Procedures

Colon Cancer is a cancer that develops in the large intestine and rectum. It is the third most common type of non-skin cancer for men and women. Colon cancer is the second leading cause of cancer death. These malignant tumors invade nearby tissue and spread to other parts of the body. Colon cancer develops from Small growths in the large intestine called precancerous or adenomatous polyps. Polyps are usually benign if found early and removed. Polyps can be removed easily during colonoscopy and are not life threatening. However, if benign polyps are not removed from the large intestine, they can become malignant (cancerous) over time. DrTajong does a thorough examination of the colon and removes all polyps that are found at the time of the procedure.

The primary goal of colon cancer screening is to prevent deaths from colon cancer. This progression takes at least 8 to10 years in most people. All adults should undergo colon cancer screening beginning at age 50 or earlier, depending upon the person’s risk of developing colorectal cancer. Dr Nelson Tajong will recommend how often you should have a colonoscopy based on his findings. He will discuss these results with you and your family members immediately after the procedure.

Colon Cancer Signs & Symptoms 

Though colon cancer has no specific signs or symptoms there are some conditions that should cause you to get an evaluation by gastroenterologist. DrTajong recommends that all patients with the following be seen: a change in bowel habits, dark stools, rectal bleeding, cramping/abdominal pain, or persistent weakness and fatigue could be symptoms of colon cancer. Most of these symptoms are likely to be caused by conditions other than colon cancer, but they could also be signs of colon cancer so you should get checked out immediately if you are over 50 or have had any of the above symptoms.

Is Colorectal Cancer Curable? 

Colorectal cancer is both preventable and curable. Regular screening is the best way to find colon cancer early.. Colorectal cancer is prevented by removing precancerous colon polyps. It is cured if found early and is surgically removed before it spreads to other parts of the body. Colonoscopy is the only screening test that may prevent colon cancer entirely, by finding certain types of polyps in the colon that could become cancerous. DrTajong believes that a screening colonoscopy can help identify cancers at an early and potentially treatable stage.

"OPEN ACCESS" COLONOSCOPY

Dr Nelson Tajong now offers "open access" colonoscopy. This is a unique program where many adults who qualify can be scheduled for a screening colonoscopy directly without an office visit. DrTajong understands the hassles both in time and the cost of a separate office visit before a routine procedure. This program was designed to streamline the process of getting a screening colonoscopy done for those who qualify. Ask us about this program to see if you or your loved one may qualify.

What is Colonoscopy?

Colonoscopy lets the physician look inside your entire large intestine, from the lowest part, the rectum, all the way up through the colon to the lower end of the small intestine. This procedure enables your physician to examine the lining of the colon for abnormalities and early signs of cancer in the colon and rectum by inserting a flexible tube into the anus and advancing it slowly into the rectum and colon. During this procedure the physician can see inflamed tissue, abnormal growths called polyps, ulcers, and bleeding, and cancers of the colon.

What can be expected during Colonoscopy?

Colonoscopy takes 30 to 40 minutes. Prior to your colonoscopy, you will be given a sedative and pain medicine to keep you from feeling any discomfort during the exam. During the procedure you will be lying on your left side or on you back. Dr Nelson Tajong will insert a long, flexible, lighted tube called a colonoscope into your rectum and slowly guide it into your colon to carefully examine the lining of your colon. You are asleep during the entire procedure and should experience little to no discomfort . During the procedure if anything unusual is in your colon, like a polyp or inflamed tissue, DrTajong can remove a piece of it using tiny instruments passed through the scope. Bleeding and puncture of the colon are possible complications of colonoscopy. However, such complications are uncommon.

Preparation

Your colon must be completely clean and empty for the colonoscopy to be thorough, safe, complete and accurate. To prepare for the procedure you have to follow a clear liquid diet until midnight. You will be prescibed a laxative regimen to take the day before the procedure. We recommend that you arrange for someone to drive you home after your procedure because of the sedatives. Please contact our office prior to your exam if you have any questions

EGD also known as Esophago-gastro-duodenoscopy or Upper Endoscopy is an examination of the lining of the esophagus, stomach, and upper duodenum with a small camera (flexible endoscope) which is inserted down the throat. Upper endoscopy Is performed to diagnose and treat multple conditions including stomach ulcers.

How Is The Test Performed

The procedure typically takes between 10 and 20 minutes to complete. You will be given a sedative that should make you feel no pain nor remember the procedure. The endoscopy is performed while you lie on your left side. A mouth guard will be inserted to protect your teeth and the endoscope. The scope has a lens and a light source that allows your doctor to see the inner lining of the upper gastrointestinal tract on a TV monitor. Many people sleep during the test while others are very relaxed and generally not aware of the examination. Dr Nelson Tajong may take tissue samples called biopsies or perform specific treatments such as dilation, removal of polyps, treatment of bleeding. You may experience a mild discomfort as air is pushed into the intestinal tract. This is not harmful and belching may relieve the sensation. The endoscope does not interfere with breathing. Taking slow, deep breaths may help you to relax.

When is Upper Endoscopy used?

EGD can be used to determine the cause of illnesses such as anemia, nausea, vomiting, gastric reflux, abdominal pain, swallowing difficulties, and bleeding in the upper GI tract and many other conditions of the upper GI tract.

What are the risks associated with Upper Endoscopy?

There are certain risk associated with EGD. These include bleeding from biopsy, abnormal reaction to sedatives and an accidental puncture of the upper GI tract. After Upper Endoscopy if you experience fever, vomiting, swallowing difficulties, bloody or very dark stool, throat, chest and abdominal pain, please contact their doctor immediately.

Endoscopic Retrograde Cholangio-Pancreatography (ERCP) enables Dr. Tajong to diagnose problems in the liver, gallbladder, bile ducts, and pancreas. ERCP is used primarily to diagnose and treat conditions of the bile ducts, including gallstones, inflammatory strictures, leaks from trauma and surgery, and cancer. It combines the use of x-rays and an endoscope, (a long, flexible, lighted tube that Dr. Tajong uses) to see the inside of the stomach and duodenum and takes about 30 minutes to 2 hours. Air is blown into the duodenum and dye is injected the ducts to make them show up clearly on x rays. The pain medicine and sedative should keep you from feeling too much discomfort. Once you swallow the endoscope, it is guided through your esophagus, stomach, and duodenum until it reaches the spot where the ducts of the biliary tree and pancreas open into the duodenum.

If the exam shows a gallstone or narrowing of the ducts, an instrument will be insert into the scope to remove or relieve the obstruction. This treatment may require an overnight stay at the hospital. After the procedure, we will make sure you do not have signs of complications.

Possible complications of ERCP

here are certain risk associated with ERCP. These include infection, bleeding, perforation of the duodenum and inflammation of the pancreas called pancreatitis.

Preparation for ERCP

• Do not eat 6 to 8 hours before your procedure
• Do not eat or drink the night before the procedure
• Arrange for a driver due to the effects of the sedative
• Keep an empty stomach for procedure to be accurate and safe
• Inform your physician of any allergies
• Please call our office if you have any questions

Small Bowel Capsule Endoscopy (SBCE) is a procedure that involves swallowing a large vitamin pill sized video capsule. This capsule contains a tiny camera, light source, and battery which will pass naturally through your digestive system while taking pictures of your small intestine. The images taken are transmitted over 8 hours via sensors which are placed on the abdomen and stored in a recording device worn on a belt around the waist. After 8 hours the sensors and recording device are disconnected at your gastroenterologist’s office. These data images are then read and interpreted by Dr. Tajong.

The small bowel capsule will be excreted naturally in your bowel movement. In the rare case that it is not excreted naturally, it will need to be removed endoscopically or surgically.

Why Is Capsule Endoscopy Performed?

SBCE is used most often to find bleeding in portions of the small intestine that are hard to reach with a conventional endoscope. DrTajong also be uses capsule endoscopy to help identify suspected Crohns disease or other small bowel abnormalities.

How Do I Prepare For Small Bowel Capsule Endoscopy?

An empty stomach and clear GI tract is needed in order to get the best visual and accurate information from this examination.
Notify Dr. Tajong of the following medical conditions:

• If you could be pregnant
• A pacemaker or automatic internal defibrillator
• Personal history of diabetes including your medications 
• Previous abdominal surgery, swallowing problem, or history of bowel obstruction.

Please contact our office for a specific dietary regiment you MUST adhere to on the day of your procedure

48-hour Bravo pH Capsule is a procedure that that is performed by attaching a tiny capsule to the wall of your esophagus in order to measures presence of acid (pH) and sends a wireless signal to a receiver you wear on your waistband. This 48-hour monitoring allows your doctor to evaluate your heartburn and acid reflux symptoms and determine the best treatment plan for you. The disposable pH capsule will spontaneously detach and pass through your digestive system after several days.

The capsule is attached to a long tube called an introducer which is swallowed. Once it is at an appropriate level, suction is applied to the tube and a small about of esophageal lining is suctioned into the side of the capsule. A pin is then pushed through this lining, leaving the capsule “pinned” to the lining of the esophagus. A small recorder is worn for 48 hours and data is collected. It is subsequently downloaded into a computer program, and a printout is made available to Dr. Tajong to be interpreted.

Benefits of the 48-hour Bravo Test

Dr Tajong performs BRAVO testing to help in the management of patients with certain types of acid reflux symtoms.It is a catheter-free pH test, It is more tolerable and convenient way to evaluate your heartburn symptoms, and it allows you to engage in your usual activities during the test period:;e.g. Eat normally, Bathe and sleep comfortably, Maintain your daily life

Risks of the 48-hour Bravo Test

Potential complications associated with gastrointestinal endoscopy include perforation, hemorrhage, aspiration, fever, infection, hypertension, respiratory arrest, and cardiac arrhythmia or arrest. Potential complications associated with nasal intubation include: sore throat, discomfort, and nasopharyngeal damage resulting in bleeding and soft tissue damage. Other complications include: Premature detachment of the pH capsule, tears in the mucosal and sub mucosal layers of the esophagus, causing bleeding and requiring possible medical intervention, All pH testing procedures carry some risks. Talk to your doctor about your concerns and testing options.

Esophageal manometry enables your doctor to examine the contractions and pressure in your esophagus as a result of unexplained chest pain, difficulty swallowing, or heartburn. The preparation consists of being without water or food 6 hours prior to the procedure.

During esophageal manometry, you will be seated in a chair or lying on the side, and a thin soft tubing is gently passed through the nose, or occasionally the mouth. Upon swallowing, the tip of the tube enters the esophagus and the technician then quickly passes it down to the desired level. The procedure itself takes approximately 30 minutes, although you should plan on 2 hours for waiting, preparation, and testing. Esophageal manometry is generally well tolerated and safe. Complications may include a sore throat and minor bleeding. Pressure recordings are made and the tubing is withdrawn. Patients can usually resume regular activity, eating, and medicines immediately after the exam. Contact your doctor if you notice severe throat or chest pain or bleeding.

Helicobacter Pylori also known as H. Pylori is a bacterium that infects your stomach or the first part of your small intestine. There is no one symptom or set of symptoms which may be directly attributed to H. pylori infection. Some of the symptoms associated with the infection includes nausea, esophageal reflux, upper and mid-abdominal pain, bloating, or belching. Conversely, one may be completely asymptomatic for many years. H. pylori resides in the gastrointestinal tract and is known to be a major cause of peptic ulcers and is a potential contributor to the development of stomach cancer.

The Urea Breath Test (UBT) offers a simple, noninvasive way to test for H. Pylori. There is no single drug that can effectively eliminate H. Pylori. However, a combination of two types of antibiotics and a proton pump inhibitor (PPI) is used to decrease the stomach's acidity, allowing the inflamed stomach lining to heal. A drug combination is commonly known as “Triple Therapy” which lasts about 10 to 14 days or shorter. This treatment is successful for most patients; however please see your doctor if additional treatment is needed.