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Capsule Endoscopy by Pillcam SB

Pillcam SB is a widely used, patient friendly tool for visualization of the entire small bowel and is the standard of care for detecting small bowel abnormalities.

The pill is the size of a large gel cap. The video capsule contains a camera and light source and transmits images to a receiver at a rate of two images per second, generating more than 50,000 pictures in the eight-hour procedure.

The patient begins by fasting at midnight the day before the procedure. The following morning, the patient arrives at the physician office at 8am. The nurse will fit the patient with a comfortable belt containing the receiver.

After being fitted with the belt, that patient will be given a glass of water to help swallow the vitamin sized capsule. After the patient has successfully swallowed the capsule, the patient will be able to resume their normal daily activities. After 8 hours, the patient returns the receiver and belt to the physician's office. The Pillcam capsule will pass naturally with a bowel movement, usually within 24 hours. The capsule is not reusable.

The recorder is attached to a computer so that the data recorded can be downloaded into the computer and then analyzed.

Some patients cannot have this type of monitoring. Patients with known or suspected gastrointestinal obstructions; strictures or fistulas; pacemakers, implantable defibrillators, neurotransmitters; and swallowing disorders.

Hemorrhoid Treatment by Infrared Coagulation (IRC)

Infrared coagulation is a non-surgical office procedure used to treat small to medium sized internal hemorrhoids. Internal hemorrhoids are dilated blood vessels in the anal area caused by increased pressure from childbirth, prolonged sitting or straining with defecation.

The objective is to eliminate hemorrhoids through obstruction of blood flow to the area affected. A small handheld probe is placed in the rectum to apply pulses of light energy to the hemorrhoid tissue. The veins collapse above the hemorrhoid which causes the hemorrhoid to shrink and recede. The pinpoint scar that is formed protects against further inflammation. This procedure usually takes approximately 10-15 minutes.

This is generally not a painful procedure. A brief sensation of warmth or pin prick may be experienced. Pain is extremely uncommon. Since this procedure is so well tolerated, oral or intravenous medications are not needed. A topical anesthetic is usually applied.

To prepare for the procedure, a single enema is required to clean the rectum. There is no special diet of laxative required.

The recovery time is relatively short. Patients typically can return to their regular activities the same day. You may experience a slight amount of spotted bleeding. Heavy straining or lifting and aspirin products should be avoided for a few days. Typically, the procedure must be repeated in 12 to 14 days and only one hemorrhoid at a time can be treated per session.

Generally hemorrhoids treated by IRC do not recur. Other methods for treating hemorrhoids are either associated with higher complications, less tolerated by patients or have a lower success rate in curing the hemorrhoids. Extremely large hemorrhoids may require surgery for complete relief. Surgery is generally not as well tolerated by patients when compared with IRC.

Pathology

The specialized nature of the GI Pathology lab provides a high level of expertise in the diagnosis and interpretation of GI cases. As a specialized GI Pathology lab, we have the resources needed to provide a highly accurate diagnosis which is essential to prompt, effective treatment.

Our Board Certified Pathologists complement the quality of care provided by Gastroenterology Associates' physicians through their efficiency and expediency.

Once biopsy samples arrive at the laboratory, they are grossed and processed by experienced histology technicians who, like the pathologists, focus on GI samples exclusively each and every day. Everything is the laboratory is geared towards the GI biopsy. This efficient process provides a high quality, consistent result.

A computer interface linking the pathology laboratory and the electronic health record provides an efficient delivery method of GI pathology results to the ordering physician and the patient's electronic health record.

Esophageal pH Monitoring

Esophageal pH monitoring is a test used to evaluate for gastroesophageal reflux disease (GERD, Reflux) and to determine the effectiveness of medications used that prevent acid reflux. This test measures the amount of acid backing up from the stomach into the esophagus (the "food pipe" leading from the mouth to the stomach).

Bravo pH monitoring system uses a capsule that is attached to the esophageal lining to monitor esophageal pH. The capsule is approximately the size of gel cap. The capsule contains an acid sensing probe, a battery and a transmitter. During an upper endoscopy, under conscious sedation, the capsule is introduced into the esophagus on a catheter through the mouth and is attached to the lining of the esophagus with a clip. The catheter is then detached from the capsule and removed. The capsule monitors the acid in the esophagus and transmits the information to a receiver (about the size of a pager) that is worn by the patient on a belt. The monitoring period is 48 hours (2 days).

During the recording, the patient continues his or her normal activities. Meal, periods of sleep, and symptoms are recorded by the patient in a diary and by pushing buttons on the recorder. The diary helps the physician to interpret the results.

The patient returns 48 hours after placement and returns the recorder. The recorder is attached to a computer so that the data recorded can be downloaded into the computer and then analyzed.

The capsule will fall off the esophageal lining, usually after five to seven days, and is passed in stool. The capsule is not reusable.

Patients cannot have an MRI (Magnetic Resonance Imaging) during the test and for 30 days afterwards.

Some patients cannot have this type of monitoring. Patients with pacemakers, implantable defibrillators or neurotransmitters cannot use Bravo. Patients with a history of bleeding diatheses, strictures, severe esophagitis, varices, obstruction, and prior esophageal resection are not candidates for Bravo pH monitoring.

Infusion Therapy

GI Associates had been providing infusion therapy to patients in a relaxed and comfortable environment since 2000. Our physicians and nursing staff are specialty trained in infusion therapy.

Remicade is a medication used to treat Crohn's Disease and Ulcerative Colitis. Remicade is given by intravenous (IV) infusion. There are three starter doses - the first dose is followed by additional doses at two and six weeks and then every eight weeks thereafter.

The infusion takes about 2 hours; three hours with preparation. An infusion nurse administers the medication through an intravenous line and monitors you throughout the infusion. There is no special patient preparation for the infusion. During the infusion, you will be able to eat or drink, read, watch TV or surf the net with our free wireless internet access.

Before the infusions, you will need to have a Mantoux test or chest x-ray.

Remicade is generally well tolerated. Mild reactions include; chills, headache, chest tightness, hives, itching, low-grade fever or rash.

Severe reactions include: fever greater than 101 degrees F, hypotension, shortness of breath, bronchospasm, throught tightness or wheezing.

Your nurse will closely monitor you throughout the infusion for any reactions.

Before therapy you will be enrolled in the ACESS ONE program which verifies you insurance coverage, identifies pre-authorization requirements, informs you if you are eligible for financial assistance programs. You will be notified prior to your appointment of any co-payments or insurance deductibles that will be due at the time of service.