Endoscopic Ultrasound (cont.)
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What is the preparation for EUS?
Your doctor will want to know about your health status especially if you have any allergies, other significant health problems such as heart disease, lung disease, or diabetes mellitus.You will also be asked about allergies to iodine or shellfish as, under certain circumstances, iodine containing contrast material may be used. If there is a possibility of fine needle aspiration (FNA), the doctor will want to check your blood for proper clotting. It is important to inform your doctor of any family history of bleeding problems or if you are taking medications that interfere with blood clotting (such as Coumadin) or platelet function (such as aspirin, Motrin, ibuprofen, Aleve, and other NSAIDs). The wisest approach is to inform your doctor of any prescription or non-prescription medication you might be taking. Antibiotics are usually not required except in patients with certain heart valve problems.
EUS is performed with sedation so you will not be able to return to work or to drive for 24 hours. It also means that you will need someone to take you home as this is usually an out-patient procedure.
You will need to have an empty stomach, which means no oral intake for 6 or more hours. In case of a rectal EUS, you will probably need to take some enemas or laxatives. In either case, full instructions will be given to you.
How is EUS performed?
Upon arrival at the endoscopy center, the nurse or the doctor will discuss the procedure and answer any questions. You will then be asked to sign a consent form indicating you were informed about the procedure, its alternatives, and its risks. You will undress and put on a hospital gown. An IV will be placed in a vein and kept open with a slow drip of IV fluid. This IV will be used to administer the sedatives or other required medication. Anesthesia is rarely used. You will then be taken into the procedure room and, after the administration of the sedation, the EUS will be carried out. Small electrode patches will be placed on your skin for the monitoring of your blood pressure, pulse, and blood oxygen.
Once sleepy, the special endoscope will be inserted and the procedure started. Due to the sedation, you will only feel minimal discomfort, if any, during the entire procedure. The physician will observe the inside of your intestinal tract on a TV monitor and the ultrasound image on another monitor. The entire procedure generally takes 30 to 90 minutes depending on the complexity and whether fine needle aspiration (FNA) is performed.
After the procedure, you will be sleepy for up to one hour and be unable to drink or walk. Once you are fully awake, the doctor will discuss with you and, if desired the person with you, the findings of the procedure. Barring any rare complications, when you are fully awake, your companion will be able to take you home where you should rest for the remainder of the day. Light meals and fluids are allowed. You may feel bloated from the carbon dioxide that may have been used to distend your abdomen, but this feeling will only be temporary. Should your throat be mildly sore, for a day or two, salt-water gargles will provide relieve. You should call your doctor if concerned about your progress or having severe pain, vomiting, passage or vomiting of blood, chills or fever. If EUS was particularly difficult or complicated you may be kept in the hospital overnight. The endoscopist will discuss this with you, when you wake up.
Medically Reviewed by a Doctor on 1/31/2014