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- Colon, Liver, Gastro Consultants
- 16651 Southwest Freeway, Suite 370
- (Sugar Land Methodist Hospital professional Bldg #1)
- Sugar Land, TX 77479
- Phone: 832-667-7355 OR 281-565-1009
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Here is a brief description of various tests/procedures you might be required to undergo. For details about major procedures like Colonoscopy or EGD click on the links to the left. UPPER GI SERIES Mostly done to rule out ulcer in your stomach or duodenum (the first part of your intestine). You will swallow barium and X-rays will be taken of the esophagus, stomach and duodenum. Entire test usually takes upto fifteen minutes. A mild laxative such as Milk of Magnesia should be taken after the test to purge the barium since it can occasionally lead to severe constipation. LOWER GI SERIES (BARIUM ENEMA) In addition to detecting colon cancer and polyps this test also helps identify a redundant colon or diverticulosis, a lax colon, or strictures and other less common conditions. Except when looking specifically for colon cancer or polyps, a barium enema provides much more information than a colonoscopy. The test is performed by inserting a small tube into the rectum and a filling a balloon air so it cannot be easily expelled. Barium is then introduced through the tube until the colon is full. When an "air contrast barium enema" is done, air is also infused for better visualization. The test takes ten to fifteen minutes. You may experience mild cramping and a mild urge to have a bowel movement. CATSCAN This test takes multiple x-rays of the abdomen from different angles which are then assembled into a single picture by a computer to provide a cross-sectional view of different "slices" of the abdomen. You drink thin barium before the test and and iodine based contrast will be given intravenously. If you are allergic to iodine, several medicines can be taken for three days before the test and a low iodine contrast material will be given intravenously. You will be moved through a short tunnel-like structure (about three feet long). The test takes between ten to thirty minutes and is painless. ULTRASOUND This test is done by passing ultrasound waves through your abdomen. Usually, the gallbladder, liver, pancreas and kidney are examined. No radiation is involved and the test should take no more than ten to twenty minutes. It is painless, but some pressure is felt because the ultrasound probe must be firmly pressed against the abdomen. NUCLEAR MEDICINE More and more we are coming to realize that many of the symptoms of IBS are due to motility disturbances (i.e. contraction and relaxation of the gut). Nausea, vomiting, abdominal fullness, and ulcer pain in the absence of an ulcer can all be caused by stomach and upper small intestine dysmotility (abnormal motility). For this test, you will be asked to eat a small amount of food that has a minute amount of radioactive material attached to it. By using extremely sensitive scanners, the meal can be seen in the stomach and the time it takes for the stomach to empty can be determined. If the test shows slow emptying, your doctor can give you medicines that can normalize it. The test is painless and takes sixty to ninety minutes to perform. The radioactivity you receive is about the same dose as for a routine chest X-ray and is very safe.
Endoscopy EGD / UPPER PANENDOSCOPY (for more details and
pictures see the respective pages) In order to do the test, you must fast overnight. An IV will be inserted into a vein so that sedative medication can be given. After you are asleep, a thin tube that can send a picture to a television screen will be placed into your mouth and then into the esophagus. Since you will be asleep you will not gag or vomit. The doctor doing the test will be able to see your esophagus, stomach and upper small intestine. Biopsies can be done if necessary (you have no pain nerves here so it won't hurt and you won't be sore afterward). This is by far the best test to look for ulcers, esophagitis, gastritis, etc., but it is also expensive and relative invasive so your doctor will order it only in highly selected cases. If your friends have told you "horror stories" about their endoscopies, I can assure you that the test was not properly done. The only uncomfortable part should be the IV. The sedation time is usually five to ten minutes, the endoscopy takes five to fifteen minutes and the recovery (i.e. waking up time) is twenty to thirty minutes. COLONOSCOPY This test is the best test to look for cancer and polyps and will discover over 95% of these lesions (barium enemas will miss 15%-20%). If a polyp is found, it can be removed at the same time; this is painless since you have no pain nerves in the lining of your colon. Biopsies can also be done if a mass is found or if colitis (inflammation) is suspected. When pain is the primary symptom, this is not the best test to do since a barium enema will provide more information about the shape and function of the colon. As with the upper panendoscopy, an IV is placed so that sedation can be given. The test generally takes thirty to sixty minutes and the waking up time is twenty to thirty minutes. This is not a painful test if done properly! The only time this test is painful is if the doctor doesn't give you enough sedation. The colon must be very clean to do the test and therefor harsh laxatives must be given beforehand to purge completely. FLEXIBLE SIGMOIDOSCOPY This is like a colonoscopy but the tube that is inserted is much shorter and only enemas are needed to prepare the colon. It is often done in your physician's office and doesn't require an IV or sedation. It can quickly tell your doctor if your have inflammation of your colon or if bleeding is coming from the lower part of the colon. Biopsies can be done (again, this painless). The test should take only five to ten minutes in experienced hands and generally you will only feel some gas and moderate cramping. In women who have had a hysterectomy the test is more uncomfortable due to adhesions (scar tissue) around the bowel. Some patients with IBS are more sensitive to bowel distention and stretching and can be momentarily more uncomfortable.
Blood Tests CBC This is a blood count. It tells your doctor if you're anemic, if your white cell count is high (possibly indicating an infection) or low (possibly indicating a virus, etc.), and other aspects of your blood. This should be done in all patients initially. If you are anemic, then other tests may need to be done. In patients over forty, iron deficiency anemia should always be explained and further testing should be done. Starting iron therapy without testing is never acceptable. CHEMISTRY PANEL This test provides a wealth of information to your doctor. It shows how much salt and potassium (which can be lost with diarrhea) are present, how the liver is functioning and even give a very general picture of your nutrition. ANTIGLIANDIN ANTIBODIES Celiac sprue is a partially understood disease that has a very insidious onset. It is caused by a sensitivity (not an allergy) to gluten, a component of certain grains such as wheat, barley and oats. In this disease, the cells in the small intestine that are responsible for absorbing food lose their ability to absorb nutrients. This results in the slow onset of malabsorption and ultimately, malnutrition. Early symptoms can be bloating, increasingly audible bowel sounds, loose stools, etc. Since these may be the same symptoms that many patients with IBS experience, the diagnosis could be falsely attributed to IBS. A blood test has been developed to detect this sensitivity to gluten - antigliandin antibodies. This test is especially useful in children, but in adults it can give unacceptably high false results. It can be "positive" in 20% of people who don't have the disease and "negative" in 15% of people who do have it. Since the diet that must be maintained for the rest of your life is very rigid and Spartan, this diagnosis should never be made on the basis of a blood test. Currently, the only definitive way to make the diagnosis is by biopsying the small intestine at upper panendoscopy. Other blood tests are currently being evaluated, but they are as yet unproved in establishing this diagnosis. ANTIGIARDIA ANTIBODIES Giardia is a parasite that lives in the small bowel. It can cause severe diarrhea when the infection is acute, but chronically it can cause more subtle symptoms such as intermittent bloating, flatulence, loose stools, etc. Blood testing for this parasite is still being evaluated and may eventually be useful, but currently it should not be relied upon. Testing of stool samples for antigens (i.e. parts of the organism) has proven useful and can even pick up cases of infection when the microscopic examination of the stool was negative. Presently, most doctors and labs make the diagnosis of Giardia by having specially trained technicians look at stool specimens for the parasites. If nothing is seen after looking for twenty minutes, then the sample is reported as negative. Human error or low concentrations of parasites can lead to "false-negatives", which means a test is reported as negative when the patient really has the disease. H. PYLORI ANTIBODIES In the past few years, we have come to understand that most ulcers are actually caused or perpetuated by a bacterium (Helicobacter Pylori) that lives in stomach. Research into this area is rapidly changing our understanding of the diseases and symptoms caused by this bacterium. At present, we know that it can cause gastritis (irritation of the stomach lining but with no ulceration) and should be treated. However, it can also be present when there are no ulcers or gastritis are found in patients who have ulcer-like symptoms (non-ulcer dyspepsia). Your body develops antibodies to H. Pylori if you are infected and these can be found by a blood test. If you have an ulcer and a positive blood test, you should definitely be treated for this infection. If you have ulcer symptoms and no ulcer, most studies show no improvement over placebo when the infection is treated. However, our knowledge is rapidly expanding and new research could change these recommendations. |
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