Gastroenterology & Nutrition Center

Colonoscopy is a procedure used to see the inside of the colon (the large intestine and the last part of your digestive system) and rectum. A colonoscopy can detect inflamed tissue, ulcers and
abnormal growths.

• To prepare for this procedure, patients need to clean out their system. A laxative or an enema may be suggested to aid in clean out.
• On the night before the procedure, children cannot eat after midnight and through the morning of the scheduled procedure.

EGD is a procedure for upper gastrointestinal ailments, such as reflux, esophagitis, gastritis and ulcer disease.

• EGD is an examination of the lining of the esophagus, stomach, and upper duodenum (the first part of the small intestine) with an endoscope (a lighted, flexible tube), which is inserted down the throat.
• After the patient is given an IV and is sedated (either moderate or deep sedation) the doctor will pass the tube through the mouth and back of the throat into the esophagus, stomach and duodenum and a picture or a video will be taken.
• The EGD procedure checks for ulcers and other abnormalities the patient may have. If necessary, an instrument can be passed through the tube to take a small piece of tissue (a biopsy) for examination in the laboratory.

We’re one of only a handful of hospitals to participate in these studies on the West Coast. Impedance studies are tests that are done to find out if contents from the stomach are coming up into the esophagus or food tube. It helps evaluate acid and non-acid gastroesophageal reflux. Most of these procedures require an overnight stay.

• During this test, a thin, flexible tube is passed through the nose, down through the back of the throat, and into the esophagus.
• The end of the tube is attached to a computer which will remain at the child's bedside throughout the study. The child will need to stay overnight in the hospital, to ensure that the computer can record the necessary data.
• The study takes approximately 18 to 24 hours and the tube is left in place during this time.
• Parents will be asked to keep a diary of their child's activity during the impedance study and the doctor will then use the diary to compare the computer reading with the child's activity. When going through this test parents are encouraged to bring books, small toys, videos or other items to occupy the child while he or she is in bed.

We use the Bravo Implantable pH Probe to do the world’s only catheter-free intraesophageal pH probe test. The test uses a probe to measure the pH (acidity) levels in the esophagus. These measurements allow the doctor to evaluate the patient’s heartburn and acid reflux symptoms and plan the best treatment for the patient’s diagnosis.

The Bravo System has the potential to provide a more accurate picture of acid exposure compared to data collected using catheter-based systems. Another positive aspect of this leading test is the patient is allowed to do normal activities during the pH test, and doesn’t have to go through the discomfort of having a catheter put in.

• The probe is at the end of a thin tube which is passed through one side of the nose, swallowed and is moved to a given location in the bottom of the esophagus.
• The patient then goes home and the Bravo Receiver takes continuous pH measurements and transmits information wirelessly to a small receiver the patient wears on his or her waistband. The number of GE reflux (backwashing of acid into the esophagus) episodes and length of each episode is recorded by the device attached to the probe.
• Most importantly, the catheter-free test allows the patient to engage in his or her normal activities. Patients can eat normally and engage in their normal activities during the test.
• The patient or patient’s parents/caretakers should keep a diary of any symptoms and the times that they occur.
• The probe is usually worn for 18 to 24 hours so that there is ample opportunity to detect both daytime and nighttime GE reflux episodes.
• After the study, information from the receiver is uploaded to a computer for analysis.

• Liver biopsy is a procedure where small pieces of liver tissue are removed and tested to diagnose any diseases that affect the liver.
• Gallbladder removal is a procedure done in general surgery when someone has gallstones or if the gallbladder is not functioning properly. This is when the doctor may recommend gallbladder removal surgery. Our hepatologists work side-by-side with our general surgeons to complete this procedure and get patients back on track. Our surgeons can perform this surgery using minimally invasive surgery, to decrease scarring, minimize pain and shorten hospital stays — often only taking about one hour to complete.