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Endoscopy Unit

Subject Headings
Endoscopy

Endoscopy is the examination of hollow organs with an instrument. This instrument allows both imaging and some operations such as biopsy. It is called as 'the light hose' among the people. But it would be unfair to call this tool just a hose. It is an excellent diagnostic tool. If we are performing endoscopy to view the esophagus, stomach and duodenum, this is called 'esophagogastroduodenoscopy' in medicine. In short, it can be called 'gastroscopy'. If it is done for the large intestine, it is called 'colonoscopy'. During gastroscopy, the esophagus, the junction of the esophagus and the stomach, the stomach, the exit part of the stomach and the duodenum are examined.

What happens during the endoscopy, is it difficult?
Endoscopy has been used for 40 years, especially for digestive system examination. Compared to the past, there are devices that are very mobile, flexible, thinner and have high display capacity. The success of the endoscopy and the patient does not feel uncomfortable with the endoscopy depends on who does it, where it is performed, how it is performed, and whether there is an experienced assistant team. Endoscopy should be performed by those trained in this field, namely gastroenterologists. If there is no obstacle, medication should be administered to the patient as a preliminary preparation. First of all, the tongue root and small tongue area of ​​the patient is numbed with a spray that makes regional numbness, which is also used by dentists. This eliminates nausea. Then, relaxing and mild sleep-inducing drugs are given through the arm vein. Endoscopy is very comfortable when done this way. Most of the time, the patient says, "Have you really done a gastroscopy? Is it done?" he asks. In addition, sleep-relieving drugs are applied after endoscopy if necessary. After the procedure is over, the patient can be at work after a couple of hours. But we don't want him to drive and do things that require extreme attention that day.

So what kind of process is this?
The work done is this: An extremely soft pipe of 8-10 millimeters thick is guided through the esophagus through the stomach and duodenum. The device, which is approximately 110-120 centimeters in length, has a camera at the end and reflects the regions it passes through on a television screen. By looking at these images, the doctor sees the inner surface of the patient's area under examination and can make a diagnosis. During this procedure, the patient's pulse status and oxygen level are monitored. If necessary, a piece is taken for diagnosis (biopsy) or therapeutic procedures such as stopping bleeding and removing polyps can be performed. The process is completed in 3-5 minutes. Before, at least 6 hours of fasting is required.
Gastroscopy

Gastroscopy procedure, painless (by being put to sleep when necessary) with a soft bendable instrument, examination of the esophagus, stomach, duodenum, diagnosis, treatment if necessary (drying of esophageal varicose veins, non-surgical balloon opening of strictures, removal of polyps, stenting in esophagus cancers, oral non-operative tube insertion for patients who cannot be fed, etc.).

Who Should Have Gastroscopy?

• Anyone over the age of 45 with digestive system complaints

• Those under the age of 45 who have difficulty in swallowing, nausea, vomiting, loss of appetite, weight loss or whose complaints continue despite treatment

• Those with upper digestive system bleeding

• Those with suspicious images in the stomach film

• Those with a history of stomach cancer

• In abdominal pains of unknown cause

Long-term reflux complaints, especially in patients over the age of 50

For follow-up purposes in patients with Barret esophagus

• In B12 deficiency of unknown cause

For patients with gastric ulcer, 6-8 weeks later for control

• Once a year in those with cirrhosis and varicose veins of the esophagus (stage I-II), and every 2 years in those who do not

This process is carried out in our office with the latest technology video system.

Colonoscopy

Colonoscopy is the examination of the large intestine with the help of a thin, flexible and lighted device called a colonoscope. Your doctor can obtain large and clear images of the inside of the large intestine from the anus to the appendix with a colonoscope.
Colonoscopy provides a direct view of the entire intestinal lining. Common reasons for using a colonoscopy:

Early detection and prevention of cancer. If your age is between 50 and 80, your doctor will recommend that you have a colonoscopy at least every 10 years. If cancer risk is high due to personal or family history, you should have this test done more often. With the help of colonoscopy, your doctor can detect and remove polyps in the intestine before they turn into cancer. Also, diagnosing cancerous growths at an early stage will help the treatment to be successful.

Illness. When your doctor cannot explain the symptoms of your illness, he or she may perform this procedure to find out the cause of the symptoms. For example, in cases of abdominal pain of unknown cause or abnormal bowel movements, colonoscopy can identify inflammation in the intestines or infected parts of the intestinal wall.
You should not smoke before and after the colonoscopy.

If you need to take pain relievers in the week of the colonoscopy, you should choose drugs that do not thin the blood. Thus, there will be less bleeding during the procedure. If you need to take aspirin every day because of your health problems, you should discuss this with your doctor before the colonoscopy.

Your doctor will inform you in writing what to do to clean your intestines.

• You will be asked if you have taken any solid food in the last 48 hours before the colonoscopy.

• It is recommended to take only liquid foods in the last 24 hours. These liquid foods can be water, apple or grape juice, tea or coffee (without milk or cream), and mineral water.

• A few hours before the colonoscopy, you will be asked to take a liquid laxative to clear stool from the intestines. Performing this procedure is extremely important, colonoscopy cannot be performed if feces remain in the intestines.

• During the bowel emptying process, you can eat liquid foods to regain lost electrolytes (potassium and sodium) and prevent dehydration.

What you should tell your doctor:

• Allergies
• The medications you use
Antibiotics you should take before dental procedures or because of heart valve disease

Colonoscopy takes between 20 and 30 minutes. However, you may need to stay in the clinic for up to two hours for control, examination and recovery time. After the procedure, it is recommended to have someone with you to help you go home.
Colonoscopy can be performed at your doctor's clinic.

Before the colonoscopy, you will be given a sedative medicine to help you relax.

You will be asked to lie on a table with your sides and knees pulling towards your stomach. Or, your doctor may use a special table to help you kneel by resting your stomach. Thus, the most appropriate positions are taken to facilitate the passage of the colonoscope from the anus and rectum to the intestine.

Your doctor can view images of the bowel on television. As the device moves through the intestine, air will be introduced into the intestine to see the intestinal wall more clearly. This air can cause cramps.

During the procedure, a sample of abnormal things seen in the bowel will be examined with a colonoscope. Also, abnormal areas, polyps, or small tumors can be removed with the help of a colonoscope. Thus, there is no need for another procedure to remove them.

Rectoscopy

Rectosigmoidoscopy is the examination of the rectum and lower large intestine with a finger-thick flexible instrument with a lighted tip. For healthy observation, the intestine should be completely empty and clean. Bleeding focus, polyp, tumor and mucosal changes can be observed, and more detailed examinations can be performed by taking biopsies from these areas.
Cystoscopy

Cystoscopy If your urological examination indicates a problem with your urinary tract, the best way to directly see and treat your urinary tract is cystoscopy.

Cystoscopy is the observation of the lower urethra and urinary bladder (bladder) with a device containing a telescopic, lighted and lens system.

A powerful light source illuminates the environment from the tip of the cystoscope. Various telescopes are used to view the bladder and urethra. (see picture)

Performing the procedure by entering your lower urinary tract with a device may be considered uncomfortable. However, your doctor will advise you considering the importance of this intervention and the benefit it will provide to you. You act calmly enough and establish a safe cooperation with your doctor, considering the objectives of the intervention and the benefits it will provide to you. It will be of great benefit to both you and your doctor.

In most people, cystoscopy for examination can be performed awake and with little discomfort. In this case, a gel-like drug with a numbing and lubricating effect is applied into your lower urinary tract, and after 10 minutes, the intervention is performed. In some cases, protective antibiotic injection is applied before the procedure.

Many radiological examinations and treatments are performed with cystoscopy. This type of interventions may require anesthesia as they take more time. Since the lower urinary tract is longer in men than in women, anesthesia may also be required. The anesthesia method to be applied depends on your general health condition and some special test results. Before deciding this, the opinion of the anesthesiologist or internal medicine physician can be consulted.

With cystoscopy, the following diseases in the lower urinary tract and urinary bladder are diagnosed and some treatment attempts can be made:

- Lower urinary tract (Uretra) strictures, inflammations, benign and malignant tumors, stones, congenital anomalies,
-Prostate size, degree of occlusion tumors,
- Urinary stones, tumors, inflammation and anomalies,
- Internal urinary tract (ureter) and disorders in the urinary junction area,
-Radiological imaging of the internal urinary tract or inserting a catheter to remove the obstruction
- Diagnosis and treatment of urinary incontinence disorders

SIDE EFFECTS (COMPLICATIONS)

As with any surgical intervention, undesirable problems may occur after cystoscopy. Even if a very thin cystoscope is used, if there is an infection, the symptoms related to infection may increase after the procedure.
Bleeding may occur after the procedure. Even if there is no infection, this can occur. Making a sudden movement during the examination can cause injury and perforation in the internal urinary tract. Therefore, you should be in absolute cooperation and communication with your doctor. These are very rare, but all attention is paid and can be seen despite care.

SUMMARY

Cystoscopy is used because it is the only way to keep you away from an operation that may be unnecessary by making the appropriate diagnosis and applying the correct treatment. Your doctor will decide on this by considering possible complications. Feel comfortable asking any questions you may have. Depending on the situation, it may be necessary to do the intervention asleep in the hospital or in the outpatient clinic: Talk to your doctor Understanding how and for what reasons will be very beneficial for your doctor and more importantly for yourself.