Can You Have a Colonoscopy If You Are Constipated?

A colonoscopy is a routine procedure performed to diagnose colorectal polyps. This screening method has been instrumental in diagnosing colon cancer in its early stages, as well as preventing growths from morphing into cancer altogether.

The first step to an accurate diagnosis is an effective bowel prep. However, some conditions may interfere with the bowel prep, most notable of which is chronic constipation. 

Can you still have a colonoscopy if you are constipated? Yes, you can but some adjustments have to be made to ensure that your chronic constipation doesn’t interfere with the rest of the procedure. 

In this article we discuss everything you need to know to have a successful colonoscopy, even if you’re constipated. Read on to learn about the science behind colonoscopy screenings and how to improve constipation before your colonoscopy. 

How Is Constipation Diagnosed?

Constipation comes and goes and is characterized by infrequent, if not difficult, passing of the stools. Signs of constipation include:

• Difficulty passing stools or not passing stools altogether
• Feeling blockage in the rectum, preventing easier bowel movements
• Feeling “dry” stools that are difficult to pass
• Bloating and gassiness
• Not being relieved after passing a bowel movement

Constipation is often a result of dietary and lifestyle choices. Eating foods high in fat can affect stool consistency. Similarly, eating a high-fiber diet and eating less processed foods can regulate and improve your bowel movements. Drinking lots of liquids and staying active is also key in regulating bowel movements. 

In some cases, constipation lasts more than a few weeks, even with dietary interventions. At this point, doctors will characterize your constipation as chronic and you’ll be subject to tests to understand the state of your gastrointestinal system.

Diagnosing constipation isn’t as straightforward as you think. According to the guidelines published by The American Society of Gastrointestinal Endoscopy, diagnosing constipation shouldn’t just be based on frequency but also other factors such as:

• Discomfort during the passing of bowels
• Passage of hard stools
• Whether a patient is straining excessively during a bowel movement

Colonoscopy and Constipation

Can Colonoscopies Treat Constipation?

It’s possible to undergo a colonoscopy while constipated. In fact, some doctors recommend colonoscopies precisely because a patient is constipated. 

A colonoscopy is typically recommended if the patient is also experiencing the following symptoms:

• Rectal bleeding
• Weight loss
• Iron-deficiency anemia
• Rectal prolapse
• Signs of intestinal obstruction 
• Severe abdominal pain 

Chronic constipation could be a sign of bowel obstruction caused by colorectal polyps. As such, further investigation is required to understand if physical blockages are causing constipation. As a diagnostic tool, a colonoscopy can visually confirm if constipation is being caused by a physical obstruction. 

However, the diagnostic benefits of undergoing colonoscopy because of constipation are limited. Researchers suggest that its diagnostic rates are similar to the case of an asymptomatic patient undergoing regular colon cancer screening. This means that constipation alone is not a good indicator that colorectal polyps are present in the colon.

For instance, a study involving 563 colonoscopies performed to evaluate constipation found the following results:

• Only 1.4% of the cases detected colon cancer
• 14.6% of the cases found adenomas or growths 
• 4.3% found advanced lesions on the intestinal wall

Colonoscopy: Beneficial or Excessive?

That’s not to say that colonoscopies aren’t instrumental in handling constipation. In fact, a colonoscopy can still be recommended to guide long-term treatment plans for constipated patients. Doctors may choose to perform a colonoscopy to see how a patient is responding to modifications in diet and medication, and use these insights to further improve the patient’s quality of life. 

Colon Cancer Screening with Constipation: Is It Possible?

In other instances, colonoscopy is performed to investigate symptoms other than constipation. In this case, patients might be experiencing temporary constipation and are worried about how this will affect the findings. 

As mentioned, colonoscopy with constipation is still possible but extra precaution is advised to ensure proper preparations, especially when it comes to the bowel prep. 

How Does Constipation Affect Bowel Preparation?

A study published in Frontline Gastroenterology illustrates how constipation can impact the effectivity of a bowel prep. While this may seem irrelevant now, keep in mind that a thorough bowel prep can actually be the difference between an effective colonoscopy and a failed one. 

According to the researchers, an inefficient bowel prep can reduce polyp detection rate and increase the overall cost of colon cancer prevention. When done poorly, a bowel prep can prevent gastroenterologists from viewing the lower intestine as clearly as possible, resulting in compromised results or additional tests. 

Recommended Colonoscopy Prep For Constipated Patients

Researchers found that different prep drinks can lead to varying prep results. Constipated patients that were asked to undergo colon cleansing using bisacodyl resulted in more satisfying rates of colon prep. 

Although bisacodyl is usually associated with abdominal pain, patients who are already experiencing constipation did not experience worse abdominal pain compared to non-constipated patients. The study suggests that the use of NaP or sodium phosphate with bisacodyl is the best way to undergo a successful colon prep for constipated patients. 

As a patient, you can ask your doctor to recommend stronger doses of bowel prep drinks, or find ones that have NaP and bisacodyl in the ingredients list. This will help ensure that your colon prep is thorough and successful. 

How To Improve Constipation Before Colonoscopy

So you’re due for a colonoscopy but you’re also constipated. You can try to alleviate constipation two weeks before your colonoscopy in order to improve the results of your bowel prep. These at-home remedies can help regulate your bowel movement and take care of constipation for good:

1. Drink More Liquids

You’ve heard it before and you’ll hear it again. Dehydration can make bowel movements sluggish, accounting for dry and hard to pass stools. When you drink water, you’re increasing the water uptake in your bowels and can kickstart a more frequent bathroom schedule again. 

2. Take Laxatives

Senna, an all-natural laxative, is widely used to treat constipation. It comes in many forms, including one in tea bags that you can drink and take whenever you need. Senna is an herbal laxative that stimulates bowel movements with no help from chemicals, although it’s not recommended for pregnant people or individuals with inflammatory bowel disease. 

3. Drink Coffee

Coffee is a powerful diuretic but did you know it can make you go to the bathroom too? High amounts of caffeine can stimulate your gut muscles and improve your bowel movements. Just make sure you’re getting your caffeine supply from sources like tea or coffee instead of energy drinks. 

4. Eat High-Fiber Foods

High-fiber foods are associated with better bowel movements because they improve the consistency of stool, making it easier to pass through the colon. Various studies even support that high-fiber meals can improve chronic constipation if it’s added to the patient’s long-term diet. 

When you’re picking out fibers, make sure to stick with soluble fibers. These are often found in oat bran, beans, nuts, seeds, and lentils. Soluble fibers are primarily responsible for adding water to your stool, which improves its consistency. Unlike insoluble fibers, soluble fibers are easier to digest and won’t complicate other bowel problems such as irritable bowel syndrome. 

5. Eat Probiotic Foods

Sometimes all it takes to become regular again is to enlist the aid of some good bacteria. Various studies affirm the benefit of adding probiotics to your diet, which is especially useful for individuals with functional bowel diseases. 

Probiotics restore balance in the gut and help fight off bad bacteria from colonizing the colon. The presence of beneficial microbes can also aid in the digestion process, allowing for more frequent bowel movements and improved stool consistency. 

Yogurt isn’t the only source of probiotics. You can incorporate fermented foods such as sauerkraut and kimchi to see a difference in your digestive system. You can also choose to take probiotic supplements, but these usually take a couple of weeks before showing significant improvements.

Post-Colonoscopy Constipation: What It Means & What to Do With It

A patient may experience constipation after a colonoscopy due to the extra air in the colon. Patients typically report feeling full, bloated, and having difficulty passing stools immediately after their colonoscopy. These symptoms are normal and should be no cause for worry. They typically disappear 3-4 days after the procedure. 

In the meantime, we suggest eating smaller meals the day after your procedure to help your colon relax. Feel free to resume your normal meals when you have a more regular bathroom schedule again.

If your constipation gets worse 4+ days after your colonoscopy, accompanied by bleeding, vomiting, or fever, get in touch with your doctor immediately. You might be asked to undergo another colonoscopy to evaluate what is happening in your colon.

Colon Cancer Screening Made Easy

At Gastro Center NJ, we want to give you a comfortable colonoscopy experience. From start to finish, we’re dedicated to making sure our patients are informed, compliant, and in only in the best hands.

If you’re concerned about your colonoscopy prep, get in touch with us today and let’s find a solution together. 

The post Can You Have a Colonoscopy If You Are Constipated? appeared first on Gastro Center NJ.

from Gastro Center NJ https://gastrocenternj.com/can-you-have-colonoscopy-if-you-are-constipated/
via https://gastrocenternj.com

Back Pain After Colonoscopy: Is It Serious?

Upper Endoscopy Sedation: Short Guide

Preparing for an upper endoscopy can be nerve-wracking. Thankfully, this routine procedure employs sedatives to maximize patient comfort. Medical professionals often use benzodiazepines and an opioid to put the patient in a state of moderate sedation. An additional dose of hypnotic-like drugs may be administered when needed.

All in all, is upper endoscopy sedation safe? Yes. Sedation is a common part of any medical procedure. It is safer than anesthesia because patients remain awake during the procedure, and often don’t require respiratory support, which decreases the risk of complications.

The Science Behind Sedation 

What Does a Sedative Do?

A sedative is a type of drug that targets the brain and nervous system to reduce or eliminate discomfort and fear, as well as promote patient compliance. In minimally-invasive procedures such as an upper endoscopy, a sedative is administered to patients for pain relief and anxiety control. Doctors may elect to increase the dosage for especially uncooperative patients.

Choice of Sedatives

There are two kinds of sedatives administered during an upper endoscopy. Usually both forms of sedatives are administered to maximize patient comfort:

1. Throat Spray: Doctors rarely proceed with an upper endoscopy if the patient has chosen to be unsedated. If in any circumstance the patient is unable to take sedatives, a throat spray is usually administered to manage discomfort. The throat spray numbs the throat area so the patient doesn’t have to feel the endoscope as it enters through the mouth.
2. Intravenous Sedation: IV sedation or monitored anesthesia is routinely used for upper endoscopies and colonoscopies. Instead of putting the patient into a deep state of unconsciousness, IV sedation allows patients to experience an anxiety-free and pain-free upper endoscopy, without having to rely on machines for breathing support. 

With IV sedation, the patient remains conscious but unaware of the procedure. This grants doctors complete patient compliance, and makes patients more open to the possibility of another upper endoscopy in the future.

Three Levels of Sedation

• Minimal: Under minimal sedation, the patient is able to respond to verbal instructions. Patient is also somewhat aware of the procedure due to the low dosage of sedation.
• Moderate: Under moderate sedation, a combination of a benzodiazepine and an opiate are often combined. Under moderate sedation, purposeful verbal and tactile stimuli are required to get a response from the patient.
• Deep: Under deep sedation, the patient is still conscious but is unaware of the procedure. A powerful sedation such as a large dose of hypnotic and opiate are often combined to put a patient in this state. Under deep sedation, patients only respond to extremely painful stimuli. 

Patients undergoing an upper endoscopy can be put under a minimal or moderate state of sedation, depending on the pre-sedation assessment conducted by the gastroenterologist. It’s possible for doctors to raise the level of sedation if needed in order to guarantee a successful examination.

What’s In It?

In order to create a relaxing environment for the patient, doctors often use two or more types of sedatives to achieve the ideal level of sedation. Below are the following drugs used in order to create this effect:

Benzodiazepines

Benzodiazepines are drugs that cause sedation. An additional drug such as opiod is often required for an upper endoscopy since benzodiazepines don’t have anesthetic qualities. They don’t help with pain and exclusively produce sedation when ingested. 

There are different kinds of benzodiazepines used for medical procedures. Diazepam is often used in daytime surgeries. However, patients under diazepam take a long time to recover, which is why doctors recommend a newer sedative called midazolam. 

Unlike diazepam, midazolam breaks down faster, meaning patients don’t have to wait more than 24 hours before resuming normal activities. A different type of benzodiazepine might be recommended for pregnant women.

Opioids

Opioids are drugs designed for pain relief. Opiods work by attaching on receptors responsible for sending pain messages to the brain. Blocking the communication between the brain and receptors lead to a reduced feeling of pain.

Various opioids are available for medical use. Morphine and oxycodone are often administered to patients who are suffering from chronic pain or who have just undergone major surgery. For a minimally invasive procedure like upper endoscopy, fentanyl is the common opioid used by doctors.

Like benzodiazepines, some opioids may not be ideal to use for pregnant women. It’s important to let your doctor know if you are expecting in order to find alternatives to fentanyl and similar types of opioids.

Hypnotics

Drugs with hypnotic properties can be used to put a patient into deeper sedation. One of the most commonly used hypnotics in an upper endoscopy is propofol. Propofol produces an anesthetic-like effect in that the patient reaches sedation similar to unconsciousness. However, during a state of deep sedation induced by propofol, more monitoring is required in order to prevent respiratory complications.

As such, gastroenterologists have to employ certain techniques to prevent any complications during propofol sedation. Propofol is only administered if the gastroenterologist is ready to insert the endoscope. Propofol doses are often carefully mixed with a fast-acting opioid in order to suppress respiratory problems in the patient. 

How Long Do Sedatives Last?

After the procedure, patients are usually asked to stay 1 to 2 hours in the hospital or clinic as the sedative wears off. Even after the patient recovers from the procedure, an escort is still necessary to take the patient home, since grogginess is still strong within 24 hours after the procedure. 

Expect the following side-effects of sedatives:

• Having trouble focusing 
• Poor reflexes 
• Speaking more slowly 
• Impaired vision and perception 
• Drowsiness 
• Dizziness 

In general, we advise individuals to stay at home for 24 hours to fully recover from an upper endoscopy. It is not advisable to take on activities such as driving or any other activity immediately after the procedure.

Why Use a Sedative?

An upper endoscopy is a screening and diagnostic procedure that is performed by inserting a long, thin, flexible tube through the mouth to study the esophagus, stomach, and duodenum. While the exam only takes 15 to 30 minutes, an upper endoscopy isn’t exactly the most relaxing medical procedure. 

Doctors sometimes inflate the stomach or intestine for better visualization. To some patients, the extra air in their digestive tract can be uncomfortable. Sedation is routinely administered by gastroenterologists to maximize patient comfort.

Upper endoscopy uses what is known as “conscious sedation”. During the procedure, patients are sedated, but remain awake during the exam. Sedatives help control anxiety and discomfort, which allows patients to relax during the procedure.

Sedatives often have an amnestic component, which means that patients are put in a state of short-term memory loss. The amnestic characteristic of sedatives means patients will not recall the examination, improving their overall experience. This is crucial in ensuring future endoscopy recommendations are well-received and that patients who have undergone endoscopic procedures in the past don’t discourage other patients from undergoing the procedure.

It’s possible for patients to undergo an upper endoscopy without sedation. Different clinics have certain rules regarding sedation. Be sure to check with your doctor for options to undergo a non-sedated exam. 

Possible Risks and Complications

According to a study published in World Journal of Gastrointestinal Endoscopy, the risk of sedation-related problems during an endoscopy are incredibly low. The risk only increases under the following circumstances:

• If the patient is 60 years old and above
• If the patient is already medically compromised
• If the patient has cardiovascular and respiratory ailments
• If the procedure involves an inexperienced trainee or medical professional 

The possible complications associated with an upper endoscopy are:

• Hypotension or the rapid decline in blood pressure
• Hypertension or the rapid increase of blood pressure
• Irregular heart rates due to anxiety
• Airway obstruction
• Allergic reaction to anesthesia or sedative
• Vomiting and nausea

Special Cases for Sedatives

Special medical cases require further consideration when it comes to taking sedatives. These include:

Medical History: Before administering a sedative, patients are required to undergo a pre-sedation evaluation so doctors can understand whether patients will be receptive of the sedatives or not. Normal healthy patients are characterized as those who have no history of long-term alcohol and cigarette use, as well as not have a history of diseases. 

Patients with mild systemic diseases, for example hypertension, are still allowed to under sedation, provided that they don’t have a medical history of withdrawal from sedatives. On the other hand, patients with severe to life-threatening diseases such as coronary artery disease often undergo various tests to prevent any complications during the upper endoscopy. 

Allergies: The pre-sedation assessment also includes an understanding of the patient’s allergic history. Although rare, allergic reactions can occur during sedation. Reactions range from mild to more severe. If the patient experiences respiratory problems, antihistamines and airway management is applied to manage the situation. 

Patients with known allergies to sedatives used during an upper endoscopy may opt to undergo the procedure unsedated. In this case, a throat spray will be used to numb the throat. However, the patient will be fully aware of the procedure. 

Pregnancy and Lactation: Pregnant and lactating women can still undergo sedation during an upper endoscopy. However, certain adjustments are recommended as outlined by the guidelines provided by the American Society for Gastrointestinal Endoscopy (ASGE). 

For instance, the commonly used drug diazepam should not be used for pregnant women due to a link in fetal deformation. Midazolam is often used as an alternative, provided that the patient is not in the first trimester. 

Treatment is more rigorous for expectant individuals. Pregnant patients have narrower airways and are more susceptible to cardiopulmonary complications. As such, monitoring is made mandatory for sedated pregnant patients. 

After The Endoscopy: What to Avoid

Patients can still experience dizziness, grogginess, confusion, short-term amnesia, and poor reflex hours after an endoscopy. We recommend staying away from the following activities on the day of the exam:

• Cooking because of the risk of burns and accidents involving fire
• Making major financial decisions
• Being in charge of children and the elderly
• Taking additional sedative medication not prescribed by doctors
• Drinking alcohol
• Driving any sort of vehicle
• Using heavy machinery
• Participating in activities such as sports that require skill and judgment

FAQ

What if I am not allowed to take the sedative?

Patients who aren’t allowed to take a specific sedative are usually administered with a safer variation of the drug. If in any case medical professionals strongly recommend going unsedated, a throat spray will be used to numb your throat and minimize your discomfort during the endoscopy. 

How will I feel after being sedated?

Immediate side-effects of sedation include grogginess, poor reflexes, confusion, minor depressive symptoms, amnesia, difficulty focusing and making decisions, and sleepiness. We suggest resting the entire day of your endoscopy, and continuing bed rest if side-effects persist the next day. 

Why Do I Need an Escort After My Endoscopy?

Sedatives can affect a patient’s reflexes and alertness. As such, it is advised for patients to find an escort to take them home after an endoscopy. Driving a vehicle while under the influence of sedatives can lead to an accident. We recommend asking a relative or friend to drive you home on the day of your procedure. 

Is sedation for endoscopy safe?

Yes. Sedation is routinely performed during upper endoscopy. A pre-sedation assessment is also performed to ensure patient safety.

How much do sedatives cost?

IV sedation often costs between $200 – $900 depending on the drug used and dosage. You can ask your gastroenterologist beforehand for the cost of the sedative before the procedure. 

Book an Upper Endoscopy Today 

At Gastro Center in New Jersey, we understand the qualms patients have regarding an upper endoscopy. But with proactive medical practices and compassionate customer service, we are dedicated to giving you a pain-free and anxiety-free session.

We recommend undergoing the exam sedated for best results, but patients can also opt to go unsedated if needed.

Get in touch with us today to learn more about sedative options for upper endoscopy.

The post Upper Endoscopy Sedation: Short Guide appeared first on Gastro Center NJ.

from Gastro Center NJ https://gastrocenternj.com/upper-endoscopy-sedation-short-guide/
via https://gastrocenternj.com

How to Get Rid of Gas After Upper Endoscopy

Is There a Difference Between an Endoscopy and an Upper Endoscopy?

A Complete Overview of Upper GI Endoscopy

An upper endoscopy, sometimes referred to as esophagogastroduodenoscopy or EGD, is a type of endoscopy performed on the upper GI tract. This procedure is considered the golden standard for identifying certain gastrointestinal disorders such as celiac disease.

Unlike its lower GI tract counterpart, colonoscopy, an endoscopy doesn’t require patients to prepare with a cleanse. A clear liquid diet is usually enough to ensure the exam’s success. This procedure is currently being used to diagnose anything from stomach cancer to ulcers and is an integral part of maintaining one’s upper GI health. 

So, are upper GI endoscopies necessary? This depends on your case. Some patients might benefit from blood tests and imaging services, while others might require a definitive visual diagnosis from an upper GI. This is especially true for GI disorders that involve structural abnormalities such as stomach cancer (even in its early stage) and peptic ulcer. 

Before getting an upper endoscopy, it’s important to understand crucial information that will help you prepare for the procedure. In this article, we discuss everything from costs, to risks, to aftercare in order to prepare for a comfortable and successful upper GI. 

Introduction to the Upper GI 

The upper GI (upper gastrointestinal tract) refers to the organs and mechanisms in the upper tract of the gastrointestinal system. The distinction “upper” and “lower” exists to allow medical professionals to easily identify the site of an abnormality, for example, gastrointestinal bleeding. 

The organs in the upper GI are: 

• Mouth: The mouth is the entryway of food to the digestive tract. Enzyme-containing saliva is released during food intake to help break down carbohydrates. When swallowed, food travels down the pharynx and into the esophagus 
• Pharynx: The pharynx is a membrane that connects the nose and mouth to the esophagus. Its primary role is to serve as a pathway for food as it travels down the esophagus.
• Esophagus: The esophagus is a hollow tube that extends from the pharynx to the stomach. A “valve” called the lower esophageal sphincter serves as a door that allows food to enter the esophagus, while ensuring that the stomach contents aren’t regurgitated back up. However, this valve can malfunction, leading to a condition called acid reflux.
• Stomach: The stomach receives ingested food and continues to digest it by releasing acids and enzymes to further break down the food. The stomach secretes acids to aid with digestion and kill any residual bacteria from food and drink, and mucus to protect the stomach lining. 
• Duodenum: The duodenum is the first section of the small intestine. Here, nutrients are absorbed and food is further digested. As the food passes through the duodenum, secretions from the pancreas and Brunner glands are triggered to neutralize the acid and protect the small intestine. 

Upper GI Complications

Disorders concerning the upper GI are common. Upper GI complications can arise due to a variety of reasons, creating alarming symptoms that could cause anxiety, pain, and reduced quality of life. 

For instance, gastro-esophageal reflux disease (GERD) affects about 20% of the U.S. population and is considered one of the most common chronic gastrointestinal diseases.

The stomach functions best when the stomach lining called mucosa is able to maintain a balance between acid and mucus secretion. When disrupted, this can lead to ulcers, erosion, and even tumor. The American Cancer Society predicts that 27,510 cases of stomach cancer will be diagnosed in 2019, with less than half of those patients reaching mortality. 

Although alarming, upper GI disorders are now easily managed thanks to advanced screening methods such as endoscopy. 

Overview on Upper GI Endoscopy

Understanding the nature of your upper GI is made possible through a sophisticated method of visual examination. Through an endoscopy, medical specialists can clearly observe the location and condition of an ulcer, growth, infection, or any other GI abnormality. 

What Is an Upper GI Endoscopy? 

An endoscopy (also called an esophagogastroduodenoscopy or EGD) is a procedure that uses a viewing tool called an endoscope. The endoscope is a thin, flexible tube inserted through the mouth and is gently moved down to inspect the throat, stomach, and duodenum. This tool is equipped with a camera and a small flashlight, which projects images onto a computer. Some endoscopes are equipped with a colored light to aid in the detection of precancerous conditions. This is referred to as narrow band imaging. 

Upper GI Fluoroscopy VS Endoscopy

CT scans, ultrasounds, and other imaging techniques are also a viable method of diagnosis. For diagnosing abnormalities concerning the upper GI tract, a specialized x-ray called fluoroscopy is used in order to study everything from the esophagus to the duodenum. A contrast material such as barium is ingested which allows the scan to reflect the inside of the body using minor exposure to radiation. 

Fluoroscopy is performed to detect ulcers, tumors, and inflammation. It is usually recommended after an ultrasound or x-ray has detected an abnormality that needs further probing. Unlike regular x-rays, fluoroscopy uses radiation imaging to examine the GI tract. 

Unlike an endoscopy, fluoroscopy is a non-invasive procedure. At most, the patient is required to take the contrast material and to restrict diet and relevant medication in order to produce the best results. 

Fluoroscopy is useful in detecting clearly visible large ulcers. Infections such as those caused by the bacterium Helicobacter pylori may also be detected. However, additional tests are required in order to confirm the bacterial presence. 

Despite its many uses, fluoroscopy is unable to localize abnormalities and detect smaller growth in the GI tract. On the other hand, an upper endoscopy gives doctors complete visuals of the GI tract, making for a more accurate diagnosis. During an endoscopy, doctors may also perform a biopsy for further study or complete tissue removal. Results are sent back to a lab where pathologists can determine whether the cells are precancerous or show strains of bacterial infection. 

Upper Endoscopy VS Colonoscopy

A colonoscopy is performed to observe the colon, which is found in the lower part of the gastrointestinal tract, whereas an upper endoscopy is performed to observe the esophagus, stomach, and duodenum – all found in the upper GI tract. 

A colonoscopy is a procedure that also involves an endoscope to investigate the colon. This procedure is done to evaluate symptoms such as rectal bleeding, changes in bowel habits, constipation, and abdominal pain. 

Unlike colonoscopy, an upper endoscopy doesn’t require bowel cleansing. Although patients are required to undergo a clear diet, patients undergoing an upper endoscopy don’t have to take any laxatives to clean out the upper GI tract. 

Individuals 50 years old and above are at above-average risk for colon cancer. As such, a colonoscopy is encouraged for all adults, especially for individuals who are more predisposed to developing colon cancer due to genetics and medical history. 

Read more: Is Colonoscopy Necessary for Everyone?

Meanwhile, there is no recommended age for upper GI screening. An upper endoscopy will be recommended to a patient once crucial signs and symptoms show. 

Reasons For Upper GI Endoscopy 

An upper endoscopy may be recommended to satisfy the following: 

1. Diagnose Diseases

Doctors may perform a biopsy, a process involving the removal of tissue samples, in order to test for diseases. Bleeding, inflammation, blood loss, and irregular bowel movements can be a cause for concern, especially when these signs are accompanied by other symptoms and worsen with time. As such an endoscopy is performed to diagnose abnormalities in the gastrointestinal tract and rule out the possibility of diseases. 

2. Investigate Symptoms 

Persistent symptoms, both related to digestion and food consumption, can point to problems in the GI tract. As such, an upper endoscopy is performed to locate the source of the problem. The most common symptoms that prompt an upper GI endoscopy are:

• Persistent stomach, abdominal, or chest pain 
• Difficulty swallowing
• Bloating and discomfort after eating 
• Ulcer, gastritis, high levels of acidity 
• Inconsistent bowel habits
• Chronic constipation 
• Bleeding 
• Heartburn or acid reflux
• Nausea 
• Vomiting

3. Treat Disorders and Diseases

An upper GI endoscopy can also be used as a treatment tool. After discovering an abnormal growth or polyp along the upper gastrointestinal tract, an endoscopy may be performed to remove the polyp from the stomach lining to prevent the polyp from morphing into cancerous growth. An upper GI endoscopy can also be used to treat conditions such as bleeding from ulcers. 

An upper GI endoscopy can also be used to aid in other treatment methods. For patients with benign esophageal stricture (narrowing of the esophagus), the treatment called esophageal dilation is performed during an endoscopy. 

What Can Upper GI Endoscopy Detect?

An upper GI endoscopy is useful in treating various disorders affecting the gastrointestinal tract. These include:

1. Blockages and other structural problems

Patients suffering from an obstruction in the GI tract may experience nausea, vomiting that contains food and drinks, and constipation. Obstructions can appear on the GI tract as a result of growths blocking food and fluids from passing through the gastrointestinal system. 

Blockages are common in patients with esophageal and stomach cancer. As such, an upper endoscopy can confirm the presence of a blockage. When found, doctors may perform surgery to remove the obstruction along the GI tract. 

2. Ulcers 

Ulcers are sores that appear on the lining of the stomach and small intestine. Peptic ulcers are ulcers localized in the upper GI, which includes gastric ulcers (stomach ulcers) and duodenal ulcers (ulcers located in the duodenum). 

Common causes for ulcers include the presence of the bacterium Helicobacter pylori and long-term overuse of NSAIDs. Patients usually report feeling stomach pain, intolerance to fatty foods and drinks, and heartburn. 

An endoscope is performed to confirm the presence of an ulcer. Doctors may recommend performing a biopsy in order to rule out the H. pylori bacterium as the cause for the ulcer. 

3. Gastroesophageal Reflux Disease 

Chronic acid reflux and heartburn are characterized as gastroesophageal reflux disease or GERD. Acid reflux occurs when the lower esophageal sphincter malfunctions, allowing stomach contents to travel back up the esophagus, sometimes reaching the mouth. 

Patients with GERD report bile-tasting acid traveling back up the esophagus, which can often irritate the esophagus lining. As such, an endoscopy can be instrumental in diagnosing GERD. 

In an attempt to identify GERD, the endoscopist will be looking for acidic damage along the esophagus lining, as well as hernia and other physical abnormalities. More importantly, doctors will keep an eye out for the symptoms of Barett’s esophagus, a complication that is associated with a higher chance of developing esophageal cancer. 

Individuals with GERD might experience esophageal narrowing due to prolonged exposure to acid damage. In the event of esophageal narrowing, doctors may perform esophageal dilation (or the stretching of the esophagus) as part of the endoscopy. 

4. Stomach Cancer 

An upper endoscopy is a definitive test in identifying stomach cancer. Used both as a diagnosis and a screening tool, an upper endoscopy may help doctors distinguish cancerous lesions from normal lesions. 

In its early stages, stomach cancer appears as small and subtle lesions on the stomach lining. Alternatively, stomach cancer may also appear like an ulcer with visible mass or flat parts. Even without the use of other imaging methods, doctors with a trained eye can identify pre-cancerous tissue just by evaluating its structure alone.

5. Celiac Disease

Celiac disease is a disorder wherein the body is unable to process gluten. As an immune system response to gluten, patients experience inflammation and minor intestinal damage. A blood test is the go-to method for identifying celiac disease. However, test results can sometimes come out inaccurate, at which point an endoscopy would be recommended by the doctor. 

Small finger-like tissues called villi exist in the small intestine. Individuals with celiac disease usually have fat villi, caused by the body’s adverse reaction to gluten. As such, endoscopists investigate the small intestine and observe whether the villi is flattened or in normal shape. 

When Is Upper GI Endoscopy Not Useful?

Despite its many benefits, an upper GI endoscopy may not be beneficial for patients with the following conditions: 

• Organ perforation in the upper GI tract 
• Diagnosing or treating irritable bowel syndrome 
• Acute diverticulitis
• Colon inflammation 
• Severe gastrointestinal bleeding 
• Severe upper GI bleeding
• Coronary artery disease or any other heart-related disorder
• Peritonitis 
• Bleeding in the abdomen caused by torn blood vessel 

Who Performs an Upper Endoscopy?

An upper endoscopy is routinely performed by a gastroenterologist. A surgeon or any other trained medical professional may also perform an upper GI endoscopy. This procedure is usually done in a doctor’s office, hospital, or gastrointestinal clinic. 

Understanding the Procedure

Upper GI endoscopy involves various components that contribute to its success. Knowing key information about the procedure will help you prepare for your upper endoscopy, ensuring accurate results. 

Before the Procedure

Patients should inform doctors regarding medical history, medicine use, and family medical history. These variables are important in deciding whether an upper endoscopy is the best screening or diagnostic method for the patient. Medications that may interfere with the test will be suspended. 

Minor fasting is involved in an upper endoscopy. Patients will be required not to eat or drink 8 hours before the test to ensure test accuracy. Only clear liquids such as water, clear juice, broth, and coffee and tea without cream are allowed. As with a colonoscopy, foods with dye are to be avoided. The use of NSAIDs and blood-thinning drugs before an upper endoscopy is also prohibited. No laxatives and preparations are necessary. 

A sedative is usually administered during the procedure, typically through an IV line, to help patients relax during the procedure. Arrange a ride home after the procedure. Some medical centers would go as far as to not let patients have the procedure until they prove they have a designated driver. 

During the Procedure

An upper endoscopy is an outpatient procedure that is typically performed in 30-60 minutes. During the procedure, doctors will administer sedatives to minimize discomfort and allow relaxation. Doctors may spray an anesthetic to numb the throat in preparation for the endoscope. A mouth guard may be applied to help keep the mouth open. 

Although endoscopy is a painless procedure, it’s normal to feel some pressure in the throat as the tube makes its way down the upper GI. The gastroenterologist may instruct you to swallow during the exam. 

The endoscope will project images of your upper digestive tract onto a computer. The doctor will be using this to investigate any symptoms and understand the cause of any abnormality. During an endoscopy, the gastroenterologist may gently inflate your digestive tract in order to navigate the tract more freely. 

Complications and Risks 

Gastrointestinal Perforation

Although uncommon, gastrointestinal tearing can occur during an endoscopy. This happens when the endoscope damages the gastrointestinal lining, which could lead to hospitalization. The risk of GI perforation increases when other procedures are performed alongside the endoscopy, such as esophagus dilation. 

Infection 

Contamination on endoscopes is possible without proper disinfection and sterilization methods. Bacteria may form on the surface of the endoscope and can be transferred from one patient to another. Despite this, infections from endoscopies can easily be treated with antibiotics. Ask your doctor about preventive antibiotics before the procedure so you don’t have to worry about contracting a bacterial infection. 

Bleeding

Bleeding from an endoscopy may be caused by a biopsy or any other accompanying procedure. A blood transfusion might be necessary in the event of bleeding. However, this is extremely rare and unlikely to happen in standalone upper endoscopies.

Allergies and Sensitive Reactions

Negative reactions to sedatives and anesthesia are possible. It’s important to talk to your doctor about any known allergies to mitigate the risk of complications during the procedure itself. If applicable, discuss your previous surgical history and note instances of allergic or severe reactions to anesthetics and sedatives. 

Things to Watch Out For

Dizziness and disorientation is normal within 24 hours after the procedure. Get in touch with a medical professional if a patient is exhibiting the following problems following an upper endoscopy: 

• Black, tarry, stool or any other unusual bowel appearance
• Heart palpitations and shortness of breath
• Fever
• Vomiting, with blood or without
• Severe chest pain
• Unusual abdominal pain 
• Gastrointestinal bleeding 
• Discomfort in the throat
• Pain during swallowing
• Difficulty breathing

Cost and Insurance

Costs on upper endoscopy vary depending on a patient’s gastroenterologist, city, and facility you are doing it in. On average, an upper endoscopy can cost anywhere from $1,200 to $3,300. This usually includes sedative, anesthetic, and doctor’s fees. 

Coverage for endoscopies depend on your healthcare plan. Get in touch with your insurance provider and ask whether or not a gastrointestinal endoscopy is covered in your plan. 

After the Upper GI Endoscopy 

Common Side Effects, Recovery, and After Care

Doctors may ask you to stay in the medical facility 1-2 hours after the procedure as the sedative wears off. Patients are allowed to leave the hospital after an endoscopy, but will be instructed to rest at home within the day. Avoid any physical activities throughout the day and allow the sedative to wear off completely.

We recommend easing into your normal diet at least 24 hours after the procedure. After that, you are free to consume your normal meals. Keep in mind that a sore throat is a common side-effect of endoscopy and will go away in a matter of days. Bloating and nausea are other common side-effects.

How Long Do Results Take?

Results are typically available 1-2 days after the examination. Additional days may be required if a biopsy was performed alongside the endoscopy. You will get a call from your gastroenterologist asking you to come back to the clinic to discuss the results once a final report has been sent. 

Understand the State of Your Upper GI 

Your upper gastrointestinal tract is a crucial part of the digestive process. At Gastro Center in New Jersey, we are equipped with the latest tools and techniques to make your upper endoscopy a comfortable experience.

Worried about some symptoms? Book an appointment with us today and get the answers you’ve been waiting for. 

The post A Complete Overview of Upper GI Endoscopy appeared first on Gastro Center NJ.

from Gastro Center NJ https://gastrocenternj.com/complete-overview-of-upper-gi-endoscopy/
via https://gastrocenternj.com

Can Intermittent Fasting Help IBS?

Watchful eating, regular exercise, medication and antibiotics are traditional methods of managing IBS symptoms. However, more and more patients are recognizing the benefits of intermittent fasting in dealing with IBS. 

Can intermittent fasting help with IBS? Anecdotal evidence shows that intermittent fasting can indeed improve a patient’s quality of life by reducing pain and discomfort, as well as regulating bowel movements. 

In this article, we talk about the benefits of intermittent fasting on IBS, and what happens in your body when your intestines aren’t busy digesting food.

What Is Intermittent Fasting

Intermittent fasting (or IF) is an eating pattern with periods or cycles of eating and fasting. Unlike regular meal times, people on an IF schedule fast for a specific number of hours and only eat within a certain window. Intermittent fasting is not concerned with the kinds of food you eat but is more focused on the timing of consumption. 

Intermittent Fasting VS Regular Fasting

Regular fasting can be predicated on medical conditions or religious practices. Individuals undergoing a fast go on hours of not eating, sometimes extending to days, in respect to medical prerequisites (when preparing for a colonoscopy) or according to religious mandates (during the holy month of Ramadan). 

On the other hand, intermittent fasting is a dietary option usually done for its perceived benefits, the most popular of which is weight loss. Unlike regular fasting, intermittent fasting follows a schedule and is recurring. Individuals who adopt IF often make adjustments to their lifestyle, specifically with their meal times, in order to accommodate the cycles of eating and fasting. 

Types of Intermittent Fasting

The key principle of intermittent fasting is limiting your meal times within a certain window. As such, there is no one way to do IF. Below are three of the most popular ways to do IF: 

1. 16/8 Method

Considered by many as the most sustainable way to perform IF. The 16/8 method involves 16 hours of fasting and a window of 8 hours for consumption. The 16/8 window can be adjusted into 14-16 hours of fasting with 8-10 hours of consumption.

The 16/8 is sustainable because it already resembles regular feeding patterns. An example of a 16/8 method is eating your last meal at 6 PM and eating your next meal at 10 am. To many people, this eating pattern is already instinctive and doesn’t need to be reinforced. But to those who tend to snack every hour, IF might prove beneficial for their weight loss goals. 

2. 5:2 Fasting

The 16/8 method requires a daily commitment to the fasting and eating times. Another option called the 5:2 fasting only involves 2 days of fasting every week. Instead of consuming the usual 1,500 – 2,000 calories per day, dieters are expected to eat only 500 – 600 calories for two select days and eat normally for the rest of the week.

Although less restrictive, the lower amount of calories consumed twice a week may prove too few for some individuals. The 5:2 fasting is typically not recommended for individuals who need consistently high energy to complete their day to day activities. 

3. Eat-Stop-Eat 

Eat-Stop-Eat refers to a 24-hour fasting cycle done one to two times a week. Doctors don’t recommend fasting for more than 24 hours for longer than 3 days because this can severely impact your energy levels. 

Drinking water, coffee, and tea are allowed during the 24-hour fast. Caloric beverages such as energy drinks and shakes are also not allowed. Individuals doing the eat-stop-eat IF are recommended to reach their daily caloric goals on their feeding days. Additional restriction on non-fasting days can increase the chances of failure and lead to binge eating. 

The Effect of Intermittent Fasting On IBS

Intermittent fasting has many known benefits. For people who want to lose weight, IF offers an opportunity to cut down on calories and control one’s relationship with food. But its real health benefits hailed by science go beyond cutting down extra weight.

By altering feeding and fasting cycles, the body is able to “take a break” from digesting food. The modern human consumes a significant amount of preservatives from everyday foods. But even without these preservatives, sugars, oils, and salts in the system, the mere quantity of food being digested today is usually enough to upset the stomach, which is especially true for people with IBS. 

IF allows the body to restart certain metabolic processes that promote better overall health. Studies show that intermittent fasting can decrease inflammatory responses and reduce stress, both of which are crucial in managing gastrointestinal syndromes, specifically IBS.

How Intermittent Fasting Can Help With IBS

For the majority of IBS patients, food consumption often triggers symptoms. Diarrhea, bloating, and abdominal pain can occur immediately after eating. Intermittent fasting can help manage symptoms by limiting gut responses to specific meal times. 

Read more: What Makes Irritable Bowel Syndrome Worse?

This means that patients no longer have to endure discomfort throughout the day. Instead of feeling abdominal pain 24/7, patients who undergo intermittent fasting have better control over their symptoms, and can easily make adjustments in order to prevent any episodes. 

More importantly, IF allows the gut to relax and repair itself by establishing periods of non-consumption. Instead of introducing new foods every 3 hours or so, the gastrointestinal system doesn’t have to work on digesting foods, which for many patients is enough to trigger abdominal pain and distension. 

With no food to process, the gastrointestinal system doesn’t produce any uncomfortable responses. When done right, intermittent fasting can put an end to urgent bowel movements, constipation, and bloating. 

Patient Success With Intermittent Fasting

Although more research is needed to make intermittent fasting a definitive solution to managing IBS symptoms, anecdotal evidence shows that IF can significantly improve a patient’s quality of life. 

Patients report a “lighter” experience due to the eating restrictions necessary to perform intermittent fasting. Patients feel less bloated and less prone to urgent bowel movements. For patients whose sleep is disturbed by untimely bowel movements, IBS has been proven to regulate their toilet visits as long as a strict eating window is followed. 

One patient affirms that intermittent fasting has helped regulate his bowel movements. With a slow digestive system, food takes a lot longer to process and is often expelled at irregular times. Even then, as is the case with majority of IBS cases, the bowel movement doesn’t relieve the feeling of having to go to the toilet. 

But with intermittent fasting, patients have reported a significant improvement in abdominal pain, distension, irregular bowel movements, and stool consistency. 

Benefits of IF for IBS: The Science Behind a Clean Gut

The feeling of being “lighter” and “cleaner” after adopting intermittent fasting isn’t just a placebo effect. IF activates certain mechanisms that are difficult to maintain with constant eating. Periods of fasting or “emptiness” allow the gastrointestinal system to resume maintenance procedures that normally wouldn’t be triggered during digestion.

The Role of Bacteria in IBS

Changes in gut bacteria can interfere with normal intestinal functions, affecting intestinal motility (or the movement of the intestinal muscles) as well as mucus secretion that protects the intestinal lining. 

Bacterial composition changes depending on a person’s age, environment, eating habits, and drug use. However, bacterial cultures in IBS patients are different from healthy individuals, in that beneficial bacteria are lower in individuals with IBS. 

In order to control the symptoms, it’s important to promote bacterial balance in the gut in order to restore normal digestive functions. 

What Is the Migrating Motor Complex (MMC)

The migrating motor complex is a series of processes in the gastrointestinal system. Although what triggers the MMC is still unclear, scientists have observed that this kicks in about three hours after the last meal. 

The MMC’s primary role in the digestive process is to clean out any undigested residual material. Extra bile secretions are also observed during the MMC, which plays a crucial role in maintaining a healthy habitat for beneficial bacterial culture. Bile is also known to manage systemic inflammation, which is useful to patients trying to regulate their IBS symptoms. 

Here’s a general rundown of what happens when the MMC is activated:

• Smooth muscle contractions happen and during which stomach acid is secreted
• This stomach acid will sweep away undigested food particles and bacteria left over in the stomach
• Muscle contractions will aid in moving particles along into the pylorus, a “valve” that separates the stomach and the small intestine
• Stomach contents move through the small intestine
• Pancreas and gallbladder enzymes are released to neutralize stomach acid 
• The small intestine moves the enzymes and stomach contents towards the colon
• As bile moves through the gastrointestinal system, it starts killing off residual bacteria, preventing any from attaching to the gut wall
• Bile is redirected into the gallbladder and reabsorbed. During which, antimicrobials are released again to eliminate any remaining bacteria
• Bacteria and other stomach contents move to the colon and stays there until the next MMC or until food is consumed

The MMC occurs every 1.5 to 2 hours as long as no food is present. Once food is reintroduced into the system, the MMC stops completely. Instead of “maintenance”, food in the stomach signals your body to redivert its energy to digesting food instead.

Is it bad to interrupt the MMC? Yes. Continuous interruptions of the MMC can lead to bacterial build up in the small intestine. Healthier individuals are equipped with the system to fight off any effects of bacterial build-up. However, IBS patients, due to an increased sensitivity, will only suffer the effects of bacterial overgrowth in the small intestine. 

Increasing Good Bacteria: Firmicutes and IBS

IBS patients are no strangers to the world of antibiotics. Prescriptions are taken regularly, often after every meal, to control bacterial growth in the gut. However, some studies suggest that beneficial bacteria can be cultivated in the gut just through intermittent fasting alone. 

Animal studies and a number of human intervention runs have shown that intermittent fasting can encourage the regrowth of good bacteria and aid in fighting off bacterial attacks. A study involving Salmonella-infected mice reported that an alternate day fasting for 12 weeks resulted in better immune responses and increased mucus production that protected the intestinal lining.

The same is also applicable to human hosts.  A study found out that an increase in the bacteria Firmicutes is observed after intermittent fasting. Firmicute bacteria are associated with reduced inflammation in the gut. 

When Is Intermittent Fasting Not Beneficial For IBS?

Just like a low FODMAP diet, success with intermittent fasting isn’t guaranteed. Depending on your type of IBS, your stomach might respond negatively to a lack of food. 

Intermittent fasting may not be useful for patients whose symptoms occur as a response to an empty stomach. Patients who experience acid reflux and abdominal pain due to an empty stomach are not good candidates for intermittent fasting.

As with any new technique for managing symptoms, we suggest easing into this new process. Instead of fasting for 24 hours or even 16 hours, we recommend doing shorter fast times in order to evaluate whether or not your stomach is against fasting. 

In order to preserve the benefits of intermittent fasting, make sure you don’t overeat during your feeding time. Consuming excess calories during your feeding time is only going to make your fasting attempt irrelevant. Stick to a healthy calorie limit and eat foods that won’t aggravate your symptoms. 

Read more: Irritable Bowel Syndrome: Symptoms and Causes

Managing IBS With Gastro Center in New Jersey 

IBS is a long-term battle that requires patience, understanding, and proactive medical help. At Gastro Center NJ, our goal is to find the right lifestyle modifications to improve your quality of life.

Book a consultation with us today to learn more about the different techniques used to manage IBS symptoms, and how intermittent fasting can benefit you. 

The post Can Intermittent Fasting Help IBS? appeared first on Gastro Center NJ.

from Gastro Center NJ https://gastrocenternj.com/can-intermittent-fasting-help-ibs/
via https://gastrocenternj.com