Endoscopy

ABOUT ENDOSCOPIES

Here at the office of Indira Donepudi, M.D., we can perform multiple types of endoscopies in order to treat and diagnose our patients. Keep reading to learn more about upper endoscopies, endoscopic ultrasounds, capsule endoscopies, and biliary endoscopies.

Rest assured that no matter what endoscopy the doctor suggests, you’ll be in safe, experienced, and knowledgeable hands throughout your procedure. Patient education is very important to Dr. Donepudi, so she will make sure you know exactly what to expect before, during, and after your procedure.

Learn more about the different procedures below and call us today to schedule an appointment.


UPPER ENDOSCOPY

If you are experiencing symptoms like nausea, vomiting, anemia, bleeding in the upper GI tract, or unexplained weight loss, the doctor might suggest an upper endoscopy in order to figure out what is going wrong. This is a procedure that is used to examine the upper GI tract (esophagus, stomach, duodenum). Using a flexible, lighted endoscope with a camera mounted on it, the doctor will check for a wide range of conditions or problems, including inflammation, precancerous conditions, bowel obstruction, ulcers, hiatal hernias, and abnormal growths.

We often suggest that patients experiencing one or more of the following symptoms have an upper endoscopy, so we can determine exactly what is wrong:

  • Abdominal pain
  • Anemia
  • Bleeding in the upper GI tract
  • Difficulties with swallowing
  • Gastric reflux
  • Nausea
  • Unexplained weight loss
  • Vomiting

Before the Procedure

As you and the doctor are discussing this procedure, please make sure you inform her about any medical conditions you have – particularly lung or heart problems, allergies, and diabetes – as well as telling her about every medication you take. Depending on the types of medication you take, you may be asked to stop or pause their use. This is especially true if your medications affect blood clotting or interact with sedatives.

The doctor may ask you to pause or restrict the following medications and vitamins:

  • Antidepressants
  • Blood pressure medications
  • Blood thinners
  • Diabetes medications
  • Dietary supplements
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, naproxen (Aleve), and ibuprofen (Advil)

On the day of and before your procedure, you must completely empty the upper GI tract. To do this, you will have to stop eating and drinking 4-8 hours before the procedure. You cannot chew gum or smoke during this time, either.

You should also arrange for transportation to and from your appointment, as you will not be able to drive for 12-24 hours following your upper endoscopy. Risks of the procedure include reacting abnormally to the sedatives, bleeding from a biopsy, or accidental punctures to the GI tract. Please discuss any concerns you might have with the doctor prior to your procedure.

During the Procedure

We’ll perform your procedure either in a hospital or outpatient surgery center. Rest assured that your safety and comfort will be our foremost concerns. We’ll give you a local, liquid anesthetic to gargle or spray on the back of the throat to numb the area and control any gag reflex. We’ll also monitor your vital signs throughout the procedure to ensure that the sedatives are working normally.

As the procedure begins, the doctor will carefully guide the endoscope through the esophagus and, from there, into the stomach and duodenum. She will carefully monitor the computer screen to check for any abnormalities in the intestinal lining. If she finds any, she can use tools that she slides through the endoscope to perform a biopsy, remove abnormal growths, or even stop any bleeding.

After the Procedure

The first area of concern is to ensure the sedatives wear off properly. Generally, we’ll monitor you for about an hour to make sure that the initial round of sedatives has worn off, though again, you will not be able to drive for 12-24 hours to ensure they completely wear off.

Patients normally experience some uncomfortable symptoms after the procedure, such as a sore throat, nausea, fatigue, or a bloated feeling. These are not a cause for concern. However, if you experience any of the following (rare) symptoms, let us know right away:

  • Bloody/very dark stool
  • Difficulty swallowing
  • Fever
  • Vomiting
  • Worsening pain in the throat, chest, or abdomen

Assuming that you do not experience any of these symptoms, you will probably be able to resume your normal diet and medications as soon as the procedure is over. If the doctor has additional concerns or instructions, she will let you know.

You can expect your results to be relatively quick; in fact, some are available immediately, and the doctor will discuss them with you after the sedative has worn off. However, if you needed to have a biopsy, you may need to wait a few days.


ENDOSCOPIC ULTRASOUND (EUS)

An endoscopic ultrasound (EUS) is used to examine the lining of a patient’s GI tract, including the esophagus, stomach, duodenum, colon, and rectum, as well as other internal organs like the gallbladder and pancreas. The doctor can perform either an upper EUS of the throat or a lower EUS of the rectum.

The EUS will allow the doctor to do all of the following:

  • Diagnose conditions that are causing unexplained weight loss or abdominal pain
  • Diagnose disease affecting the bile duct, gallbladder, and pancreas
  • Examine detailed images of the GI tract
  • Look for lesions or lumps
  • And more

Before the Procedure

Discuss with Dr. Donepudi any medications you are taking and learn which you can and cannot take before or after the procedure. You should also let the doctor know if you have any allergies, particularly if you are allergic to latex.

Please also arrange for a ride home after the procedure. If you receive sedatives, you will not be able to drive yourself.

During the Procedure

If you are having an upper EUS, we will numb your throat with a local anesthetic (generally in a spray form). As soon as the sedatives are working, we’ll guide the ultrasonic endoscope through your upper GI tract (mouth, esophagus, stomach into the duodenum). The entire procedure usually takes less than an hour.

If you are having a lower EUS, you generally won’t require medications or sedatives; however, we may give them to you if the procedure lasts longer than expected. For instance, if we need to perform a needle biopsy on a lesion or drain a cyst, we’ll give you a sedative. Usually this procedure takes 45 minutes or less.

After the Procedure

Please do not drive unless the doctor specifically says you can. If you have received an upper EUS, you might experience bloating or a sore throat. However, unless you are otherwise directed, you can resume your normal diet immediately after the procedure.


CAPSULE ENDOSCOPY

A capsule endoscopy is used to examine the small intestine (small bowel) and diagnose any disorders that might be present. If you are suffering from gastrointestinal bleeding of the small bowel, small bowel tumors, or Crohn’s disease, you would need a capsule endoscopy to diagnose it. During the procedure, we’ll evaluate your small intestine, checking carefully for tumors, polyps, ulcers, or the cause of any bleeding.

Before the Procedure

The doctor will give you detailed instructions before your procedure. Please make sure you share with her any medical conditions you have as well as provide a list of all medications, supplements, and vitamins you are taking. Keep in mind, too, that most patients are told not to eat or drink anything (including water) for 12 hours before the procedure.

During the Procedure

You’ll be given a small video capsule with a camera to ingest. The procedure lasts about eight hours. You’ll be able to go about your day normally, though you will be asked not to do strenuous or heavy activity. (Depending on your job, you might have to take the day off from work.)

While you are doing your normal activities, the capsule will travel through your GI tract and record images which are sent to a data recorder. After the procedure is over, the doctor will review the images to make a diagnosis.

After the Procedure

You will be able to drink clear liquids two hours after ingesting the capsule and enjoy a light meal four hours after ingesting the capsule, unless the doctor instructs you otherwise. You can expect to get your results back in about a week.


BILIARY ENDOSCOPY

A biliary endoscopy can be used to diagnose a wide range of problems and concerns in the gallbladder, liver, pancreas, or bile ducts, such as the following:

  • Cancer
  • Gallstones
  • Inflammatory strictures (scars)
  • Trauma- or surgery-induced leaks

Before the Procedure

Please make sure to discuss with the doctor any allergies you have (especially to iodine), medical conditions you have, and medications you are taking.

The doctor will provide detailed instructions on how to prepare for your procedure. However, keep in mind that patients are asked not to eat or drink anything for 6-8 hours before the procedure. Some patients with morning appointments might be asked to abstain from food and drink starting at midnight the night before. You should also arrange for a ride home, since you will not be able to drive until the sedatives wear off.

During the Procedure

This procedure can last from 30 minutes to 2 hours, depending on what exactly is done. It starts with the use of medication to numb the back of your throat and sedatives to help you relax. You will then swallow the endoscope, which the doctor will guide through the esophagus, stomach, and duodenum. Once it reaches the place where the ducts of biliary tree and pancreas enter the duodenum, we will lay you flat on your stomach. We’ll then put a small plastic tube through the scope and inject dye that will allow the ducts to be clearly visible in X-rays.

Once we’ve done this, we will carefully examine the area for gallstones or narrowing of the ducts. If we spot either, we will resolve it on the spot. However, this might require you to stay in the hospital overnight.

After the Procedure

Since you won’t be able to drive, you’ll need someone else to drive you home to give the sedatives time to wear off (1-2 hours). We’ll make sure that you are not experiencing complications before we send you home to rest.

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SEE WHAT PEOPLE ARE SAYING ABOUT DR. DONEPUDI.

  • "Wonderful doctor. Very thorough. Very helpful staff. They go above and beyond the line of duty to help their patients."
    Gabriel, Healthgrades
  • "Dr. Donepudi has a very calming, understanding, and pleasant approach. She spends a lot of time with me listening to my concerns. She is very thorough in collecting information about my problems. She takes the time to explain what needs to be done to reach a diagnosis and what follow up care will be required. I think she is an excellent Doctor and I trust her completely"
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