Gastroenterology outpatient clinic
A clinic providing dispensary and medical care for patients with diseases of the digestive tract.
Endoscopy
Endoscopic ultrasonography
Endosonography (EUS) is a modern examination method that combines endoscopy and ultrasound. The physician inserts a thin instrument through the mouth into the digestive tube and can use an ultrasound probe to get a very accurate view of the surrounding organs, especially the pancreas, bile ducts, oesophagus, stomach and rectum. Endosonography is especially crucial when tumours, inflammation, cysts or CT or MRI findings are suspected. It also allows the collection of tissue samples for histological examination.
ERCP
ERCP (endoscopic retrograde cholangiopancreatography) is a method that is used not only for the diagnosis, but mainly for the treatment of diseases of the biliary tract and pancreas. It is most commonly used to remove gallstones, resolve bile duct strictures or insert stents. For many patients, ERCP can replace surgery and significantly speed up treatment.
Gastroscopy
Gastroscopy is an endoscopic examination of the oesophagus, stomach and duodenum with the possibility of taking a biopsy, removing polyps (mucosal growths). Urgent gastroscopy is used to stop bleeding or to extract foreign bodies. The examination is performed fasting.
Colonoscopy
Coloscopy is an endoscopic examination of the colon method with the possibility of biopsy, removal of polyps, bleeding. Intestinal preparation with a laxative is necessary for the examination.
Sigmoideoscopy
Sigmoideoscopy is an endoscopic method used to diagnose and treat diseases of the rectum and sigmoid colon. Enema preparation is required for the examination.
Deep enteroscopy
Deep enteroscopy is the examination of the small intestine with an endoscope. Depending on the localisation of the presumed pathology, the examination is performed by oral or aboral approach, allows biopsy, polypectomy, bleeding. In some cases, preparation of the bowel with a laxative is necessary for the examination.
Abdominal ultrasonography
Abdominal ultrasonography is the examination of the organs of the abdominal cavity using ultrasound.
Ultrasound elastography
Elastography is the examination of the stiffness (fibrosis) of liver tissue, which is caused by the accumulation of connective tissue in the liver.
Capsule enteroscopy/coloscopy
Capsule endoscopy is a non-invasive diagnostic capsule examination of the small and/or large intestine. The examination requires preparation of the intestine with a laxative.
Recommended web links for patients:
Web site on non-specific intestinal inflammation (Crohn's disease, ulcerative colitis):
Ostomy care:
Capsule endoscopy is a non-invasive diagnostic examination of the small or large intestine using a special device – a diagnostic capsule. Capsule endoscopy does not allow tissue samples to be taken for further examination, nor does it allow any therapeutic procedures to be carried out.
It is a painless examination that does not require anaesthesia. The patient swallows the capsule – a device slightly larger than a vitamin capsule, measuring 11 x 26 (31) mm – which is equipped with a micro-camera, a light source and a transmitter. As the capsule passes through the digestive tract, it captures colour images of the intestinal lining, transmits them, and the images are stored in a recording device worn by the patient (a belt around the abdomen). A specialised computer then compiles the images into a video recording of the digestive tract, which the physician reviews and assesses. The endoscopic capsule is expelled from the patient’s body naturally via the stools after a few days (up to two weeks at the latest).
The examination is carried out on suspicion of a disease of the small or large intestine and, in the case of a known condition, to assess the activity (extent) of the disease. The likelihood of success with capsule endoscopy is high, and serious complications are rare.
An advantage of capsule endoscopy is that the examination is non-invasive (there is no need to insert a flexible endoscope into the bowel). A further advantage is the direct visualisation of the mucosa of the small and/or large intestine. The entire length of the examined bowel is visualised in approximately 75 per cent of cases (this is determined by the speed at which the endoscopic capsule travels through the digestive tract and the battery life, which powers the lighting, image capture and transmission). The battery life is approximately 8–10 hours.
Alternatives to the procedure:
- Alternatives to small bowel capsule endoscopy include X-ray examinations (CT or MR enteroclysis) or examinations using flexible endoscopes.
- Alternatives to small bowel capsule endoscopy include examination using a flexible endoscope (colonoscopy) or X-ray examinations (CT colonography, irrigography).
Possible complications and risks:
In rare cases, capsule endoscopy carries a risk of the capsule becoming lodged above a narrowed section of the bowel or within a diverticulum. If the capsule becomes lodged, it is subsequently removed endoscopically or surgically. For safety reasons, capsule endoscopy is not performed during pregnancy. Before the examination, the patient must inform the medical team if they have a pacemaker or cardioverter implanted. Also for safety reasons, an MRI scan cannot be carried out at the same time as a capsule endoscopy. There is also a rare risk of the capsule being inhaled in the event of a swallowing disorder.
If you suspect that the endoscopic capsule is stuck, or if you experience unexplained abdominal pain that coincides with the capsule endoscopy, please contact our healthcare facility during working hours on 311 552 214, or a physician at the central admissions department (24 hours a day) on 311 559 807 or 804.
Patient preparation prior to the procedure:
- A prerequisite for successful capsule endoscopy is the best possible bowel clearance. If the bowel is not properly prepared, there is an increased risk of an incomplete examination. Preparation is therefore carried out before the examination to cleanse the bowel (dietary restrictions, a laxative, and adequate fluid intake).
- At least 5 days before the procedure, you must avoid eating fruit and vegetables that contain skins or seeds, as well as bread containing coarse grains and poppy seeds.
- On the day before the examination, you must stick to a liquid diet and drink plenty of clear fluids.
- Furthermore, on the day before the examination and early in the morning on the day of the examination, you must take the laxative prescribed by your physician. Optimal bowel preparation is achieved through a two-stage process; the laxative solution, once diluted according to the enclosed instructions, must be taken at the approximate times and intervals specified below. For capsule colonoscopy, bowel preparation must also continue during the examination.
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