Dr Walker McDonald and Dr Neelima Reddy of Gastroenterology Associates are the only specialists to provide endoscopic ultrasound (EUS) in the Baton Rouge area. This minimally invasive procedure is extremely useful for evaluating and diagnosing a range of conditions, including cancers of the esophagus, lung, pancreas or stomach, colon, ampulla, and rectum. If you need an endoscopic ultrasound, then the physicians at Gastroenterology Associates will take care of you throughout the process, from initial consult through the procedure to follow up care.
What is EUS?
An endoscopic ultrasound is a procedure that doctors use to examine your upper or lower digestive tract. The endoscopist passes a flexible tube, known as an endoscope, into the mouth for an upper EUS or the anus for the lower EUS. A tiny ultrasound probe that is built into the endoscope creates images of the internal organs, allowing the doctor to look for abnormalities.
Who Needs EUS and Why?
EUS is a useful technique for diagnosing many conditions. If you have symptoms, such as abdominal pain or unintended weight loss, then your doctor might recommend an EUS to find out what the problem is.
EUS is the current standard of care for local staging to evaluate the depth of tumors or involvement of the surrounding lymph nodes or blood vessels. Determining if surgery is appropriate, for many digestive tract cancers such as those of the esophagus, stomach, pancreas, or rectum, can also be accomplished with an Endoscopic Ultrasound. Surgeons and oncologists frequently request this test for additional insight on a patient before starting treatment.
Gastroenterology Associates is a “one stop shop” for patients, providing all the tests needed for diagnosis and staging, under one roof, in a timely and convenient manner. Some of the comprehensive tests include endoscopy, colonoscopy, CT scan, labs, and EUS.
We receive referrals from other physicians and facilities in Baton Rouge, Lafayette, New Iberia, St. Francisville, and Hammond to provide Endoscopic Ultrasound for their patients. Prior to initiation of this service in 2009 by Dr. Reddy, all local and regional patients needing and EUS were referred out of town.
Some of the conditions an EUS evaluates are:
- Cancers of the esophagus, lung, pancreas, stomach, colon, ampulla, gallbladder and rectum
- Lymphoma, or evaluation of enlarged lymph nodes in the chest (mediastinum), around the lungs/ airway (this is a safe, quick and easy procedure compared to a complicated surgical procedure called mediastinoscopy for sampling these lymph nodes next to the heart and lungs)
- Barrett's esophagus, a precancerous condition caused by long standing acid reflux/ heartburn
- Neuroendocrine tumors, special tumors that may produce hormones and symptoms or may be cancerous, difficult to be diagnosed by other tests
- Acute or recurrent Pancreatitis from unknown cause when a cause needs to be identified for pancreatitis or
- Chronic pancreatitis where damage occurs from alcohol abuse
- Pancreatic cysts, which may sometimes be precancerous
- Bile duct stones, gallstones, tumors of the bile duct causing jaundice
- Rectal fistulas
- Fecal incontinence to evaluate for tears in the anal sphincter, resulting in stool leakage or accidents
It can also be used to take a closer look at lumps and lesions that have been picked up by other tests. Because ultrasound can see through tissue, EUS can also be used to look at organs that are near the digestive system, including the lungs, liver, pancreas, gall bladder, and bile duct in the upper GI tract and the bladder, uterus, ovaries, and prostate gland in the lower GI tract.
How to Prepare for EUS
To allow doctors to get a clear view of your digestive tract during EUS, the relevant organs need to be empty of food and water. If you are having an endoscopic ultrasound of the upper gastrointestinal tract, in which the scope is inserted through the mouth, then you need to avoid eating or drinking for roughly six hours before the procedure. Follow your doctor’s instructions regarding exactly when you need to start fasting. For lower EUS, in which the endoscope is inserted via the anus, your doctor will prescribe a colonic cleansing solution, laxatives, and a fasting schedule to prepare your system for the procedure. Follow the instructions exactly as your doctor prescribes to make sure your system is clear before the procedure.
In general, you can take medications as usual right up to the day of your procedure. However, there are a few exceptions, such as anticoagulants and insulin, which need to be adjusted so you can stay safe during the procedure. Let your doctor know exactly which medications you are taking so he or she can recommend a suitable adjustment. You also need to let your doctor know if you are allergic to latex, as some of the standard equipment can contain latex. As long as you let your doctor know everything you are taking and any allergies, it will usually be possible to make adjustments so you can safely have the procedure.
What to Expect During EUS
Most people receive a sedative to help them relax during EUS. Sedation is done to ensure the efficacy of the physician and to assist patient’s relaxation during the EUS, which usually takes less than an hour and is only mildly uncomfortable. Simple benign lesions such as nodules in the esophagus or stomach may only need a few minutes to be diagnosed, sometimes without a biopsy. Should there be a need for a biopsy or drainage of a lesion, the procedure may take up to one or two hours to complete.
Passing an endoscope into the mouth and down the throat won't interfere with your ability to breathe, as the tube is very thin and flexible. The endoscopist will ensure that you remain safe and comfortable throughout the procedure.
If you are sedated for your procedure, then you need to wait in the recovery area until the medication wears off before you can go home. Your throat might be a little sore if you have an upper EUS. In addition, you might feel bloated for a while after the procedure. Your doctor will let you know how the procedure went, but you might have to wait for a few days for results if you had a biopsy.
Complications of EUS
Complications of EUS are rare, but it's important to understand what the risks are before the procedure. Occasionally, patients react to the sedatives that are given. Infection, bleeding, damage to the lining of the intestine are fortunately rare complications. Most patients experience nothing more than a sore throat after upper EUS or minimal bleeding after a biopsy, as with other routine procedures like colonoscopy. These usually resolve quickly without requiring further treatment.
It is an outpatient procedure from which quick and complete recovery before discharge is expected. You may return to your activities the next day.
EUS at Gastroenterology Associates
Dr Walker McDonald and Dr Neelima Reddy have many years of experience of performing EUS. The specialized training for the procedure and the expert care in all other areas of gastroenterology from all 17 physicians means that patients have access to the largest and most complete care specifically for the digestive system.
The Digestive Health Center houses Gastroenterology Associates and the Louisiana Endoscopy Center, so the procedure can take place in the convenience of the location at 9103 Jefferson Hwy in Baton Rouge. By choosing Gastroenterology Associates for your endoscopic ultrasound in Baton Rouge, LA, you can be sure that you are in safe hands and will receive the most comprehensive and experienced care.
Disclaimer: All information provided in this article is for informational purposes only and should not replace the consultative advice and experienced feedback from your physician. Always consult with your physicians on any of your questions and concerns.