Gastroenterology Program - What To Expect
The Gastroenterology Program is located within the Endoscopy Clinic at St. Joseph’s Hospital. Patients arrive to the clinic for registration and proceed through the admission process to ensure the health care team is aware of all pertinent information prior to the procedure.
At a designated time the patient is escorted into the procedure room where they are met by the health care team who reviews specific details with the patient to ensure all safety measures are met.
Procedure rooms are scheduled to begin at 8:15 am and last procedure is scheduled at 3 pm. Our stand alone recovery room ensures patients receive post procedure monitoring until patients meet all criteria for safe discharge.
The state-of-the-art Endoscopy Clinic provides a range of specialized diagnostic procedures for gastrointestinal disorders. It is the largest service in the region for colonoscopies.
The unit is staffed by an interdisciplinary team of gastroenterologists, surgeons, nursing staff, clinical reception assistant, endoscopic cleaning technologist and administrative staff..
Diagnostic procedures offered include:
• Manometry – esophageal and rectal
• Endoscopic ultrasound
Colon cancer screening
St. Joseph's Endoscopy Clinic is the designated site in London to provide high quality colonoscopies for the ColonCancerCheck screening program.
ColonCancerCheck is a province-wide screening program. It recommends that all Ontarians aged 50 and over be screened for colorectal cancer. For those at average risk for colorectal cancer, a simple at home test – Fecal Immunochemical Test (FIT) – is performed at regular intervals.
For those at increased risk because of a family history of one or more first-degree relatives (parent, sibling or child) with a diagnosis of colorectal cancer, colonoscopy is advised.
The purpose of ColonCancerCheck is to reduce deaths from colorectal cancer. When caught early, there is a 90 percent chance that people with colorectal cancer will be cured.
If you require a colonoscopy
Talk to your family doctor or nurse practitioner at your next routine health exam about colon cancer screening and the right screen for you.
If you require a colonoscopy, your family physician will initiate the referral process for you. You can contact the ColonCancerCheck program by email or call the INFOline at 1-866-410-5853.
Colonoscopy and Polypectomy
What is a colonoscopy?
A colonoscopy is the insertion of a long flexible tube, about the thickness of a finger. It is inserted into the rectum and into the large bowel (colon) and allows the doctor to carefully examine the lining of the colon. Abnormalities suspected by x-ray can be confirmed and studied in detail. Abnormalities which are too small to be seen on x-ray may be identified.
If the doctor feels that it is necessary, he can pass an instrument through the colonoscope and take a small piece of tissue (a biopsy) for examination in the laboratory. Biopsies are taken for many reasons and do not necessarily mean that cancer is suspected.
What is a polypectomy?
During the colonoscopy, a polyp may be found. Polyps are abnormal growths of tissue which vary in size from a tiny dot to several inches. If your doctor feels that removal of the polyp is necessary, he will pass a wire loop (snare) through the scope and remove the polyp from the bowel wall by means of an electric current. You should feel no pain during removal of the polyp. Polyps are usually removed because they can cause rectal bleeding or may contain cancer. Although the majority of polyps are benign (non-cancerous), a small percentage may contain an area of cancer in them or may develop into cancer. Removal of colonic polyps, therefore, is an important means of prevention and cure of colon cancer.
Why is a colonoscopy necessary?
Colonoscopy is a valuable tool for the diagnosis and treatment of many diseases of the large bowel. Abnormalities suspected by X-ray can be confirmed and studied in detail. The cause of symptoms such as rectal bleeding or change of bowel habits may be found by colonoscopy. It is also useful for diagnosis and follow-up of patients with inflammatory bowel disease.
Colonoscopy’s greatest impact is probably in its contribution to the control of colon cancer by polyp removal. Before colonoscopy became available, major abdominal surgery was the only way to remove colonic polyps to see if they were cancerous. Most polyps can now be removed easily and safely without surgery.
Periodic colonoscopy is a valuable test for follow-up of patients with previous polyps or colon cancer, and as a screening tool for people at risk of colon cancer.
Colonoscopy is a safe and extremely worthwhile procedure which is very well-tolerated. The decision to perform this procedure was based upon assessment of your particular problem. If you have any questions about your need for colonoscopy, do not hesitate to speak to your doctor.
Esophagogastro-Duodenoscopy (EGD) or Gastroscopy
What is an gastroscopy?
A long flexible tube, approximately the size of your little finger, is passed through the mouth and examines the lining of the esophagus, stomach and duodenum (the first portion of the small intestine).
Abnormalities suspected by X-ray can be confirmed and others may be detected which are too small to be seen on x-ray. If the doctor sees a suspicious area, he can pass an instrument through the endoscope and take a small piece of tissue (a biopsy) for examination in the laboratory. Biopsies are taken for many reasons and do not necessarily imply cancer.
Other instruments can be passed through the endoscope without causing discomfort, ,including a small brush to wipe cells from a suspicious area or a wire loop to remove polyps (abnormal growths of tissue).
Why is a gastroscopy necessary?
The decision to perform this procedure is based upon assessment of your particular problem. If you have any questions about your need for a gastroscopy, do not hesitate to speak to your doctor.
A gastroscopy is used to check for the cause of symptoms such as heartburn, trouble swallowing, vomiting, bleeding, abdominal pain or abnormalities supsected by X-ray.
A gastroscopy may also be needed for treatment, for example, for stretching narrowed areas of the esophagus, for removal of polyps or swallowed objects, or to control upper gastrointestinal bleeding.
A gastroscopy may detect cancers that are too small to be seen by X-ray, can confirm the diagnosis by biopsies or brushings, and identify the site of upper gastrointestinal bleeding.
What is an EUS?
Upper EUS: A long flexible tube, approximately the size of your little finger, with a camera and a miniaturized ultrasound machine is passed through the mouth and past the back of the throat into the upper digestive tract. The instrument is designed to give limited ability to see the lining of the digestive tube but is very good at visualization of the structures around the digestive tube (lung, lymph glands, heart, pancreas, gallbladder, liver etc.). EUS provides greater detail than ultrasound through the skin since the instrument can get very close to the places of interest. The doctor is also capable of passing a small needle through the endoscope into adjacent structures to obtain tissue that can be analyzed. The same needle can be used to inject medicines into diseased areas, and to help other types of treatment, such as removal of large polyps or drainage of local cysts or abscesses.
Rectal EUS: The above examination can also be done to visualize the rectum and structures surrounding it.
The EUS procedure will last 30-90 minutes.
Why is an EUS necessary?
EUS is a valuable tool for the diagnosis, staging and treatment of many diseases of the esophagus, lung, stomach, pancreas, bile ducts, liver, gallbladder and rectum. While an EUS can help to evaluate and manage benign disease it is most frequently used to diagnose and stage different types of cancers. An abnormality suspected by clinical history, blood tests or x-ray can be confirmed and studied in detail as well small samples can be obtained using a small needle or biopsy forceps through the flexible tube.
In patients with suspected cancer, EUS can help to obtain tissue to diagnose the cancer and to help guide the surgeon choose the proper surgical procedure as well as help the oncologist determine if chemotherapy or radiation therapy is necessary.
EUS is a safe and extremely worthwhile procedure which is very well-tolerated. The decision to perform this procedure was based upon assessment of your particular problem. If you have any questions about your need for EUS do not hesitate to speak to your doctor.
What is a flexible sigmoidoscopy?
A flexible sigmoidoscope is a short flexible tube that is about the thickness of a finger. It is inserted into the rectum and into the large bowel and allows the doctor to carefully look at the lining of the lower bowel.
The doctor can pass an instrument through the scope and take a small piece of tissue (a biopsy) to be examined under a microscope. Biopsies are taken for many reasons and do not necessarily imply cancer.
What is a polypectomy?
During the course of the examination, a polyp may be found. Polyps are abnormal growths of tissue. If your doctor feels that removal of the polyp is needed, this can be done through the scope.
You should feel no pain during removal of the polyp. Polyps are usually removed because they can cause rectal bleeding or contain cancer. Although the majority of polyps are benign (non-cancerous), a small percentage may contain an area of cancer in them or may develop into cancer.