While gastroscopy enables an exact examination of the inner lining of the digestive tract, EUS makes it possible to look deeper and to obtain images of the entire thickness of the intestinal wall.
It is used to examine the upper digestive tract (oesophagus, stomach, duodenum), or the lower digestive tract (the last part of the colon - rectum). An examination of some organs surrounding the gastrointestinal organs is also possible (liver, pancreas, bile ducts, gallbladder ...).
The procedure is performed with a thin, flexible tube, called an endoscope, which is inserted under eye guidance through the mouth or anus to the place of interest. Then the ultrasound device is switched on, which generates ultrasonic waves, by means of which an image of the examined tissue or organ is obtained.
The exam is performed by a gastroenterologist - endoscopist, who is a highly qualified specialist for performing such procedures.
If after a careful medical assessment, clinical examinations, laboratory tests and other ultrasound or endoscopic procedure, there is a suspicion of certain disease of the oesophagus, stomach, rectum, biliary ducts or pancreas, we arrange for EUS, which may be useful as a complementary or a final diagnostic test.
Most often it is used for:
- identifying bile duct stones (especially in the presence of problems which are similar to those before a gallstone surgery)
- identifying pancreatic diseases (when abnormal lab test or abnormal abdominal organ ultrasound indicators are present)
- identifying different thickenings of the gastrointestinal wall, which may have surfaced during the previous endoscopic examinations (gastroscopy, colonoscopy). EUS allows us to assess the nature, size and distribution of these changes and possibilities for surgical removal.
Prior to the examination of upper gastrointestinal tract you may not eat or drink for at least 6-8 hours.
For the examination of the lower part of the gastrointestinal tract (rectum), the last part of the intestine needs to be prepared for the procedure with the aid of laxatives or enema. In exceptional cases, the colon needs to be cleaned entirely just like for the complete endoscopic examination - colonoscopy. You prepare for the examination of the rectum in our Centre, with the assistance of qualified medical staff.
The procedure is performed while the patient is under sedation (medications with sedative effect). Prior to the exam, a nurse will insert a needle into a vein of your arm, through which you will receive a medication – a sedative. The doctor will administer the sedative just before the procedure. This will enable you to remain calm during the exam, you will tolerate it better, but you will not fall asleep. After the examination, you will be observed for at least two hours. Later, someone else should take you home, because at least 12 hours after the procedure you are not allowed to operate vehicles.
Consult your physician, who will tell you, which medications you should not stop taking even before the procedure. You may take them already several hours prior to the procedure with a small amount of water. Tell the endoscopist about your allergies to medications or rubber. In the latter case, the examination is unfortunately not possible.
Generally, antibiotics are not required prior to EUS. Due to their underlying disease, which poses a risk of infection, some patients need to ingest a preventive dose of antibiotics before and after surgery. In most cases, the patients diagnosed with such disorders are familiar with this. Please, tell your endoscopist about it.
Prior to the examination of your upper digestive tract, your pharynx will be numbed with a local anaesthetic. In order to protect the endoscope against biting, we will insert a mouthpiece in your mouth. While you are lying on your left side, the doctor will introduce the endoscope. You can breathe normally throughout the procedure, and you will not feel pain.
Most patients undergoing the procedure perceive it as mildly uncomfortable, while others even fall asleep. The procedure lasts 15-45 minutes.
In most cases, no medication is needed for examining the rectum. For this procedure you will be also positioned on your left side, and it will take from 10 to 30 minutes.
You may feel mild bloating due to air and water, and a slight pain in your throat. These problems subside quickly. For at least one hour after the procedure it is not recommended to ingest food or liquid.
Your doctor will discuss with you the examination results and further procedures. You will receive a written report after the examination, in exceptional cases it will be sent by post in a few days.
Although complications are possible, they are extremely rare
The pain in throat may linger for another day or two. To relieve the pain, you can take some lozenges for sore throat. Sometimes it is necessary to take a painkiller.
Other possible complications are:
- allergic reaction to the medication which you received during the procedure (local anaesthetic, sedative)
- bleeding in the passage between the oesophagus and stomach, due to bloating (the complication is tackled endoscopically)
- transient occurrence of fever in the afternoon,
- a puncture in the wall by the endoscope, which may require surgery.
In the case the following symptoms ensue after the examination, immediately contact your personal physician or emergency doctor: severe pain in the chest or abdomen, stiff abdomen, blood in vomit or black sticky mud, dizziness, loss of consciousness, fever and/or hypothermia.