Dilation is a procedure used to stretch open a narrowed area in the esophagus or other part of the gastrointestinal tract. Narrowing or constriction of the esophagus usually causes difficulty swallowing. Food or liquid may become lodged in the chest or neck. When this occurs, it is a most distressing sensation and can cause pain and a feeling of choking. Esophageal dilation usually will relieve these symptoms if they are due to a narrowing. Dilation may also relieve chest pain and swallowing difficulty in patients who suffer from esophageal spasm.

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What is Colonoscopy?
Colonoscopy is an examination of the large intestine, or colon, using a long flexible instrument called a colonoscope. This test may be done for a variety of reasons. Commonly it is done to investigate the finding of blood in the stool, diarrhea, abdominal pain, a change in bowel habits, or an abnormality noted on a colon x-ray or barium enema. Colonoscopy is also recommended in patients over age 50 to screen for colon cancer and colon polyps.

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Virtual Colonoscopy (also called CT colography) has been in the news and we would like to share some information with you about this fascinating new procedure.

At this time, it is not clear as to where this procedure will fit into our recommendations regarding Colorectal Cancer Screening. It is certainly an exciting new development, but further study is needed to know whether the expected benefits are real. In any case, it may be a way to make colorectal cancer screening available to and accepted by more patients. Anything we can do to reduce deaths from colorectal cancer is a positive.

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What is ERCP?
ERCP is a very specialized type of endoscopic examination. This is an abbreviation for Endoscopic Retrograde Cholangio Pancreatography. The purpose of this examination is to inject dye into the pancreatic duct and the bile duct using an endoscope and then take x-ray pictures in order to diagnose suspected problems in these organs.

What Happens During the Procedure?
The procedure will be performed at the hospital. An intravenous (IV) will be started in your arm, and enough medication will be given to make you drowsy and relaxed. Most patients do not have any sensation during the examination, and usually do not have any recollection of the procedure itself. In some cases, the procedure will be performed under general anesthesia.

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Digestive Health Physicians is pleased to announce the availability of the Medtronic “Bravo Ambulatory pH system”. This is a device used for evaluation of patients with gastroesophageal reflux. The Bravo system is based on a miniature pH  monitoring device that is implanted in the esophagus. The device transmits pH data to a recording device worn on the belt. The system eliminates the need for an uncomfortable nasal tube. This greatly improves patient acceptance since the capsule is placed endoscopically under sedation and the patient is completely unaware of its presence. Furthermore, pH data is collected for longer periods, usually 48 hours, making for more accurate studies that are further enhanced by the patient’s ability to maintain his usual diet and lifestyle due to a lack of the transnasal catheter.

For more information about Bravo please see the Medtronic web site.

Digestive Health Physicians is pleased to announce that we have performed over 200 studies with the Given Imaging Capsule Endoscopy system. This device is a tiny video camera  that is swallowed by the patient. The capsule, about the size of a large vitamin pill, takes photos twice a second as it passes through the digestive tract. The images are sent via a radio transmitter to a small computer that is worn on a belt during the examination. Pictures are then downloaded to a computer workstation and reviewed by one of our physicians. This procedure was developed to diagnose diseases of the small intestine, an area that has been relatively inaccessible to direct examination.

The procedure is indicated in patients who are suspected of having disease of the small intestine that has not been diagnosed by routine testing. It is not a replacement for standard tests such as colonoscopy or gastroscopy. If you think you might benefit from this test, please call to arrange an consultation.
If you would like to learn more, see the Given Imaging web site.

Digestive Health Physicians was the first group in our region to perform Video Capsule Endoscopy with the M2A Capsule Endoscope for diagnosis of small bowel diseases. In the very near future, we will introduce a new development. On October 26, 2004, Given Imaging was granted approval for its new system for imaging the esophagus.

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