Procedures | Kian Makipour MD

Colorectal cancer is the 2nd leading cause of cancer in the United States and afflicts roughly 150,000 Americans every year. However, colorectal cancer is preventable using technology offered by colonoscopy.
Colorectal cancer screening should began at the age of 45.

Upper endoscopy or EGD is a relatively simple and safe diagnostic and therapeutic procedure used to visualize and treat diseases of the upper digestive tract including the esophagus, stomach and duodenum.
EGD is an important tool in the detection and investigation of esophageal and gastric cancer, ulcers, anemia, Upper gastrointestinal bleeding, Heartburn and chronic acid reflux, Persistent vomiting, Difficulty in swallowing, Persistent nausea.

Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure used to treat diseases of the bile duct and pancreas. ERCP is a therapeautic procedure and has an inherent risk of pancreatitis.
ERCP is use to remove stones from the bile duct, treat inflammatory strictures, bile leaks (from trauma or surgery) and cancer.

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An esophageal pH test measures the amount of acid in your esophagus to determine if you truly have GERD. This test can also be used to determine the effectiveness of medications for reflux.
A small capsule, about the size of a gel cap, is temporarily attached via gentle suction to the wall of the esophagus during an EGD. The capsule transmits information to a receiver worn on a belt or waistband. The capsule typically falls off spontaneously and is expelled in the stools.
While the capsule is attached the patient is expected to resume his or her normal diet and activities. Acid reflux medications are typically stopped starting a few days prior to the test and during the test.

Endoscopic ultrasound or EUS is a procedure performed by highly skilled gastroenterologists. This procedure combines endoscopy with ultrasound to obtain images of various internal organs.
EUS is a very important procedure used to diagnose many different types of cancer including esophageal, gastric and pancreatic cancer. EUS can also be used for staging of rectal cancer.

Gastroenterologists play an important role in the diagnosis and management of gastrointestinal malignancies.
The placement of stents in luminal organs such as the esophagus, duodenum or colon can provide relief to the patient while other therapies are initiated or can be used for palliation.

High resolution esophageal manometry (HREM) is a motility procedure that measures both the pressures and pattern of contraction in the esophagus. HREM is used to diagnose conditions that can cause chest pain (after a negative cardiac evaluation), heartburn and difficulty swallowing.
During the procedure a thin,lubricated tube is passed through your nose and advanced into your stomach while you swallow sips of water. Pressures are measured as this tube is slowly withdrawn.

Deep (single/double balloon) enteroscopy is a technique developed in the early 2000s that allows for almost complete visualization of the small bowel (which is roughly 25 feet in length).
This procedure involves use of a balloon attached to the end of an long enteroscope and an overtube.
Common indications for deep enteroscopy include an investigation of obscure gastrointestinal bleeding and iron deficiency anemia in the setting of a negative EGD and Colonoscopy.

Video capsule endoscopy is used to examine the small intestine, most of which cannot be used during a conventional EGD and colonoscopy.
The capsule is the size of a pills and captures pictures like a camera as it travels down the gastrointestinal tract.
Capsule endoscopy is used to examine obscure gastrointestinal bleeding of suspected small bowel origin and unexplained abdominal pain thought to be secondary to Crohn's disease.

Percutaneous endoscopic gastrostomy (PEG) is an endoscopic procedure in which a PEG tube is passed into the patients stomach via the abdominal wall during direct visualization using an upper endoscope.
PEG tubes are used to provide supplemental nutrition in certain cases. For example, PEG tubes are often used when normal oral feeding is hindered by stroke or radiation therapy for head and neck tumors.
Patients who require PEGs are chosen after a very careful evaluation.