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Gastroenterology and Hepatology – General Endoscopy

Our Gastroenterology Endoscopy Unit performs diagnostic and therapeutic studies which include motility studies in addition to endoscopic studies.

Make an appointment

To schedule an appointment, sign in to My Penn State Hershey Health or call 800-243-1455.

Gastrointestinal endoscopy is the examination of the digestive tract with a flexible, lighted instrument called a "scope." This enables the physicians to directly visualize the esophagus, stomach, portions of the small intestine, and the colon. In this way, your physician can more accurately diagnose and treat diseases of the digestive system. Also, through these "scopes" a physician can take biopsies, dilate narrowed areas called strictures, and remove polyps which are growths in the digestive tract. Some of the more common conditions that can be diagnosed and treated are gastro-esophageal reflux, ulcers, Crohn's disease, ulcerative colitis and gallbladder disease.

All procedures are performed by the physicians or trained personnel in the Division of Gastroenterology and Hepatology, including procedures scheduled directly by your primary care physician.

The results will be mailed or faxed to your Primary Care Physician who ordered the study. You will be informed of the findings, however, the management of your condition and advice on further medication will be determined by your Primary Care Physician who will remain in charge of, and responsible for your care.

Our services include:

In certain conditions, endoscopy will be performed on an open access basis, when scheduled directly by the Primary Care Physician. When a consultation is required from the gastroenterologist for recommendations for appropriate tests or management, and for any of the exclusion criteria, the patient may be evaluated in an office visit prior to endoscopy.

Contact us

Phone: 717-531-4950

To schedule an appointment, sign in to My Penn State Hershey Health or call 717-531-4950 (outpatient consultations) or 717-531-8364 (procedures).

What is an Impedance study?  

This new technology allows us to further evaluate the esophagus (feeding tube in the chest) when patients have symptoms that may or may not be related to acid reflux. This will help your doctor determine the cause of your symptoms.  There are other movements of air/gas and liquid (or a mixture) within the esophagus that may give you symptoms but are not caused by acid reflux. Impedance testing can tell us whether it is that (or acid reflux) that is causing your symptoms.

How is the Impedance study performed?

This test involves placement of a soft catheter/tube through the nose and down into the esophagus. The nurse then asks you to take 10 swallows of water. After that you leave the Endoscopy suite with the catheter/tube taped in place and you return the next day for removal of the tube and to bring back the recording device.

What preparation is required?

You may have a very light meal and/or just liquids up until 4 hours before your appointment but then you should not eat or drink anything for 4 hours before your appointment. You may take your usual morning medications. You should remain on all your usual medications before and during the test.

What should you expect during and after the procedure?

A thin flexible tube is lubricated and then gently passed through a nostril down to the correct level in the esophagus. You may experience gagging or coughing briefly during the insertion of the tube but it will soon pass. You will leave the Endoscopy suite with a tube coming out of your nose (and taped across your cheek).

How does it work?

You will carry a recording device with you and you will receive instructions on how to use that. The messages from the Impedance catheter/tube are sent to the recording device and after you return to the Endoscopy suite we remove the tube and download the information from the recorder into the computer for the doctor to review.

What will you need to do?

We ask that you carry on with a normal day including eating and drinking normally as well as participating in your usual activities. We do not want you to avoid things that usually make you have your typical symptoms. You should stay on all your medications.

Your doctor will be sent the results of your study.

What is the Bravo pH study? 

This is a new technology that allows us to accurately measure acid reflux for 48 hrs in the esophagus and to correlate the pH (acid level) with your symptoms. First an upper Endoscopy (EGD) is performed under sedation in the Endoscopy Suite to look at the esophagus, stomach and duodenum; the correct location for placement of the Bravo capsule is also determined. Then, the Bravo capsule is inserted through the mouth (while you are still sedated) and placed with a tiny pin into the esophageal wall at the correct location; you do not have tubes or wires coming out of your nose or mouth afterwards. This device can then measure acid reflux over 48 hours while you carry on with normal activities. The capsule will come loose and fall off on its own and is disposable (will come out with a bowel movement).

What preparation is required?  

In order for the EGD study to be done you need to have nothing to eat or drink after midnight as directed in the upper Endoscopy directions*. That way, we can safely do the procedure and give you sedation for the scope and the insertion of the Bravo capsule.

What should you expect during and after the procedure? 

You will be sedated during the procedure and may not remember much of it. Afterwards you may be slightly groggy and should therefore have a driver to take you home. Some people have an awareness of “something” in the esophagus (feeding tube in the chest where the capsule is temporarily attached) especially during eating but patients generally tolerate it very well and do not usually have pain from the capsule.

How does it work?

You will carry a recording device with you; the messages from the capsule (acid reflux etc) are sent to the recording device and stored. After the study is completed you bring the recorder back to the Endoscopy suite and it is connected to a computer that downloads the information for the doctor to review. The capsule simply falls off and is lost in your bowel movements (you may or may not see it).

What will you need to do?

We encourage you to carry on with a normal day including eating and drinking normally as well as participating in all your usual activities. We do not want you to avoid things that make your reflux symptoms worse during this time. You will receive an instruction sheet when you are here for the study which will explain more of these things to you. You should not take over-the-counter antacids during the study but you need to decide with your doctor in advance if the test is to be done ON or OFF acid suppressive medications (such as Prilosec, Nexium etc). You should anticipate that you can NOT have an MRI after the capsule has been placed and for 30 days afterwards or until you are sure that the capsule has passed in your stools.

Patient Instructions

  • You should have nothing to eat or drink after midnight until two hours prior to the scheduled test time.
  • Two hours prior to the test you should eat 2 pieces of dry toast and drink 6 oz. of apple juice.
  • Any pro- or anti-motility medications (see below) must be stopped 3-4 days prior to the scheduled test.
  • On the day of the scheduled test, you should report to the Endoscopy Suite (UPC Suite 2000) for registration 30 minutes prior to your appointment time.

Medications That Must Be Stopped 72 Hours Before The Test:

  • Reglan
  • Propulsid
  • Domperidone
  • Bethanechol
  • Narcotic Drugs (Codeine, Demerol, Darvocet,  Morphine, Percocet, Percodan)
  • Calcium channel blockers (Procardia)
  • Compazine
  • NSAIDS (Relafen, Advil, etc.)

Medications That May Be Continued:

  • H2-Blockers (Zantac, Pepcid)
  • PPIs (Prilosec, Prevacid, Aciphex)

What is Capsule Endoscopy?

Capsule Endoscopy consists of swallowing a small video camera about the size of a large vitamin capsule. It records two pictures every second and moves down the intestines like food normally would. Up to 50,000 pictures are taken and later viewed by your doctor to evaluate the inside of your intestines.

What preparation is needed?

At noon the day before the procedure, please begin having a clear liquid diet only.  After midnight, have nothing to eat or drink until after your appointment. Continue taking your prescription medications, except as outlined below.

Things to avoid

  • For seven days prior to the procedure, YOU MUST STOP TAKING: Antacids, sucralfate and iron
  • For three days prior to the procedure, we strongly recommend that you stop taking narcotic medications such as codeine, Percocet, morphine, etc.

If you are taking narcotic medications, please call 717-531-5863 to speak to a nurse.

Please continue to take: Coumadin, Plavix, other blood thinners

Day Of Appointment: 

  • No vigorous physical activities, like jumping
  • No exposure to magnetic fields (MRI testing and amateur HAM radios)

Procedure

After registration at the front desk of the Endoscopy unit, you'll be taken to the procedure room. A nurse will obtain necessary information from you and you will be asked to sign a consent form. You will be fitted with a belt pack and monitoring equipment. You will swallow the capsule with sips of water. The whole process will take approximately 30 minutes.

When study is complete

You must wear the system for eight hours. After that, you will return to the Endoscopy unit for removal of the belt and equipment.

What happens to the capsule?

The capsule is disposable and passes out with your bowel movements. You do not need to retrieve the capsule.

Possible risks

There is a possibility of the capsule getting stuck in an unexpected stricture, or large diverticulli. Though very rare, this may require surgical intervention.

Questions

To speak to a nurse, you may call 717-531-5863 between the hours of 8 a.m. and 5 p.m. If you are calling after hours, and your appointment is the next business day, you may call the main operator at 717-531-8521 and ask for the GI Fellow on call.

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