Gastrointestinal Services
Bethesda North Hospital specializes in the diagnosis and treatment of gastrointestinal – or upper GI – disorders that affect the esophagus, stomach and small bowel. Our dedicated team supports our patients though the diagnoses and treatment of many different gastrointestinal disorders, including:
- Ulcers
- Gastritis
- Gastroparesis
- Zollinger-Ellison Syndrome
- Stomach Cancer
- GERD
- Hiatal Hernia
- Esophagitis
- Espohageal cancer
- Barrett’s Esophagus
For more information on these or other gastrointestinal disorders, visit www.gi.org.
Team approach
Our gastrointestinal service is a collaboration between various specialists. Together, gastroenterologists, surgeons, radiologists, oncologists and nutritionists provide a unified approach of treating our patents. This approach includes a dedication to safety and quality, which is an integral part of our mission.
We also believe in a strong patient education program to support and improve our patients’ health. We understand that the more patients know about their disorder, the more likely there are to have a good response to therapy.
Specialized services
We utilize the latest in technology to provide a safe environment in which we deliver excellent care to our patients and their families.
Esophagogastroduodenoscopy (EGD)
Escophagogastroduodenoscopy is the visual examination of the esophagus, stomach and duodenum – or small bowel.
This procedure is done with a flexible video endoscope through which your physician may take specimens.
An EGD is an outpatient procedure that takes approximately 15 to 30 minutes to complete. Patients usually recover in about 45 minutes.
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Esophageal manometry
Esophageal manometry is a test that records muscle functioning of the esophagus that often is used to evaluate swallowing disorders of the esophagus. It also can be performed prior to surgical treatment of the esophagus and to uncover the cause of chest pain and heartburn. It usually is performed after structural abnormalities have been excluded by endoscopy or x-ray studies
The benefit of this exam is that your physician will be able to evaluate swallowing problems and then decide on appropriate therapy. Treatment might consist of medications, endoscopy with injection of medicine into the esophagus, or possibly dilatation of the esophagus.
Esophageal manometry takes about an hour. You will have a thin tube placed through your mouth or nose into your stomach. Numbing spray is used to decrease any possible gagging. During the exam, you will be instructed to swallow saliva or water to help evaluate swallowing function. Since there is no sedation, you can resume normal activities immediately following the test.
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Endoscopic ultrasound
Endoscopic ultrasound – or EUS – combines endoscopy and ultrasound to address the limitations of endoscopic technology. It not only can detect the presence of a mass within or outside the gastrointestinal wall, but also explain its character and obtain tissue to allow pathological diagnosis of it. EUS-guided tissue also allows sampling to help differentiate malignant from benign lesions.
The preparation, sedation and risks associated with EUS are essentially the same as other endoscopic procedures
There are both diagnostic and interventional uses for EUS:
- Diagnostic
- Subepithelial mass definition
- Mediastinal mass definition
- Lung cancer staging
- Large gastric folds
- Esophageal cancer: local and regional staging
- Gastric cancer: local and regional staging
- Ampullary cancer: local and regional staging
- Pancreatic cancer: evaluation of respectability
- Pancreatic endocrine tumors: preoperative localization
- Other abdominal masses (adrenal, lymphoma)
- Chronic pancreatitis: diagnosis
- Choledocholithiasis: diagnosis
- Rectal cancer: local staging
- Rectal cancer: local staging
- Anal sphincter defects (incontinence)
- Interventional
- Endoscopic mucosal resection
- Treatment of vascular lesions
- Transmural pseudocyst drainage
- Celiac plexus neurolysis
In addition, using a tool called endoscopic ultrasound-fine needle aspiration – or EUS-FNA – doctors can make diagnoses in the mediatinum and abdomen:
- Mediatinum
- Primary tumors
- Subeptithelial tumors of the esophagus
- Lung cancer
- Mesothelioma
- Thymoma
- Schwannowa
- Spindel cell tumor
- Malignant histiocytoma
- Sarcoma
- Teratoma
- Neuroendocrine tumor
- Lymph nodes
- Metastases from primary tumors
- Lymphoma
- Sarcoidosis
- Histoplasmosis
- Tuberculosis
- Abdomen
- Primary and secondary tumors
- Gastric and duodenal supepithelial tumors
- Lymphoma
- Pancreatic tumors/carcinoma
- Neuroendocrine tumors
- Metastatic tumors
- Primary hepatobiliary and hepatocellular tumors
- Cholangiocarcinoma
- Liver metastases
- Subepithelial tumors of the rectum
- Primary and secondary tumors of the adrenal glands, prostate and seminal vesicles
- Lymph nodes
- Metastases from primary tumors
- Lymphoma
- Sarcoidosis
- Tuberculosis
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Capsule endoscopy
Capsule endoscopy lets your doctor examine the lining of the middle part of your gastrointestinal tract, otherwise known as the small bowel.
The most common reason your doctor will recommend capsule endoscopy is to search for a cause of bleeding form the small intestine. It may also be useful for detecting polyps, ulcers, and tumors of the small intestine, as well as Crohn’s disease.
Capsule endoscopy utilizes a pill-sized video capsule with its own lens and light source to capture images that are then displayed on a video monitor. Non-invasive and painless, it provides valuable help in examining the small intestine and searching for problems that could be difficult to diagnose, since most of this area cannot be reached by upper endoscopy or colonoscopy.
Your doctor will prepare you for the examination by applying a sensor device to your abdomen with adhesive. The capsule endoscope is swallowed and passes naturally through your digestive tract while transmitting video images to a data recorder that you wear on your belt for about eight hours. At the end of the procedure you will return the data recorder and the images will be downloaded to a computer for your physician to review.
Potential risks of capsule endoscopy include complications from obstruction. This usually relates to a stricture or tumor that is diagnosed for the first time during treatment.
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Medtronic Bravo™ pH monitoring system
The Medtronic Bravo™ pH Monitoring System is the first catheter-free system used to measure acidity levels in patients who have gastroesophageal reflux disease.
Your physician may order this test to determine whether symptoms of heartburn, chest discomfort, difficulty swallowing, hoarseness, or coughing are reflux related. Additionally, measurement of pH may be helpful in determining the success of medications you are taking for acid reflux.
This test takes two days to complete. While you are sedated during an endoscopy, your physician will attach a small capsule the size of a gelcap to the distal part of the esophagus. The capsule contains a miniature sensor that measures acid in the esophagus and is able to transmit that information to a portable recorder that is carried on the waist.
Patients can eat and drink normally and engage in their usual activities during testing. However, you should review all the medications you are taking prior to the procedure to determine if any need to be discontinued prior to testing.
The study is completed after 48 hours, when you will return the recorder to the hospital and the data is then analyzed to determine your course of treatment. The capsule then passes harmlessly through the digestive tract.
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