For the best possible examination, the stomach must be empty. The
patient should not eat anything after midnight on the evening preceding
the exam. In case the procedure is performed early in the morning, no
liquid should be taken. In case the examination is performed at noon time,
a cup of tea, juice, milk, or coffee can be taken 4 hours earlier. Heart
and blood pressure medications should always be taken with a small amount
of water in the early morning. Since the procedure will require
intravenous sedation, the patient needs to have a companion drive him/her
home after the procedure.
The patient will be given medication through a vein to cause relaxation
and sleepiness. The patient will be given some local anesthetic to
decrease the gag reflex. Some physicians do not use local anesthetic and
prefer to give the patients more intravenous medication for sedation. This
also applies to those patients who have a history of allergy to Xylocaine,
cannot tolerate the bitter taste of the local anesthetic, or the numbness
sensation in the throat. While the patient is lying on the left side on
the x-ray table, the intravenous medication is given and then the
instrument inserted gently through the mouth into the duodenum. The
instrument advances through the food pipe and not the air pipe. It does
not interfere with the breathing and gagging is usually prevented or
decreased by the medication.
When the patient is in semi-conscious state, he/she can still follow
instructions to change the position on the x-rays table. Once the
instrument has been advanced into the stomach, there is minimal discomfort
except for the foreign body sensation in the throat. The procedure can
last any where from fifteen minutes to one hour, depending on the skill of
the physician and the anatomy or abnormalities in that area.
After the procedure, the patients should be observed in the recovery
area until most of the effects from the medication have worn off. This
usually takes one to two hours. The patient may feel bloated or slightly
nauseated from the medication or the procedure. Very rarely a patient
experiences vomiting and may belch or pass some gas through the rectum.
Upon discharge, the patient should be driven home by his/her companion and
is advised to stay home for the rest of the day. The patient can resume
usual activity the next day. Even though the physician may explain to the
patient or companion regarding the findings after the procedure, it is
still necessary to call the physician the next day to ensure that the
patient understands the results of the examination.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Gallstones are stones that form when substances in the bile harden. Gallstones (formed in the gallbladder) can be as small as a grain of sand or as large as a golf ball. There can be just one large stone, hundreds of tiny stones, or any combination. The majority of gallstones do not cause symptoms.
Pancreatic cancer is a malignant tumor of the pancreas. Pancreatic cancer has been called a "silent" disease because early pancreatic cancer usually does not cause symptoms.
Pancreatitis is a rare disease in which the pancreas becomes inflamed, occurring when digestive enzymes are activated and begin attacking the pancreas causing damage to the gland. There are two types of pancreatitis, acute and chronic. Most commonly caused by alcohol or gallstones, it can lead to bleeding in the gland, serious tissue damage, infection, and cysts. Enzymes and toxins may then enter the bloodstream and seriously injure organs, such as the heart, lungs, and kidney.
Jaundice is a yellowish staining of the skin and whites of the eyes (sclerae) with bilirubin, the pigment found in bile. Jaundice can be an indicator of liver or gallbladder disease, or it may result from the rupture of red blood cells (hemolysis).
Gallbladder cancer is a rare form of cancer with symptoms that include jaundice, abdominal pain, fever, nausea and vomiting, abdominal lumps, and bloating. Risk factors include being female and Native American. Treatment of gallbladder cancer depends upon the stage of the cancer, the type of gallbladder cancer, and whether the cancer can be removed by surgery.
Primary sclerosing cholangitis (PSC) is a chronic, progressive disease of the bile ducts that channel bile from the liver into the intestines. There is an association between primary sclerosing cholangitis and ulcerative colitis and Crohn's disease. Symptoms of primary sclerosing cholangitis include abnormal liver blood tests, itching, fatigue, and jaundice. Primary sclerosing cholangitis is treated with medications and in some cases, liver transplant.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
Pancreas divisum is a common congenital anomaly (an anomaly that is present at birth) of the pancreatic duct(s). The human embryo starts life with two ducts in the pancreas; the ventral duct and the dorsal duct. In more than 90% of the embryos, the dorsal and the ventral ducts will fuse to form one main pancreatic duct. In approximately 10% of embryos, the dorsal and the ventral ducts fail to fuse. Failure of the ventral and the dorsal pancreatic ducts to fuse is called pancreas divisum (because the pancreas is drained by two ducts). In pancreas divisum, the ventral duct drains into the major papilla, while the dorsal duct drains into a separate minor papilla. The majority of individuals born with pancreas divisum experience no symptoms throughout life, will remain undiagnosed and will not require treatment. A small number of patients with pancreas divisum will experience repeated episodes of pancreatitis.
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