We offer endoscopy and colonoscopy procedures in conjunction with our bariatric surgery procedures. We have one of the most experienced endoscopy and colonoscopy teams for bariatric surgery patients in the Northeast.

Upper Endoscopy

An upper endoscopy (EGD) is a procedure used to look at the interior lining of the esophagus, the stomach, and the first part of the small intestine through an endoscope. The endoscope is inserted through the mouth and then gently fed down the throat into the esophagus, stomach, and duodenum (upper gastrointestinal tract). You will be under sedation and asleep for this procedure.

It is important to perform this procedure in patients prior to bariatric surgery to make sure the patients don’t suffer from gastroesophageal reflux disease, hiatal hernia, bacterial infection with H. pylori, ulcers, and tumors. Endoscopy is sometimes performed in bariatric surgery patients after surgery if they experience persistent vomiting, abdominal pain, inability to feel full, decreased weight loss, gastroesophageal reflux disease. If patients develop a stricture of the gastro-jejunostomy (the connection between the stomach pouch and small intestine) it can be easily dilated in the office in our state of the art endoscopy suite.

Colonoscopy

Colonoscopy is a test that looks at the interior lining of the large intestine (rectum and colon) through a thin viewing instrument called a colonoscope. A colonoscopy, inserted through the rectum, helps detect ulcers, polyps, tumors, and areas of inflammation or bleeding. During a colonoscopy, a biopsy can be performed and abnormal growths can be removed. Colonoscopy also can be used as a screening test to identify and remove pre-cancerous and cancerous growths in the colon or rectum (colorectal cancer). Colonoscopy enables visual inspection of the entire large bowel from the distal rectum to the cecum. The procedure is a safe and effective means of evaluating the large bowel. The technology for colonoscopy has evolved to provide a very clear image of the mucosa through a video camera attached to the end of the scope.

The camera connects to a computer, which can store and print color images selected during the procedure. Compared with other imaging modalities, colonoscopy is especially useful in detecting small lesions such as adenomas; however, the main advantage of colonoscopy is that it allows for intervention, because biopsies can be taken and polyps removed. Screening for and follow-up of colorectal cancer are among the indications for colonoscopy. Although colorectal cancer is highly preventable, it is the second most common cancer and cause of cancer deaths in the United States. Both men and women face a lifetime risk of nearly 6% for the development of invasive colorectal cancer. Proper screening can help reduce mortality rates at all ages, and colonoscopy plays an important role in this effort.

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Indications For Colonoscopy

Surveillance of asymptomatic people of average risk older than 50 years Recommendations varies among the leading organizations in this field, namely the American Cancer Society (ACS), the World Health Organization (WHO), the US Preventive Services Task Force (USPSTF), and the American College of Physicians (ACP). It is generally recommended, however, that average-risk adults should begin colorectal cancer screening at age 50 years, utilizing one of several options for screening, among which is colonoscopy, every 10 years. Annual fecal occult blood testing (FOBT) and periodic flexible sigmoidoscopy with follow-up colonoscopy are also recommended for average-risk screening.

Further Evaluation of Polyps

The finding of a polyp larger than 1 cm in diameter during sigmoidoscopy is an indication for examination of the entire colon because 30-50% of these patients have additional polyps. Though controversy continues regarding whether colonoscopy is indicated for patients with a polyp(s) smaller than 1 cm, the general belief is that most cancers arise in preexisting adenomatous polyps, which should lead to a full colonoscopic examination, regardless of size.

If clinical signs and symptoms suggest colon cancer or when screening (by radiography or sigmoidoscopy) identifies a large bowel tumor, a full colonoscopic examination should be performed to obtain biopsy samples and to search for other lesions. Findings on colonoscopy may also have implications for the surgical treatment plan.

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