Prime Healthcare Gastroenterology Group

Barrett's Esophagus

Barrett’s esophagus is a rare condition in which the tissue lining in the esophagus changes color and composition as a result of long-term exposure to stomach acid. While most patients with Barrett’s esophagus do not experience any symptoms, this condition most often affects patients with gastroesophageal reflux disease, and as a result may have symptoms such as heartburn, chest pain and difficulty swallowing food. Patients with this condition may have an increased risk of developing esophageal cancer.

Treatment for Barrett’s esophagus depends on the severity of the condition and the overall health of the patient, but may include simply monitoring the condition through regular endoscopies, or surgery to remove the esophagus or the damaged cells. Removing damaged cells can often be done using minimally invasive techniques, such as an endoscopy or photodynamic therapy. Your doctor will help decide which treatment option is best for your individual condition.

Capsule Endoscopy

While recent technology has made examining the upper gastrointestinal tract and colon much easier, the small intestine remains a difficult area to reach without surgery. Although parts of the intestine can be seen during a colonoscopy or upper endoscopy, those procedures do not reach far enough to view the entire area. Barium X-rays have typically been used to diagnose problems of the small intestine, although they are not as accurate and easy as other procedures.

In response to the outdated procedures of this unreachable area, doctors have developed a capsule endoscopy. Also known as a wireless capsule endoscopy, this procedure involves swallowing a video capsule that will rapidly photograph the esophagus, stomach and small intestine on its way down. The video capsule is much larger than a pill and contains one or two video cameras, a light bulb, battery and radio transmitter. The photographs are transmitted to a receiver worn on the waist and then downloaded to a computer about 24 hours after the procedure. The capsule is then passed by the patient.

Although this procedure can provide more accurate and detailed results than X-rays, it is still not as successful as other camera procedures. A capsule endoscopy cannot perform any therapy in the area because the doctor does not control the device. The photographs may be blurred or hard to identify what location they are from. Despite these inaccuracies, capsule endoscopy is a rapidly improving technology that is making abnormalities of the small intestine much easier to diagnose.

Colonoscopy

A colonoscopy is a diagnostic procedure that allows your doctor to visually examine the inside of the colon for closer inspection of irregularities. This is accomplished by inserting a tube with a camera on the end into the anus and through the colon. The images from the camera are viewed either through the instrument or on a display monitor.

Why is a colonoscopy performed?

Colonoscopies are performed to investigate irregularities found on an X-ray or CT scan, abdominal pain, diarrhea or blood in the stool. They may also be performed regularly for people at risk for polyps or colon cancer.

How can I prepare for the procedure?

The colon must be completely clean to achieve accurate results. Patients will usually be given a special cleansing solution to drink before the exam, or may be asked to consume only a clear liquid diet with laxatives or enemas. Most medications can still be taken, although some such as aspirin or blood thinners may require special instructions. Your doctor will instruct you on how to prepare.

What can I expect during a colonoscopy?

Before the procedure, an IV is inserted with medication to make the patient relaxed and sleepy. The heart, blood pressure and oxygenation of the blood are monitored throughout the procedure. During the colonoscopy, the patient lies on their left side or back as the colonoscope is slowly inserted. It reaches all the way to the tip of the colon and examines the lining of the area as it passes in and out. The procedure takes about 15-60 minutes. A biopsy may be taken during the procedure if an area needs to be examined further.

What happens after a colonoscopy?

After the procedure, patients will be kept under observation for about an hour or two, until the medication wears off. Reflexes and judgment may be impaired for the rest of the day. Some cramping or bloating may be experienced, but should be relieved quickly. Eating and other normal activities can resume immediately.

What are the risks or complications of the procedure?

Complications of a colonoscopy are rare and minor. The procedure is very safe when performed by a trained and experienced professional. If they do occur, complications can include bleeding from the site of the biopsy, perforation of the bowel wall or reactions to the IV medication.

What do abnormal results mean?

Abnormal results of a colonoscopy can be a result of:

Inflammatory bowel disease
Diverticulosis
Lower gastrointestinal bleeding
Polyps
Tumor

Further diagnostic testing such as X-rays and CT scans may be done to follow up on these results.

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