Gastroenterology Procedures

Comprehensive Diagnosis for GI Disorders

Rochester Regional Health offers many state-of-the-art endoscopy procedures to help diagnose and treat disorders of the digestive tract, esophagus, colon, and lungs. A small instrument called an endoscope is used to see the inside of the digestive tract.

Common health conditions diagnosed from endoscopic procedures include:

Acid reflux disease
Celiac disease
Colorectal cancer
Crohn's disease
Diverticulitis
Inflammatory bowel disease
Irritable bowel syndrome

Common Procedures

Our expert physicians work together to provide advanced treatment options for conditions affecting the digestive system, including the stomach, intestines, colon, pancreas, liver, and esophagus. Some of our most common procedures are explained in detail below.

Upper Endoscopy

An upper endoscopy is a diagnostic procedure that explores the inner structures of the uppermost digestive system to pinpoint the cause of unexplained symptoms like:

Vomiting
Abdominal pain
Difficulties swallowing
Gastrointestinal bleeding

The test may also be useful for accessing the damage in your esophagus caused by acid reflux and gastroesophageal disease (GERD).

This outpatient procedure involves the insertion of an endoscope into your mouth and down into your esophagus. The endoscope is a flexible tube that holds a light and a tiny camera used to send back images of your esophagus and stomach to an external monitor.

Your doctor watches the monitor to identify any abnormalities or damage in your stomach, esophagus, and beginning of the small intestine, such as:
- Ulcers
- Polyps
- Infection
- Inflammation

Colonoscopy

A colonoscopy is both a diagnostic and preventive procedure that can identify changes in your large intestine, colon, and your rectum. These changes can indicate the presence of disease that affects your gastrointestinal health, including colon cancer.

50 years old is the recommended age for a screening colonoscopy. Talk to your doctor about getting a colonoscopy sooner if:
- You or a close relative have had colorectal polyps or colorectal cancer
- You have Inflammatory Bowel Disease such as Crohn’s or Ulcerative Colitis
- You have experienced rectal bleeding or a change in regularity
Since the early stages of colon cancer won’t typically cause noticeable symptoms, a screening colonoscopy is the most effective way to diagnose precancerous or cancerous changes before the disease can advance.
You will be prepared before your procedure with instructions for a clear-liquid diet and prescribed a specific preparatory solution to clean out your colon.

During the procedure, the gastroenterologist inserts a long, flexible tube that contains a small camera into the rectum and guides it through your lower gastrointestinal tract. Moderate Sedation administered intravenously ensures your comfort.

The camera sends real-time images of your inner structures to a monitor, which your doctor watches throughout the procedure to identify polyps and other abnormalities.

In the event your provider finds suspicious areas of tissue, they can take tissue biopsy or remove existing polyps during a colonoscopy.

Your doctor sends these samples to a medical lab for further evaluation. Depending on the results of your lab testing, your provider works with you closely on a treatment plan for your condition.

Endoscopic Retrograde Cholangiopancreatography (ERCP)

In an ERCP procedure a dye is injected into your bile and pancreatic ducts using a flexible, video endoscope. Then, X-rays are taken to outline the bile ducts and pancreas. An open channel in the scope allows other instruments to be passed through it to perform biopsies, inject solutions, make incisions, or place stents. ERCP helps in diagnosing and treating conditions of the bile ducts, gallbladder, and pancreas.

ERCP may be used for:

Gallstones, which are trapped in the main bile duct
Blockage of the bile duct
To evaluate yellow jaundice, which turns the urine dark and your skin yellow
Cancer of the bile ducts or pancreas
Pancreatitis, which is inflammation of the pancreas
Infections of the bile ducts
Leaks of the bile duct or pancreatic duct

An ERCP uses x-ray and is performed in the hospital. You will be sedated and the endoscope is then gently inserted into your upper esophagus. A thin tube is inserted through the endoscope to the main bile duct entering the duodenum. Dye is then injected into this bile duct and/or the pancreatic duct and x-ray films are taken. If a gallstone is found, steps may be taken to remove it. An incision can be made using electrocautery (electrical heat) to open the lower portion of the duct as it enters the duodenum. Additionally, it is possible to widen narrowed ducts and to place small tubing, called stents, in these areas to keep them open. Your Gastroenterologist may also take biopsies of abnormal tissue. The exam takes from 20 to 40 minutes, but could take up to an hour or more, depending on the complexity of the procedure, after which you will be taken to the recovery area.

After the exam, your physician will explain the results. Your provider will then work with you closely on a treatment plan for your condition.

Endoscopic Ultrasound (EUS)

An endoscopic ultrasound (EUS) is a minimally invasive test to further evaluate the digestive tract on a more advanced level. An EUS combines two diagnostic tools:

Endoscope: A flexible, tube that is used to further examine organs that are not inside of the digestive tract, as well as lesions that are not visible to the naked eye via regular endoscopy.
Ultrasound: Uses sound waves to generate detailed images of your body on a monitor

EUS can be used to detect tumors, biopsy tumors, and stage tumors in the gastrointestinal (GI) tract. EUS can be used to take tissue and fluid samples to provide a diagnosis. Or, evaluate abnormal findings from imaging tests, such as cysts of the pancreas.

EUS can also help:

Assess how deeply a tumor penetrates your abdominal wall in esophageal, gastric, rectal, pancreatic and lung cancers
Evaluate abnormal findings from imaging tests, such as cysts of the pancreas
Guide drainage of pseudocysts and other abnormal collections of fluid in the abdomen

EUS is performed under sedation on an outpatient basis on our Unity and Rochester General Hospital campuses and is well-tolerated by most people.

Video Capsule Endoscopy

Video capsule endoscopy (also known as a small bowel capsule endoscopy) is a procedure that uses a tiny wireless camera inside a capsule to take pictures of your digestive tract. The capsule endoscopy is a vitamin-sized capsule and contains a camera.

Video capsule endoscopy provides pictures inside your small intestine — an area that isn't easily reached with more-traditional endoscopy procedures. VCE examines the intestinal track not easily reached by Colonoscopy or Upper Endoscopy. Unlike a traditional endoscope, the capsule can access the entire length of your small intestine. However, the capsule is not able to treat the conditions it detects.

Video capsule endoscopy may be recommended to:

Find the cause of gastrointestinal bleeding. The most common reason for doing capsule endoscopy is to explore unexplained bleeding in the small intestine.
Diagnose inflammatory bowel diseases, such as Crohn's disease. Capsule endoscopy can reveal areas of inflammation in the small intestine.
Diagnose cancer. Capsule endoscopy can show tumors in the small intestine or other parts of the digestive tract.

Video capsule endoscopy is performed a Unity, Wilson Health Center, and Clifton Spring Campuses.

The patient is given the pill-sized camera device to swallow. The Pill Camera will take pictures as it passes through the digestive tract. These pictures will be transmitted to a data recorder that the patient will wear around the waist. After the test has been administered, the patient may move freely and return home to follow a modified routine. The procedure lasts approximately 8 hours and the patient returns to the office to turn in the recorder.

Your provider will review the images captured by the data recorder. The capsule typically passes naturally and painlessly with a bowel movement. There is no need for sedation, and you go about your activities of daily living during the eight or so hours of the study.
The camera captures images of your esophagus, stomach, and small intestine to diagnose and monitor potential illness. It can also help determine if you need further treatment. Unlike a traditional endoscope, the capsule can access the entire length of your small intestine. However, the capsule is not able to treat conditions it detects. Your Doctor will Review the pictures and Data provided by the capsule and make further recommendations based on the results.

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