COLONOSCOPY

A colonoscopy is an examination which allows the physician to examine the colon (large intestine, or bowel with a slim, flexible, lighted tube called a colonoscope.

A polypectomy may have to be performed. To remove a polyp your doctor will pass a wire loop (snare) through the colonoscope and sever the attachment of the polyp from the intestinal wall by means of an electrical current. Polyps are usually removed because they can bleed or contain cancer. The majority of polyps are benign (non-cancerous); however a small percentage may contain an area of cancer or develop into cancer.

Colonoscopy is the most direct and complete way to see the entire lining of the colon. It is usually done for one of the following reasons:

  • Prevention and early detection of cancer. If you are 50 years old, you should have a colonoscopy every 5 years. It can help your doctor find and remove growths (polyps) that could become cancerous. It can also allow your doctor to detect cancerous growths early, when the cancer is easier to cure.
  • Diagnosis of illness. If you have symptoms of illness that your doctor has not been able to explain, you may have this procedure to try to find the cause of your symptoms. For example:
    • To establish the cause of gastrointestinal bleeding, especially in the presence of iron deficiency anemia.
    • To diagnose inflammatory bowel disease (colitis,crohn's).
    • To look for a cause of chronic diarrhea or constipation.
    • As part of treatment, to remove colon polyps, stop bleeding, dilate narrowed

SIGMOIDOSCOPY

A sigmoidoscopy is an examination which allows the physician to look for fissures and haemorrhoids, to establish the cause of persistent blood in the stools, and to diagnose inflammatory bowel disease.

As a screening test, to look for colorectal cancer or for polyps however we recommend colonoscopy for this purpose.

GASTROSCOPY

Gastroscopy is a medical term that has two parts: gastro for "stomach," and scop for "looking." Gastroscopy, then, is a diagnostic test that enables the doctor to look inside your stomach. The instrument used to perform this simple test is the gastroscope; a long, thin, flexible tube. Within the end of this remarkable device is a miniaturised colour TV camera with a wide angle lens. By passing this "scope" into your stomach, your doctor can directly examine the lining of your upper digestive system on a television monitor.The technical name for this test is Esophago-Gastro-Duodenoscopy. To simplify things the shortened form of the name GASTROSCOPY is usually used, or the initials EGD. The examination is quick and painless.

This procedure may be done if you have:

  • Problems swallowing
  • Repeated heartburn
  • Abdominal pain
  • Chest pain
  • Gastrointestinal bleeding
  • Vomiting
  • Abnormal findings in gastrointestinal x-rays

CAPSULE ENDOSCOPY

Capsule Endoscopy will provide your doctor with pictures of your small intestine. Capsule Endoscopy enables your doctor to examine the three portions (duodenum, jejunum, ileum) of your small intestine. Your doctor will use a vitamin-pill sized video capsule as an endoscope, which has its own lens and light source. While the video capsule travels through your body, images are sent to a data recorder you will wear on a waist belt. Afterwards your doctor will view the images on a video monitor.

Capsule Endoscopy helps your doctor determine the cause for recurrent or persistent symptoms such as abdominal pain, diarrhea, bleeding or anemia after a gastroscopy and a colonoscopy has been performed without revealing a diagnosis. In certain chronic gastrointestinal diseases the method can also help to evaluate the extent to which your small intestine is involved or monitor the effect of therapeutics. Your doctor might use Capsule Endoscopy to obtain motility data such as gastric or small bowel passage time.

Your doctor will prepare you for the examination by applying a sensor array to your abdomen with adhesive sleeves. The capsule endoscope is ingested and passes naturally through your digestive tract while transmitting video images to a data recorder worn on a belt for approximately eight hours. The capsule endoscope doesn't interfere with your breathing; most patients consider the test comfortable. You will be able to eat after four hours following the capsule ingestion unless your doctor instructs you otherwise.

At the end of the procedure, you will need to return to the office to return the data recorder and sensor arrays. The images acquired during your exam will be downloaded to a workstation for physician review. After ingesting the capsule and until it is excreted, you should not have an MRI examination nor be near a Magnetic Resonance Imaging (MRI) or a radiologic imaging device. After you return the equipment (waist belt, data recorder, battery pack & sensor array), your doctor will process the information from the DataRecorder.

The doctor will view a color video of the pictures taken from the capsule. After the doctor has looked at this video, you will be contacted with the results. The capsule is disposable and passes naturally with your bowel movement. You should not feel any pain or discomfort.

pH TESTING CAPSULE (WITHOUT CATHETER)

The catheter-free capsule pH Monitoring System is revolutionizing the way pH testing is done. The capsule allows patients to maintain their regular diet and activities during pH testing. And because it is catheter-free, the added convenience for patients allows more information representative for physicians.

Easy to place during gastroscopy, with 24-hour or 48-hour monitoring and powerful diagnostic software. Capsule pH resting provides the advanced, yet simple-to-use tool needed for accurately diagnosing GERD (gastro esophageal reflux)

  • Miniature pH capsule the size of a gel cap is Temporarily attached to the wall of the esophagus
  • Capsule transmits pH data via radio frequency to a pager-sized receiver worn on the belt
  • Capsule naturally detaches off the esophagus after a few days and passes through the digestive tract and eliminated in the stool.

VIRTUAL COLONOGRAPHY / VIRTUAL COLONOSCOPY

- Virtual colonography is a screening tool used to look for colon cancer.
- Virtual colonography uses CT scans along with computers to produces images of the colon.
- Like regular colonoscopy, virtual colonography requires special preparations to clean the colon before the procedure.
- During the test a tube is inserted into the rectum and the colon, to inflate with air.
- Pictures are then processed by a computer to create an image of the colon which is then reviewed by a radiologist.

  • Virtual colonography does not allow the doctor to take biopsy specimens or remove polyps.
  • If polyps or any other abnormality is noted, a regular colonoscopy will need to be done.
  • Virtual colonography is a more costly / expensive procedure.

Regular colonoscopy remains the recommended and preferred screening method for colon cancer.

Virtual colonography is used more for special cases

MINOR SURGICAL PROCEDURES

HEMORRHOIDS (Internal) Ligation - the rubber band treatment

Did you know...

  • Hemorrhoids are one of the most common ailments known.
  • More than half the population will develop hemorrhoids, usually after age 30.
  • Millions of Canadians currently suffer from hemorrhoids.
  • The average person suffers in silence for a long period before seeking medical care.
  • Today's treatment methods make some types of hemorrhoid removal much less painful.

What are hemorrhoids?

Often described as "varicose veins of the anus and rectum", hemorrhoids are enlarged, bulging blood vessels in and about the anus and lower rectum. There are two types of hemorrhoids: external and internal, which refer to their location.
External (outside) hemorrhoids develop near the anus and are covered by very sensitive skin. If a blood clot develops in one of them, a painful swelling may occur. The external hemorrhoid feels like a hard, sensitive lump. It bleeds only if it ruptures.
Internal (inside) hemorrhoids develop within the anus beneath the lining. Painless bleeding and protrusion during bowel movements are the most common symptom. However, an internal hemorrhoid can cause severe pain if it is completely "prolapsed" - protrudes from the anal opening and cannot be pushed back inside.

Hemorrhoids treatement

Symptomatic hemorrhoids may require special treatment, much of which can be performed on an outpatient basis.

Ligation - the rubber band treatment - works effectively on internal hemorrhoids that protrude with bowel movements. A small rubber band is placed over the hemorrhoid, cutting off its blood supply. The hemorrhoid and the band fall off in a few days and the wound usually heals in a week or two. This procedure sometimes produces mild discomfort and bleeding.

Rubber Band Ligation of Internal Hemorrhoids:

  • A. Bulging, bleeding, internal hemorrhoid
  • B. Rubber band applied at the base of the hemorrhoid
  • C. About 7 days later, the banded hemorrhoid has fallen off leaving a small scar at its base (arrow)

A colonoscopy is required prior to this procedure for diagnostic purposes.