You’ve been alluded to have an endoscopic ultrasonography, or EUS, which will enable your specialist, to assess or treat your condition. This handout will give you a fundamental comprehension of the system – how it is performed, how it can help, and what symptoms you may involvement. It can’t answer the majority of your inquiries, since a ton relies upon the individual patient and the specialist. If you don’t mind get some information about anything you don’t get it. Endoscopists are profoundly prepared masters who welcome your inquiries with respect to their qualifications, preparing and encounter

What is EUS?

Endoscopic ultrasound (EUS) is a minimally invasive procedure to assess gastrointestinal and lung diseases. This is a test that uses ultrasound waves. It allows the doctor to see the depth of unusual areas of tissue much better than typical exams. A small flexible tube is used to examine the area.

During this procedure a special endoscope is used with high frequency sound waves to make detailed images of the lining and walls of your digestive tract and chest, and also help in examining the nearby organs such as the pancreas and liver, and lymph nodes. During this procedure, your doctor can examine as well as take a biopsy for further analysis. EUS with fine needle aspiration can be a minimally invasive alternative to exploratory surgery.

How EUS Helps Treat Cancer?

EUS helps doctors determine the extent of certain cancers of the digestive and respiratory systems and can accurately assess cancer’s depth and whether it has spread to adjacent lymph glands. EUS can also be used to obtain biopsies to help your doctor determine the proper treatment.

How to Prepare for a EUS Procedure?

Blood Thinners: If you are taking blood thinners,(Warfarin, Coumadin, Plavix) please contact our office and your primary physician for specific instructions at least one week prior to the colonoscopy. ONLY STOP THESE MEDICATIONS IF YOU HAVE BEEN AUTHORIZED BY OUR DOCTOR OR YOUR CARDIOLOGIST. Aspirin is usually stopped one week before the procedure.

For the upper gastrointestinal tract EUS, you should have nothing to eat or drink for approximately six hours before the procedure. For EUS of the rectum or colon, your doctor will instruct you to either consume a large volume of a special cleansing solution or to follow a clear liquid diet combined with laxatives or enemas prior to the procedure.

Current Medications

You can take most medications as usual until the day of your EUS procedure. Tell your doctor about all of the medications that you are taking and any medication allergies you have. Anticoagulant medications (blood thinners such as Coumadin and Plavix) might need to be adjusted before your EUS procedure. Check with your doctor in advance regarding these prescriptions. On the morning of your exam, be sure to check with your doctor about which medications to take, and only take those essential medications with a very small cup of water. If you have an allergy to latex, inform your doctor prior to the test. Patients with latex allergies often require special equipment and might not be able to have a EUS examination.

Antibiotics

Antibiotics aren’t generally required before or after an EUS procedure, but do tell your doctor if you take antibiotics before dental procedures. If your doctor feels you need antibiotics, they might be ordered during or after the EUS procedure to help prevent infection. Your doctor might prescribe antibiotics if you’re having a specialized EUS procedure, such as to drain a fluid collection or a cyst using EUS guidance.

REGISTRATION

• Enter our waiting room and check in at the reception desk.
• After check-in, you will be called to register.
• After registration, you will be called to the procedure area.
• Please keep in mind that appointments are approximate times. If a delay occurs, we will do our best to update you. What to expect during EUS?
• A physician will explain the benefits and risks of the exam and ask you to sign a consent form giving the doctor permission to do the test. Ask him/her any questions you might have.
• A nurse will place an IV needle in your arm to give you any medicines and intravenous fluids you may need during the test. You will be given sedation through the IV to help you relax.
• If you are also going to have an FNA done, you may be given antibiotics before the test.
• Your blood pressure, pulse, and oxygen level will be checked throughout the procedure.
• For an ultrasound of the upper digestive tract, you will be given a numbing medication to gargle to reduce your tendency to gag. A bite block will be put in your mouth to prevent biting on the scope. You will be asked to lie down on your left side. This will not interfere with your breathing. Your stomach may feel bloated or full during the exam

For an EUS exam of the upper GI tract, your endoscopist might spray your throat with a local anesthetic before the test begins. Usually, you will receive sedatives intravenously to help you relax. You will most likely begin by lying on your left side. After receiving sedation, your endoscopist will pass the scope through your mouth, esophagus, and stomach into the duodenum. The instrument does not interfere with your ability to breathe. The actual exam generally takes between 15 and 45 minutes. Most patients consider it only slightly uncomfortable, and many fall asleep during the procedure. An EUS exam of the lower GI tract can often be performed safely and comfortably without medications. You will receive sedation if the procedure will be prolonged or if the doctor will examine a significant distance into the colon. You will start by lying on your left side with your back toward the doctor. Most EUS examinations of the rectum last from 10 to 30 minutes.

What to expect after EUS?

• You will be taken to our Recovery Room to rest and sleep off the effects of your sedatives.
• Your blood pressure, pulse, and oxygen level will be checked until you are fully awake.
• If you gargled numbing medication, your throat may feel scratchy or numb for a short while. After you have tested your swallowing with a sip of water and there is no problem, you may eat and drink normally. Your IV will be removed.
• You will be given discharge instructions and the doctor will discuss the results of your test with you. Those results will be sent to the physician who referred you for the exam.
• If you have severe pain, shortness of breath, fever, vomit blood, rectal bleeding or a cough up more than a teaspoon of blood please call 407-201-3686. You may also go to your local emergency room

Because you receive sedation, you will be monitored in the recovery area until most of the medication’s effects have worn off. If you had an upper EUS, your throat might be a little sore. You might feel bloated because of the air and water that were introduced during the procedure. You will be able to eat after you leave the procedure area unless you are instructed otherwise. You won’t be allowed to drive after the procedure, even if you don’t feel tired. You should arrange for a ride home. You should also plan to have someone stay with you at home after the examination because the sedatives could affect your judgment and reflexes for the remainder of the day. Your doctor will usually inform you of the results of the exam on the same day. However, some tests may take several days for the results to return. Possible Complications of EUS When doctors with specialized training and experience perform the EUS examination, complications are extremely rare. Bleeding might occur at the biopsy site, but it is usually minimal and rarely requires a follow-up. You might have a slight sore throat for a day or so. Nonprescription, anesthetic type throat lozenges can help soothe a sore throat. Other potential, but uncommon risks of EUS include a negative reaction to the sedative used, aspiration of stomach contents into your lungs, infection, and complications from heart or lung diseases. One major, but very uncommon complication of EUS is perforation — a tear through the lining of the intestine that might require surgery to repair. The possibility of complications will increase slightly if a deep needle biopsy is performed during the EUS examination. All of these risks must be balanced against the potential benefits of the procedure and the risks of alternative approaches to the condition.

EUS Instructions

What is FNA (FINE NEEDLE ASPIRATION)?

One week before the exam:

• Do not take Aspirin, Advil, Ecotrin, Bufferin, Nuprin, Excedrin, Aleve and/or Ibuprofen for 7 days before your exam. Tylenol (acetaminophen), Celebrex, and Mobic are fine to take.
• If you use blood thinners Coumadin (Warfarin) or Plavix, contact your doctor about stopping it for 5-7 days.
• If you are a diabetic, contact your doctor about adjusting the dose of insulin or blood sugar pills the day of the exam.

Day of the exam:

• Do not have any solid foods or milk products after midnight. Your doctor may give you additional prep instructions if the test is to be done in the colon.
• You may have clear liquids until 4 hours before your exam, then nothing at all until after your exam. Clear liquids (not colored red or purple) include water, soda, broth, bouillon, coffee, tea, Kool Aid, clear juices, Gatorade, Jello, and popsicles.
• You may take your blood pressure medicine and any heart medicines with a sip of water.
• Bring someone with you to drive you home. You will be given sedatives during the exam and you will not be allowed to drive the rest of the day. However, please limit the number of people you bring with you to our waiting room. If you do not have a driver, your exam may be canceled or rescheduled.
• Bring a list of current medications and medication allergies with you.
• Arrive at the hospital one hour before your appointment to allow for parking and registration in our department.

Call Gastroenterology Institute of Orlando, FL at 407-201-3686 to learn more about treatment!