A colonoscopy uses a thin, flexible camera to examine the large intestine. The doctor can find and remove polyps, take tissue samples, and look for causes of digestive symptoms.

Why it may be recommended

• Routine colorectal cancer screening, usually beginning at age 45 for adults at average risk
• Previous polyps or a personal or family history of colorectal cancer
• Rectal bleeding, bowel changes, ongoing diarrhea, abdominal pain, anemia, or unexplained weight loss
• Monitoring Crohn's disease or ulcerative colitis

What to expect

You will clean the colon with a prescribed bowel preparation before the procedure. Sedation is used, and you will need an approved adult driver. Polyps or abnormal tissue may be removed during the same procedure.

An upper endoscopy, also called an EGD, uses a thin camera passed through the mouth to examine the swallowing tube, stomach, and beginning of the small intestine.

Why it may be recommended

• Ongoing heartburn or acid reflux
• Trouble or pain with swallowing
• Upper-abdominal pain, nausea, vomiting, anemia, or possible bleeding
• Monitoring Barrett's esophagus, ulcers, or stomach polyps

What to expect

You will receive fasting and medication instructions before the procedure. Sedation is commonly used. The doctor may take tissue samples or treat bleeding, narrowing, or other findings during the same procedure.

This test uses a flexible camera to examine the rectum and lower portion of the colon. It does not examine the entire colon.

Why it may be recommended

• Rectal bleeding or bowel changes
• Lower-abdominal discomfort
• Monitoring inflammation in the lower colon
• Checking a known area of concern

What to expect

Preparation is often less extensive than for a full colonoscopy. Sedation may or may not be used. Your care team will tell you whether you need a driver.

Hemorrhoid banding places a small rubber band around an internal hemorrhoid. The band reduces its blood supply so the tissue shrinks and falls away naturally.

Why it may be recommended

• Bleeding with bowel movements
• Internal hemorrhoids that bulge or cause discomfort
• Itching, pressure, or drainage that has not improved with basic treatment

What to expect

Banding may be performed during a colonoscopy or flexible sigmoidoscopy. Mild pressure, fullness, or light bleeding may occur afterward. Follow your discharge instructions and contact the office for bleeding that is heavy or worsening.

Esophageal dilation gently stretches a narrowed area of the esophagus - the tube that carries food from the mouth to the stomach.

Why it may be recommended

• Food feels stuck in the chest
• Swallowing is difficult or painful
• Scar tissue from reflux has narrowed the esophagus
• Rings, webs, or other narrowing are present

What to expect

Dilation is commonly performed during an upper endoscopy. A balloon or flexible dilator is used to widen the narrowed area. Some patients need more than one treatment.

You swallow a vitamin-sized capsule containing a small camera. The capsule takes pictures of the small intestine and sends them to a recorder you wear.

Why it may be recommended

• Unexplained bleeding or iron-deficiency anemia
• Possible Crohn's disease or celiac disease
• Ongoing abdominal pain or diarrhea when other tests have not found a cause
• Possible small-bowel polyps or tumors

What to expect

You will receive fasting and medication instructions. Sensors and a recorder collect images as the capsule passes naturally through your digestive tract. Tell the practice if you have trouble swallowing, a history of bowel narrowing, or an implanted medical device.

ERCP combines endoscopy and X-ray imaging. It allows the doctor to find and treat blockages in the bile ducts or pancreatic duct.

Why it may be recommended

• Bile-duct stones
• Jaundice or abnormal liver tests caused by a blockage
• Narrowed or leaking ducts
• Selected complications of pancreatitis or previous surgery

What may be done during ERCP

• Remove a bile-duct stone
• Open a narrowed area
• Place a stent to improve drainage
• Take a tissue sample

Gallstones can move into the bile duct and block the flow of bile. During ERCP, the doctor may open the duct and remove the stone with small tools or a balloon.

Possible signs of a bile-duct blockage

• Upper-right or middle abdominal pain
• Yellow skin or eyes
• Fever, chills, nausea, or vomiting
• Abnormal liver-test results

Your doctor will usually review imaging and laboratory results before deciding whether ERCP and stone removal are appropriate.

A biliary stent is a small tube placed inside a narrowed or blocked bile duct. It allows bile to drain normally and is usually placed during ERCP.

Why it may be recommended

• A stone, scar, inflammation, or growth is blocking the duct
• Bile is not draining normally
• A duct needs support while it heals after stone removal
• Jaundice or infection is related to a blockage

Some stents must be removed or exchanged later. Your doctor will explain the follow-up plan.

A PEG tube is a soft feeding tube placed through the abdominal wall into the stomach with endoscopic guidance. It can provide nutrition, fluids, and medicine when swallowing is unsafe or not possible.

Why it may be recommended

• Stroke or a neurologic condition affects swallowing
• Head or neck cancer or surgery prevents safe eating
• Serious illness prevents enough nutrition by mouth
• Longer-term feeding support is needed

What to expect

The procedure is performed with sedation. The patient and caregivers receive instructions for cleaning the site, giving feedings and medicine, flushing the tube, and recognizing problems.