Services

What is an office consultation?
An office consultation is a visit with a doctor or other medical provider to discuss your health concerns. During the consultation, the provider will ask questions about your symptoms, medical history, and overall health. They will also perform an exam and may order tests. The consultation helps the provider learn more about your health issue so they can make a diagnosis and recommend a treatment plan. They are a chance for you to explain your health issues to the provider and for the provider to offer their medical expertise. After the visit, the provider will summarize the consultation and next steps in a report sent to your primary care doctor.

What is an EGD?
An esophagogastroduodenoscopy (also called EGD or upper endoscopy) is a procedure to examine the upper digestive system. During an EGD, a gastroenterologist inserts an endoscope (a thin, flexible tube with a camera) into the mouth and down the throat. The endoscope allows the doctor to view the esophagus, stomach, and upper small intestine (duodenum) on a video monitor. An EGD helps diagnose digestive problems like difficulty swallowing, heartburn, belly pain, ulcers, and bleeding. The doctor may collect tissue samples (biopsy) or perform procedures during the EGD to treat any abnormalities found. The procedure takes 15-30 minutes and sedation is used to make the patient comfortable. Patients can usually go home the same day and resume normal activities the next day.

What is a colonoscopy?
A colonoscopy is a procedure that allows a doctor to examine the inside of the large intestine (colon and rectum). During a colonoscopy, a long, flexible tube called a colonoscope is inserted into the rectum. The colonoscope has a tiny camera on the end, which projects images onto a video monitor so the doctor can see the entire length of the colon and rectum. The doctor is looking for any abnormalities or signs of disease, like polyps, inflammation, or bleeding. Polyps can be removed through the colonoscope during the procedure. A colonoscopy usually takes 20-30 minutes and is generally done with sedation to keep patients comfortable and relaxed. The bowel must be thoroughly emptied before the procedure. Colonoscopies are recommended for colorectal cancer screening starting at age 45. The procedure is safe and effective at detecting changes in the colon before they become cancerous.

What is flexible sigmoidoscopy?
A flexible sigmoidoscopy is a screening test that allows a doctor to examine the inside of the rectum and lower third of the colon (sigmoid colon) using a thin, flexible tube called a sigmoidoscope. The procedure is similar to a colonoscopy, but it does not typically require sedation (although some may request it) and examines only the lower part of the colon.

During a sigmoidoscopy, the doctor inserts the lubricated sigmoidoscope through the rectum into the lower colon. The scope blows air into the colon to inflate it for better viewing. The doctor is looking for any polyps, abnormal growths, or signs of disease. If anything looks concerning, a biopsy can be taken through the sigmoidoscope. The procedure takes about 10-20 minutes.

What is video capsule endoscopy?
A video capsule endoscopy is a procedure that allows a doctor to see inside the small intestine. It is a diagnostic test used to examine the middle part of the gastrointestinal tract that cannot be seen well with other types of endoscopies.

During a capsule endoscopy, the patient swallows a small capsule (about the size of a vitamin pill) that contains a color camera, light source, transmitter, and batteries. As the capsule travels through the digestive tract, it takes thousands of color photographs. These images are transmitted to sensors on a belt worn around the patient’s waist. The pictures are then downloaded onto a computer for the doctor to view.

The capsule endoscope captures detailed images of the lining of the small intestine to help diagnose issues like bleeding, abdominal pain, diarrhea, or bowel irritation. The capsule is disposable and passes naturally out of the body during a normal bowel movement. Patients go about their normal routine during the test, which takes 8-12 hours to complete. The capsule allows the small intestine to be examined without sedation, incisions, or radiation.

What is hemorrhoid banding?
Hemorrhoid banding is a procedure used to remove hemorrhoids. Hemorrhoids are enlarged, swollen veins that protrude from the anus. The banding technique works by cutting off the blood supply to the hemorrhoid, causing it to shrink and fall off.

During the procedure, the doctor places a tight elastic band around the base of the hemorrhoid, which stops blood flow to that area. The hemorrhoid then goes away within a few days and will detach during a normal bowel movement. Patients may feel cramping or minor discomfort afterwards.

Banding is typically used for internal hemorrhoids that prolapse (protrude from the anus). It can provide rapid relief from the pain and bleeding caused by hemorrhoids. The procedure only removes one hemorrhoid at a time, so several treatments may be needed for multiple hemorrhoids. Banding is a quick outpatient procedure that does not require anesthesia. It is an effective alternative to surgical hemorrhoid removal that allows patients to resume normal activities shortly after treatment.

What is esophageal manometry?
Esophageal manometry is a test to measure the function of the esophagus and check for problems with motility (muscle contractions). During this test, a thin, flexible tube with sensors is passed through the nose and down the esophagus. The tube contains pressure sensors that detect muscle contractions as the patient swallows sips of water.

The test measures the coordination and force of the muscle contractions that move food and liquid down the esophagus into the stomach. Abnormal manometry results can indicate conditions like acid reflux, inflammation of the esophagus, or dysfunction of the esophageal sphincters. This allows the doctor to properly diagnose disorders that cause difficulty swallowing, heartburn, chest pain, or regurgitation.

The esophageal manometry procedure takes about 30 minutes and is done in the outpatient setting. Some numbing gel may be used in the nose to increase comfort during insertion of the tube. The test is painless once the tube is in place and patients can breathe normally during the process. The results help the doctor recommend appropriate treatment options for the patient’s condition.

What is a Bravo pH study?
A Bravo pH study measures the amount of stomach acid that flows back into the esophagus over a period of time. During the procedure, a small capsule with a pH sensor is temporarily attached to the esophagus during an upper endoscopy. The capsule measures and records the pH levels in the esophagus over the next 48 hours as patients go about their normal routines. The data is transmitted to a receiver worn around the neck. Levels of acid exposure that are higher than normal can indicate gastroesophageal reflux disease (GERD) or acid reflux and allow for proper treatment. The capsule detaches on its own and passes through the digestive system. The Bravo pH test is an ambulatory assessment that documents reflux symptoms in a patient’s normal environment.

What is an endoscopic ultrasound (EUS)?
An endoscopic ultrasound (EUS) is a procedure that uses sound waves to create detailed pictures of the digestive tract and surrounding organs. During an EUS, the doctor inserts an endoscope with an ultrasound probe down the throat into the esophagus and stomach. The probe produces sound waves that bounce off surrounding tissues, creating echoes that are converted into black and white images on a monitor. EUS allows the gastroenterologist to examine the lining of the esophagus, stomach, small intestine, colon, pancreas, liver, bile ducts, and more. It helps evaluate lumps, tumors, inflammation, fluid collections, and lymph nodes. EUS also guides biopsies and certain treatments like cyst drainage. The test takes 30-60 minutes and patients receive sedation. EUS provides extremely detailed images that can accurately diagnose gastrointestinal and lung diseases.

What is an endoscopic retrograde cholangiopancreatography (ERCP)?
An ERCP (endoscopic retrograde cholangiopancreatography) is a procedure to examine the bile ducts and pancreatic duct. During an ERCP, a flexible tube with a camera (endoscope) is passed through the mouth into the small intestine. A catheter is passed through the endoscope and contrast dye is injected into the ducts. X-rays are then used to look for blockages, gallstones, tumors, narrowing, leaks, or other problems in the biliary and pancreatic ducts. The doctor can also take biopsy samples or remove stones during the ERCP. The procedure takes 30-90 minutes and patients are given anesthesia and a sedative. ERCP helps diagnose issues in the ducts that can cause jaundice, abdominal pain, acute pancreatitis, or other symptoms. It is also used to treat certain conditions in the bile and pancreatic ducts.

What is a Liver FibroScan?
A liver FibroScan is a non-invasive test that measures liver stiffness to assess fibrosis and cirrhosis. Fibrosis refers to scarring of the liver that can progress to irreversible cirrhosis.

During a FibroScan, an ultrasound transducer probe is pressed against the skin over the liver. The probe creates vibrations that generate shear waves passing through liver tissues. Special sensors measure the speed of these waves, which correlates with liver stiffness. Higher speeds indicate increased fibrosis and cirrhosis damage.

The scan is quick, taking less than 10 minutes, and painless for the patient. Results are available immediately after the procedure. The FibroScan can detect liver disease at earlier stages compared to standard blood tests. It also avoids the risks and discomfort of a liver biopsy. This makes it a useful tool for evaluating and monitoring patients with chronic liver conditions. Repeated scans over time can show progression of fibrosis or the benefits of treatment.

What are Intravenous (IV) infusions?
An IV infusion is a method of delivering fluids or medications directly into a patient’s vein. It involves inserting a small plastic tube called an intravenous catheter into a vein, usually in the arm or hand. The catheter is connected to an IV line that runs to an IV bag filled with sterile solution or medication that will infuse into the bloodstream.

IV infusions provide a way to deliver medications that are absorbed quickly since they skip being processed through the digestive system. The rate of the infusion can be adjusted with an electronic pump. IVs allow precise control over the dosage and timing of delivery.