7. Procedure Statistics
⢠Colonoscopy - 3,829 performed each year
⢠EGD - 2,272 performed each year
⢠On average, 30 procedures are performed
daily!
http://www.youtube.com/watch?feature=play
er_detailpage&v=fZkAHDf8WsA
8. Colonoscopy
⢠Screening starting at age 50 or
younger with positive family
history for cancer
⢠Screening every five to 10 years
thereafter if polyps are found
⢠Outpatient procedure
⢠Moderate sedation/general
anesthesia
⢠Pathology results in five to seven
days
9. Did You Know?
⢠Dr. Hiromi Shinya pioneered modern
colonoscopic techniques in 1970 in New York.
⢠St. Agnes Hospital started performing colonoscopies
in 1985.
⢠In 1997, St. Agnes Hospital had two procedures
rooms. Six colonoscopies were performed each day.
⢠Currently, St. Agnes Hospital boasts six procedure
rooms and 20 pre- and post-operative rooms. Thirty
procedures are performed each day.
10. Will It Be Uncomfortable Or
Will I Remember the Procedure?
⢠Moderate sedation
â Fast acting, short duration, amnesiac side effects
â Able to return to regular activities the next day
⢠Deep sedation/general anesthesia
â For patients with more complex medication
conditions
11. Bowel Preparation
⢠The bowel preparation â do it right!
â Choosing the right preparation for
you
â Limit your diet to low residue several
days before starting preparation
â Be sure you understand the
preparation instructions â call for
clarification if unsure
â Maximize clear liquid intake!
Before, during and after the
preparation.
12. Would you rather drive on a snowy day or a
clear, sunny day?
It is easier to visualize details in the colon if it is
clear of all waste.
13. Preventing Colon Cancer
⢠With widespread routine screening, nearly
30,000 lives in the United States could be
saved each year.
⢠Despite the fact that colonoscopy is the gold
standard screening method for colon cancer, it
is underused compared to screening methods
for breast and cervical cancers.
14. Upper Endoscopy
⢠Examination of the
esophagus, stomach and
duodenum (first part of
small bowel)
⢠Screening for complaints of
heart burn (reflux)
⢠Difficulty swallowing
⢠Abdominal pain
⢠Feeling of fullness
⢠Loss of appetite
⢠Esophageal stent placement
http://www.youtube.com/watch?feature=play
er_detailpage&v=jhO-aEVFDOg
15. Barrettâs Esophagus
⢠Barrettâs esophagus is a serious
complication of gastroesophageal reflux
(GERD).
⢠Barrettâs esophagus does not have
specific symptoms.
⢠Individuals with Barrettâs esophagus may
have symptoms related to GERD.
⢠Individuals with symptoms related to
GERD have an increased risk of
developing esophageal adenocarcinoma
â a serous cancer of the esophagus.
16. Barrettâs Esophagus
⢠About 10 to 15 percent of people with chronic
symptoms of GERD develop Barrettâs
esophagus.
⢠Average age at diagnosis is 50.
⢠30 percent of patients over the age of 50 with
reflux are diagnosed with Barrettâs esophagus.
⢠Many patients over the age of 50 with Barrettâs
esophagus have no symptoms of reflux.
17. Barrettâs Esophagus
Diagnosis & Treatment
⢠Can only be diagnosed with an upper endoscopy and
biopsy.
⢠Physicians recommend that people with a long-
standing history of reflux be screened for Barrettâs
esophagus.
⢠Family history of esophageal cancer.
⢠Gastroenterologists foresee that endoscopic
radiofrequency ablation or cryotherapy of Barrettâs
esophagus will shift current management from
surveillance to cancer prevention.
20. ERCP
⢠Test designed to diagnose and treat diseases
of the pancreas, bile ducts, liver and
gallbladder
⢠Therapeutic techniques
â Open bile ducts
â Extract stones
â Place stents
21. Capsule Endoscopy
⢠Examination of the small intestine
â Ingestion of video capsule
â Lasts eight hours
â Capsule takes 60,000 images over eight-hour
period
â Doctor views images on video monitor
23. Endoscopic Ultrasound
⢠Endoscope which contains built-in ultrasonic
capabilities that allows for highly accurate
staging of cancers and complex
gastrointestinal diseases.
24. Esophageal Motility
⢠Procedure to determine esophageal peristaltic
action in the esophagus and lower and upper
esophageal sphincter function
⢠Difficulty swallowing
⢠Complaints of reflux
⢠Prior to surgical treatment of reflux
25. BRAVO pH Monitoring
⢠Monitoring device implanted during an EGD
⢠Identifies the cause of heartburn
⢠Recording device worn on belt for 48 hours
⢠Patient keeps diary of reflux symptoms
⢠Physician analyzes downloaded information