any identified lesions and then using a snare device to capture, cut, and remove them. If this is not necessary, your doctor will perform RFA. They will inflate a balloon-catheter to make contact with the targeted area and apply heat energy for a second or so. 

After the Radiofrequency Ablation

Afterwards, you will wait in a post-op area where you can recover from the sedation while being monitored for any complications. Once you have recovered, your doctor will discuss their findings with you. Some results may take days or weeks to return. They will also give you information on any follow-up appointments. 

For the first 24 hours after the procedure, you should not drive or make important decisions due to sedative effects. Your doctor will also recommend a clear liquid diet for a few days following the treatment. 

Patients commonly feel some chest discomfort and have difficulty swallowing for a few days after the procedure. Your doctor will be prescribe medications to help with any pain or nausea. You will also need to take a proton pump inhibitor twice a day for 30 days. 

Complications

There are a few complications that can occur from the procedure. In around 6% of cases a stricture or narrowing of scar tissue develops in the esophagus. Doctors can treat this with dilation during an upper endoscopy. Another more rare complication is a tear in the esophagus, which occurs less than .02% of the time. 

Our experienced team at GHP has years of experience performing radiofrequency ablation. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Capsule Endoscopy: What You Need to Know

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A Capsule Endoscopy is a procedure that allows doctors to examine the middle part of the gastrointestinal tract. Patients swallow a pill that contains a video camera, battery, and light source. The camera takes pictures as it travels through the GI tract, which allow doctors to examine the GI tract. 

Here’s what you need to know about the procedure. 

When it’s used

Capsule Endoscopies are used to examine the small intestine, which is not easily reached with other endoscopy procedures that involve passing an endoscope through the throat or anus. Specifically, the procedure can help doctors investigate causes of bleeding in the area, polyps, tumors, inflammatory bowel disease, and ulcers. 

Preparing for a Capsule Endoscopy

There are a few important steps to take to prepare for a Capsule Endoscopy. Your doctor will give you specific instructions leading up to the procedure. A cleansing routine is at the core of the preparations. You should stop eating and drinking 12 hours before the procedure, and may need to follow a clear liquid diet prior to that. You may also need to take a laxative to flush out your small intestine. All of this can help improve picture quality from the procedure. Additionally, you will need to discuss your medical history and medications with your doctor. 

During the procedure

The procedure begins with you swallowing the camera capsule with water. A monitor is attached to your abdomen to record images obtained from the camera. You are then able to leave the office and go about your day. Some restrictions apply as the camera records, like strenuous activity. 

As the camera in the capsule passes through your digestive tract, it will take thousands of color pictures. The images are saved and transferred to a computer, where they are then strung together into a video format. This is what your doctor will view to examine your digestive tract. Getting results back can take a week or two. 

After the Capsule Endoscopy

Around two hours after the procedure, you can start drinking clear liquids again. After four hours, you can have a light lunch or snack. The procedure is over after eight hours or when you see the capsule after a bowel movement, whichever occurs first. Since everyone’s digestive system varies, you may pass the capsule in a few hours or in a few days. At that point, you can remove the monitor, pack it up, and follow the equipment return instructions given by your doctor. You can flush the camera capsule. If you have not seen the capsule pass within two weeks, you should contact your doctor. 

Complications from a Capsule Endoscopy are rare. In some cases, the capsule can get stuck in the digestive tract, especially where there is a stricture from surgery, a tumor, or inflammation. Symptoms of obstruction include vomiting, abdominal pain, and unusual bloating. It’s important to recognize the signs of an obstruction early on. Contact your doctor if you experience any of these symptoms after the procedure. 

Our experienced team at GHP has years of experience performing Capsule Endoscopies. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

 

Preparing for an Upper Endoscopy

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An Upper Endoscopy (EGD) is an outpatient procedure in which an endoscope is passed through the throat to examine the lining of the upper GI or digestive tract. There are a few things you should know about an EGD if you are preparing for one. Here’s an overview of the Upper Endoscopy: 

When it’s used

The Upper Endoscopy allows gastroenterologists to examine the upper digestive system. Doctors can use the procedure to diagnose or treat conditions affecting the stomach, esophagus, and duodenum (beginning of the small intestine). It can help determine the cause of digestive symptoms like vomiting, trouble swallowing, gastrointestinal bleeding, and abdominal pain. The procedure also allows doctors to collect tissue samples to test for specific conditions or diseases like anemia or cancer. They can even use the procedure to treat some conditions; doctors can clip off polyps, treat bleeding, remove foreign objects, and widen a narrow esophagus during the procedure. 

Preparing for an Upper Endoscopy

To prepare for an Upper Endoscopy, there are a few steps you need to take. Your doctor will discuss these with you. You should abstain from eating or drinking starting around six hours before the procedure. This is helpful because an empty stomach allows for a safer and more effective examination. Your doctor will give you specific guidance on timing for starting to fast, as it can vary case-to-case. 

Additionally, you should discuss any medications you are taking with your doctor. You may need to adjust the dosage of medication leading up to the procedure; in particular, blood-thinners can cause excessive bleeding during the procedure, so these should be addressed. If you take insulin, you will need to adjust your dosage or timing before the procedure as well. Last, you and your doctor will need to discuss any allergies to medication that you have. 

During the procedure

An Upper Endoscopy is an outpatient procedure, meaning that you will be able to leave the location of your procedure the same day it occurs. Directly before an EGD, you will enter a pre-op area where nurses will place an IV and record your medical history. An anaesthesiologist will also discuss how sedation will be used during the procedure.

After, once you have been taken to a procedure room, you will be connected to monitors that track your heart rate, blood oxygen levels, and blood pressure. You will be under sedation for the procedure’s duration, which takes around 10-15 minutes. During the procedure, a bite block is inserted in your mouth to prevent damage to your teeth or the endoscope. As you are on your left side, the doctor will pass the endoscope through your mouth and into your upper digestive tract. Depending on your situation, they will then examine, diagnose, or treat as needed. 

After the Upper Endoscopy

After an EGD, you are taken to a post-op room to be monitored for any potential complications. Your blood pressure, breathing, and pulse will be monitored for stability. Your doctor will discuss initial findings with you after you have recovered. Results from biopsies will take several more days to come back. Because of the sedative effects, you will need someone to drive you home. Additionally, you should avoid operating machinery or making important decisions for 24 hours. Your diet may return to normal, unless otherwise indicated by your doctor. It’s normal to feel gassy or bloated following the procedure, and mild cramping or sore throat is common for a brief time post-op. 

Though uncommon, there are some more severe complications to be on the lookout for following the procedure. If you notice tarry stools, severe abdominal pain, fever and chills, or difficulty swallowing after the procedure, contact your doctor immediately. These can be signs of complications like excessive bleeding from a biopsy, a perforated intestine, or a reaction to sedation. In general, these severe complications are very uncommon, and are far outweighed by the general safety and health benefits of an upper endoscopy. 

Our experienced team at GHP has years of experience performing EGDs. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

 

Crohn’s & Colitis Foundation 2020 Take Steps Walk

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Join us on Saturday, June 20th for the Crohn’s and Colitis Take Steps Virtual Walk

The Take Steps Walk is put on by the Crohn’s & Colitis Foundation, an organization with a mission to provide support and resources for people suffering from Inflammatory Bowel Disease. The nationwide walk will help fund patient services, education, advocacy and research.

Gastroenterology Health Partners proudly sponsors this event. Through better treatment methods and cures, we can improve the quality of life for those affected by IBD. To schedule an appointment and get screened, contact us today.

This Year’s Virtual Walk

In light of CDC guidelines during the ongoing COVID-19 pandemic, the Crohn’s & Colitis Foundation will not be hosting in person walks this year. Instead, they are hosting a national TAKE STEPS + VIRTUAL walk experience on Saturday, June 20, 2020. Visit their website to read a full update on the event.

What is Inflammatory Bowel Disease (IBD)?

IBD is a term that describes disorders involving chronic inflammation of the digestive tract. Crohn’s Disease and Ulcerative Colitis are two of the most common types of IBD. Crohn’s Disease affects the lining of the entire digestive tract. Ulcerative Colitis specifically inflames the lining of the colon and rectum.

While the causes for Crohn’s Disease and Ulcerative Colitis are currently unknown, combined they affect nearly 3.1 million Americans. Patients tend to get diagnosed between the ages of 15 and 35. However, the fastest growing segment of patients is children under the age of 18.

IBD and COVID-19

The Crohn’s & Colitis Foundation has compiled helpful information and resources on the topic of COVID-19 and IBD on their website. This includes video interviews with medical professionals, helpful tips, and other resources. Visit their website to learn more.

Join and Support the Walk

The Crohn’s and Colitis Take Steps Walk is a great opportunity for patients, families, healthcare providers and organizations to come together as a community and offer lasting support to one another. For those interested in registering as a virtual walker, donating, or creating a team of virtual walkers, visit the Virtual Walk FAQ page for more information. Each team and individual is able to set their own fundraising goal. Visit the Kentucky Take Steps page or the Indiana Take Steps page to learn more, register, and make a donation!

Colonoscopy: What to Expect

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A colonoscopy is a procedure that allows a physician to examine a patient’s colon. Colonoscopies are often used to evaluate GI disorders and screen for colon cancer. Here’s what you need to know if you are preparing for a colonoscopy.  

When it’s used

There are a few reasons your doctor may recommend a colonoscopy. The procedure is commonly used as a screening tool for colon cancer, which starts from polyps in the colon. A colonoscopy can help your doctor examine your colon for any polyps and other warning signs of colon cancer. You may also need a colonoscopy if you have previously had polyps. In this case, your doctor will likely look for more polyps and remove any, as a preventative measure against colon cancer. Last, you may need a colonoscopy if you have any GI pain or distress that your doctor needs to identify and diagnose through examination. 

Preparing for a Colonoscopy

There are a few important pre-procedure steps you need to take leading up to a colonoscopy. You will be asked to adhere to a cleansing routine the day before the procedure. This typically consists of taking a liquid laxative the day before to empty your bowels, and switching to a clear liquid diet. You may be asked to drink plenty of liquids as well. Following the instructions on laxative use is a crucial step to properly prepare for the exam, so always be diligent in this regard. 

In addition to the cleansing routine, you should also discuss any medications you use with your doctor. You may have to stop use of some medications like blood-thinners prior to the procedure. This is because some of these medications can increase the risk of excessive bleeding. If you use insulin, you may need to adjust dosage and timing the day of the procedure. Your doctor will also want to know about any allergies to medication you have. 

What to Expect During the Procedure

A colonoscopy takes about 20-30 minutes in total. You will be sedated for the entire procedure, so there is no discomfort during it. Your doctor will monitor your heart rate, blood oxygen levels, and blood pressure throughout the process as well. During the procedure, your doctor will insert a colonoscope (a thin, flexible tube with a light and camera) in your anus while you lay on your side and advance it to the end of your colon. The camera and light allow your doctor to fully examine the colon lining. 

If your doctor sees anything they want to analyze further, they may take a small tissue sample (biopsy) for later analysis. In the case that they see any bleeding during the examination, they can feed instruments through the colonoscope to medicate, cauterize, or clip affected areas and control bleeding. If they find any polyps, they can use an instrument threaded through the colonoscope to remove them. None of these techniques cause discomfort during the procedure. 

After the Procedure

It typically takes around an hour to mostly recover from the sedation after a colonoscopy. As such, you should always have someone take you home afterwards. The effects can linger to an extent for the next 24 hours, so you should avoid driving, making important decisions, or working for that period of time as well. If any polyps were removed during the procedure, you may be prescribed a temporary special diet. It’s common to pass gas and feel bloated for a few hours after the exam. Walking can help ease some of this discomfort. 

You may see a small amount of blood in your stool during your first bowel movement post-procedure; this is not cause for alarm most of the time. However, if bleeding persists or you develop a fever or consistent bowel pain within a week or two of the procedure, you should contact your doctor. 

Our experienced team at GHP has years of experience performing colonoscopies. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.