What instrument is used for a lower GI endoscopy? Explore the details of GI endoscopy procedures, including colonoscopy, sigmoidoscopy, and more. Discover the preparation, potential side effects, and risks involved. Get the facts you need to make an informed decision.

The Instruments Used in GI Endoscopy Procedures

GI endoscopy procedures utilize a variety of specialized instruments to examine and diagnose conditions within the gastrointestinal tract. The primary instrument used in these procedures is the endoscope, a flexible, lighted tube equipped with a miniature camera. Depending on the specific endoscopic procedure, different types of endoscopes may be employed:

Colonoscopy

During a colonoscopy, the endoscopist uses a flexible endoscope that is inserted through the anus to examine the lining of the large intestine, including the rectum, sigmoid colon, descending colon, transverse colon, ascending colon, and cecum. This endoscope is connected to a video monitor, allowing the doctor to view the interior of the colon and perform various diagnostic and treatment procedures.

Sigmoidoscopy

Sigmoidoscopy, also known as flexible sigmoidoscopy, utilizes a shorter, more flexible endoscope that is inserted through the anus to examine the lower third of the colon, including the rectum and sigmoid colon. This procedure is often performed without sedation, though sedation can be used if necessary.

Other Endoscopic Procedures

In addition to colonoscopy and sigmoidoscopy, there are several other types of endoscopic procedures that use specialized instruments:

• Esophagogastroduodenoscopy (EGD): Also called upper endoscopy, this procedure uses an endoscope inserted through the mouth to examine the esophagus, stomach, and upper part of the small intestine (duodenum).
• Enteroscopy: This procedure allows for the visualization of a greater portion of the small intestine than is possible with EGD, using either a long conventional endoscope, a wireless ingestible camera (capsule endoscopy), or a double-balloon endoscope.
• Endoscopic Retrograde Cholangiopancreatography (ERCP): This specialized endoscopic procedure utilizes a side-mounted camera on the endoscope to facilitate the passage of a catheter into the bile and pancreatic ducts, allowing for the study and treatment of problems in these areas.
• Endoscopic Ultrasound (EUS): This procedure uses a special endoscope fitted with a small ultrasound device at the end to examine the layers of the gastrointestinal tract wall and surrounding organs, such as the pancreas, liver, gallbladder, spleen, and adrenal glands.
• Percutaneous Endoscopic Gastrostomy (PEG): This procedure involves the placement of a flexible feeding tube through a small incision in the abdominal wall and into the stomach, with the assistance of an endoscope.

Preparing for a GI Endoscopy Procedure

Proper preparation is essential for ensuring the success and safety of a GI endoscopic procedure. The specific preparation required may vary depending on the type of endoscopy being performed, but generally, patients will be asked to:

• Avoid eating and drinking for a period of time before the procedure, typically 6-12 hours.
• Undergo a bowel cleansing regimen, such as taking laxatives or enemas, to ensure a clear view of the GI tract during the procedure.
• Inform their healthcare provider of any medications they are taking, as some may need to be adjusted or temporarily discontinued before the procedure.
• Arrange for transportation, as patients are typically given sedation during the procedure and will not be able to drive themselves home afterwards.

Potential Side Effects and Risks of GI Endoscopy

While GI endoscopic procedures are generally safe, there are some potential side effects and risks that patients should be aware of:

• Bleeding: Slight bleeding may occur, particularly if a biopsy is taken or a polyp is removed during the procedure.
• Infection: There is a small risk of infection, which can typically be managed with antibiotics.
• Perforation: In rare cases, the endoscope can create a hole or tear in the gastrointestinal tract, which may require surgery to repair.
• Adverse reactions to sedation: Patients may experience side effects from the sedation used during the procedure, such as nausea, vomiting, or respiratory difficulties.

Patients should discuss these potential risks with their healthcare provider and report any concerning symptoms after the procedure.

Understanding the Findings of a GI Endoscopy

The findings of a GI endoscopic procedure can provide valuable information about the health and condition of the gastrointestinal tract. Common findings may include:

• Polyps: Abnormal growths in the lining of the GI tract that may be benign or precancerous and may require removal.
• Inflammation: Irritation or swelling of the GI tract, which can be a sign of conditions like Crohn’s disease or ulcerative colitis.
• Ulcers: Sores or lesions in the lining of the GI tract that can be caused by factors like H. pylori bacteria or certain medications.
• Bleeding: Identification of the source of gastrointestinal bleeding, which can be a symptom of various conditions.
• Tumors or cancers: Detection of abnormal growths that may require further evaluation or treatment.

The endoscopist will provide a detailed report of the findings, which the patient’s healthcare provider can then use to develop an appropriate treatment plan.

Considerations for Choosing a GI Endoscopy Procedure

When deciding on the most appropriate GI endoscopic procedure, healthcare providers will consider factors such as the patient’s symptoms, medical history, and the specific region of the GI tract that needs to be examined. In some cases, a combination of different endoscopic techniques may be recommended to provide a more comprehensive evaluation. Patients should discuss the pros and cons of each procedure with their healthcare provider to make an informed decision that aligns with their individual needs and preferences.

The Role of GI Endoscopy in Diagnosing and Treating Conditions

GI endoscopic procedures play a crucial role in the diagnosis and management of a wide range of gastrointestinal conditions, including:

• Colorectal cancer: Colonoscopy is considered the gold standard for colorectal cancer screening and can detect and sometimes remove precancerous polyps.
• Inflammatory bowel diseases: Endoscopic procedures can help diagnose and monitor conditions like Crohn’s disease and ulcerative colitis by identifying areas of inflammation and obtaining biopsies.
• Gastrointestinal bleeding: Endoscopy can locate the source of bleeding in the upper or lower GI tract and may allow for immediate treatment, such as the removal of polyps or the application of cautery to stop bleeding.
• Swallowing disorders: EGD can help diagnose and assess conditions that affect the esophagus, such as gastroesophageal reflux disease (GERD) or esophageal cancers.
• Gallbladder and pancreatic diseases: ERCP can be used to diagnose and treat problems in the bile and pancreatic ducts, such as stones, strictures, or tumors.

By providing direct visualization and the ability to obtain biopsies or perform therapeutic interventions, GI endoscopic procedures are essential tools for the comprehensive management of gastrointestinal health.

Conclusion

GI endoscopic procedures, such as colonoscopy and sigmoidoscopy, utilize specialized instruments like endoscopes to examine and diagnose conditions within the gastrointestinal tract. These procedures are generally safe, but patients should be aware of potential side effects and risks, and follow the appropriate preparation instructions. Understanding the findings of a GI endoscopy and the role it plays in diagnosing and treating various gastrointestinal conditions can help patients make informed decisions about their healthcare. By working closely with their healthcare providers, patients can ensure they receive the most appropriate endoscopic procedure to address their specific needs.

ASGE | Endoscopic Procedures

Media Backgrounder

Colonoscopy: An
examination of the inside of the colon, including the rectum, sigmoid colon,
descending colon, transverse colon, ascending colon, and cecum (where the small
bowel attaches to the large bowel), using an endoscope – a thin, lighted
flexible tube inserted through the anus. More…

Sigmoidoscopy: An
examination of the inside of the rectum and sigmoid colon using an endoscope – a
thin, lighted flexible tube (sigmoidoscope) inserted through the anus. Also
called flexible sigmoidoscopy and proctosigmoidoscopy. More…

Endoscopy: A procedure
using an endoscope to diagnose or treat a condition. There are several types of
endoscopy. Those using natural body openings include esophagogastroduodenoscopy
(EGD) which is often called upper endoscopy, gastroscopy, enteroscopy,
endoscopic ultrasound (EUS), endoscopic retrograde cholangiopancreatography
(ERCP), colonoscopy, and sigmoidoscopy. Percutaneous endoscopic gastrostomy
(PEG) is a procedure that utilizes endoscopy to help placement of a tube into
the stomach; a small incision in the skin is also required. Endoscopies are
usually performed under sedation to assure maximal patient comfort. More…

Enteroscopy: A
procedure that allows the visualization of a greater portion of the small bowel
than is possible with EGD. Enteroscopy can be achieved by using a long
conventional endoscope, a wireless ingestible camera (a capsule endoscopy), or a
double-balloon endoscope (inserted in the mouth or through the rectum). More…

Endoscopic retrograde
cholangiopancreatography (ERCP): A procedure using a specific technique to
study and treat problems of the ducts involving the liver, pancreas and
gallbladder. This procedure utilizes a specialized endoscope with a
side-mounted camera that can facilitate passage of a catheter into the bile and
pancreatic ducts. More…

Endoscopic Ultrasound
(EUS): An examination with a special endoscope fitted with a small
ultrasound device on the end, used to look inside the layers of the wall of the
gastrointestinal tract and visualize the surrounding organs including the
pancreas, liver, gallbladder, spleen and adrenal glands. The scope is inserted
in the mouth or anus in the same manner as a conventional endoscope. More…

Percutaneous
Endoscopic Gastrostomy (PEG): A procedure through which a flexible feeding
tube is placed with the assistance of an endoscope through a small incision in
the abdominal wall into the stomach. This procedure is performed in cases where
oral ingestion of nourishment or medication is impossible. More…

Colonoscopy

Colonoscopy is a common, safe test to examine the lining of
the large bowel. During a colonoscopy, doctors who are trained in this
procedure (endoscopists) can also see part of the small intestine (small bowel)
and the end of the GI tract (the rectum). This procedure is often done under
sedation to assure maximal patient comfort.

During a colonoscopy, the endoscopist uses a flexible tube,
about the width of your index finger, fitted with a miniature camera and light
source. This device is connected to a video monitor that the doctor watches
while performing the test. Various miniaturized tools can be inserted through
the scope to help the doctor obtain samples (biopsies) of the colon and to
perform maneuvers to diagnose or treat conditions.

Colonoscopy can detect and sometimes treat polyps,
colorectal bleeding, fissures, strictures, fistulas, foreign bodies, Crohn’s
Disease, and colorectal cancer.

For more information see the ASGE patient education brochure
Understanding Colonoscopy online at www.asge.org.

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Sigmoidoscopy

Sigmoidoscopy, or “flexible sigmoidoscopy,” lets a
physician examine the lining of the rectum and a portion of the colon (large
intestine) by inserting a flexible tube about the thickness of your finger into
the anus and slowly advancing it into the rectum and lower part of the colon.
This procedure evaluates only the lower third of the colon. Sigmoidoscopy is
often done without any sedation, although sedation can be used if necessary.

Various miniaturized tools can be inserted through the scope
to help the doctor obtain samples (biopsies) of the colon and to perform
maneuvers to diagnose or treat conditions.

Flexible sigmoidoscopy can detect and sometimes treat
polyps, rectal bleeding, fissures, strictures, fistulas, foreign bodies,
colorectal cancer, and benign and malignant lesions.

Flexible sigmoidoscopy is not a substitute for total
colonoscopy when it is indicated. The finding of a new, abnormally growing
polyp during sigmoidoscopy, for example, is an indication for a colonoscopy to
search for additional polyps or cancer. Sigmoidoscopy should not be used for
polypectomy unless the entire colon is adequately prepared. This procedure
should also not be used with cases of diverticulitis and peritonitis

For more information see the ASGE patient education brochure
Understanding Flexible Sigmoidoscopy online at www.asge.org.

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Upper Endoscopy

Upper endoscopy allows for examination of the lining of the
upper part of the gastrointestinal (GI) tract, which includes the esophagus,
stomach and duodenum (first portion of the small intestine). In upper
endoscopy, the physician uses a thin, flexible tube called an endoscope. The
endoscope has a lens and light source, which projects images on a video
monitor. This procedure is also referred to as upper GI endoscopy, or
esophagogastroduodenoscopy (EGD). Upper endoscopy is often done under sedation
to assure maximal patient comfort.

Upper endoscopy helps the doctor evaluate symptoms of
persistent upper abdominal pain, nausea, vomiting or difficulty swallowing. It
is the best test for finding the cause of bleeding from the upper GI tract and
is also more accurate than X-rays for detecting inflammation, ulcers and tumors
of the esophagus, stomach, and duodenum.

A physician may also use upper endoscopy to obtain small
tissue samples (biopsies). A biopsy helps distinguish between benign and
malignant (cancerous) tissues. Biopsies are taken for many reasons, and a
doctor might order a biopsy even if cancer is not suspected. For example, a
biopsy can be taken to test for Helicobacter pylori, a bacterium that can cause
ulcers and celiac disease, an inflammatory condition of the small bowel that
can lead to anemia, weight loss and diarrhea.

Upper endoscopy can also be used to perform a cytology
(cell) test, in which a small brush is passed through the channel of the
endoscope to collect cells for analysis. Other instruments can be passed
through the endoscope to directly treat many abnormalities with little or no
discomfort. For example, the doctor may stretch a narrow area (a stricture),
detect Barrett’s esophagus (a possibly precancerous alteration in the
esophageal lining), detect and biopsy gastrointestinal cancers, remove polyps
(usually benign growths), treat bleeding (with standard cautery or the newer
argon plasma coagulation method), and detect and treat symptoms of
gastroesophageal reflux disease (GERD).

For more information see the ASGE patient education brochure
Understanding Upper Endoscopy online at www.asge.org.

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Enteroscopy

Enteroscopy includes several types of procedures that allow
a physician to look further into the small bowel (which is up to 20 feet long)
than is possible with other methods mentioned here. A physician may use a
longer conventional endoscope, a double-balloon endoscope or a capsule
endoscope. Enteroscopy is primarily used to find the source of intestinal
bleeding, but can also be used to find lesions and determine causes for
nutritional malabsorption.

An extended version of the conventional endoscope, called a
“push endoscope,”may be employed to study the upper part of the small
intestine down to about 40 inches beyond the stomach.  While more of the small bowel is accessible
with this type of endoscopy than with EGD, it is able to visualize only a
limited portion of the small bowel.  The
same techniques for therapy used during EGDs are possible during push
enteroscopy.

Capsule endoscopy uses a swallowable capsule containing tiny
video cameras. The capsule, about the size of a large vitamin pill, contains a
light source, batteries, a radio transmitter and an antenna. The capsule
transmits the images to a recording device worn around the patient’s waist.
When complete, the recording is downloaded to a computer which displays it on a
screen. The capsule is disposable and usually takes eight hours to move through
the digestive system, after which it is passed harmlessly in a bowel movement.
Capsule endoscopy does not require sedation and is painless. Capsule endoscopy
can be used to diagnose hidden GI bleeding, Crohn’s disease, celiac disease,
and other malabsorption problems, tumors (benign and malignant), vascular
malformations, medication injury, and to a lesser extent, esophageal disease.
Currently, capsule endoscopy cannot be used to biopsy or treat any conditions.
See also the media
backgrounder on capsule endoscopy.

Double-balloon enteroscopy uses a basic endoscope for
viewing the inside of the entire small bowel, but that endoscope travels inside
another tube which is pulled along the inside of the small bowel or colon by
alternately inflating and deflating two small balloons against the inside of
the intestinal wall. This allows the scope to travel further, give stable
images, perform biopsies, remove polyps, and perform other therapies. This
procedure is done under sedation to assure patient comfort. A similar method
using a single-balloon device has been recently developed. These procedures can
be performed with or without the assistance of an X-ray machine (fluoroscopy).
See also the media
backgrounder on balloon-assisted enteroscopy.

For more information see the ASGE patient education brochure
Understanding Capsule Endoscopy online at www.asge.org.

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Endoscopic Retrograde Cholangiopancreatography
(ERCP)

Endoscopic retrograde cholangiopancreatography (ERCP) is a
specialized technique used to study and treat problems of the liver, pancreas
and, on occasion, the gallbladder. ERCP is performed under sedation. Generally,
the level of sedation for ERCP is deeper than upper endoscopy and colonoscopy
due to the complexity and length of the procedure.

To reach the small passageways, known as ducts, that connect
these organs, an endoscope is passed through the mouth, beyond the stomach and
into the small intestine (duodenum). The ducts from the liver and pancreas
drain into the duodenum via a small opening known as the papilla. A thin tube
(catheter) is then inserted through the endoscope into the papilla, thereby
gaining access to the common bile duct and pancreatic duct that connect the
liver and pancreas to the intestine. A contrast material (dye) is injected
through the catheter and flows into the liver and pancreas, outlining those
ducts as X-rays are taken. The X-rays can show narrowing or blockages in the
ducts that may be due to a cancer, gallstones or other abnormalities. During
the test, a small brush or biopsy forceps can be put through the endoscope to
remove cells for study under a microscope. In addition, small cylindrical tubes
(stents) can be placed within the bile duct and/or pancreatic duct to treat
obstructions from either benign or malignant diseases.

ERCP can be used to diagnose biliary colic, jaundice,
elevated liver enzymes, cholangitis (inflammation of a bile duct), pancreatitis
(inflammation of the pancreas), and bile-duct (biliary) obstruction due to
gallstones (choledocholithiasis) and cancer. ERCP can be used to treat
gallstones, malignant and benign biliary strictures, cholangitis, pancreatic
cancer and pancreatitis. Traditionally, ERCP was used as both a diagnostic and
therapeutic endoscopic tool for evaluating diseases of the bile ducts, pancreas
and gallbladder. With improved Magnetic Resonance Imaging (MRI) and the
emergence of endoscopic ultrasound (EUS), ERCP is now primarily a therapeutic
instrument for treating conditions of the bile ducts and pancreas.

Cholangioscopy or pancreatoscopy are adjunctive procedures
performed during ERCP for selected indications, in which miniature endoscopes
are passed through the conventional endoscope, to enable direct visualization
of the inner lining of the bile ducts and pancreatic ducts respectively. These
procedures permit the endoscopist to obtain tissue specimens directly from the
inner lining of the ducts and are also used to treat stones that are difficult
to remove using conventional techniques. (ASGE Technology Status Evaluation
Report Gastrointestinal Endoscopy 2008;
68(3):411-421)

For more information see the ASGE patient education brochure
“Understanding
ERCP” online at www. asge.org.

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Endoscopic
Ultrasound (EUS)

A flexible endoscope which has a small ultrasound device
built into the end can be used to see the lining and wall of the esophagus,
stomach, small bowel, or colon. The ultrasound component produces sound waves
that create visual images of the digestive tract which extend beyond the inner
surface lining and also allows visualization of adjacent organs. Endoscopic
ultrasound examinations (also called endoluminal endosonography) may be
performed through the mouth or through the anus. EUS is performed under
sedation.

EUS provides more detailed pictures of the digestive tract
anatomy. It can be used to evaluate an abnormality below the surface of the
inner lining (mucosa) such as a growth that was detected at a prior endoscopy
or by X-ray. EUS, because of its ability to examine the wall layers of the GI
tract, provides a detailed picture of the growth, which can help the doctor
determine its nature and decide on the best treatment.

EUS can also be used to diagnose diseases of the pancreas,
bile duct and gallbladder when other tests are inconclusive, and it can be used
to determine the stage of cancers. More importantly, EUS provides a minimally
invasive method for acquiring tissue samples from gastrointestinal tumors and
lymph nodes that may not be easily accessible by other methods (i.e. radiographic
or surgical guidance). Fine Needle Aspiration (FNA) can be performed by passing
a biopsy needle down the channel of the endoscope and across the intestinal
wall under ultrasound guidance to obtain tissue for the diagnosis and staging
of cancer. More recently, EUS has emerged as a therapeutic tool for treating
both solid and cystic tumors of the pancreas, alleviating intractable abdominal
pain secondary to advanced pancreatic cancer, and obtaining access to the bile
ducts and pancreatic duct in cases of failed ERCP.

For more information see the ASGE patient education brochure
Understanding EUS-Endoscopic Ultrasonography online at www. asge.org.

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Percutaneous
Endoscopic Gastrostomy (PEG)

Percutaneous endoscopic gastrostomy, or PEG, is a procedure during
which an endoscope assists the placement of a flexible feeding tube through the
abdominal wall and into the stomach. The PEG procedure is for patients who have
difficulty swallowing, problems with their appetite or an inability to take
enough nutrition through the mouth. It allows nutrition, fluids, and/or
medications to be put directly into the stomach, bypassing the mouth and
esophagus.

In this procedure, the endoscopist uses a lighted, flexible
tube called an endoscope to guide the creation of a small opening through the
skin of the abdomen and directly into the stomach. This allows the doctor to
place and secure a feeding tube into the stomach. Patients generally receive a
sedative and local anesthesia, and an antibiotic is given by vein prior to the
procedure. Patients can usually go home the day of the procedure or the next
day.

A PEG does not prevent a patient from eating or drinking,
but depending on the medical condition and situation, the doctor might decide
to limit or completely avoid eating or drinking.

PEG tubes can last for months or years. However, because
they can break down or become clogged over extended periods of time, they might
need to be replaced. The doctor can remove or replace a tube without sedatives
or anesthesia, although he or she might opt to use sedation and endoscopy in
some cases. PEG sites close quickly once the tube is removed, so accidental
dislodgment requires immediate attention.

For more information see the ASGE patient education brochure
Understanding Percutaneous Endoscopic Gastrostomy (PEG) online at www.asge.org.

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Reviewed August 2014

Types of Endoscopy | Cancer.Net

Endoscopy is a procedure that allows a doctor to view the inside of a person’s body. Doctors use it to diagnose diseases in the following parts of the body:

• Esophagus

• Stomach

• Colon

• Ears

• Nose

• Throat

• Heart

• Urinary tract

• Joints

• Abdomen

What is an endoscope?

During an endoscopy, the doctor inserts a tool called an endoscope into a person’s body. Most endoscopes are thin tubes with a powerful light and tiny camera at the end.

The endoscope’s length and flexibility depend on the part of the body the doctor needs to see.

For example, a straight endoscope helps a doctor look at joints. Meanwhile, a flexible one helps a doctor view the inside of the colon.

Other tools used during an endoscopy

Typically, an endoscope has a channel through which the doctor can insert tools. These tools collect tissue or provide treatment.

Types of tools include:

• Flexible forceps. These tong-like tools take a tissue sample.

• Biopsy forceps. These remove a tissue sample or a suspicious growth.

• Cytology brushes. These take cell samples.

• Suture removal forceps. These remove stitches inside the body

Why you may need an endoscopy

Your doctor may recommend an endoscopy for various reasons:

To screen for and prevent cancer. For example, doctors use a type of endoscopy called a colonoscopy to screen for colorectal cancer. During a colonoscopy, your doctor may remove growths called polyps. Without removal, polyps could develop into cancer.

To diagnose a disease or find out the cause of symptoms. The type of endoscopy your doctor will recommend depends on the part of the body under examination.

To give treatment. Doctors use endoscopes for certain treatments.

Treatments that may involve an endoscope include:

• Laparoscopic surgery, which is done through small incisions in the skin

• Laser therapy, which uses a powerful beam of light to destroy cancer cells

• Microwave ablation, which uses heat to destroy cancerous tissue

• Endoscopic mucosal resection or endoscopic submucosal dissection, which is surgery using an endoscope inserted into the gastrointestinal tract

• Photodynamic therapy, which destroys a tumor with a laser after injecting it with a light-sensitive substance

• Medication delivery, also called medication administration

Types of endoscopy

The most common types of endoscopy are listed below.

Doctors who do an endoscopy go through extensive training to learn these procedures. They also are continually learning about new developments in technology.

How should I prepare for an endoscopy?

Your health care team will give you detailed instructions on how to prepare before your appointment. For example, you may need to take these steps:

• Avoid eating or drinking anything for several hours before the procedure.

• Stop taking blood-thinning medications several days before the procedure. This reduces the risk of bleeding. Ask your doctor about which medications to stop taking. And ask when you should start taking the medications again.

• Take a laxative or use an enema to remove stool from your bowels. You will only need to do this for certain types of endoscopy.

Insurance, costs, and consent. Before your appointment, ask your insurance provider what costs will be covered. Find out how much you will have to pay. Once you arrive at the doctor’s office or hospital, you will be asked to sign a consent form. This form states that you understand the benefits and risks of the procedure and that you agree to have it.

During the procedure

For most endoscopic procedures, you will not need to stay in the hospital overnight.

You may receive a type of anesthesia, depending on the type of endoscopy. Anesthesia blocks the awareness of pain. You may be awake, drowsy, or asleep during the procedure depending on the type of anesthesia you have. While you receive anesthesia, your health care team will provide “anesthesia care,” which includes monitoring your temperature, blood pressure, and heart rate.

During the procedure, your doctor will review and, possibly, record images from the endoscope. He or she will also perform any procedures. This could include the collecting tissue for testing.

After the procedure

After the endoscopy, you will rest in a recovery area. You may have mild side effects. Side effects depend on the type of endoscopy and may include a sore, dry throat, or bloating and gas.

Depending on the type of anesthesia you receive, you may need to have someone drive you home.

What should I expect after returning home? Problems from an endoscopy are uncommon, but they can happen. These include a hole or tear in the examination area, bleeding, or infection.

Talk with your doctor immediately if you have any of these symptoms:

Advances in endoscopy

New techniques continue to make endoscopy more comfortable for people. They also make it easier for doctors to diagnose diseases.

New endoscopic techniques include:

Virtual endoscopy. Unlike a standard endoscopy, the doctor does not insert an endoscope into the body. These tests involve computed tomography (CT) scans of thin segments of the body. A computer combines these images to create a more complete view.

Researchers continue to study these and other types of virtual endoscopy:

• Virtual colonoscopy. This procedure looks at the inside of the colon. People having this test still need to follow the same bowel-cleansing preparations. They will also need a traditional colonoscopy if polyps are found.

• Virtual bronchoscopy. This procedure looks at the inside of the lungs.

Capsule endoscopy. A patient swallows a small, vitamin-sized capsule with a camera. The camera takes pictures of the inside of the esophagus, stomach, and small intestine. A device that you wear for approximately 8 hours records the pictures. Then, the doctor reviews them.

Related Resources

Colonoscopy

Sigmoidoscopy

Upper Endoscopy

More Information

MedlinePlus: Endoscopy

Lower GI Exam (Barium Enema)

Lower gastrointestinal tract radiography or lower GI uses a form of real-time x-ray called fluoroscopy and a barium-based contrast material to help detect disease and abnormalities and diagnose symptoms such as pain, constipation or blood in the stool. It can often provide enough information to avoid more invasive procedures such as colonoscopy.

Tell your doctor if there’s a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you’re taking and allergies, especially to contrast materials. You doctor will instruct you on how to cleanse your bowel, restrict you to clear liquids on the day before your procedure, and not allow you to eat or drink anything after midnight. Take your regular medication with sips of water. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

What is Lower GI Tract X-ray Radiography (Barium Enema)?

Lower gastrointestinal (GI) tract radiography, also called a lower GI or barium enema, is an x-ray examination of the large intestine, also known as the colon. This examination evaluates the right or ascending colon, the transverse colon, the left or descending colon, the sigmoid colon and the rectum. The appendix and a portion of the distal small intestine may also be included.

An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.

The lower GI uses a special form of x-ray called fluoroscopy and a contrast material called barium or a water soluble iodinated contrast.

Fluoroscopy makes it possible to see internal organs in motion. When the lower gastrointestinal tract is filled with barium, the radiologist is able to view and assess the anatomy and function of the rectum, colon and sometimes part of the lower small intestine.

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What are some common uses of the procedure?

A physician may order a lower GI examination to detect:

• Hirschsprung disease in children (a blockage of the large intestine).

The procedure is frequently performed to help diagnose symptoms such as:

Images of the small bowel and colon are also used to diagnose inflammatory bowel disease, a group of disorders that includes, fecal incontinence, Crohn’s disease and ulcerative
colitis.

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How should I prepare for the procedure?

Your physician will give you detailed instructions on how to prepare for your lower GI imaging.

You should inform your physician of any medications being taken and if there are any allergies, especially to iodinated contrast materials. Also inform your doctor about recent illnesses or other medical conditions.

On the day before the procedure you will likely be asked not to eat, and to drink only clear liquids like juice, tea, black coffee, cola or broth, and to avoid dairy products. After midnight, you should not eat or drink anything. For adults (but not usually in children), it is important that your colon be completely empty for the procedure. You may also be instructed to take a laxative (in either pill or liquid form) and to use an over-the-counter enema preparation the night before the examination and possibly a few hours before the procedure. Just follow your doctor’s instructions. You can take your usual prescribed oral medications with limited amounts of water.

You will be asked to remove some of your clothes and to wear a gown during the exam. You may also be asked to remove jewelry, removable dental appliances, eye-glasses and any metal objects or clothing that might interfere with the x-ray images.

Women should always inform their physician and x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby. See the Safety page for more information about pregnancy and x-rays.

Infants and children may undergo lower GI radiography. Usually, there is no special preparation, but your doctor will give you detailed instructions to prepare your child for the examination. The use of barium and the taking of x-ray images is similar to that described for adults.

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What does the x-ray equipment look like?

The equipment typically used for this examination consists of a radiographic table, one or two x-ray tubes and a television-like monitor that is located in the examining room. Fluoroscopy, which converts x-rays into video images, is used to watch and guide progress of the procedure. The video is produced by the x-ray machine and a detector that is suspended over a table on which the patient lies.

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How does the procedure work?

X-rays are a form of radiation like light or radio waves. X-rays pass through most objects, including the body. Once it is carefully aimed at the part of the body being examined, an x-ray machine produces a small burst of radiation that passes through the body, recording an image on photographic film or a special detector.

Fluoroscopy uses a continuous or pulsed x-ray beam to create a sequence of images that are projected onto a fluorescent screen, or television-like monitor. When used with a contrast material, which clearly defines the area being examined by making it appear dark (or by electronically reversing the image contrast to white), this special x-ray technique makes it possible for the physician to view joints or internal organs in motion. Still images or movies are also captured and stored electronically on a computer.

Most x-ray images are digital files that are stored electronically. These stored images are easily accessible for diagnosis and disease management.

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How is the procedure performed?

The lower GI examination is usually done on an outpatient basis and is often scheduled in the morning to reduce the patient’s fasting time.

A radiology technologist and a radiologist, a physician specifically trained to supervise and interpret radiology examinations, guide the patient through the barium enema.

The patient is positioned on the examination table and an x-ray film is taken to ensure the bowel is clean. After performing a rectal examination, the radiologist or technologist will then insert a small tube into the rectum and begin to instill, using gravity, a mixture of barium and water into the colon. Air may also be injected through the tube to help the barium thoroughly coat the lining of the colon. In some circumstances, the radiologist or referring physician may prefer a water and iodine solution rather than barium. Next, a series of x-ray images is taken.

You must hold very still and may be asked to keep from breathing for a few seconds while the x-ray picture is taken to reduce the possibility of a blurred image. The technologist will walk behind a wall or into the next room to activate the x-ray machine.

The patient may be repositioned frequently in order to image the colon from several angles. Some x-ray equipment will allow patients to remain in the same position throughout the examination.

When the examination is complete, you may be asked to wait until the radiologist determines that all the necessary images have been obtained.

Once the x-ray images are completed, most of the barium will be emptied through the tube. The patient will then expel the remaining barium and air in the restroom. In some cases, additional x-ray images will be taken.

A barium enema is usually completed within 30 to 60 minutes.

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What will I experience during and after the procedure?

As the barium fills your colon, you will feel the need to move your bowel. You may feel abdominal pressure or even minor cramping. Most people tolerate the mild discomfort easily. The tip of the enema tube is specially designed to help you hold in the barium. If you are having trouble, let the technologist or radiologist know.

During the imaging process, you will be asked to turn from side to side and to hold several different positions. At times, pressure may be applied to your abdomen. With air contrast studies of the bowel (air contrast barium enema), the table may be moved to an upright position.

After the examination, you may be given a laxative or enema to wash the barium out of your system. You can resume a regular diet and take orally administered medications unless told otherwise by your doctor. You may be able to return to a normal diet and activities immediately after the examination. You will be encouraged to drink additional water for 24 hours after the examination.

Your stools may appear white for a day or so as your body clears the barium liquid from your system. Some people experience constipation after a barium enema. If you do not have a bowel movement for more than two days after your exam or are unable to pass gas rectally, call your physician promptly. You may need an enema or laxative to assist in eliminating the barium.

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Who interprets the results and how do I get them?

A radiologist, a physician specifically trained to supervise and interpret radiology examinations, will analyze the images and send a signed report to your primary care or referring physician, who will discuss the results with you.

Follow-up exams may be needed. If so, your doctor will explain why. Sometimes a follow-up exam is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. A follow-up exam may also be done to see if there has been any change in an abnormality over time. Follow-up exams are sometimes the best way to see if treatment is working or if an abnormality is stable or has changed.

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What are the benefits vs. risks?

Benefits

• X-ray imaging of the lower GI tract is a minimally invasive procedure with rare complications.
• Radiology examinations such as the lower GI can often provide enough information to avoid more invasive procedures such as colonoscopy.
• Because barium is not absorbed into the blood, allergic reactions are extremely rare.
• No radiation remains in a patient’s body after an x-ray examination.
• X-rays usually have no side effects in the typical diagnostic range for this exam.

Risks

• There is always a slight chance of cancer from excessive exposure to radiation. However, the benefit of an accurate diagnosis far outweighs the risk.
• The effective radiation dose for this procedure varies. See the Radiation Dose in X-Ray and CT Exams page for more information about radiation dose.
• In rare cases, the barium could leak through an undetected hole in the lower GI tract producing inflammation in surrounding tissues.
• Even more rarely, the barium can cause an obstruction in the gastrointestinal tract, called barium impaction.
• Iodinated contrast administered rectally may cause allergic reactions, but this is very rare.
• Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant. See the Safety in X-ray, Interventional Radiology and Nuclear Medicine Procedures page for more information about pregnancy and x-rays.

A Word About Minimizing Radiation Exposure

Special care is taken during x-ray examinations to use the lowest radiation dose possible while producing the best images for evaluation. National and international radiology protection organizations continually review and update the technique standards used by radiology professionals.

Modern x-ray systems have very controlled x-ray beams and dose control methods to minimize stray (scatter) radiation. This ensures that those parts of a patient’s body not being imaged receive minimal radiation exposure.

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What are the limitations of Lower GI Tract Radiography?

A barium enema is usually not appropriate for someone who is in extreme abdominal pain or who has had a recent colonic biopsy. If perforation of the colon is suspected, the enema should be performed with a water-soluble contrast solution.

X-ray imaging is not usually indicated for pregnant women.

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This page was reviewed on January, 23, 2019

Gastroenterology and Endoscopy Procedures and Services

First, what is an endoscope?

Flexible sigmoidoscopy – rectum to lower colon

Colonoscopy – entire colon, from rectum to the lower end of the small intestine

Virtual Colonoscopy – uses x rays and computers to produce two- and three-dimensional images of the colon (large intestine) from the lowest part, the rectum, all the way to the lower end of the small intestine and display them on a screen

Capsule Endoscopy – looks at the small bowel

Upper Endoscopy (EGD) – esophagus, stomach, duodenum

Endoscopic ultrasonography (EUS) – esphagus, stomach lining, and upper/lower gastrointestinal tract

Endoscopic Retrograde Cholangiopancreatography Test (ERCP) – liver, gall bladder, pancreas, bile ducts

Liver Biopsy – GI procedure. Not an endoscopy, but performed in the GI endoscopy unit

Transit Study – GI procedure. Not an endoscopy, but performed in the GI endoscopy unit

Gastroenterology Health Questionnaire – Please print, fill out and bring to your appointment.

Endoscope

An Endoscope is a medical instrument that enables gastroenterologists to see organs within the body that are usually hidden from view. The endoscope may be inserted through the mouth or rectum. The endoscope is a long tube with an optic viewing system on the end. The physician uses a TV monitor to view what the endoscope sees.

The endoscope can be used as a treatment tool by passing tiny surgical instruments through this tube; the gastroenterologist can remove polyps, take biopsy samples, or remove gallstones.

Flexible sigmoidoscopy

This procedure enables the physician to look at the inside of the large intestine from the rectum through the lower part of the colon, called the sigmoid colon. Physicians may use this procedure to find the cause of diarrhea, abdominal pain, or constipation. They also use sigmoidoscopy to look for early signs of cancer in the colon and rectum. With sigmoidoscopy, the physician can see bleeding, inflammation, abnormal growths, and ulcers.

For the procedure, you will lie on your left side on the examining table. The physician will insert a short, flexible, lighted tube into your rectum and slowly guide it into your colon. The tube is called a Sigmoidoscopy. The scope transmits an image of the inside of the rectum and colon, so the physician can carefully examine the lining of these organs. The scope also blows air into these organs, which inflates them and helps the physician see better.

If anything unusual is in your rectum or colon, like a polyp or inflamed tissue, the physician can remove a piece of it using instruments inserted into the scope. The physician will send that piece of tissue (biopsy) to the lab for testing.

Bleeding and perforation of the colon are possible complications of sigmoidoscopy. However, such complications are uncommon.

Sigmoidoscopy takes 10 to 20 minutes. During the procedure, you might feel pressure and slight cramping in your lower abdomen. You will feel better afterwards when the air leaves your colon.

The colon and rectum must be completely empty for sigmoidoscopy to be thorough and safe, so the physician will probably tell you to drink only clear liquids for 12 to 24 hours beforehand. A liquid diet means fat-free bouillon or broth, Jello, not red, strained fruit juice, water, plain coffee, plain tea, or diet soda. The night before or right before the procedure, you may also be given an enema, which is a liquid solution that washes out the intestines. Your physician may give you other special instructions

Colonoscopy

The procedure is used to diagnose the causes of unexplained changes in bowel habits. It is also used to look for early signs of cancer in the colon and rectum. Colonoscopy enables the physician to see inflamed tissue, abnormal growths, ulcers, bleeding, and muscle spasms.

For this traditional procedure, you will lie on your left side on the examining table. You will probably be given pain medication to keep you comfortable. The physician will insert a long, flexible, lighted tube into your rectum and slowly guide it into your colon. The tube is called a colonoscope. The scope transmits an image of the inside of the colon, so the physician can carefully examine the lining of the colon. The scope bends, so the physician can move it around the curves of your colon. You may be asked to change position occasionally to help the physician move the scope. The scope also blows air into your colon, which inflates the colon and helps the physician see better.

If anything unusual is in your colon, like a polyp or inflamed tissue, the physician can remove a piece of it using tiny instruments passed through the scope. That tissue (biopsy) is then sent to a lab for testing. If there is bleeding in the colon, the physician can pass a laser, heater probe, or electrical probe, or inject special medicines, through the scope and use it to stop the bleeding.

Bleeding and perforation of the colon are possible complications of colonoscopy. However, such complications are uncommon.

Virtual Colonoscopy

Virtual Colonoscopy(or CT colonography) is a rapid CT examination of the abdomen to examine the air-filled colon for masses or polyps. It offers the advantages of less invasiveness, no sedation, and incidental imaging of the other abdominal organs. Despite its many advantages, virtual colonoscopy still requires a cathartic colon prep, and is not able to remove polyps or biopsy abnormalities. In addition, it is not yet accepted as an option for screening for colorectal cancer outside of clinical trials.

Capsule Endoscopy

Capsule Endoscopy lets your doctor examine the lining of the middle part of your gastrointestinal tract, which includes the three portions of the small intestine (duodenum, jejunum, ileum). Your doctor will use a pill sized video capsule called an endoscope, which has its own lens and light source and will view the images on a video monitor. You might hear your doctor or other medical staff refer to capsule endoscopy as small bowel endoscopy, capsule enteroscopy, or wireless endoscopy.

Capsule endoscopy helps your doctor evaluate the small intestine. This part of the bowel cannot be reached by traditional upper endoscopy or by colonoscopy. The most common reason for doing capsule endoscopy is to search for a cause of bleeding from the small intestine. It may also be useful for detecting polyps, inflammatory bowel disease (Crohn’s disease), ulcers, and tumors of the small intestine.

1. Optical Dome
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4. Illuminating LEDs (Light Emitting Diode)
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7. ASIC (Application Specific Integrated Circuit) transmitter
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Upper Endoscopy

An Upper GI endoscopy or EGD (esophagoastoduodenoscopy) is an examination of the lining of the upper digestive tract through a flexible tube (endoscope). This allows a specially trained physician to directly view the esophagus (food tube), stomach and duodenum (first portion of the small intestine) and identify any problems.

Endoscopic ultrasonography (EUS)

Endoscopic ultrasonography (EUS) allows your doctor to examine your esophageal and stomach linings as well as the walls of your upper and lower gastrointestinal tract. The upper tract consists of the esophagus, stomach and duodenum; the lower tract includes your colon and rectum. EUS is also used to study other organs that are near the gastrointestinal tract, including the lungs, liver, gall bladder and pancreas.

Endoscopists are highly trained specialists who welcome your questions regarding their credentials, training and experience. Your endoscopist will use a thin, flexible tube called an endoscope that has a built-in miniature ultrasound probe. Your doctor will pass the endoscope through your mouth or anus to the area to be examined. Your doctor then will use the ultrasound to use sound waves to create visual images of the digestive tract.

Why is EUS done?

EUS provides your doctor with more information than other imaging tests by providing detailed images of your digestive tract. Your doctor can use EUS to diagnose certain conditions that may cause abdominal pain or abnormal weight loss.

EUS is also used to evaluate known abnormalities, including lumps or lesions, which were detected at a prior endoscopy or were seen on x-ray tests, such as a computed tomography (CT) scan. EUS provides a detailed image of the lump or lesion, which can help your doctor determine its origin and help treatment decisions. EUS can be used to diagnose diseases of the pancreas, bile duct and gallbladder when other tests are inconclusive or conflicting.

Why is EUS used for patients with cancer?

EUS helps your doctor determine the extent of spread of certain cancers of the digestive and respiratory systems. EUS allows your doctor to accurately assess the cancer’s depth and whether it has spread to adjacent lymph glands or nearby vital structures, such as major blood vessels. In some patients, EUS can be used to obtain a needle biopsy of a lump or lesion to help your doctor determine the proper treatment.

Endoscopic Retrograde Cholangiopancreatography Test (ERCP)

Endoscopic retrograde cholangiopancreatography (ERCP) enables the physician to diagnose problems in the liver, gallbladder, bile ducts, and pancreas. The liver is a large organ that, among other things, makes a liquid called bile that helps with digestion. The gallbladder is a small, pear-shaped organ that stores bile until it is needed for digestion. The bile ducts are tubes that carry bile from the liver to the gallbladder and small intestine. These ducts are sometimes called the biliary tree. The pancreas is a large gland that produces chemicals that help with digestion.

ERCP may be used to discover the reason for jaundice, upper abdominal pain, and unexplained weight loss. ERCP combines the use of x-rays and an endoscope, which is a long, flexible, lighted tube. Through it, the physician can see the inside of the stomach, duodenum, and ducts in the biliary tree and pancreas.

Liver Biopsy

Liver biopsy is the only certain way to confirm certain types of liver disease. Liver biopsy requires taking a small amount of tissue from the liver. The physician may use ultrasound, CAT scan or a laparoscope to look at the liver and find the best places from which to remove tissue samples. The samples are then sent to a pathology lab, where they are analyzed and a diagnosis can be made. Liver biopsy is often performed as an outpatient procedure.

Transit Study

This is the most helpful test to find the cause of constipation. This test measures how long it takes food residues to travel through the gut. This is done by having you swallow tiny soft rubber rings in a capsule about 1/2 inch across and then taking an x-ray 5 days later to see how many of the rings are left.

In the illustration of the lower intestines at your right, (1) indicates Sitzmarks showing the movement of the contents of your intestines, and (2) shows the location of your rectum.

Transmission of Infection by Flexible Gastrointestinal Endoscopy and Bronchoscopy

Relevance of Cleaning and Disinfection

According to the Spaulding classification system, medical devices are divided into three categories based on the risk of infection (11). Critical medical instruments (e.g., surgical instruments and prosthetic heart valves) that enter the vascular system and normally sterile tissues and that carry a high degree of infection risk if contaminated during use should be sterilized. Noncritical medical devices, such as stethoscopes, coming into contact with intact skin require low-level disinfection or simple cleaning with detergent and water. Most flexible endoscopes belong to semicritical devices which come into contact with mucous membranes during use and have a moderate degree of infection risk if contaminated at the time of use. They should receive at least HLD. HLD is a process that eliminates or kills all vegetative bacteria, mycobacteria, fungi, and viruses, except for small numbers of bacterial spores (12, 13). Sterilization results in the complete destruction of all forms of microbiological life, including bacterial spores.

Flexible endoscopes for therapeutic procedures (bronchoscopy and ERCP) and reusable accessories, such as biopsy forceps, are used in sterile body cavities and should be classified as critical devices (12, 13). They should be sterilized after each procedure. Due to their material composition, most flexible endoscopes cannot be steam sterilized (9). They tolerate ethylene oxide and hydrogen peroxide plasma sterilization, which are expensive and are not preferred by most institutions (14). No data are available demonstrating that sterilization results in a lower frequency of postendoscopic infection than does HLD. Ethylene oxide and hydrogen peroxide plasma sterilization have rapid and reliable efficacy compared to HLD (15). However, both sterilizers destroy chemical, biological, and mechanical properties of instruments, including flexible endoscopes. Gas sterilization with ethylene oxide may fail in the presence of organic debris after inadequate cleaning (16, 17) and when biofilm has settled in internal endoscope channels (2, 18).

Natural bioburden levels detected on flexible GI endoscopes range from 10⁵ CFU/ml to 10¹⁰ CFU/ml after clinical use (19, 20). Cleaning must precede HLD or sterilization to remove organic debris (e.g., blood, feces, and respiratory secretions) from the external surface, lumens, and channels of flexible endoscopes (4, 21). Inadequate cleaning of flexible endoscopes has been frequently associated with microbial transmission during endoscopic procedures. Appropriate cleaning reduces the number of microorganisms and organic debris by 4 logs, or 99.99% (20).

The manual cleaning procedure for flexible endoscopes includes brushing of the external surface and removable parts (e.g., suction valves) and immersion in a detergent solution followed by irrigation of internal channels with a detergent. The endoscope and accessories should be inspected for damage, and a leak test should be performed before disinfection (4).

AERs are strongly recommended for reprocessing of flexible endoscopes to document all steps and to minimize contamination and contact with chemicals and contaminated instruments (5). However, contaminated and defective AERs can result in inadequate reprocessing and contamination of endoscopes and have been associated with outbreaks of endoscopy-related infections (22–26). Presence of biofilms in the AERs has been detected during these outbreaks (23, 25, 26).

Disinfecting agents used for HLD must have bactericidal, mycobactericidal, fungicidal, virucidal, and sporicidal activity (12, 13). According to their activity against bacteria, fungi, spores, and viruses, disinfectants can be classified into the following three groups: high-level (glutaraldehyde, peracetic acid, and ethylene oxide), intermediate-level (ethanol, formaldehyde, and phenolic solutions), and low-level (povidone-iodine, cetrimide, and benzalkonium chloride) disinfectants (11, 12, 27). Intermediate-level disinfectants do not have sporicidal activity. Disinfectants with low potency do not destroy Mycobacterium tuberculosis, atypical mycobacteria, and bacterial spores. Concentration and exposure time of a disinfecting agent are crucial; inappropriate dilution and insufficient exposure can result in a failure of effective reprocessing (28–30). Inappropriate disinfectants with low and intermediate potency are not recommended for HLD and have been replaced by glutaraldehyde, hydrogen peroxide, ortho-phthalaldehyde, peracetic acid, and superoxidized and electrolyzed acid water (31, 32). Advantages and disadvantages of commonly used high-level disinfectants are summarized in .

Table 1

Advantages and disadvantages of commonly used high-level disinfectants

Glutaraldehyde (2 to 4%) is a disinfecting agent effective against bacteria, viruses, fungi, and spores that is relatively inexpensive, is noncorrosive to metal, and does not damage endoscopes and processing equipment (5, 33). Two percent aqueous solutions of glutaraldehyde killed vegetative bacteria in <2 min, fungi and viruses in <10 min, and spores of Bacillus spp. and Clostridium spp. in 3 h (33–35). However, glutaraldehyde has irritant properties for the respiratory tract, eyes, and skin and can cause allergic reactions, contact dermatitis, and asthma (36). For these reasons, the use of this high-level disinfectant should be done with containment to minimize aerosolization of glutaraldehyde. Acute colitis occurring after lower GI endoscopy was probably caused by glutaraldehyde residues in the endoscope after disinfection (37). Other disadvantages of glutaraldehyde are coagulation and fixation of proteins and failure to eliminate atypical mycobacteria within standard contact times (5, 35, 38).

Microorganisms possessing resistance to glutaraldehyde include atypical mycobacteria (Mycobacterium chelonae and Mycobacterium avium complex) (39, 40) and Cryptosporidium parvum (41). P. aeruginosa resistance to glutaraldehyde was responsible for three separate clinical episodes of ERCP-associated cholangitis (42). The mechanism of the high biocide resistance of mycobacteria is probably associated with the decreased penetration of a disinfectant through the hydrophobic lipid-rich cell wall (35). Two percent alkaline glutaraldehyde completely inactivated M. tuberculosis in bronchoscopes after 10 min of incubation (43). M. avium, Mycobacterium gordonae, and Mycobacterium intracellulare were more resistant to inactivation by 2% alkaline glutaraldehyde and survived the treatment for more than 10 min (38). Since mycobacteria are more resistant to glutaraldehyde than other bacteria, the manufacturers’ instructions for flexible endoscopes and this high-level disinfectant should followed to determine the correct conditions.

ortho-Phthalaldehyde (0.55%) is a high-level disinfectant with a higher mycobactericidal efficacy than glutaraldehyde (5, 44). Disadvantages of this disinfectant include slow action against bacterial spores, irritation of the respiratory tract and eyes of the patients and staff, and the possibility of causing “anaphylaxis-like” reactions after repeated use (5, 36, 45). ortho-Phthalaldehyde stains skin, instruments, clothing, and surfaces and is more expensive than glutaraldehyde (46).

Peracetic acid is an oxidizing agent usually used for HLD of flexible endoscopes in AERs. It rapidly deactivates a large variety of pathogenic microorganisms, viruses, and spores at low concentrations (<0.3%) (5, 7). No development of microorganism resistance to peracetic acid has been reported. This disinfectant can be used at low temperatures and causes less irritation than glutaraldehyde but has corrosive action depending on the pH value and concentration (7). Several disinfectants that contain peracetic acid and hydrogen peroxide are available. Although the biocidal effect of peracetic acid on sessile microorganisms is well known, the effect of this disinfecting agent on microbial biofilms has not been completely studied. A recent study demonstrated insufficient efficacy of 1% peracetic acid disinfectant for 10 min against P. aeruginosa, Stenotrophomonas maltophilia, and Candida sp. biofilms (47). According to the literature, peracetic acid has the ability to fixate biofilms, and therefore, it can show limited efficacy in biofilm removal from the abiotic surfaces and in killing bacteria within the biofilm (48, 49). Vigorous cleaning with brushes or agitated liquids is important to remove as much biofilm as possible (4).

Electrolyzed acid and superoxidized water are relatively new disinfectants used for endoscope reprocessing (15). These disinfectants are produced by the electrolysis of sodium chloride solutions. They have excellent biocidal activity and are inexpensive, nontoxic to biological tissues, and nonirritating to the respiratory tract, eyes, and skin (15). However, antimicrobial efficacy can be reduced in the presence of organic soil after inappropriate cleaning (50).

After the disinfection phase, the remaining disinfectant must be removed from the exterior and from the internal channels by rinsing the endoscope with bacterium-free water. According to the Guideline Committee of the European Society of Gastrointestinal Endoscopy, sterile water is preferable for the final rinse to prevent recontamination (5). Many outbreaks of endoscopy-related infections and cross-contaminations due to P. aeruginosa, Serratia marcescens, M. chelonae, Mycobacterium xenopi, and Methylobacterium mesophilicum have been related to rinsing flexible endoscopes after disinfection with nonsterile tap water (30, 51–57). The accepted procedures to produce bacterium-free water in disinfectors for endoscopes include filtration, UV radiation, or heating followed by cooling (5). However, major U.S. guidelines recommend the use of sterile, filtered, or tap water to rinse the endoscope channels after HLD, followed by flushing of the endoscope channels with 70% to 90% ethyl alcohol or isopropyl alcohol (6, 7, 21). The rinse water must be discarded after each cycle. Water bottles used for irrigation during the procedure should be high-level disinfected or sterilized at least daily. Sterile water should be used to fill the water bottle.

Relevance of Drying and Storage

Accurate endoscope drying is crucial, whereas a humid environment facilitates microbial growth during storage. The final drying steps greatly reduce the risk of remaining pathogens as well as the possibility of recontamination of the endoscope by waterborne microorganisms such as Pseudomonas spp. and Acinetobacter spp. (58). Flexible endoscopes should be dried with filtered compressed air manually or in AERs between endoscopic procedures (a short drying cycle) and at the end of the day (an intensive final drying) (5, 59). Several guidelines recommend forced air drying, preceded by flushing of the internal channels with 70% to 90% ethanol or isopropanol at the end of a clinic day (6, 7, 21). Allen et al. (22) showed a high efficiency in preventing P. aeruginosa contaminations by flushing 70% ethanol through endoscope channels followed by drying with compressed air. Due to the fixative properties of ethanol, its use is not recommended in some countries.

Storage is an important factor in the maintenance of bacterium-free endoscopes. It is recommended that a dust-free drying cabinet be used for endoscope storage, in which the endoscopes are hung vertically (5, 60, 61). Noy et al. (62) noted that storing the endoscopes vertically in air after cleaning until the next use of the endoscope resulted in a drop of the contamination rate from 35 to 0%. According to the literature, endoscopes stay bacterium free after prolonged storage if an adequate drying procedure is applied (60, 61). When stored in the drying cabinet with a laminar airflow, no growth of bacteria and Candida spp. was found in endoscope channels 5 days after reprocessing (61). Low levels of microbial contamination on endoscopes stored in the drying and storage cabinet were detected, compared with the stable or increased microbial numbers on endoscopes stored outside the cabinet (60).

Many outbreaks of health care-associated infection after endoscopy and cross-contaminations due to P. aeruginosa, S. marcescens, M. tuberculosis, and M. chelonae have been associated with drying of flexible endoscopes without ethanol flushing or lack of a drying procedure (22–24, 30, 52, 57, 63–76).

Endoscopy Specialist – Kingsport, TN & Johnson City, TN: Tri-Cities Gastroenterology: Gastroenterologist

What is endoscopy?

An endoscopy is a nonsurgical procedure used to examine the inside of your gastrointestinal (GI) tract. It’s done using an endoscope, which is a long, thin, flexible tube that contains a video camera.

As your doctor gently threads the endoscope through your GI tract, the camera sends magnified images to a computer screen that allow your doctor to see inflammation, ulcers, polyps, tumors, and other problems.

How is endoscopy used?

Endoscopy serves two purposes: It diagnoses the cause of your symptoms and to treat conditions found during the visual examination.

While the endoscope is in place, special medical tools can be inserted through the scope to take a biopsy or perform minimally invasive surgery, such as removing tissue. The doctors at Tri-Cities Gastroenterology frequently perform upper and lower GI endoscopies.

What is an upper GI endoscopy?

An upper GI endoscopy examines and treats the upper part of your GI tract, which includes your esophagus, stomach, and duodenum, or the first part of your small intestine just past your stomach. After administering anesthesia, your doctor guides the endoscope through your mouth and down the GI tract.

You may need an upper GI to determine the underlying cause of problems such as trouble swallowing, indigestion, abdominal pain, and nausea. A few conditions often diagnosed using an upper GI endoscopy include:

• Barrett’s esophagus
• Acid reflux
• H-pylori infection
• Peptic ulcer disease

What is esophageal dilation?

If you have trouble swallowing or feel like food gets stuck in your chest, the problem may be due to a narrowing of your esophagus. This condition often develops when acid reflux scars the esophageal lining.

During an endoscopy, your doctor can stretch the narrowed area using a dilating balloon, plastic dilators, or a tapered dilating instrument. When the procedure is over, you’ll be able to swallow normally.

What is a lower GI endoscopy?

Lower GI endoscopies are better known as colonoscopies because this type of procedure uses a variety of endoscope called a colonoscope.

Colonoscopies examine your colon or large intestine, allowing your doctor to screen for colon cancer, find and remove polyps, and detect other problems like inflammatory bowel disease and diverticulitis.

To learn more about endoscopy, call Tri-Cities Gastroenterology or if you have symptoms affecting your upper or lower GI tract, book an appointment online.

Treatments using Endoscopy | Stanford Health Care

Expert Endoscopic Tests and Treatment at Stanford Health Care

Endoscopy is a nonsurgical technique for treating conditions affecting any part of your digestive tract. With the help of a thin, flexible tube fitted with a light and camera (endoscope), we view video images of your gastrointestinal tract on a high-definition video monitor.

Endoscopes come in different lengths, which we adjust to carry out different types of endoscopic procedures.

• For upper endoscopy procedures, we pass the endoscope through your mouth and throat to access and examine your esophagus, stomach and upper small intestine (duodenum).
• For lower endoscopy procedures (colonoscopy), we pass the endoscope (also known as a colonoscope) through your rectum to access and examine your large intestine (colon).

Endoscopic Treatments for Gastrointestinal Disorders at Stanford Health Care

Our nationally renowned endoscopists are experts in advanced techniques, allowing us to perform routine and complex procedures for a broad range of conditions with minimal disruption to your gastrointestinal tract.

Endoscopic treatments allow us to deliver therapies directly to your gastrointestinal tract without incisions. They result in a more comfortable procedure and faster recovery.

Endoscopic treatments available at Stanford Health Care include:

• Ablation for esophagus disorders for Barrett’s esophagus
• Dilation and stenting
• Endoscopic mucosal resection
• Endoscopic submucosal dissection
• Endoscopic techniques for fistula closure
• Resection of giant polyps

Ablation for Esophagus Disorders

We offer a range of minimally invasive techniques for removing precancerous tissue using hot or cold energy.

Learn more about ablation for esophagus disorders.

Dilation and Stenting

Dilation gently stretches narrowed areas in your gastrointestinal tract, creating a wider passage. We may also need to implant a special device (stent) to help keep the passage open. Learn more about dilation and stenting.

Endoscopic Mucosal Resection

During this minimally invasive procedure, we remove large areas of abnormal tissue, including colon polyps or areas of diseased tissue (dysplasia) due to Barrett’s esophagus. Learn more about endoscopic mucosal resection.

Endoscopic Submucosal Dissection

Creating a cushion between healthy tissue and the base of the polyp by injecting small amounts of fluid, we slowly and carefully remove large, complicated polyps in one piece. Learn more about endoscopic submucosal dissection.

Endoscopic Techniques for Fistula Closure

We use endoscopic devices to seal abnormal connections between your organs (fistulas). A fistula can form as a result of inflammation. We offer a range of minimally invasive fistula repair procedures. Learn more about fistula repair.

Resection of Giant Polyps

During this procedure, we remove large colon polyps using special tools and advanced techniques.

Endoscopy of the gastrointestinal tract | Capsule endoscopy of the stomach, intestines (colon, rectum)

Endoscopic methods of diagnostics and treatment of the gastrointestinal tract are used in the “Road Clinical Hospital”. Endoscopy of the stomach, intestines, colon and rectum is performed, as well as a unique capsule endoscopy.

Endoscopy allows you to determine the pathological process in the organs of the gastrointestinal tract, as well as to collect material for subsequent histological and cystological studies, to assess the extent of the pathology and the effectiveness of the accepted therapeutic measures (surgical interventions, drug or radiation treatment).

During a diagnostic endoscopy, a puncture is performed, a scraping is taken (using a specialized brush and a scarifier), a biopsy is performed, and partial or complete removal of the formation can be performed. There are various types of surgical intervention during endoscopy:

• mechanical – biopsy, puncture;
• with electrical impact;
• with laser action.

Types and features of gastrointestinal endoscopy

• Esophagoscopy
  
  Thanks to the high-resolution fiber optic machine, it is possible to examine the esophageal mucosa.As a rule, in the case of a tumor formation in the esophagus, it looks like a focal seal or similar to a polyp. Depending on the stage, ulcers, nodes, color changes (whitish, bright red, etc.) may appear. Esophagoscopy has 98% accuracy in confirming esophageal cancer.
• Endoscopic ultrasound
  
  This is another method that allows you to examine the digestive tract. Unlike esophagoscopy, in this case, an ultrasound probe is inserted through the esophagus.The examination allows the specialist to evaluate the layer-by-layer structure of the esophagus wall, duodenum, stomach, determine the extent of the pathology spread, and check the state of regional lymph nodes. In addition, during endoscopic echography, the specialist carries out differential diagnostics of submucosal formations and pathology of adjacent organs.
• Colonoscopy
  
  Colonoscopy is also called colon endoscopy. This endoscopic examination is indispensable for colon polyps.As a rule, polyps are characterized by a large variability in size, shape, number and location, so the picture during colon endoscopy can be different. So, polyps can be single or numerous, have a round shape or elongated, sizes vary from 2 to 50 mm with localization mainly in the left half of the intestine. Intestinal endoscopy is performed if there is suspicion of cancers in the colon, ulcerative colitis, Lesnevsky-Crohn’s disease, clinical manifestations of diarrhea, the origin of which is unclear.In addition, intestinal endoscopy is performed as a screening test for diagnostic purposes – to detect polyps and early stage cancers.
• Sigmoidoscopy
  
  It is an endoscopy of the rectum as well as the lower part of the sigmoid colon. Endoscopy of the rectum is indicated for difficult bowel movements, the presence of various secretions (mucus, pus, blood, etc.), uncomfortable and painful sensations in the lower abdomen and rectum.In addition, sigmoidoscopy is prescribed if there is a suspicion of the presence of tumor formations or inflammatory processes in the colon. The procedure allows you to perform various surgical procedures, including biopsy, removal of polyps, etc.
• Gastroscopy
  
  Gastroscopy is an endoscopy of the stomach in particular and of the upper gastrointestinal tract in general (esophagus, stomach, duodenum). The endoscopist of the “Road Clinical Hospital” examines the gastrointestinal tract organs with an endoscope for diagnostic purposes or conducts certain therapeutic manipulations by introducing compact sterile instruments.

  Endoscope is a modern high-precision apparatus of a complex device. It is a thin tube made of flexible materials, fitted with a lens at one end. Thanks to the device, a specialist can perform an endoscopy of the stomach and other organs of the upper gastrointestinal tract, safely bringing the instrument directly to the organ and examining its surface. The capabilities of the procedure allow you to record what is happening on a digital medium.

  Using a gastroscopy, the specialist identifies the cause of common symptoms such as:

  • Abdominal discomfort and pain;
  • Bleeding
  • Difficulty swallowing;
  • Problems with defecation.

  Gastroscopy with maximum accuracy detects ulcers, polyps, tumor formations and other pathological processes that require immediate treatment.

  Preparation for gastroscopy

  Regardless of the reason for the study, gastroscopy requires three important preparatory steps:

  1. Delivery of a full range of analyzes;
  2. Deliveries to notify the attending specialist about the drugs taken, allergies and diseases;
  3. For 10-12 hours before gastroscopy, follow a fasting diet.This is important, since gastric endoscopy will be difficult in the presence of food, making an accurate diagnosis impossible.

  Recovery after gastroscopy

  Normally, after the procedure, the patient feels discomfort in the throat. This is due to the introduction of a specialized sterile tube. The unpleasant sensation completely disappears no later than the next day.

• Capsule endoscopy

  The main difference between capsule endoscopy and traditional endoscopy is in the form of an endoscope.In this case, instead of a flexible tube, a capsule with a perfectly smooth surface and dimensions – 11×24 mm is used. The transparent capsule contains a miniature video camera and a light source. The camera’s capabilities are unprecedented: 170-degree angle of view and shooting speed of 3 frames / sec. All this allows us to guarantee the formulation of a highly accurate diagnosis and the passage of the procedure without the discomfort that is inherent in more traditional diagnostic methods. The patient swallows the capsule easily. Thanks to peristalsis, it goes all the way through the digestive tract and leaves the body naturally through defecation.As the capsule moves, the image is transmitted to a compact device that is attached to the patient’s belt. After 11 hours, the data obtained can already be analyzed.

  Advantages of Capsule Endoscopy

  • High quality recording of what is happening in the gastrointestinal tract allows for a thorough analysis of the state of organs and make an accurate diagnosis;
  • You do not need to go to the hospital for the procedure.Diagnostics occurs without interruption from ordinary affairs, including work;
  • The procedure does not cause any pain or any discomfort;
  • The procedure is safe and harmless – tissue puncture cannot occur;
  • No risk of infection.

  Indications for Capsule Endoscopy

  • Painful sensations in the abdomen of undetermined origin;
  • Latent gastrointestinal bleeding;
  • Tumors of the small intestine;
  • Congenital pathologies;
  • Enteritis (bloating, pain around the navel, loose and fetid stools, etc.) etc.

  Contraindications to the procedure

  • The procedure is not performed on young patients;
  • Pregnant patients;
  • For patients with a pacemaker and / or defibrillator;
  • Patients with epilepsy;
  • Patients who cannot swallow food or tablets;
  • Patients suffering from indigestion or slow gastric emptying;
  • Patients with small bowel diverticulosis;
  • Capsule endoscopy cannot be performed if there is a diagnosed or suspected gastrointestinal obstruction, perforation, fistula, or stricture.

  Features of preparation for the procedure

  1. The day before: lunch with ordinary food can be carried out no later than noon, after that eat only liquid food as prescribed by the doctor;
  2. 12 hours before the procedure, complete abstinence from food is indicated – only pure water (tea, coffee, juice and other drinks are not allowed), smoking is also prohibited;
  3. 2 hours before taking the endoscopic capsule, exclude the use of any medications;
  4. For 1 week, exclude the use of iron preparations;
  5. The doctor may prescribe specialized medications to simplify the procedure;
  6. In the presence of diabetes mellitus, the dosage of insulin must be adjusted in accordance with the instructions of a specialist;
  7. Recommendations for clothes on the day of the procedure: spacious, not restricting movement, preferably a set of two items;
  8. After taking the capsule, the patient should not eat or drink for another 2 hours.After 2 hours you can drink, after 2 more – take light food.

All branches

Endoscopic diagnostics

Esophagogastroduodenoscopy (abbreviated as gastroscopy, FGS or EGDS) is a visual examination of the upper parts of the digestive tract (esophagus, stomach and duodenum) from the inside using a special apparatus – a gastroscope.

The gastroscope is an ultra-thin flexible controlled probe with a built-in video camera. It is inserted through the mouth while lying on the left side after local anesthesia of the pharynx (to relieve the gag reflex). The image from the probe is fed to the monitor of the Pentax video stand, and the endoscopist has the opportunity to examine the state of the organs in detail.

If necessary, the doctor can take pieces of tissue for histological examination. This procedure is called a biopsy and is completely painless.

The indications for gastroscopy are extensive, but the main one is any, even a slight change in the state of the gastrointestinal tract:

• suspicion of inflammation, ulcer, erosion, polyps, tumors of the gastrointestinal tract
• for gastric bleeding to clarify the localization of the process, as well as to assess the effectiveness of treatment
• for carrying out therapeutic measures and for observing the results of previously performed operations (resection of the stomach, removal of polyps, etc.)etc.)

Gastroscopy must be performed in the so-called risk groups, which include people with a genetic predisposition to various diseases of the esophagus, stomach and duodenum. With the help of gastroscopy, it is possible to detect oncological diseases of the gastrointestinal tract in the early stages.

The results of gastroscopy allow you to prescribe the correct treatment in each case.

In “Medgard” gastroscopy can be accompanied by a number of diagnostic and therapeutic procedures carried out with the help of thin flexible instruments, which are introduced through a special channel of the gastroscope.In addition to biopsy, various methods of staining the mucous membrane are used, which make it possible to more accurately identify diseases.

Through the gastroscope, polyps and some other tumors of the digestive tract are successfully removed, foreign bodies are removed, and gastrointestinal bleeding is stopped. These jewelry interventions, painless for the patient, make it possible to avoid large operations on the abdominal organs.

Gastroscopy is performed by our endoscopist doctors professionally, quickly and as carefully as possible.The procedure is usually well tolerated, and even if patients experience a little discomfort, the doctor will take all measures to reduce the discomfort. It is possible to perform gastroscopy under general anesthesia.

Endoscopic examination room

Included in the surgical department

Contact phone: (internal numbers are dialed through mini ATC numbers (8172) 71-00-10, 71-14-98)
office manager extension 421
doctors’ offices (8172) 71-75-15, internal numbers 422, 425
doctor’s office extension 428
bronchographic office, extension number 423
gastroscopy room, extension 424

Head of office – Igor Vitalievich Bezugly,
pediatric surgeon of the highest qualification category,
work experience since 1994.

The endoscopy room of the regional children’s hospital was organized in 1991 thanks to the efforts of the head of the surgical department of the hospital Yuri Konstantinovich Balalaev.

Staff:

In addition to the head, doctors work in the office:
Balalaev Yuri Konstantinovich, doctor of the highest qualification category, Kolobov Evgeny Vladimirovich, doctor of the first qualification category,
all doctors of the department have been trained at the endoscopy departments of the academies of postgraduate education in Moscow, St. Petersburg and Nizhny Novgorod, have specialist certificates and work experience in the specialty from 10 to 25 years.
Good assistants to doctors in the office are nurses Skvortsova V.N., Smirnova I.E., Smirnova M.A.

Material and technical base:

Since 2013, the endoscopy office includes outpatient and inpatient services. The polyclinic unit consists of two endoscopic rooms, in which studies of the upper and lower gastrointestinal tract are carried out. The inpatient unit includes three endoscopy rooms and two operating rooms.
The cabinet is equipped with modern Olympus endovideo systems with flexible endoscopes adapted to them and the necessary set of instruments, endoscopic equipment from Karl Storz, documentation devices, which allows, if necessary, to take photographs and record video images during procedures, with the subsequent entry of data into the video archive and the possibility copying an image to digital media.
For the prevention of infectious diseases, automated washing processing of all endoscopic equipment is used using modern washing machines that fully comply with the requirements of sanitary and epidemiological rules.

Main activities:

A wide range of endoscopic diagnostic and therapeutic studies of the digestive and bronchopulmonary systems is performed daily, including videoesophagogastroduodenoscopy, video colonoscopy, video bronchoscopy with the possibility of using the NBI mode (narrow-spectrum endoscopy). The presence of ultrathin endoscopes allows examining children of all ages, including newborns. The studies are carried out under both local anesthesia and general anesthesia.

The department performs the following endoscopic examinations:

• fibroesophagogastroduodenoscopy (FGDS) with the possibility of taking a biopsy for the HELIK test with the subsequent possibility of histological examination;
• fibrobronchoscopy with the possibility of bronchial lavage and bronchoalveolar lavage, brush biopsy, pinch biopsy;
• diagnostic rhinoscopy, laryngoscopy;
• fibrocolonoscopy with the ability to perform biopsy;
• sigmoidoscopy with the ability to perform biopsy;
• polypectomy;
• removal of foreign bodies from the gastrointestinal tract and respiratory tract;
• endoscopic bougienage and balloon dilatation of cicatricial esophageal stenosis, as well as various types of anastomoses after surgical interventions.

The office works with an average annual workload of about 2300 studies per year.

Survey on a paid basis:

In the consultative and diagnostic polyclinic, at the request of the parents, city patients can be examined on a paid basis. Patients are admitted from 9.00 to 14.00.
To receive medical assistance, you must have a referral from a doctor, a passport of one of the parents.
Studies are carried out on an empty stomach, a light dinner is taken the night before.You should have a towel or a diaper and a change of shoes with you.
Registration for examination is carried out by phone. Registries: (8172) 71-26-33, 71-04-99.

Regional Center for Endoscopy – Diagnosis and Treatment of Gastrointestinal Diseases

Good morning. I was examined on 10.06.2021 by doctors Serebryakov E.Yu. and Tretyakova K.Yu. I want to express my deep gratitude to the doctors. Evgeny Yurievich made me an FGDS examination.I was very much afraid of this procedure. But the examination was carried out at a high level, with filigree precision, I had the feeling that every millimeter of the stomach was examined. Then she visited the gastroenterologist Karolina Yurievna. The doctor very carefully, thoroughly examined, established the picture of the disease and prescribed treatment. I have been taking the prescribed medications for only 2 days, and the pain from my stomach has gone. These are high-level specialists !!! Low bow to you in your noble, hard work !!!!

Elena Aleksandrovna

Good afternoon, everyone.In December 20 of the year in the State Budgetary Healthcare Institution of the Republic of Mordovia “Republican Clinical Hospital No. 5” Polyclinic No. 3 in the endoscopic department during video colonoscopy, a polyp was found in the intestine. On the recommendation of the attending physician, I contacted the Regional Endoscopy Center Nizhny Novgorod by e-mail. I didn’t have to wait long for an answer. The doctor, Mitrakov Alexander Anatolyevich, sent an invitation to the Regional Center for Endoscopy. Due to the epidemic situation, the meeting was postponed to the spring.A meeting was scheduled in early May and the Regional Endoscopy Center sent in a complete step-by-step checklist to prepare for the operation. May 18, 21 to 8.00. hours, as scheduled, arrived at the Regional Center for Endoscopy. The operation is scheduled for 9.00. hours. The reception rooms of the Regional Center are amazingly clean. Comfortable and soft armchairs for a quiet rest of the accompanying persons, quiet music sounds. Tea, coffee are offered for accompanying persons, everything is calm with respect. Sister – administrator Maria invites you to receive medical documents politely, answers questions calmly, calms you down, noticing the excitement.Exactly at 9.00. invited for an operation. A preliminary conversation with the anesthesiologist Sergei Olegovich Dyadyura, Alexander Anatolyevich Mitrakov in a mild pleasant form, then the operation itself. After the operation, the doctor offers to rest and get results, dietary recommendations and an invitation for further consultation. Everything is calm and with great respect for its visitor. From the bottom of my heart many thanks to Dr. Mitrakov Alexander Anatolyevich, anesthesiologist Dyadyura Sergei Olegovich for his high professionalism and sincere kind attention.I thank the sisters Maskova I.V., Ryabinchuk O.A. and sister – administrator Maria for their care and kind attitude. Give you GOD OF HEALTH, HAPPINESS and GOOD LUCK in your endeavors. Thank you. If anyone has problems in this area, I RECOMMEND to visit the Regional Endoscopy Center Nizhny Novgorod. Sincerely, Muravyova N.B.Saransk 05/22/2021

Nelly

She came to this center on the recommendation of her doctor at the local clinic. Before that I was in two honey. institutions where she did not receive clear explanations about her diagnosis and left in doubts without solving the problem.In this center, the administrator picked up a convenient appointment time to two specialists (gastroenterologist and endoscopist) by phone. Doctor Kryazhov V.A. politely listened to my complaints, questions and gave a clear explanation of the diagnosis, Dr. Mikhailova Ya.V. gave recommendations on the diagnosis with inflammation of the pancreas, explained all the examination results and made recommendations for a long period. I signed up for the removal of the polyp here. I express my gratitude for the professionalism and competence of the doctors and administrators of this center!

Maria

Visited this clinic on the recommendation of friends and did not regret it.The staff is very friendly, when you come there, you understand that everything will be fine and the examination will be done at the highest level, and that a team of professionals is working with the patients! I want to thank all the staff of the clinic who performed a comprehensive examination for me.

Natalya

I was looking for a woman doctor with experience and good reviews. I was advised by friends Smirnova from the Nizhny Novgorod oncological dispensary, but there she is on maternity leave, and now she works 2 times a week only at the regional endoscopy center.So I got to them on Yamskaya. A clinic in an interesting style, some kind of oriental theme. Very clean, nice, comfortable sofa, relaxing music, smiling receptionist. I don’t remember the procedure itself, because I did it in a dream, so I remember a conversation with doctors and nurses, delicious coffee after waking up (it was incredibly handy) and the joy that I made up my mind and passed the examination. Thanks to the staff for their attitude, to the doctor for a detailed story about the state of my intestines, and further treatment tactics.It turned out to be not as scary as I imagined myself. 😀 I recommend the clinic, everything is competent, mentally and with great attention, willingness to answer all questions and help in everything. Bravo!

Svetlana

I would like to thank Roman Sergeevich Bushuev and all the staff who performed a comprehensive examination under sedation. I was very worried, but the result pleased me. In the future, I will check your health and recommend to friends.

anna

I would like to express my gratitude to the staff of the center.A colonoscopy was scheduled, I was very worried about how it would pass, it took a long time to adjust, but upon arrival at your center, all fears were gone. Thanks to the endoscopist Bushuev Roman Sergeevich and his entire team of qualified specialists for the work done. Administrators Maria and Anastasia for their attention and support.

Raisa

Hello. I would like to express my deep gratitude to the staff of the Center. This is not the first time I have been examined in this Center. Before the first examination, N.Novgorod, now I am sure that my choice was correct. I am very glad to be in good hands! Postoperative examination was carried out by endoscopist Yevgeny Yuryevich Serebryakov, anesthesiologist Sergei Olegovich Dyadyura, nurses Ekaterina Guskova (anesthesia) and Irina Moskova (endoscopy). Indeed, the professionals are of the highest class! Competently, confidently and very calmly, they carry out all the manipulations. They want to trust. Modern medical equipment allows you to conduct examinations at the highest level! And Dr. Serebryakov will explain the results in great detail and clearly, answering all the questions.But an accurate examination is the key to further successful treatment. This excellent medical team is able to create a comfortable psychological mood for the patient, which is very important for us, probably, the positive attitude of a sick person also contributes to a speedy recovery. And thank you very much to the administrator of the Center Natalya Auzyak. She is the first to meet patients, receive phone calls. Responsive and friendly, will always help to solve the problem! Thank you all very much! You are awesome! I wish you all good health, personal well-being and all the very best! With great respect, Olga Smirnova.

Olga Smirnova

I don’t write reviews often, but here I just can’t help but share, suddenly someone is also in constant search. Lots of letters)) How glad I am that I chose this particular center to do a comprehensive examination! (colonoscopy and gastroscopy). From the very beginning I really liked the atmosphere, the interior, even the site. Nice colors, comfortable and understandable. This is important for me, my mental perception is heightened. After all, what surrounds us is a reflection of the inner. Lovely girls at the reception, everything is beautifully arranged, oriental themes, I would even say cozy, does not make you nervous).I love Japanese culture and their approach to many things. I was very impressed that the doctors of the center undergo advanced training abroad, constantly learn new things, develop. I read all the articles on the site))) I have a rather difficult health situation, I have tried so many clinics this year, and everything is not right. Sedation cannot be done, so I was preparing for the examination in consciousness, it was a little scary, of course. But when I saw the doctor – Kryazhov Vladimir Alekseevich, I even felt better at once)) kind, sympathetic, competent person, many thanks to him for his support and understanding! The office itself is comfortable, disposable linen, dim lights, a pillow, everything is as needed.I asked a lot of questions about my problem and not only, I wanted to learn more from an experienced specialist, since there was such an opportunity) I was struck by how the doctor turned this hose with buttons and wheels, as if playing some instrument masterly: D Since anesthesia was not, I tried to distract myself as I could) but actually not as scary as it seemed. Vladimir Alekseevich always warned when it would be unpleasant (at the bends of the gut). Since I’m quite thin, it felt stronger.But in general, the procedure is tolerable, when your life, health depends on it … all the more when you entrust it to a professional and a good person! On occasion, I will undoubtedly recommend, especially to relatives, grandparents of the age. With a patient approach like the Regional Endoscopy Center, there is nothing to be afraid of. At the expense of prices – although a little more expensive than in some other clinics, but for me the main thing, in addition to reliable results, is the humane attitude and the mood that remains after the appointment.Thanks to all the workers, doctors who have chosen this difficult path! Prosperity to the center! Thank you from my heart

Marina

Good afternoon, everyone! When the doctor prescribed me a comprehensive examination (FGS + colonoscopy) I was horrified, to be honest, it was VERY scary! For two weeks I was worried and collected my thoughts. I chose the procedure under sedation at the Regional Endoscopy Center clinic, and never regretted it! Choosing a clinic specialist, I got acquainted with his high qualifications, with reviews, watched the video, and decided – Roman Andreevich Gagaev.I was very pleased with the doctor and the entire team of the team of doctors who worked with me. All specialists are correct, there was no shyness or fear. The experts told and supported everything. Waking up from the procedure, there were no unpleasant sensations, everything is cool! Probably to say thank you, this is nothing to say! There would be more such young highly qualified specialists – professionals. Thank you so much – Roman Andreevich! I would also like to say a huge thank you to the doctors who worked with me: the anesthesiologist – Dyadyura Sergey Olegovich, and the anesthetist Olga Ryabinchuk – all professionals, provided support.For those who have doubts about doing or not doing such a procedure, I will say this – be sure to do it!

Elena

Visited this clinic for the first time, chose for a long time, and did not regret her choice. At the reception, the administrator of the center, Maria, professionally explained the procedure for conducting the survey, answered all the questions asked, and helped with the paperwork. The examination procedure and surgery (removal of polyps in the intestines), in my opinion, went perfectly. Medical staff Serebryakov Evgeny Yurievich (endoscopist), Dyadyura Sergei Olegovich (anesthesiologist), nurses Maskova Irina and Guskova Ekaterina are high-class professionals.Before the procedure, anesthesiologist Sergei Olegovich asked questions in order to have a complete “picture” of my condition. After that, Evgeny Yuryevich talked to me, who listened to me attentively and clearly explained how the examination would take place. The nurses are very attentive, I especially want to mention Katyusha Guskova. I am very grateful to the Doctor (with a capital letter) Evgeny Yuryevich Serebryakov. My husband and I decided that in a couple of months he will also undergo a comprehensive examination in your clinic by Doctor Serebryakov E.Yu It’s already been three days, I feel great! Thanks a lot! …

natalia 68 years old

Good afternoon! I want to express my deep gratitude to Raisat Saidovna Smirnova for her work! For her reverent attitude towards the patient! For her light hand, I have already done a colonoscopy 4 times! The first three times I did it in an oncological dispensary without medication, on the fourth I decided to try it in my sleep! Excellent doctor! Good results, very grateful for the consultation and before the procedure! Helped, advised a medicine to cleanse the intestines! If all the doctors were like that, believe me, it would be possible not to bring to a lot! And find out about your problems before! All health! Raisat Saidovna, thank you from my whole family!

Oksana

My mother was examined today at your clinic and asked me to express my gratitude for the sensitive attitude and support.She is not “friendly” with a computer due to her age, but after recovering from anesthesia she forgot everything out of absent-mindedness and could not thank her doctor Vladimir Alekseevich Kryazhov and his assistants for delicately and very kindly carried out the procedure. Thank you, doctor! Prosperity and more grateful patients, and of course, good health to everyone. Respectfully yours, Anna Mikhailovna

Anna

08/01/2021 did an endoscopy at the doctor Elena Anatolyevna Kirgintseva. the doctor “came running” to work at 10 minutes 9.literally in 5 minutes the doctor called me. I came to this clinic because I had a stomach ache, the pains were gone, but I wanted to find out why I had them. Elena Anatolyevna performed the procedure for me. I will say this, there are doctors who directly conduct a dialogue with the patient. Elena Anatolyevna just did her job and wrote out a conclusion to me. I myself clarified what I should take if there are pains, the doctor prescribed Omez. then I come home. I don’t eat anything. everything hurts me. just the strongest pains in the stomach, belching is going on, I can neither walk, nor sit, nor lie down, because my stomach ached very badly.my body was shaking all over. with tears in my eyes, I went to the pharmacy, where the pharmacist was horrified to see me and hear my story. the pharmacist contacted another pharmacist and decided that Almagel A. would help me by the evening my temperature rose by 39. The night passed. in the morning I get up. I still have a burp of air !! although I did not eat anything and I have never had anything like it. temperature 37.5. called the clinic. my doctor Elena Anatolyevna did not contact me. Mitrakov Alexander Anatolyevich contacted me.after that he accepted me. Thank you very much for taking the time to examine me. also the doctor is constantly in touch with me! I am very grateful to Alexander Anatolyevich. I refused to do FGDS again, because I still have pains. my opinion is the unprofessionalism of the doctor Kirgintseva E.A. … The question is, why am I still belching ?! I believe that I have accumulated air in my stomach and it expands the walls of the stomach. this gives me great pain. for such a procedure, I gave a total of 3.500tr. and in addition to this, I am being treated and buy medications after this procedure.although I went to the clinic to be examined, my health. but it turned out that they also crippled me with a plus! I still have a temperature of 37.5, belching (I don’t eat anything), stomach pains. Why should I give so much money for a poorly performed procedure? Why didn’t my doctor Elena Anatolyevna contact me? Why is it still burping? Alexander Anatolyevich is in touch with me for which I am grateful to him! …

Olga Goncharova

My choice of a doctor and clinic met all my expectations.I was going to do a comprehensive examination for a very long time, but I was scared by the preparation for the examination, and the procedure itself, because. I read all sorts of “horror stories” on the Internet, but on the site everything was described in detail and the girls administrators called back several times, clarified whether everything was clear and could have any questions. My preparation went well, I did not experience any negative consequences. I chose the doctor, Mitrakova Alexander Anatolyevich, got acquainted with his high qualifications, with reviews, with his scientific works, and decided to go only to him.My intuition did not disappoint me, neither in choosing a clinic, nor in choosing a doctor, this is a DOCTOR, there are very few of them today. Thank you very much Alexander Anatolyevich !!! A friendly administrator met and escorted me to Alexander Anatolyevich, who asked me in detail about my complaints, looked through the tests, told me how the examination would take place. I was very afraid, I was just shaking with fear, he calmed me down, assuring me that everything would go well, Then the anesthesiologist Dyadyura Sergei Olegovich talked to me, questioned, reassured me, and handed me over to the wonderful nurses Elena and Irina, who also supported me very much with their sensitivity and kind attitude towards me, thank them very much.From fear, my blood pressure jumped up, a drug was injected to normalize the pressure, and I very gently and imperceptibly sank into sleep. The whole examination went well. There were no negative sensations after the procedure, as if I just slept and that’s it. It turned out that all my fears were in vain, I got into the excellent professional hands of the medical staff! After the procedure, Alexander Anatolyevich told me everything and issued a conclusion on the diagnostics performed. I will definitely recommend your center to all my friends and acquaintances who need such an examination.I wish you, Alexander Anatolyevich, and your center new achievements in your work. With gratitude, Galina Gennadievna.

Galina Gennadievna

I would like to tell a very sensitive and attentive doctor Bushuev Roman Sergeevich. Previously I was examined by him in another clinic, but since he now works here, I signed up and came to you. The doctor already 3 years ago saw a polyp, albeit a very small, but still not very good polyp, which was not seen in the district clinic.It’s good that, feeling that something was wrong, I went to double-check, as a result, Roman Sergeevich deleted everything on time and without consequences. This time, fortunately, everything is fine, the doctor congratulated me sincerely! I recommend both the doctor and the clinic to everyone. Do not be afraid of anything, the attitude here is like with a child, no discomfort, in a kind way, you really want to live. All the best! Now I will celebrate the New Year calmly and without worries. Hope everyone has it better than this one. Happy New Year!)

Tatiana V

In November 2020, I arrived for hospitalization from Saransk, I was placed in a comfortable environment, then an operation was performed to remove a polyp in my stomach.I would like to express my gratitude to Mitrakov A.A. and all the medical staff for their professionalism, attentive attitude to the patient. The operation was successful thanks to their skill. Thank you so much!

Ekaterina Chetvergova

Good afternoon! Thanks for the info. My wife Tatyana Nikolaevna Bulakh expresses her gratitude to the doctor Serebryakov Evgeny Yurievich for the research (gastroscopy and colonoscopy). Before the examination, the doctor talked to her, and after the examination, he explained everything in detail based on the results of the study.Thanks also to the doctor – anesthesiologist Dedyura Sergey Olegovich, very friendly and attentive. Best regards, Bulakh family.

Anatoly Bulakh

I applied to the Regional Endoscopy Center in October 2020 regarding the removal of intestinal polyps. Many thanks to everyone! I would like to express my gratitude to the dearest girl consultant Natalya, who called several times, explained everything in detail, was interested in her well-being, gave her tea, and, of course, a deep bow to the maestro-doctor himself! Vladimir Alekseevich Kryazhov, attentive, tactful, explained everything clearly and in detail.I am surprised and shocked that we still have such doctors. Good luck and prosperity to your clinic! Hold on, gentlemen! (As far as possible, at this difficult time) I will definitely come in the spring.

Anna

In October 2020, underwent a comprehensive examination under sedation. Dear Nina Nikolaevna! Thank you, as the head of the Regional Endoscopy Center, which has created a wonderful medical institution in which you feel very comfortable from the first minute of your stay until the end of the examination.Your well-chosen staff has made your center one of the best in the city. I would like to express my gratitude to you for your great skill, the highest professionalism and the warm atmosphere that lives in your center. I wish you and your team good health, energy, great success and joy, so that you have the strength to do good as long as possible. My thanks to you, sincere, huge, from the bottom of my heart! Sincerely, Lemzyakova S.F.

Lemzyakova S.F.

This is not the first time I visit the Regional Endoscopy Center, and there are only positive impressions, friendly and tactful Administrators at the reception, and what is really important is competent and attentive Doctors.Reception is carried out at exactly the appointed time. This medical center can be recommended with confidence to your relatives and friends.

Elizaveta

Passed FGDS at E.Yu. Serebryakov in June 2020. The clinic is clean and comfortable. Before the examination, the doctor asked everything, clarified what worries and what was in the previous examinations. I froze my throat thoroughly (I underwent FGDS without anesthesia), told everything about how the procedure would go, then carried out the procedure itself. Since I have something to compare with, I have about a dozen FGDS behind me, I can say that the doctor does the procedure itself well, which is important, he is not silent during the whole procedure, he says what and how to do, talks with the patient))) looks carefully and neat.After the procedure, the doctor told me what he saw during the examination. The only thing that remained incomprehensible to me when atrophy was detected, for some reason, they did not take a biopsy.

Ekaterina

Good clinic. Very friendly staff. Doctors with excellent practice, explain everything in detail.

Maria

June 22 was at the FGDS in this center. Everything went smoothly and painlessly. They met, explained everything, took him to Doctor Serebryakov Yevgeny Yuryevich, he explained everything literally, what and how it would be carried out.Then they took me to the anesthesiologist, talked to him (unfortunately I did not remember the name of the anesthesiologist). Then the medical staff entered the work, they did everything and put them neatly. Then you fall asleep and wake up. They took me to the resting place, gave me tea and cookies, and went home. After several days, I visited the gastroenterologist Y.V. Mikhailova. she explained everything and chewed it up in a language I could understand. I liked everything about this center. Many human thanks to everyone.

Alexander

June 20, 2020 underwent a comprehensive examination by Vladimir Alekseevich Kryazhov.The doctor is very pleasant, as well as the whole team. Previously, I heard not the most pleasant reviews about such procedures, so I decided to trust only the experienced team of the Regional Endoscopy Center and only under intravenous sedation (anesthesia). It went like a fairy tale. They turned you off – turned on and you’re done. And most importantly, not any painful sensations. I wish the whole team health and family well-being.

Denis

On May 16, a very large polyp in the sigmoid colon was removed.I was received by Dr. Vladimir Alekseevich Kryazhov. A handsome, attentive, courteous young man met me at the receptionists. The operation went well, for which I am very grateful to Dr. Vladimir Alekseevich Kryazhov and all the medical workers who were fussing around me. After the operation, they gave me tea, gave the appropriate recommendations and documents, and took them to the exit. We were invited to consultations. I would like to say about the center itself: a beautifully decorated room and a polite lady at the reception cheer you up.What surprises me is that I sent all the analyzes, all certificates and other documents for the operation by e-mail. The doctor got acquainted with my documents and by phone appointed the day and time of the operation. When I arrived at the appointed time, they were already waiting for me in the center. Once again, I thank all the workers of the regional endoscopy center for your work and wish you all HEALTH, HEALTH and HEALTH. Sincerely Zueva Lyudmila Nikolaevna, Kulebaki, Nizhny Novgorod region

Lyudmila

I did a comprehensive examination at Vladimir Alekseevich Kryazhov on Saturday.Everything went great – many thanks to all the staff for such a friendly attitude towards their patients.

Sergey

I liked the clinic very much !!! I did a comprehensive study (FGDS and colonoscopy) under sedation. Everything went perfectly! I want to express my deep gratitude to the doctor Elena Anatolyevna Kirgintseva and all the specialists who were near me. All are friendly, masters of their craft, professionals! I was very afraid and worried before this procedure, but it was in vain.I fell asleep, and woke up after all the manipulations. I will recommend this clinic to friends and family, because health is the most expensive !!! Thank you BIG to all the staff.

Yana, 36 years old

I visited this clinic for the first time and never regretted my choice. I signed up for a not very pleasant procedure (as it seemed to me initially) gastroscopy and colonoscopy under medical anesthesia, but then my opinion changed for the better, thanks to the friendly doctors and staff. Everything went perfectly, from making an appointment to saying goodbye.I’ll tell you from the very beginning. Upon entering the clinic, you immediately switch to a spiritual and calm mood, everything is very clean, neat and home-like. The affable and radiant administrator Julia immediately told everything and took him to the doctor Serebryakov Evgeny Yuryevich. The doctor inquired in detail about my complaints, looked through all the available tests and previously done studies, told in detail how my procedure would be held. After talking with him, my fears just disappeared. Then I went to the office, where nurse Irina and anesthesiologist Daria met me, measured my blood pressure, and provided me with special underwear for colonoscopy.Everything went just perfect. I express my deep gratitude to you all for your work, responsiveness, understanding. I will definitely recommend this clinic to my friends and acquaintances. I wish you health and prosperity to the clinic!

Anna

It was necessary to undergo an unpleasant colonoscopy procedure, I postponed everything for a very long time, I did not dare, because I had heard enough reviews. I went to your clinic and was very pleased. The atmosphere is more friendly – everything is clear, calm, from the reception to the procedure itself.The procedure itself took place in a dream, the nerve cells were not wasted. Doctor Serebryakov Evgeny Yuryevich explained everything in detail, before the procedure, and afterwards introduced the results of the examination, everything in a very understandable language. Thank you all! I would be happy to recommend your clinic.

Tatiana

I would like to share with you about the FGDS procedure (gastroscopy with sedation). I did this procedure in a polyclinic (without anesthesia) and it was so terrible that it was postponed for the rest of my life. When I needed to repeat EGD, I turned to the Regional Endoscopy Center.From the first step I found myself in a friendly atmosphere, I was met by a wonderful girl at the reception – Ksenia, and then everything was like in a fairy tale, first I talked to a wonderful doctor – Serebryakov E. Yu., He asked me everything, calmed me down and handed me over to anesthesiologists A. A. and Olechka R., they set me up, calmed me down and a wonderful nurse Irina made a professional injection into a vein, and I fell asleep. Then they woke me up. I am very grateful to this team, which is doing their job at the highest professional level.Thank you very much. Respectfully yours, IA Lipatova. I recommend this center to everyone.

Lipatova I.A.

I liked the atmosphere, attentive administrators, very pleasant and attentive nurse Irina. Special thanks to Doctor Kryazhov! I went through FGDS urgently, everything was very neat and not painful, very attentive doctors and medical staff, they explained everything, set up. Excellent new equipment, high-quality repairs, tea / coffee (not even useful) – they accepted it right away. I didn’t think that such a procedure would cause such positive emotions.And a week earlier, my mother had a colonoscopy in this clinic, without sedation, she was pleased with the attentive attitude and the absence of severe discomfort! Accepted on time, reminding us of the visit in advance! I would recommend the “Regional Endoscopy Center” to my friends, everything is at the highest level, thank you very much, you are real professionals!

Anonymous

Got an appointment with the chief physician, Professor Nina Nikolaevna Mitrakova. This is the first time I have met a doctor of this level, I have already tried to do the third colonoscopy and finally it worked! I want to say one thing: there are many good equipment now, but golden hands are rare.It doesn’t hurt, with detailed comments and an attentive tactful attitude – this is how I can tell you about the examination itself. You rarely meet such a competent doctor (I can only compare her with Abelevich). I recommend the center itself to everyone, and especially Mitrakov, now I send all my relatives only to her. Thank you!

Elena

I visited this center for the first time, signed up for a study. I really liked that, from the point of view of the client’s safety, the work there was very well organized during the quarantine period.There were no clients except me, when I entered, a woman came out in front of me. That is, the recording is carried out so that people do not intersect with each other. All surfaces are treated with antiseptics. Roman Andreevich Gagaev is a calm, attentive, tactful person, he looked at everything very carefully. He correctly identified my problem, although he was not obliged to advise me. I got the result in my hands, the description is detailed. I was very pleased!

Natalia

Visited an endoscopist.I was accepted even early. The doctor is polite and helpful. The procedure was performed with anesthesia. The doctor immediately wrote the description. It can be seen that the doctor is a professional with a capital letter, as he explained everything clearly and intelligibly to me and I was very pleased. And everything in the center, I would even say, is sterile and at the reception everyone is polite and everything is at the highest level!

Sergey

I want to express my deep gratitude to the doctor Vetyugov Dmitry Evgenievich for the professionally conducted research (colonoscopy and gastroscopy).I am very lucky that my doctor is a highly qualified and responsible specialist who listened very carefully to all the complaints before the examination and gave detailed explanations based on the results of the study. Many thanks to the anesthesiologist Olga Vyacheslavovna Polyakova, Elena Guseva, the nurse, and Lyubov, the administrator of Loginova, for their kind and sensitive attitude.

Kolomytova V.I., 70 years old

I would like to express my gratitude to the endoscopist Gagaev Roman Andreevich and the anesthesiologist Isakov Oleg Vyacheslavovich for their professionalism, efficiency in decision-making, and attentive, humane attitude.In September 2019, my mother was contacted at this center, a colonoscopy (with sedation) was performed with the simultaneous removal of intestinal polyps. The operation was painless, and there were no discomfort after the operation either. Thank you again and further success in your profession !!!!

Julia

At the highest level, everything – starting with the provision of parking, the clinic itself – everything is beautiful, cozy, comfortable, everything you need is provided. up to shoe care products and deodorant. Well, in fact, the medical services are at the highest level.I am very happy! Many thanks to Alexander Anatolyevich and all the other specialists who participated. I was very afraid of the procedure itself (colonos and gastroscopy), but even after the examination there were no unpleasant sensations in the body – as if I was just sleeping. Previously, I did FGDS in other places – the larynx hurt for a couple of days later. I was afraid to even think about the column. Attentive staff, informal, human attitude. While I was resting after the procedure, after consulting a doctor, a nutritionist talked to me, clarified how to eat after a diet and examination.offered tea and treated with personal chocolate, which was very supportive both mentally and physically – I really wanted to eat))). Many thanks to everyone again! I will come to you, as the doctor prescribed, in a year and a half!

Svetlana

My mom needed to check the upper and lower intestines. We made an appointment with Raisat Saidovna Smirnova for a diagnostic examination. At the first visit, an FGDS study was performed: everything went very easily and painlessly. This is not the first time Mom has done FGDS – and always unpleasant sensations, it was much better here.During the third visit, a colorectal examination was scheduled. Preparations for the study went smoothly on Moviprepe. Everyone who talked about this procedure said that the preparation for it is difficult: you need to drink a lot of liquid, and as a result, the intestines are not clean. But the preparation and the procedure itself went well. Mom did it without anesthesia, carbon dioxide was injected into the intestines. On the first day after the study, the intestines “did not swell”. Before that, they did it in another center “in the air” and for a long time there were unpleasant sensations: (After the procedure, they gave me the opportunity to rest and sent me home by taxi.I recommend this center to everyone. The staff is friendly, competent specialists!

Ekaterina

I thank all the staff of the clinic for their friendly attitude towards their patients! The clinic has an atmosphere of kindness and comfort. All medical processes are organized at a high level! The examinations are carried out in a very comfortable environment for the patient. As a doctor, I want to note the highest professionalism of the center’s specialists! I wish you success and prosperity!

Ekaterina

I express my HUGE THANKS to the specialists of the center and especially to Mitrakov Alexander Anatolyevich for HUGE PROFESSIONALISM.Before contacting the “ENDOSCOPY CENTER” For several years we have been trying to make the correct diagnosis, underwent a large number of examinations, did a colonoscopy – the result was zero. On the advice of friends, we turned to Alexander Anatolyevich, although we had to go to another city, we are from Samara, but Mom’s health is more expensive. Nice and polite staff, they made high-quality anesthesia, conducted a thorough examination (there is something to compare with), they explained and told everything. Finally, the correct diagnosis was made. Now we are undergoing treatment in our city.We will definitely apply for a follow-up examination after undergoing a course of treatment. THANK YOU!!! Health to all!

Radjabov Kazbek

Dear Alexander Anatolyevich! Many thanks to you and the staff of the endoscopy center for a prompt and high-quality operation. I wish you success, health and well-being! Thank you! Respectfully yours, patient Igor Vasilievich G.

Igor Vasilievich

Vladimir Alekseevich Kryazhov is one of the best endoscopists in our city, he has a lot of well-deserved awards and certificates.I studied the reviews for a long time before deciding to remove the formation in the intestine, and did not regret choosing it. I did everything neatly, removed the tumor, nothing bled with sweat, did not hurt, and after six months, no traces remained in this place at the control examination. Thank you, doctor!

Nikiforova Olga

I did the examination of the intestines under anesthesia at Elena Anatolyevna Kirgintseva. As soon as I opened my eyes, first the anesthesiologist talked to me, and then the doctor came to the ward and answered my questions in general terms.There was nothing special to tell, as it turned out that everything was fine with me. And those horror stories that scared me in another clinic are just functional features. There is nothing that needs to be removed, you just need to change your attitude to nutrition and lifestyle !!! And I also liked the attitude towards myself, the paramedics reassured me, the anesthesiologist was also good, the doctor consulted me, fully informed me about the procedure. She told everything with humor to relieve my tension. She managed to calm me down.The main thing is that after the examination, I do not feel the consequences. Judging by the conclusion received, I do not need to reapply. But if the need arises – only to her.

Oksana Mamontova

Swallowing the intestine for bowel examination – it became pleasant, of course, but at least without pain and quickly enough, as it turned out. I did it for the first time, so I was afraid. It was done by the doctor Raisat Saidovna. I fell asleep and then they woke me up when it was over. There was no pain. Thank you!

Ekaterina

I have been undergoing treatment for a year with a gastroenterologist and everything is unsuccessful, I change one medicine for another.I accidentally heard from my friends about a good consultation with Dr. Gagaev and decided to go. The examination was good, there is something to compare with (it was the 4th FGDS, a couple of times the throat was ripped off, which then could not eat). We also discussed nutrition with the doctor, gave recommendations on diet and lifestyle. The doctor has a wide knowledge of his field. I think that I will be able to recommend it to my friends, as well as to me in due time. Later, I visited a gastroenterologist on his recommendation, and finally the treatment began to help, and I have experience of referring to other doctors, so I have something to compare with.I brought with me fresh examinations, a week ago, I also had tests with me. I would also like to note that I was given twice as much time as previously agreed, although it was the end of the working day and the clinic was already closing. Summary: score 5 points for professionalism and attitude towards patients!

Pavel Alekseevich

I want to express my deep gratitude to the endoscopist Mitrakov Alexander Anatolyevich for his excellent work, professionalism and attentive attitude.I am very glad that I fell into the hands of such a highly qualified doctor! I also thank A.V. Klyueva. and Belyakov O.B. for a sensitive attitude and benevolence. I wish you all health, prosperity and success in everything! Thank you!

Lyudmila

I want to express my gratitude to the excellent specialist – Mitrakov Alexander Anatolyevich, as well as his assistants for their professional, responsible and qualified work! For your attention and responsiveness, understanding and goodwill! I would like to wish you good health and great success!

Galina Vasilievna

Endoscopy room – Private healthcare institution Hospital RZD-MEDICINE, Volkhov city

Endoscopic diagnostics

Currently, endoscopic diagnostics is a real means of preventing early cancer of the stomach and colon.Unfortunately, cancer in the early stages does not hurt, and all the clinical manifestations associated with this disease indicate that it has reached a fairly advanced level. In this case, the possibilities of both surgical and other types of treatment may be limited. Only the screening of early cancer, the detection of precancerous conditions allows for timely treatment, including through an endoscope, and to achieve complete deliverance of a person from cancer. Therefore, in modern living conditions (environmental conditions, quality of nutrition), endoscopy of the upper and lower gastrointestinal tract is necessary for absolutely everyone, starting from the age of 40 years , even in the absence of symptoms of the disease.

Endoscopy office of the private healthcare institution “Hospital” Russian Railways-Medicine “of the city of Volkhov”

The office is equipped with a modern digital video endoscopic system Pentax EPK-1000 (made in Japan),
allowing high-quality diagnostics. Equipment processing is carried out in accordance with modern sanitary
rules and regulations. Research and interpretation of results is carried out in accordance with Russian and 90,020 international recommendations.The conclusion is formed on the basis of modern classifications. Quiet atmosphere,
polite and friendly staff, and the possibility of conducting research under anesthesia (medication sleep) will make the
examination as comfortable as possible for you.

The following types of diagnostic and treatment-diagnostic studies are performed in the office:

• Esophagogastroduodenoscopy.
• Colonoscopy.
• Sigmoidoscopy (examination and assessment of the condition of the rectum and part of the sigmoid colon).
• Chromoendoscopy (staining of the mucous membrane for a more accurate diagnosis of difficult to distinguish diseases).
• Express diagnostics of Helicobacter pylori.
• Sampling of material for histological examination (biopsy).
• Removal of polyps and other neoplasms of the gastrointestinal tract.
• Mucosal resection for laterally growing tumors.
• Extraction of foreign bodies from the esophagus, stomach, duodenum, colon.
• Endoscopic hemostasis for gastrointestinal bleeding by clipping, electrocoagulation.

Esophagogastroduodenoscopy (VGDS, EGDS, FGDS)

Esophagogastroduodenoscopy – a type of endoscopic examination of the organs of the upper gastrointestinal tract (esophagus, stomach and duodenum) using an endoscope. This procedure allows, if necessary, to conduct a biopsy, express diagnostics of Helicobacter pylori, and, if necessary, makes it possible to perform therapeutic manipulations (stop bleeding from an ulcer, remove neoplasms, remove a foreign body).

Read more: Esophagogastroduodenoscopy

Video colonoscopy (VKS, FKS)

Video colonoscopy is a modern method of endoscopic examination of the colon and terminal ileum. It is performed using a special flexible instrument (colonoscope). The device has a light source at the end and a video camera that transmits a high-resolution image to the monitor.