Test/Procedures

An anoscopy is an examination using a small, rigid, tubular instrument. This is inserted a few inches into the anus in order to evaluate problems of the anal canal.

The Halo procedure uses heat energy (radiofrequency ablation) combined with EGD (esophagogastroduodenoscopy). By targeting only Barrett’s tissue (the abnormal area), this minimally invasive procedure leaves healthy tissue undamaged.

The Bravo system is a pH test to help us determine if you have acid reflux (GERD). This test measures and records the amount of acidity or alkalinity in your esophagus. The test can also be done to determine the effectiveness of medications or surgical treatment for GERD. The measurements allow us to evaluate your heartburn and acid reflux symptoms and plan the best treatment for your diagnosis.

• Fructose Breath Test (FBT)
  Our fructose breath test can provide a quick diagnosis of fructose intolerance. This test determines whether you have difficulty absorbing fructose, a sugar found in onions, artichokes, pears etc. The test is performed in our office or your home.
• H. Pylori Breath Test (PYBT)
  This urea breath test is a rapid diagnostic procedure that indirectly detects the presence of H pylori-associated urease by measuring CO2 in your breath
• Kristalose Breath Test (KBT)
  The kristalose breath test is used to determine if bacteria have invaded the small intestine from either the stomach, where they are usually killed from the stomach acid, or the large intestine where they are normally found and are necessary for normal intestinal function.
• Lactose Breath Test (LBT)
  The lactose breath test is used to assist in diagnosing lactose intolerance and bacterial overgrowth for IBS.

In the colonoscopy test, we look at the entire length of the colon and rectum with a colonoscope which is a thin, flexible, lighted tube with a small video camera on the end. It’s placed in through the anus and into the rectum and colon. Special instruments can be passed through the colonoscope to biopsy (sample) or remove any suspicious-looking areas such as polyps, if needed. Your colonoscopy may be done in a hospital outpatient department, in a clinic, or in our office.

• Endoscopic Mucosal Resection (EMR)
  Sometimes your physician may discover a large polyp or early cancer at colonoscopy or upper endoscopy. In previous years, these growths would have required surgery to be removed. EMR allows your physician to use an ordinary gastroscope or colonoscope (and some special tools and attachments) to safely remove many of these tumors without the need for surgery.
• Endoscopic Retrograde Cholangiopancreatography (ERCP)
  Endoscopic retrograde cholangiopancreatography is a procedure that combines upper gastrointestinal (GI) endoscopy and X-rays to treat problems of the bile and pancreatic ducts including gallstones, inflammatory strictures (scars), leaks (from trauma and surgery), and cancer. Through the endoscope, we can see the inside of the stomach and duodenum, and inject a contrast medium into the ducts in the biliary tree and pancreas so they can be seen on radiographs.

For many patients who are suspected of having pancreatic disease, we may recommend that they undergo an endoscopic ultrasound. EUS combines both endoscopy and ultrasound to get images and information about your digestive tract and the surrounding tissue and organs. In the endoscopy procedure, your physician will insert a long flexible tube via the mouth or the rectum to visualize the digestive tract and the ultrasound will use high-frequency sound waves to produce images of the organs and structures inside the body.

A gastroscopy (upper gastrointestinal endoscopy) is a procedure used to visually examine your upper gastrointestinal tract: esophagus, stomach, and duodenum using a tiny camera on the end of a long, flexible tube. The camera is connected to either an eyepiece for direct viewing or a TV to display the images. When you have symptoms that are unexplained or unresponsive to diet modification or drugs, your physician may order this test for diagnosis and treatment. The most common indications are dyspepsia (upper abdominal pain), persistent heartburn, acute bleeding from the upper gut, and anemia. Less common reasons for the test are an abnormal upper gut X-ray, difficulty swallowing, unexplained weight loss, or when your physician has cause, such as a family history, to think that you are at risk to develop an esophageal or gastric cancer.

Endoscopic hemorrhoid band ligation (HBL) is simple, safe, and effective in the treatment of symptomatic internal hemorrhoids. Several rubber bands can be applied to your hemorrhoids in one session, and additional bands can be applied in subsequent sessions if a single session does not completely eliminate your hemorrhoids. The rubber band cuts off the blood flow to the internal hemorrhoid. Then the hemorrhoid shrinks and dies and falls off in about a week. The procedure is done in our office with the treatment success rate high, and the long-term recurrence rate low.

Infusions involves the administration of medication through a needle or catheter.  It’s recommended when a patient’s condition is so severe that it cannot be treated effectively by oral medications. Typically with an infusion, a drug is administered intravenously, but there are some situations where drugs are given through other non-oral routes, such as intramuscular injections and epidurals.

The equipment used in the esophageal pH probe test consists of a small, thin probe that is inserted through your nostril and positioned near the lower esophagus. This test is used to check how much stomach acid is entering the esophagus. It also checks how well the acid is cleared downward into the stomach. We use this test to diagnose and treat acid reflux (GERD) and help your physician decide how to best to treat you.

PillCam® SB uses a miniaturized camera contained in a disposable capsule that naturally passes through your digestive system, allowing our physicians to directly visualize the small bowel to detect and monitor abnormalities. By simply swallowing a vitamin-sized capsule, we may detect and monitor lesions, ulcers, tumors, bleeding and Crohn’s disease within the small bowel without using sedition.

PillCam® ESO Capsule Endoscopy is a tool for visualizing the esophagus. By viewing the esophagus, our physicians can monitor and detect abnormalities including esophageal varices, Barrett’s Esophagus and esophageal cancers.

An FDA approved sterile injectable gel, Solesta® gel is used to treat fecal incontinence (FI) in patients for whom other therapies such as diet change, and fiber therapy or anti-motility medications have failed. It’s given through four injections per treatment into the wall of the anal canal. Solesta® gel works by growing the surrounding tissue, the opening of the anus then narrows, and the patient may be able to better control those muscles.

Spiral enteroscopy is a technique allowing our physicians to perform procedures in the small bowel without surgery. The procedure involves the use of a special enteroscope, along with an overtube that is fitted with a spiral tip. The benefit of this procedure is that our physicians can perform treatments without surgery, such as removing polyps, biopsy of a tumor, placing a stent, dilating a stricture or cauterizing an active bleed.

The WATS^3D Assay (Wide Area Transepithelial Sample with 3D Analysis) is a diagnostic tool proven to be more effective in the detection of Barrett’s esophagus and dysplasia than forceps biopsy alone. It is a quick biopsy, and usually can be performed in about a minute. Using a continuous up-down motion to sample a wider area of the esophagus, the WATS^3D brush instrument simultaneously collects a transepithelial, full thickness biopsy specimen of the epithelium down to the lamina propria.