Abdominal CT scan

An abdominal CT scan is an imaging method that uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomography. See also: CT scan How the Test is Performed You will be asked to lie on a narrow table that slides into the center of the CT scanner. Usually, you will lie on your back with your arms raised above the head. Once you are inside the scanner, the machine's x-ray beam rotates around you. (Modern "spiral" scanners can perform the exam without stopping.) A computer creates separate images of the belly area, called slices. These images can be stored, viewed on a monitor, or printed on film. Three-dimensional models of the belly area can be created by stacking the slices together. You must be still during the exam, because movement causes blurred images. You may be told to hold your breath for short periods of time. The scan should takes less then 30 minutes. How to Prepare for the Test Certain exams require a special dye, called contrast, to be delivered into the body before the test starts. Contrast helps certain areas show up better on the x-rays.

Contrast can be given through a vein (IV) in your hand or forearm. If contrast is used, you may also be asked not to eat or drink anything for 4-6 hours before the test. Let your doctor know if you have ever had a reaction to contrast. You may need to take medications before the test in order to safely receive this substance. Before receiving the contrast, tell your health care provider if you take the diabetes medication metformin (Glucophage) because you may need to take extra precautions.

If you weigh more than 300 pounds, find out if the CT machine has a weight limit. Too much weight can cause damage to the scanner's working parts. You will be asked to remove jewelry and wear a hospital gown during the study. How the Test Will Feel Some people may have discomfort from lying on the hard table. Contrast given through a vein (IV) may cause a slight burning sensation, a metallic taste in the mouth, and a warm flushing of the body. These sensations are normal and usually go away within a few seconds. Why the Test is Performed An abdominal CT rapidly creates detailed pictures of the structures inside the belly area (abdomen). This test may help detect or diagnose:

The cause of abdominal pain or swelling Hernia The cause of a fever Masses and tumors, including cancer Infections or injury Kidney stones Appendicitis

What Abnormal Results Mean The abdominal CT scan may reveal certain cancers, including:

Breast cancer Cancer of the renal pelvis or ureter Colon cancer Hepatocellular carcinoma Lymphoma Melanoma Ovarian cancer Pancreatic cancer Pheochromocytoma Renal cell carcinoma (kidney cancer) Testicular cancer

The abdominal CT scan may show problems with the gallblader, liver, or pancreas, including:

Acute cholecystitis Alcoholic liver disease Cholelithiasis Pancreatic abscess Pancreatic pseudocyst Pancreatitis Sclerosing cholangitis

The abdominal CT scan may reveal the following kidney problems:

Acute bilateral obstructive uropathy Acute unilateral obstructive uropathy Chronic bilateral obstructive uropathy Chronic unilateral obstructive uropathy Complicated UTI (pyelonephritis) Kidney stones Kidney swelling (hydronephrosis) Kidney or ureter damage Polycystic kidney disease Uterocele

Abnormal results may also be due to:

Abdominal aortic aneurysm


Risks

Abscesses Appendicitis Bowel wall thickening Retroperitoneal fibrosis Renal artery stenosis Renal vein thrombosis

Risks of CT scans include:

Being exposed to radiation Allergic reaction to contrast dye

CT scans do expose you to more radiation than regular x-rays. Having many x-rays or CT scans over time may increase your risk for cancer. However, the risk from any one scan is small. You and your doctor should weigh this risk against the benefits of getting a correct diagnosis for a medical problem. Some people have allergies to contrast dye. Let your doctor know if you have ever had an allergic reaction to injected contrast dye.

The most common type of contrast given into a vein contains iodine. If a person with an iodine allergy is given this type of contrast, nausea or vomiting,sneezing, itching,or hives may occur. If you absolutely must be given such contrast, your doctor may give you antihistamines (such as Benadryl) or steroids before the test. The kidneys help remove iodine out of the body. Those with kidney disease or diabetes may need to receive extra fluids after the test to help flush the iodine out of the body.

Rarely, the dye may cause a life-threatening allergic response called anaphylaxis. If you have any trouble breathing during the test, you should notify the scanner operator immediately. Scanners come with an intercom and speakers, so the operator can hear you at all times. Alternative Names Computed tomography scan - abdomen; CT scan - abdomen; CAT scan - abdomen References

What is a esophagram barium swallow study?

The barium swallow is a study that is completed in radiology. The test evaluates the esophagus. The esophagus is the tube that goes from the throat to the stomach. This will help your doctor identify possible problems and the best treatment. This study is sometimes called an Esophagram.

How do you get ready for the test?

ray. Adults - No solid foods 4 hours prior to the procedure. Adult patients may be on a clear liquid diet 2 hours prior to the procedure. Give medicines at the regular times with water anytime. Children - No solid foods 6 hours prior to procedure. A clear liquid diet anytime prior to the procedure is fine. Give medicines at the regular times with water. Infants - Do not eat or drink 4 hours prior to procedure. Your child should be thirsty and ready to drink upon arrival for the barium swallow study. Bring a special cup or sippy cup your child likes to use. If your child drinks best from a bottle, bring a bottle. Give medicines at the regular times with a small amount of water. Wear clothing that you can remove from the waist up. You will be given a gown to wear. The esophagram barium swallow uses x-rays and anyone who is pregnant cannot be in the room during the x-

What happens during an esophagram barium swallow study?

Before the study you/your child will need to remove all clothing and jewelry from the waist up. You will be given a hospital gown to wear. The study is completed in a radiology (x-ray/fluoroscopy) room. If a child is having the barium swallow, a family member or caregiver will be encouraged to stay in the x-ray room to make it easier for the child. The radiologist operates the fluoroscopy equipment and takes images of the esophagus and provides a medical diagnosis for your physician. You/your child will be asked to drink 1 to 2 cups of barium. The barium is a contrast material that makes liquids show up on the image-screen as gray or black. You/your child will drink the barium while standing up and while lying down. If you have any questions or don't understand the instructions please ask.

What does barium taste like?

Barium is heavy and has a chalky taste. Children and adults may dislike the taste. Flavors may be added to make the barium pleasant tasting. Children under 12 months often like the taste of barium.What should you do after the test? Barium rarely causes any problems. It passes through the digestive system. Drink extra fluids for 12 to 24 hours after the study. If your/your child becomes constipated after the study, drink more liquids and eat more fruit. If the constipation continues, talk with your doctor.

How long will the test take?

The barium swallow study will take about 30 minutes. Some of the time is taken preparing for the study.

How do you get to your appointment?

Your appointment is in radiology. Radiology is in on the third floor of the Smith Building. On the day of your test, first report to the Admissions Desk just inside the Main Entrance. Admissions will direct you to the appropriate location for your test.

Fecal Occult Blood Test and Fecal Immunochemical Test

Also known as: FOBT; Stool occult blood; Hemoccult; Guaiac smear test; gFOBT; Immunochemical FOBT; Immunoassay FOBT; iFOBT; FIT Formal name: Occult Blood Test, Fecal

At a Glance Test Sample The Test Common Questions Ask Us Related Pages

The Test
1. 2. 3. 4.
How is it used? When is it ordered? What does the test result mean? Is there anything else I should know?

How is it used?
The main use for the fecal occult blood test (FOBT) or the fecal immunochemical test (FIT) is as a screen for early colon cancer. Blood in the stool may be the only symptom of early cancer; thus, If detected early, treatment can begin immediately, improving the chance of a cure. The FOBT is not diagnostic for cancer but, if positive, requires other follow-up procedures to find the source of the bleeding that may indicate other gastrointestinal problems. A secondary use of FOBT is to determine the cause of anemia, such as blood loss from a bleeding ulcer. If someone has symptoms and signs of anemia, such as fatigue, a low hemoglobin and hematocrit, and/or unusually dark stools, a doctor may order the FOBT. ^ Back to top

When is it ordered?
Fecal occult blood tests are most often done as part of a routine examination. The tests are used primarily as a screening tool for early detection of colon cancer. They are recommended to be done annually beginning at age 50 (by the American Cancer Society and other major organizations) or as directed by the doctor based on a person's family medical history. Most people who have them performed areasymptomatic. A doctor may sometimes order an FOBT when someone has unexplained anemia that might be caused by bleeding in the digestive tract. ^ Back to top

What does the test result mean?

The fecal occult blood test is normally negative. For the guaiac-based FOBT, a positive test result indicates that abnormal bleeding is occurring somewhere in the digestive tract. This blood loss could be due to ulcers, diverticulosis, bleeding polyps, inflammatory bowel disease,hemorrhoids, blood swallowed due to bleeding gums or nosebleeds, or due to benign or cancerous tumors. For the fecal immunochemical test, a positive result indicates abnormal bleeding in the lower digestive tract. Since this test detects only human hemoglobin, other sources of blood, such as from the diet, do not cause a positive result. Moreover, hemoglobin from bleeding in the upper digestive tract is broken down to other elements before it reaches the lower digestive tract and is not detected by the FIT. Thus, the FIT is a more specific test than gFOBT.

A positive result from either the guaiac-based or immunochemical FOBT requires follow-up testing. This usually involves an imaging procedure such as sigmoidoscopy or colonoscopy. ^ Back to top

Is there anything else I should know?

Bleeding, especially from polyps and tumors, is intermittent, so blood is not uniformly distributed in all stool samples. Taking three different samples on three different days increases the chances of detecting bleeding that is intermittent.

Endoscopy
By Mayo Clinic staff Original Article: http://www.mayoclinic.com/health/endoscopy/MY00138

Definition
Endoscopy Endoscopy is a procedure used to visually examine your upper digestive system with a tiny camera on the end of a long, flexible tube. A doctor who specializes in diseases of the digestive system (gastroenterologist) uses endoscopy to diagnose and, sometimes, treat conditions that affect the esophagus, stomach and beginning of the small intestine (duodenum). Doctors often refer to endoscopy as esophagogastroduodenoscopy (EGD) or upper endoscopy. Endoscopy may be done in your doctor's office, an outpatient surgery center or a hospital.

Why it's done

Gastrointestinal tract Endoscopy is used to diagnose and, sometimes, treat conditions that affect the upper part of the digestive system, including the esophagus, stomach and beginning of the small intestine (duodenum). Your doctor may recommend an endoscopy procedure to:

Investigate causes of digestive signs and symptoms. Endoscopy may help your doctor determine what's causing signs and symptoms, such as nausea, vomiting, abdominal pain, difficulty swallowing and gastrointestinal bleeding.

Diagnose digestive diseases and conditions. Your doctor may use endoscopy to collect tissue (biopsy) samples to test for diseases and conditions, such as anemia, bleeding, inflammation, diarrhea or cancers of the digestive system.

Treat certain digestive system problems. Using special tools during endoscopy allows your doctor to treat certain problems in your digestive system, such as bleeding from the esophagus or stomach and difficulty swallowing caused by a narrow esophagus, or to remove polyps. Endoscopy can also be used to remove foreign objects lodged in your upper digestive tract.

Endoscopy is sometimes combined with other procedures, such as ultrasound. An ultrasound probe may be attached to the endoscope to create specialized images of the wall of your esophagus or stomach. An endoscopic ultrasound may also help your doctor create images of hard-to-reach organs, such as your pancreas.

Risks
Endoscopy is a safe procedure. However it carries a very small risk of complications, including:

Bleeding. Your risk of bleeding complications after endoscopy is increased if the procedure involves removing a piece of tissue for testing (biopsy) or for treating a digestive system problem. In rare cases, such bleeding may require a blood transfusion.

Infection. An infection caused by an endoscopy procedure may require antibiotics.

Tearing of the gastrointestinal tract. A tear in your esophagus or another part of your upper digestive tract may require hospitalization, and sometimes surgery to repair it.

You can reduce your risk of complications by carefully following your doctor's instructions for preparing for endoscopy, such as fasting and stopping certain medications. Signs and symptoms that could indicate a complication Signs and symptoms to watch for after your endoscopy include:

Fever Chest pain Shortness of breath Black or very dark colored stool Difficulty swallowing Severe or persistent abdominal pain Vomiting

Call your doctor immediately or go to an emergency room if you experience any of these signs or symptoms.

How you prepare

Your doctor will give you specific instructions to prepare for your endoscopy. In some cases your doctor may ask that you:

Fast before the endoscopy. You may be asked to stop drinking and eating six to eight hours before your endoscopy. This is to ensure your stomach is empty for the procedure.

Stop taking certain medications. You may be asked to stop taking certain blood-thinning medications in the days before your endoscopy. Blood thinners may increase your risk of bleeding if certain procedures are performed during endoscopy. If you have chronic conditions, such as diabetes, heart disease or high blood pressure, your doctor will give you specific instructions regarding your medications.

Tell your doctor about all the medications and supplements you're taking before your endoscopy. Plan ahead for your recovery Most people undergoing endoscopy will receive a sedative to make them relaxed and more comfortable during the procedure. If you'll be sedated during the procedure, plan ahead for your recovery. For instance, find someone to drive you home since it won't be safe for you to drive. You may also need to take the day off from work. You may feel mentally alert after receiving a sedative, but your memory, reaction times and judgment may be impaired. Planning ahead for this can help keep you safe while

the sedative wears off. Additionally, don't make any important personal or financial decisions for 24 hours.

What you can expect

Endoscopy During endoscopy During your endoscopy procedure, you'll be asked to lie down on a table on your back or your side. Monitors often will be attached to your body to allow your health care team to monitor your breathing, blood pressure and heart rate during the procedure. You may receive a sedative medication through a vein in your arm. This medication helps you relax during the endoscopy. Your doctor may spray an anesthetic in your mouth to numb your throat in preparation for insertion of the long, flexible tube (endoscope) that will be used to see your digestive tract. You may be asked to wear a plastic mouth guard to hold your mouth open. Then the endoscope is inserted in your mouth. Your doctor may ask you to swallow as the scope passes down your throat. You may feel some pressure in your throat, but you shouldn't feel pain. You can't talk after the endoscope passes down your throat, though you can make noises. The endoscope doesn't interfere with your breathing. Your doctor then passes the endoscope down your esophagus toward your stomach. A tiny camera on the end of the endoscope transmits images to a video monitor in the exam room. Your doctor watches this monitor to look for abnormalities in your upper digestive tract. If abnormalities are found in your digestive tract, your doctor may record images for later examination. To help the endoscope move through your upper digestive tract, gentle air pressure may be fed into your esophagus. This inflates your digestive tract so the endoscope can move freely and the folds of your digestive tract are more easily examined. But the air can also create a feeling of pressure or fullness. If there's a need to collect a tissue sample or remove a polyp, your doctor will pass special surgical tools through the endoscope. Your doctor watches the video monitor to guide the tools.

When your doctor has finished the exam, the endoscope is slowly retracted through your esophagus and back out through your mouth. Endoscopy typically takes five to 20 minutes, depending on your situation. After endoscopy You'll be taken to a recovery area to sit or lie quietly after your endoscopy. You may stay for an hour or so, depending on your situation. This allows your health care team to monitor you as the sedative begins to wear off. Once you're at home, you may experience some mildly uncomfortable signs and symptoms after endoscopy, such as:

Bloating and gas Cramping Sore throat

These signs and symptoms will improve with time. If you're concerned or quite uncomfortable, call your doctor. Take it easy for the rest of the day after your endoscopy. You may feel alert, but your reaction times and judgment are delayed after receiving a sedative.

Results
When you receive the results of your endoscopy will depend on your situation. If, for instance, your doctor performed the endoscopy to look for an ulcer, you may learn the findings right away after your procedure. If your doctor performed an endoscopy to collect a tissue sample (biopsy), it may be several days until results from laboratory testing are available. Ask your doctor when you can expect the results of your endoscopy.

Endoscopic retrograde cholangiopancreatography (en-doh-SKAH-pik REH-troh-grayd koh-LAN-jee-oh-PANG-kreeuh-TAH-gruh-fee) (ERCP) enables the physician to diagnose problems in the liver, gallbladder, bile ducts, and pancreas. The liver is a large organ that, among other things, makes a liquid called bile that helps with digestion. The gallbladder is a small, pear-shaped organ that stores bile until it is needed for digestion. The bile ducts are tubes that

carry bile from the liver to the gallbladder and small intestine. These ducts are sometimes called the biliary tree. The pancreas is a large gland that produces chemicals that help with digestion and hormones such as insulin. ERCP is used primarily to diagnose and treat conditions of the bile ducts, including gallstones, inflammatory strictures (scars), leaks (from trauma and surgery), and cancer. ERCP combines the use of x rays and an endoscope, which is a long, flexible, lighted tube. Through the endoscope, the physician can see the inside of the stomach and duodenum, and inject dyes into the ducts in the biliary tree and pancreas so they can be seen on x rays. For the procedure, you will lie on your left side on an examining table in an x-ray room. You will be given medication to help numb the back of your throat and a sedative to help you relax during the exam. You will swallow the endoscope, and the physician will then guide the scope through your esophagus, stomach, and duodenum until it reaches the spot where the ducts of the biliary tree and pancreas open into the duodenum. At this time, you will be turned to lie flat on your stomach, and the physician will pass a small plastic tube through the scope. Through the tube, the physician will inject a dye into the ducts to make them show up clearly on x rays. X rays are taken as soon as the dye is injected. If the exam shows a gallstone or narrowing of the ducts, the physician can insert instruments into the scope to remove or relieve the obstruction. Also, tissue samples (biopsy) can be taken for further testing. Possible complications of ERCP include pancreatitis (inflammation of the pancreas), infection, bleeding, and perforation of the duodenum. Except for pancreatitis, such problems are uncommon. You may have tenderness or a lump where the sedative was injected, but that should go away in a few days. ERCP takes 30 minutes to 2 hours. You may have some discomfort when the physician blows air into the duodenum and injects the dye into the ducts. However, the pain medicine and sedative should keep you from feeling too much discomfort. After the procedure, you will need to stay at the hospital for 1 to 2 hours until the sedative wears off. The physician will make sure you do not have signs of complications before you leave. If any kind of treatment is done during ERCP, such as removing a gallstone, you may need to stay in the hospital overnight.

Preparation
Your stomach and duodenum must be empty for the procedure to be accurate and safe. You will not be able to eat or drink anything after midnight the night before the procedure, or for 6 to 8 hours beforehand, depending on the time of your procedure. Also, the physician will need to know whether you have any allergies, especially to iodine, which is in the dye. You must also arrange for someone to take you homeyou will not be allowed to drive because of the sedatives. The physician may give you other special instructions.

Liver biopsy
A liver biopsy is a test that takes a sample of tissue from the liver for examination. How the Test is Performed The test is usually done in the hospital. Before the test is done, you may be given a medicine to prevent pain or to calm you (sedative). If the biopsy is done through the abdominal wall, you will be lying on your back with your right hand under your head. It is important to be as still as possible. The health care provider will determine the correct spot for the biopsy needle to be inserted into the liver. The skin will be cleansed, and a small needle will be used to to inject medicine to numb the area. A small cut is made, and the biopsy needle is inserted. Ultrasound is usually used to guide the needle.You will be told to hold your breath while the biopsy is taken. This is to reduce the chance of puncturing the lung or tearing the liver. The needle is removed quickly. Pressure will be applied to stop the bleeding. A bandage is placed over the insertion site. The procedure can also be done by inserting a needle into the jugular vein. If the procedure is performed this way, you will lie on your back. X-rays will be used to guide the health care provider to the vein. A special needle and cathether (thin tube) is used to take the biopsy sample. If you receive sedation for this test, you will need someone to drive you home. How to Prepare for the Test Tell your health care provider about:

Bleeding problems Drug allergies Medications you are taking Whether you are pregnant

You must sign a consent form. Blood tests are sometimes done to test your blood's ability to clot. You will be told not eat or drink anything for the 8 hours before the test. For infants and children: The preparation you can provide for this test depends on your child's age and experience. For specific information regarding how you can prepare your child, see the following:

Infant test or procedure preparation (birth to 1 year) Toddler test or procedure preparation (1 to 3 years) Preschooler test or procedure preparation (3 to 6 years) School age test or procedure preparation (6 to 12 years) Adolescent test or procedure preparation (12 to 18 years)

How the Test Will Feel

You will feel a stinging pain from the anesthetic needle and when the anesthetic is injected. The biopsy needle may feel like deep pressure and dull pain. Some people feel this pain in the shoulder. Why the Test is Performed The biopsy helps diagnose many liver diseases. The procedure also helps assess the stage (early, advanced) of liver disease. This is especially important in hepatitis C infection. The biopsy also helps detect:

Cancer Infections The cause of abnormal levels of liver enzymes that have been found in blood tests The cause of an unexplained liver enlargement

Normal Results The liver tissue is normal. What Abnormal Results Mean The biopsy may reveal a number of liver diseases, including cirrhosis, hepatitis, or infections such astuberculosis. It may also indicate cancer. This test also may be performed for:

Risks

Alcoholic liver disease (fatty liver, hepatitis, or cirrhosis) Amebic liver abscess Autoimmune hepatitis Biliary atresia Chronic active hepatitis Chronic persistent hepatitis Disseminated coccidioidomycosis Hemochromatosis Hepatitis B Hepatitis C Hepatitis D Hepatocellular carcinoma Hodgkin's lymphoma Non-alcoholic fatty liver disease Non-Hodgkin's lymphoma Primary biliary cirrhosis Pyogenic liver abscess Reye syndrome Sclerosing cholangitis Wilson's disease

Collapsed lung Complications from the sedation Injury to the gallbladder or kidney

Internal bleeding

Alternative Names Biopsy - liver; Percutaneous biopsy

Anoscopy
Anoscopy is a method to view the anus, anal canal, and lower rectum. How the Test is Performed The procedure is usually done in a doctor's office. A digital rectal exam is done first. Then, a lubricated instrument (anoscope) is placed a few inches into the rectum. You will feel some discomfort when this is done. The anoscope has a light on the end, so the health care provider can see the entire anal canal. A specimen forbiopsy can be taken if needed. How to Prepare for the Test You may receive a laxative, enema, or other preparation before the procedure so that you can completely empty your bowels. You should empty your bladder before the procedure. How the Test Will Feel There will be some discomfort during the procedure, and you may feel the need to have a bowel movement. You may feel a pinch when a biopsy is taken. You can usually return to normal activities after the procedure. Why the Test is Performed

This test may be used to determine whether you have:

Anal fissues Anal polyps Hemorrhoids Infection Inflammation Tumors

Normal Results The anal canal appears normal in size, color, and tone. There is no evidence of bleeding, polyps, hemorrhoids, or other abnormal tissue. What Abnormal Results Mean Abnormal results may include:

Risks

Abscess Fissures Hemorrhoids Infection Inflammation Polyps (non-cancerous or cancerous) Tumors

There are few risks. If a biopsy is needed, there is a slight risk of bleeding and mild pain.

Fine Needle Biopsy

(FNB)
by Patty Kellicker En Espaol (Spanish Version)

Definition
A biopsy is used to remove a tissue sample. The sample is examined for abnormal cells, disease, or infection. In a fine needle biopsy (FNB), fluid and cells are removed using a thin, hollow needle. Needle Biopsy

2011 Nucleus Medical Media, Inc.

Reasons for Procedure

This biopsy is used to evaluate organ or tumor tissue. It is also sometimes used to find out how certain treatments are working.

Possible Complications
Complications are rare, but no procedure is completely free of risk. The potential complications will depend on the location of the biopsy. Your doctor will review a list of possible complications, which may include:

Bleeding Bruise where the needle was inserted Pain after the procedure Infection

What to Expect
Prior to Procedure
Ask your doctor if there are any instructions you should follow before the procedure. Depending on the part of the body that the biopsy is being taken from, your doctor may ask you to:

Drink contrast material. Have routine blood work. Arrange for a ride home.

Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:

Aspirin or other anti-inflammatory drugs Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)

Anesthesia
Local anesthesia is often used. It will make the area numb. A sedative may also be used to help you relax.

Description of the Procedure

Depending on the biopsy site, an ultrasound , x-ray , or computed tomography (CT) scanmay be used to help guide the needle. You will be positioned for the easiest access to the area for biopsy. The skin will be swabbed with a cleaning solution. Anesthesia will be applied to numb the area. You will be asked to stay still. A thin, hollow needle will then be inserted through the skin to the site. The needle may need to be inserted more than once. Once the needle is in the proper position, tissue or fluid will be withdrawn. You may feel a pinch, pressure, or nothing at all. You may be monitored for bleeding or other complications. The site will be bandaged.

How Long Will It Take?

Simple biopsy (site is close to surface of skin): a few minutes (in most cases) Deeper biopsy or one that is guided by an ultrasound or CT scan: 30-90 minutes

Will It Hurt?
The amount of discomfort you feel depends on the part of the body that is being examined. The anesthesia and sedative will prevent pain. You may feel a pinch or pressure. If you feel pain, tell the doctor right away. After the procedure, the site will be tender.

Post-procedure Care
Be sure to follow your doctors instructions . In general, you should check the insertion site and keep it clean. The sample will be examined by a specialist. The results are usually ready in a few days. Your doctor will talk to you about the results.

Call Your Doctor

After arriving home, contact your doctor if any of the following occurs:

Signs of infection, including fever and chills Pain, redness, swelling, heat, discharge, or a red streak in the area of the needle insertion Cough, shortness of breath, or chest pain New symptoms develop

Colonoscopy
On this page: What is colonoscopy? What are the colon and rectum? How to Prepare for Colonoscopy How is colonoscopy performed? At what age should routine colonoscopy begin? Points to Remember Hope through Research For More Information

What is colonoscopy?

Colonoscopy is a procedure used to see inside the colon and rectum. Colonoscopy can detect inflamed tissue, ulcers, and abnormal growths. The procedure is used to look for early signs of colorectal cancer and can help doctors diagnose unexplained changes in bowel habits, abdominal pain, bleeding from the anus, and weight loss.
[Top]

What are the colon and rectum?

The colon and rectum are the two main parts of the large intestine. Although the colon is only one part of the large intestine, because most of the large intestine consists of colon, the two terms are often used interchangeably. The large intestine is also sometimes called the large bowel.

The colon and rectum are the two main parts of the large intestine.

Digestive waste enters the colon from the small intestine as a semisolid. As waste moves toward the anus, the colon removes moisture and forms stool. The rectum is about 6 inches long and connects the colon to the anus. Stool leaves the body through the anus. Muscles and nerves in the rectum and anus control bowel movements.
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How to Prepare for Colonoscopy

The doctor usually provides written instructions about how to prepare for colonoscopy. The process is called a bowel prep. Generally, all solids must be emptied from the gastrointestinal tract by following a clear liquid diet for 1 to 3 days before the procedure. Patients should not drink beverages containing red or purple dye. Acceptable liquids include fat-free bouillon or broth strained fruit juice water plain coffee plain tea sports drinks, such as Gatorade gelatin A laxative or an enema may be required the night before colonoscopy. A laxative is medicine that loosens stool and increases bowel movements. Laxatives are usually swallowed in pill form or as a powder dissolved in water. An enema is performed by flushing water, or sometimes a mild soap solution, into the anus using a special wash bottle. Patients should inform the doctor of all medical conditions and any medications, vitamins, or supplements taken regularly, including aspirin arthritis medications blood thinners

diabetes medications vitamins that contain iron

Driving is not permitted for 24 hours after colonoscopy to allow the sedative time to wear off. Before the appointment, patients should make plans for a ride home.
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How is colonoscopy performed? Examination of the Large Intestine

During colonoscopy, patients lie on their left side on an examination table. In most cases, a light sedative, and possibly pain medication, helps keep patients relaxed. Deeper sedation may be required in some cases. The doctor and medical staff monitor vital signs and attempt to make patients as comfortable as possible.

During colonoscopy, patients lie on their left side on an examination table.

The doctor inserts a long, flexible, lighted tube called a colonoscope, or scope, into the anus and slowly guides it through the rectum and into the colon. The scope inflates the large intestine with carbon dioxide gas to give the doctor a better view. A small camera mounted on the scope transmits a video image from inside the large intestine to a computer screen, allowing the doctor to carefully examine the intestinal lining. The doctor may ask the patient to move periodically so the scope can be adjusted for better viewing. Once the scope has reached the opening to the small intestine, it is slowly withdrawn and the lining of the large intestine is carefully examined again. Bleeding and puncture of the large intestine are possible but uncommon complications of colonoscopy.

Removal of Polyps and Biopsy

A doctor can remove growths, called polyps, during colonoscopy and later test them in a laboratory for signs of cancer. Polyps are common in adults and are usually harmless. However, most colorectal cancer begins as a polyp, so removing polyps early is an effective way to prevent cancer. The doctor can also take samples from abnormal-looking tissues during colonoscopy. The procedure, called a biopsy, allows the doctor to later look at the tissue with a microscope for signs of disease.

The doctor removes polyps and takes biopsy tissue using tiny tools passed through the scope. If bleeding occurs, the doctor can usually stop it with an electrical probe or special medications passed through the scope. Tissue removal and the treatments to stop bleeding are usually painless.

Recovery
Colonoscopy usually takes 30 to 60 minutes. Cramping or bloating may occur during the first hour after the procedure. The sedative takes time to completely wear off. Patients may need to remain at the clinic for 1 to 2 hours after the procedure. Full recovery is expected by the next day. Discharge instructions should be carefully read and followed. Patients who develop any of these rare side effects should contact their doctor immediately: severe abdominal pain fever bloody bowel movements dizziness weakness
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At what age should routine colonoscopy begin?

Routine colonoscopy to look for early signs of cancer should begin at age 50 for most peopleearlier if there is a family history of colorectal cancer, a personal history of inflammatory bowel disease, or other risk factors. The doctor can advise patients about how often to get a colonoscopy.
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Points to Remember

Colonoscopy is a procedure used to see inside the colon and rectum. All solids must be emptied from the gastrointestinal tract by following a clear liquid diet for 1 to 3 days before colonoscopy. During colonoscopy, a sedative, and possibly pain medication, helps keep patients relaxed. A doctor can remove polyps and biopsy abnormal-looking tissues during colonoscopy. Driving is not permitted for 24 hours after colonoscopy to allow the sedative time to wear off.

Kidney Biopsy

On this page: What is a kidney biopsy? What are the preparations for a kidney biopsy? What are the procedures for a kidney biopsy? What happens after a kidney biopsy? How are kidney biopsy results reported? Points to Remember Hope through Research For More Information

What is a kidney biopsy?

A biopsy is a diagnostic test that involves collecting small pieces of tissue, usually through a needle, for examination with a microscope. A kidney biopsy can help in forming a diagnosis and in choosing the best course of treatment. A kidney biopsy may be recommended for any of the following conditions: hematuria, which is blood in the urine proteinuria, which is excessive protein in the urine impaired kidney function, which causes excessive waste products in the blood A pathologist will look at the kidney tissue samples to check for unusual deposits, scarring, or infecting organisms that would explain a persons condition. The doctor may find a condition that can be treated and cured. If a person has progressive kidney failure, the biopsy may show how quickly the disease is advancing. A biopsy can also help explain why a transplanted kidney is not working properly. Patients should talk with their doctors about what information might be learned from the biopsy and the risks involved so the patients can help make a decision about whether a biopsy is worthwhile. [Top]

What are the preparations for a kidney biopsy?

Patients must sign a consent form saying they understand the risks involved in this procedure. The risks are slight, but patients should discuss these risks in detail with their doctors before signing the form. Doctors should be aware of all the medicines a patient takes and any drug allergies that patient might have. The patient should avoid aspirin and other blood-thinning medicines for 1 to 2 weeks before the procedure. Some doctors advise their patients to avoid food and fluids before the test, while others tell patients to eat a light meal. Shortly before the biopsy, blood and urine samples are taken to make sure the patient doesnt have a condition that would make doing a biopsy risky. [Top]

What are the procedures for a kidney biopsy?

Kidney biopsies are usually done in a hospital. The patient is fully awake with light sedation. A local anesthetic is given before the needle is inserted. Patients lie on their stomachs to position the kidneys near the surface of their backs. Patients who have a transplanted kidney lie on their backs. The doctor marks the entry site, cleans the area, and injects a local painkiller. For a biopsy using a needle inserted through the skin, the doctor uses a locating needle and x-ray or ultrasound equipment to find the kidney and then a collecting needle to gather the tissue. Patients are asked to hold their breath

as the doctor uses a spring-loaded instrument to insert the biopsy needle and collect the tissue, usually for about 30 seconds or a little longer for each insertion. The spring-loaded instrument makes a sharp clicking noise that can be startling to patients. The doctor may need to insert the needle three or four times to collect the needed samples.

The kidneys filter wastes and extra fluid from the blood and direct them to the bladder as urine.

The entire procedure usually takes about an hour, including time to locate the kidney, clean the biopsy site, inject the local painkiller, and collect the tissue samples. Patients who are prone to bleeding problems should not have a biopsy through the skin. These patients may still undergo a kidney biopsy through an open operation in which the surgeon makes an incision and can see the kidney to collect tissue samples. [Top]

What happens after a kidney biopsy?

After the test, patients lie on their backs in the hospital for a few hours. Patients who have a transplanted kidney lie on their stomachs. During this time, the staff will monitor blood pressure and pulse and take blood samples to assess for blood loss. On rare occasions when bleeding does not stop on its own, a transfusion may be necessary to replace lost blood. Most patients leave the hospital the same day. Patients may notice some blood in their urine for 24 hours after the test. A rare complication is infection from the biopsy. Patients should tell their doctors or nurses if they have any of these problems: bloody urine more than 24 hours after the test inability to urinate fever worsening pain in the biopsy site faintness or dizziness [Top]

How are kidney biopsy results reported?

After the biopsy, the doctor will inspect the tissue samples in the laboratory using one or more microscopes, perhaps using dyes to identify different substances that may be settled in the tissue. Electron microscopes may be used to

see small details. Getting the complete biopsy results usually takes a few days. In urgent cases, a preliminary report may be given within a few hours. [Top]

Points to Remember

A biopsy is a diagnostic test that involves collecting small pieces of tissue, usually through a needle, for examination with a microscope. A kidney biopsy can help in forming a diagnosis and in choosing the best course of treatment. Before the kidney biopsy, patients should o talk with their doctors to make sure they understand the need for a biopsy o sign a consent form o tell their doctors about any allergies they have and medicines they take o follow their doctors' orders for food restrictions

Flexible Sigmoidoscopy
On this page: What is flexible sigmoidoscopy? What are the sigmoid colon and rectum? How is flexible sigmoidoscopy different from colonoscopy? How to Prepare for a Flexible Sigmoidoscopy How is a flexible sigmoidoscopy performed? Points to Remember Hope through Research For More Information

What is flexible sigmoidoscopy?

Flexible sigmoidoscopy is a procedure used to see inside the sigmoid colon and rectum. Flexible sigmoidoscopy can detect inflamed tissue, abnormal growths, and ulcers. The procedure is used to look for early signs of cancer and can help doctors diagnose unexplained changes in bowel habits, abdominal pain, bleeding from the anus, and weight loss. [Top]

What are the sigmoid colon and rectum?

The sigmoid colon is the last one-third of the colon. The colon comprises three main parts: the ascending colon, the transverse colon, and the sigmoid colonsometimes called the descending colon. The colon absorbs nutrients and water and forms stool.

The sigmoid colon is the last one-third of the colon.

The rectum is about 6 inches long and connects the sigmoid colon to the anus. Stool leaves the body through the anus. Muscles and nerves in the rectum and anus control bowel movements. [Top]

How is flexible sigmoidoscopy different from colonoscopy?

Flexible sigmoidoscopy enables the doctor to see only the sigmoid colon, whereas colonoscopy allows the doctor to see the entire colon. Colonoscopy is the preferred screening method for cancers of the colon and rectum; however, to prepare for and perform a flexible sigmoidoscopy usually requires less time. [Top]

How to Prepare for a Flexible Sigmoidoscopy

To prepare for a flexible sigmoidoscopy, one or more enemas are performed about 2 hours before the procedure to remove all solids from the sigmoid colon. An enema is performed by flushing water, laxative, or sometimes a mild soap solution into the anus using a special wash bottle. In some cases, the entire gastrointestinal tract must be emptied by following a clear liquid diet for 1 to 3 days before the proceduresimilar to the preparation for colonoscopy. Patients should not drink beverages containing red or purple dye. Acceptable liquids include fat-free bouillon or broth strained fruit juice water plain coffee

plain tea sports drinks, such as Gatorade gelatin

A laxative or an enema may also be required the night before a flexible sigmoidoscopy. A laxative is medicine that loosens stool and increases bowel movements. Laxatives are usually swallowed in pill form or as a powder dissolved in water. Patients should inform their doctor of all medical conditions and any medications, vitamins, or supplements taken regularly, including aspirin arthritis medications blood thinners diabetes medications vitamins that contain iron [Top]

How is a flexible sigmoidoscopy performed? Examination of the Sigmoid Colon

During a flexible sigmoidoscopy, patients lie on their left side on an examination table. The doctor inserts a long, flexible, lighted tube called a sigmoidoscope, or scope, into the anus and slowly guides it through the rectum and into the sigmoid colon. The scope inflates the colon with air to give the doctor a better view. A small camera mounted on the scope transmits a video image from inside the colon to a computer screen, allowing the doctor to carefully examine the tissues lining the sigmoid colon and rectum. The doctor may ask the patient to move periodically so the scope can be adjusted for better viewing. When the scope reaches the transverse colon, the scope is slowly withdrawn while the lining of the colon is carefully examined again.

Biopsy and Removal of Colon Polyps

The doctor can remove growths, called polyps, during flexible sigmoidoscopy using special tools passed through the scope. Polyps are common in adults and are usually harmless. However, most colon cancer begins as a polyp, so removing polyps early is an effective way to prevent cancer. If bleeding occurs, the doctor can usually stop it with an electrical probe or special medications passed through the scope. During a flexible sigmoidoscopy, the doctor can also take samples from abnormal-looking tissues. Called a biopsy, this procedure allows the doctor to later look at the tissue with a microscope for signs of disease. Tissue removal and the treatments to stop bleeding are usually painless. If polyps or other abnormal tissues are found, the doctor may suggest examining the rest of the colon with a colonoscopy.

Recovery
A flexible sigmoidoscopy takes about 20 minutes. Cramping or bloating may occur during the first hour after the procedure. Bleeding and puncture of the large intestine are possible but uncommon complications. Discharge instructions should be carefully read and followed. Patients who develop any of these rare side effects should contact their doctor immediately: severe abdominal pain


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fever bloody bowel movements dizziness weakness

Points to Remember

Flexible sigmoidoscopy is a procedure used to see inside the sigmoid colon and rectum. One or more enemas are performed about 2 hours before the procedure to remove all solids from the sigmoid colon. In some cases, the entire gastrointestinal tract must be emptiedsimilar to the preparation for colonoscopy. A sigmoidoscope transmits a video image from inside the colon to a computer screen. A doctor can biopsy abnormal-looking tissues during a flexible sigmoidoscopy. Polyps can be removed using special tools passed through the sigmoidoscope. If polyps or other abnormal tissues are found, the doctor may suggest examining the rest of the colon with a colonoscopy. A flexible sigmoidoscopy takes about 20 minutes. [Top]

Hope through Research

The National Institute of Diabetes and Digestive and Kidney Diseases conducts and supports basic and clinical research into many digestive disorders. Participants in clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research. For information about current studies, visit www.ClinicalTrials.gov. [Top]

For More Information

Fact sheets about other diagnostic tests are available from the National Digestive Diseases Information Clearinghouse at www.digestive.niddk.nih.gov, including Colonoscopy ERCP (Endoscopic Retrograde Cholangiopancreatography) Lower GI Series Liver Biopsy Upper GI Series Upper GI Endoscopy Virtual Colonoscopy