Lower Gastrointestinal Endoscopic Ultrasonography

WHAT YOU SHOULD KNOW:

• Lower gastrointestinal (gas-tro-in-TES-ti-nal) endoscopic (EN-do-skop-ik) ultrasound (UL-trah-sownd) is a procedure to check the different parts of the lower gastrointestinal tract (GIT). The lower GIT includes some parts of the small intestines, the colon and rectum. The colon is the long tube that connects the small bowel with the anus (opening through which stool passes). The colon absorbs water from digested foods and turns the digested food into stool. It stores the stool until it passes out through your anus. Lower GIT endoscopic ultrasound is used to help diagnose and treat diseases that affect the lower GIT. These may include tumors, bleeding, abscess (collection of pus), or anal fistula (an abnormal connection from the anus to another organ). This procedure may also examine structures close to the lower GIT, such as the reproductive organs, liver, pancreas, kidneys, and lymph nodes.
  
  
• With lower GI endoscopic ultrasound, caregivers use an echoendoscope to help see the GIT. An echoendoscope is a thin and flexible (bendable) metal tube with a small transducer (sensor) on its tip. This transducer works using a water-filled balloon which produces an ultrasound (high energy sound waves). As the sensor touches a certain lower GI part, pictures are seen on a TV-like screen. Some echoendoscopes have a tiny camera to give caregivers a clearer view of the organ while watching the images on a monitor. With lower GI endoscopic ultrasound, conditions of the GIT may be diagnosed, and treatment given as soon as possible.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Lower GI endoscopic ultrasound is a safe procedure but may also cause unpleasant side effects. You may have bleeding, an abnormal heartbeat, high blood pressure, or trouble breathing. Your small intestines, large intestines, or rectum may get perforated (torn) due to increased pressure while the scope is passing through. Following your caregiver's advice during and after the procedure may decrease your chances of having any problems.
  
  
• Without this procedure, your disease may not be diagnosed and proper treatment may not be given. The signs and symptoms you have may continue and worsen. You may have problems eating, digesting food, or moving your bowel that may lead to other serious medical problems. Ask your caregiver if you are worried or have questions about your procedure, medicine, or care.

WHILE YOU ARE HERE:

Before your procedure:

• Informed consent: A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• Gown: A hospital gown is used so that caregivers can easily check and treat you. Caregivers will show you how to put on your gown. When you feel better you may be able to wear your own gown or pajamas.
  
  
• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.
  
  
• Monitoring:
  
  
  • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
    
    
  • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
  
  
• Oxygen: You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.

During your procedure:

• Once you are transferred onto the special table or bed, you may be asked to lie on your left side and raise one or both knees toward your chest. Your lower body is covered with a sheet. Your caregiver examines your anus and uses a finger to perform a digital rectal exam (DRE) to check your rectum. He may feel for your prostate if you are a male. If your bowel is not empty, your caregiver may give you another enema.
  
  
• During your procedure, the echoendoscope will be lubricated with jelly and gently placed into your anus. It is then passed through the rectum and into the large intestine. The passage of the scope may cause a feeling of pressure and a little discomfort. Take small, deep breaths through your mouth, and tell your caregiver when you feel too uncomfortable. Your caregiver slowly advances the scope while watching on a small video screen and taking pictures.
  
  
• Your caregiver may take tissue samples and send them to the lab for tests. He may also remove tumors or stool that may be blocking your GIT. He may also insert special tools using the scope to stop bleeding. When the procedure is finished, the echoendoscope will be slowly removed and your anus will be wiped with gauze.

After your procedure:

You may lie in bed and rest for a while since the procedure may be tiring. When your caregiver sees that you are OK, you may be allowed to change clothes and go home. If your caregiver wants you to stay in the hospital, you may be taken back to your hospital room. Ask your caregiver for information on how to take care of yourself after your procedure.

• Eat healthy foods: Choose healthy foods from all the food groups every day. Include whole-grain bread, cereal, rice, and pasta. Eat a variety of fruits and vegetables, including dark green and orange vegetables. Include dairy products such as low-fat milk, yogurt, and cheese. Choose protein sources, such as lean beef and chicken, fish, beans, eggs, and nuts. Ask how many servings of fats, oils, and sweets you should have each day, and if you need to be on a special diet.
  
  
• Drinking liquids: Men 19 years old and older should drink about three Liters of liquid each day (about 13 eight-ounce cups). Women 19 years old and older should drink about two Liters of liquid each day (about 9 eight-ounce cups). Follow your caregiver's advice if you must change the amount of liquid you drink. For most people, healthy liquids to drink are water, juices, and milk. If you are used to drinking liquids that contain caffeine, such as coffee, these can also be counted in your daily liquid amount. Try to drink enough liquid each day, and not just when you feel thirsty.
  
  
• Medicines: You may need any of the following:
  
  
  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
    
    
    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
      
      
    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
    
    
  • Stool softeners: This medicine makes it easier for you to have a bowel movement. You may need this medicine to treat or prevent constipation.
  
  
• Monitoring: Caregivers may check for your pulses on your arms or wrists. This helps caregivers learn if you have problems with blood flow after your procedure. You may also have any of the following:
  
  
  • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
    
    

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Lower Gastrointestinal Endoscopic Ultrasonography (Inpatient Care)