Patient information

On this page you’ll find information about diagnostic treatments: gastroscopy, colonoscopy, sigmoidoscopy, capsule endoscopy, endoscopic retrograde cholangiopancreatography, and endoscopic ultrasound.

Please read the instructions provided to you by your Gastroenterologist carefully and well before the date of your test. To ensure the safe and successful completion of your procedure you must follow specific advice for adjusting certain medications, and you must follow exactly the bowel preparation instructions provided.

If you receive IV sedation, you are considered legally impaired for 24 hours after your procedure and you must have a responsible adult drive you home. If you do not have a ride and driver, your procedure may be cancelled or offered without sedation.

Gastroscopy

Gastroscopy is a medical procedure to examine the lining of the esophagus, stomach, and duodenum (small intestine). It provides useful diagnostic information in patients with:

Swallowing difficulties
Abdominal pain, nausea, weight loss
Signs of upper gastrointestinal bleeding
Unexplained anemia or low iron
Possible diagnosis of celiac disease
Abnormal imaging test

After intravenous sedation and local anaesthetic spray is administered, a long narrow, flexible optic tube is passed via the mouth into the esophagus and advanced into the stomach and duodenum. The lining of these structures can be examined as the instrument is then slowly withdrawn. If abnormalities are discovered, a biopsy is taken, which is a small sample of tissue painlessly removed for study under a microscope by a pathologist. Occasionally, a narrowed segment (stricture) will be stretched to a more normal size (dilatation).

Colonoscopy

Colonoscopy is a medical procedure to examine the lining of the rectum and colon (large bowel). It provides valuable diagnostic information regarding:

Rectal bleeding
Unexplained anemia or low iron
Diarrhea or constipation
Abdominal pain
Abnormal imaging
Bowel polyps or cancer
Crohn’s Disease or Ulcerative Colitis

Sedation is routine but optional. After intravenous sedation is administered, a long narrow, flexible optic tube is passed via the anus into the rectum and advanced to the junction between small intestine and colon. The lining of these structures can be examined as the instrument is then slowly withdrawn. If abnormalities are discovered, a biopsy is taken, which is a small sample of tissue painlessly removed for study under a microscope by a pathologist. Polyps are frequently discovered and removed.

Sigmoidoscopy

Flexible sigmoidoscopy is a medical procedure to examine the lining of the rectum and last part of the colon (large bowel). It is mainly used to investigate bleeding believed to originate in the last 30–40 cm of the colon or to reassess ulcerative colitis.

A long, narrow, flexible optic tube is passed via the anus into the rectum and advanced along the S-shaped part of the colon called the sigmoid. The lining of these structures can be examined as the instrument is then slowly withdrawn. If abnormalities are discovered, a biopsy is taken, which is a small sample of tissue painlessly removed for study under a microscope by a pathologist. Polyps are sometimes discovered and removed.

During the exam some mild cramps may occur – this will only last for a few minutes. Intravenous sedation is usually not necessary but could be given to help you relax and feel more comfortable.

Capsule Endoscopy

Capsule endoscopy uses a tiny camera that takes pictures as it passes through your digestive tract. It’s about the size of a large vitamin pill, and it has a slippery coating to make it easier to swallow. Some of these devices require adhesive patches that are attached to your abdomen. Each patch contains an antenna with wires that connect to a recorder on a special belt around your waist or in a bag over your shoulder. The recorder collects and stores the pictures taken by the camera.

You can generally go about your normal activities while the camera pill passes through your digestive tract, though you may be asked to avoid repetitive movements that could disrupt the recorder. The camera will take pictures for 8 or 12 hours. Your doctor will tell you which type of capsule endoscopy you are having, and when you can resume eating and drinking.

Your body may expel the camera within hours, or it may take several days. Each person’s digestive system is different. The procedure is complete after 8 or 12 hours, or when you see the camera capsule in the toilet after a bowel movement. You don’t need to collect the camera capsule – it can safely be flushed down the toilet. Remove the antenna patches from your abdomen, and pack them along with the recorder in a bag to return according to your doctor’s instructions.

You will be asked to return the machine to the same place where you obtained the equipment the following morning. You will also be given a requisition for an abdominal X-ray to ensure that the capsule passed through your system. Please have this done 3 days following the test.

This test is ONLY performed after having a gastroscopy and colonoscopy and for specific indications determined by the Gastroenterologist.

Endoscopic Retrograde Cholangiopancreatography

ERCP (short for endoscopic retrograde cholangiopancreatography) is a procedure to examine your gallbladder, pancreas and the ducts or tubes leading from the organs into the small intestine (duodenum). A soft, flexible tube (scope) is passed through your mouth into the first part of your duodenum where the opening from your bile and pancreatic duct is located. A small catheter is passed through the scope into the pancreatic and/or bile duct. Liquid contrast (x-ray dye) is injected through the catheter so that the gallbladder, pancreas and ducts can be viewed on the x-rays. Often it is possible to remove gallstones blocking the bile ducts. If the opening of your duct is too narrow, it may be necessary to enlarge it at this time (sphincterotomy). Sphincterotomy is a surgical procedure in which an electrical current is passed through a cutting wire, to widen the opening of a duct to allow removal of stones which may be lodged therein. You should feel no pain during a sphincterotomy. Instruments may be passed through the scope to take tiny, painless biopsies (samples of tissue) for microscopic examination in the laboratory.

Endoscopic Ultrasound

EUS allows your doctor to examine the lining and the walls of your upper and lower gastrointestinal tract. The upper tract is the esophagus, stomach and duodenum; the lower tract includes your colon and rectum. EUS is also used to study internal organs that lie next to the gastrointestinal tract, such as the gall bladder and pancreas.

Your gastroenterologist will use a thin, flexible tube called an endoscope. Your doctor will pass the endoscope through your mouth or anus to the area to be examined. Your doctor then will turn on the ultrasound component to produce sound waves that create visual images of the digestive tract.

EUS provides your doctor more detailed pictures of your digestive tract anatomy. Your doctor can use EUS to diagnose the cause of conditions such as abdominal pain or abnormal weight loss. Or, if your doctor has ruled out certain conditions, EUS can confirm your diagnosis and give you a clean bill of health.

EUS is also used to evaluate an abnormality, such as a growth, that was detected at a prior endoscopy or by x ray. EUS provides a detailed picture of the growth, which can help your doctor determine its nature and decide upon the best treatment.

In addition, EUS can be used to diagnose diseases of the pancreas, bile duct and gallbladder when other tests are inconclusive.