Diagnostic Testing
Diagnostic Testing
The following is a partial listing of diagnostic tests performed by the Advanced Endoscopy Center. The diagnostic information provided is not for self-diagnosis or self-treatment. Diagnostic testing and physician expertise are required for diagnosing your symptoms. Check with your physician to determine what may be causing your symptoms and the treatment that is right for you.
Colonoscopy
A colonoscopy is a test that allows doctors to look inside the colon for inflammation, bleeding, polyps or tumors. It often is used as a diagnostic tool for patients experiencing symptoms such as bleeding, diarrhea, constipation, abdominal pain or blood or pus in bowel movements.
Colonoscopy also is used as a screening test for polyps or cancer, to monitor patients undergoing treatment for inflammatory bowel disease, or to monitor patients who have had colon cancer or who have had polyps removed previously.
Before the test, patients receive special instructions about diet, medications and how to empty the colon (with laxatives and/or enemas) before the procedure.
During the test, the patient receives a sedative through an intravenous line to help him/her relax. With the patient lying on his/her side, the doctor first inserts a gloved finger into the anus to check for tenderness or blockages. Then, a thin, flexible instrument called a colonoscope is inserted and guided through the colon. The colonoscope has a tiny camera and lights at its tip that allows doctors to see the inside of the colon on a television screen as the scope is withdrawn.
The colonoscope also has special attachments that allow doctors to take a biopsy or remove polyps during the procedure. If bleeding is found, blood vessels can be sealed or medications can be administered through the colonoscope to control it.
During a colonoscopy, a patient may feel pressure, bloating, cramps or the need to have a bowel movement. It is normal to pass gas during the procedure.
After the procedure, passing gas helps relieve cramps. The patient is monitored until the medication wears off. He/she cannot drive after the procedure, so someone must accompany him/her home.
Computer Tomography (CT)
A computed tomography (CT) scan creates detailed pictures of the organs and structures of the body using a special computer that analyzes x rays directed through the body. The pictures produced by the computer look like "slices" of the organ being studied, and allow the radiologist to detect cysts, swelling, tumors, stones and other conditions in the liver and intestines.
During the test, the patient lies very still within the CT scanner while the images are taken. The procedure is painless, yet some people experience anxiety (claustrophobia) due to the confined space, the noise of the scanner and the need to lie still for a significant period of time. If severe, this can be relieved with a mild sedative.
If a CT scan is used to create pictures of the intestines, the patient may drink a substance called contrast material before the test. This makes the intestines show up more clearly in the pictures. When blood vessels are examined by CT scan, contrast material often is injected into a vein before the test to make them show up more clearly.
Endoscopic Retrograde Cholangiopancreatography (ERCP)
ERCP is used to diagnose and treat a variety of pancreatic and bile duct conditions. During the procedure, a thin tube (catheter) is passed through a special instrument that is used to view the intestines (called a duodenscope) and into the common bile duct or the main pancreatic duct. The gastroenterologist guides the catheter's progress using a video monitor. When the catheter reaches the common bile duct, a special substance can be used to highlight the pancreatic and bile ducts.
Accessing the bile ducts using ERCP allows gastroenterologists to perform many complex procedures without surgery. ERCP is now used to diagnose, treat and manage stones in the bile duct, post-operative and malignant strictures of the bile duct, inherited anomalies of the pancreas, acute and chronic pancreatitis, and pancreatic and bile duct cancers.
Magnetic Resonance Imaging (MRI)
Magnetic resonance imaging (MRI) is a test that produces three-dimensional pictures of the organs inside the body using a magnetic field. By looking at these images, doctors can detect problems such as tumors, cysts, blockages, scarring, bleeding and infection.
During the test, the patient lies very still and his/her body is placed under the magnet while the scan takes place. The procedure is painless. However, some people experience anxiety (claustrophobia) due to the confined space, the noise of a fan within the imaging machine, and the need to stay still for a significant period of time. Sometimes the patient is sedated with a mild tranquilizer if claustrophobia is a problem.
Ultrasound
An ultrasound creates pictures of the organs of the body. During the test, gel is rubbed on to the area of the body to be evaluated and a tool called a transducer is moved back and forth across the chest and abdomen. The transducer creates sound waves, which echo as they bounce off of the internal organs. The echoes are picked up by a special machine that translates them into pictures that are seen on a television screen. The test is painless and does not involve x rays, making it safe during pregnancy.
Upper GI X-Ray
This radiology test (also called an upper GI series) is used to examine the esophagus, stomach and small intestine. The patient swallows barium, a thick, white fluid that shows the lining of the intestine (GI tract). This test is used to diagnose swallowing difficulties, gastroesophageal reflux disease, ulcers, Crohn's Disease and other conditions affecting the upper GI tract. The upper GI series is painless, and usually takes from thirty minutes to three hours to complete, depending on the rate of movement of the barium through the intestine. Some patients have trouble swallowing barium because it is chalky and thick, but most patients do not experience any discomfort during this test.
