Screenings and Procedures

Capsule Endoscopy

Video capsule endoscopy is a procedure that allows a doctor to examine your small intestine for sources of bleeding. It may be especially helpful for diagnosing Crohn's disease.

How is it done?

For this procedure, you swallow a capsule that is less than an inch long (about 23 millimeters). A technician attaches sensors to your chest and connects them to a data recorder that you wear on a belt around your waist. The capsule contains a tiny video camera. As the capsule travels through your gastrointestinal tract, the camera takes pictures and sends them to the data recorder. After 8 hours, the technician removes the data recorder and looks at the pictures. The capsule passes out of your body in the stool in a day or two.

What are the advantages?

Video capsule endoscopy is becoming popular because it has several advantages over traditional endoscopy:

  • It can show the entire small intestine and thus may be better at finding sources of bleeding
  • It is not invasive. In traditional endoscopy, a thin, lighted tube is inserted down your throat
  • It is painless, so you do not need to take pain medicine
  • You do not have to stay in the hospital
  • You have to fast for 12 hours before swallowing the capsule, but it does not require other preparation.

When should it not be used?

Video capsule endoscopy is generally safe and well tolerated. But it should not be used if you are known to have intestinal obstructions or narrowing (strictures) or abnormal connections or openings between two organs or parts of the body (fistulas).


Colonoscopy is an outpatient procedure in which your large bowel (colon and rectum) is examined.

Your doctor may perform the procedure to diagnose and treat, when possible, certain diseases of the lower gastrointestinal (GI) tract, which includes the rectum and colon.

A colonoscopy may be used to screen for colon cancer and evaluate many problems, including:

  • Abdominal pain
  • Anemia (low red blood cells)
  • Blood in the stool
  • Change in bowel habits
  • Unexplained weight loss
Colonoscopy is often used to treat certain conditions:
  • Bleeding from diverticula or other lesions can be treated by injecting medicine around them or by applying heat to cauterize -- or seal -- them
  • Polyps, some of which may be cancerous, can be removed using a lasso-like device through the colonoscope
  • Narrowed areas or strictures can often be dilated using a balloon

Esophagogastroduodenoscopy (EGD)

An esophagogastroduodenoscopy (EGD) test is performed to examine the lining of your esophagus. The esophagus is the muscular tube that connects your throat to your stomach and the duodenum - the upper part of the small intestine.

An EGD test is administered by passing a small camera on a tube (called an endoscope) down the throat and along the length of your esophagus.

Your doctor may recommend an EGD test if you have certain symptoms that are not responding to treatment. These symptoms include:

  • Severe chronic heartburn
  • Vomiting blood
  • Black or tarry stools
  • Regurgitating food
  • Pain in the upper abdomen
  • Unexplained anemia
  • Persistent nausea or vomiting
  • Unexplained weight loss
  • A feeling of fullness after eating less than usual
  • A feeling that food is lodged behind the breastbone
  • Pain or difficulty swallowing

Your doctor may also use this test to help see how effectively a treatment is going or to track complications if you suffer from:

  • Crohn’s disease
  • Cirrhosis of the liver
  • Swollen veins in your lower esophagus

Endoscopic retrograde cholangiopancreatography (ERCP)

An endoscopic retrograde cholangiopancreatogram test checks the tubes (ducts) that drain the liver, gallbladder, and pancreas. A flexible, lighted scope (endoscope) and X-ray pictures are used.

The scope is put through the mouth and gently moved down the throat. It goes into your esophagus, stomach, and duodenum until it reaches the point where the ducts from the pancreas and gallbladder drain into the duodenum. X-rays will then be taken.

ERCP can treat certain problems found during the test. In some cases, your doctor can insert small tools through the scope to:

  • Take a sample of tissue (biopsy) from an abnormal growth. Then it can be checked for problems.
  • Remove a gallstone in the common bile duct.
  • Open a narrowed bile duct. A narrowed bile duct can be opened by inserting a small wire-mesh or plastic tube (called a stent) in the duct.
Why It Is Done? ERCP is done to:
  • Check lasting belly pain or jaundice.
  • Find gallstones or diseases of the liver, bile ducts, or pancreas.
  • Remove gallstones from the common bile duct if they are causing problems. These may include a blockage (obstruction), inflammation or infection of the common bile duct (cholangitis), or pancreatitis.
  • Open a narrowed bile duct or insert a drain.
  • Get a tissue sample for further testing (biopsy).
  • Measure the pressure inside the bile ducts (manometry).

Motility and pH Testing

Often symptoms alone cannot be reliably used for accurate diagnosis of a patient's motility disorder. Proper evaluation of patients with suspected gastrointestinal motility disorders is important to correctly diagnose a patient's condition and to treat the patient in an appropriate manner. Routine motility tests such as esophageal manometry, gastric emptying, and anorectal manometry are available at Digestive Health Center. The wireless motility capsule is being increasingly utilized to assess whole gut transit as well as regional transit of the stomach, small bowel, and large bowel. Tests of gastrointestinal (GI) motility allow the assessment and identification of abnormal patterns and physiology. For each area of the GI tract, there are different GI motility tests that assess different functions and provide different types of information.

Gastrointestinal motility testing provides physicians with important information for patient care including:

  • Correct diagnosis of GI motility disorders
  • A guide for treatment of patients
  • Prognostic information of the patient.

The first set of tests that are often recommended define the anatomy of the intestinal tract. Possible structural problems need to be ruled out before proceeding to the second set of studies, which evaluate how the GI tract functions.

Upper Endoscopy

An upper endoscopy can be used to determine the cause of heartburn and is often performed as an outpatient procedure. Upper endoscopy uses a thin scope with a light and camera at its tip to look inside of the upper digestive system -- the esophagus, stomach, and the first part of the small intestine, called the duodenum. During endoscopy, certain procedures such as taking a small tissue sample (biopsy) for testing may be performed.

Sometimes, the procedure is done in emergencies in the hospital or emergency room to both identify and treat upper digestive system bleeding such as from an ulcer.

In addition to heartburn, the procedure may also be used to help evaluate:

  • Upper abdominal pain
  • Nausea and vomiting
  • Stomach bleeding
  • Swallowing disorders
  • Endoscopy can also help identify inflammation, ulcers, and tumors.

Upper endoscopy can be more accurate than X-rays or other imaging for detecting abnormal growths and for examining the inside of the upper digestive system.