Q: Do you have any additional questions?
Patient Instructions for Endoscopic Ultrasonography
A: It is normal to feel hesitant and apprehensive about any medical
1. Your endoscopic ultrasonography is scheduled for:
procedure. Your physician and the Digestive Health Center staff
are available to answer any additional questions that you might
have regarding endoscopic ultrasound, alternative approaches to
your problem, the cost of the procedure, as well as issues regarding
insurance billing. Do not hesitate to speak to your physician or a
2. Please arrive at:
member of the Digestive Health Center staff about any questions
3. The Digestive Health Center is located at 720 S.W. Lane.
you might have regarding your EUS examination.
The Endoscopy Center is located on the ﬁrst ﬂoor.
This brochure has been designed to answer your
4. You shouldn’t eat, drink or take anything after midnight.
questions about endoscopic ultrasound. This
If your exam is scheduled to start later than noon, you
brochure will give you a basic understanding of
may drink a clear liquid breakfast at 6 a.m. and then take
the procedure – why it is performed and what
nothing else by mouth. Brushing your teeth is permitted.
5. Make prior arrangements for someone to drive you home
or leave a phone number for your nurse to use on your
behalf when you are ready to go home.
6. Do not plan on returning to work, school, etc., after your
Qside effects you might experience.
It is important to read this brochure carefully.
If you have questions or concerns, feel fee to ask
the Cotton-O’Neil Digestive Health Center
gastroenterologist who is scheduled to perform
exam. You can plan on resuming normal activities the
7. Our phone number is (785) 354-0538 if you need further
assistance before or after your procedure. On the day of
your exam, please leave your valuables at home. The
Digestive Health Center is not responsible for the loss of
8. If this procedure was not directly scheduled in the
gastroenterologist’s ofﬁce, a nurse from the Endoscopy
Center will call you to review
medications and instructions,
discuss the necessary
schedule the exam.
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WL. aLnaen •e T
Q: What is Endoscopic Ultrasonography?
Q: What about my current medications or allergies?
The endoscope does not interfere with your ability to breathe. An EUS
A: EUS is an imaging technique that combines endoscopy with
A: Tell your physician or member of the Endoscopy Center staff in
examination generally takes between 30 and 45 minutes.
ultrasonography. This allows for the detailed examination of the walls
advance of the procedure about all medications that you are taking and
An EUS examination of the lower GI tract can often be performed safely
of the upper and lower gastrointestinal tract. The upper gastrointestinal
about any allergies that you have to medication. You will be informed
and comfortably without medications, although sedation may be
tract is the esophagus, stomach and duodenum. The lower
as to whether or not you can continue to take your medications as usual
given if the examination will be prolonged or if the examination is a
gastrointestinal tract includes the colon and rectum. EUS is also used
before the EUS examination. Generally, you will be asked to stop taking
signiﬁcant distance into the colon. Patients undergoing an EUS
to study internal organs that lie next to the gastrointestinal tract,
aspirin, Plavix, Coumadin, and anti-inﬂammatory drugs such as Motrin
examination of the lower GI tract typically lay on their left side. Most
such as the gallbladder, biliary tract and the pancreas.
and Aleve ﬁve days before the procedure. The Endoscopy Center staff
lower GI tract EUS examinations take 15 to 30 minutes.
EUS is performed using a thin, ﬂexible tube called an endoscope.
will instruct you regarding which medication you should take the
The endoscope is passed through the mouth or anus to the area to be
morning of the EUS examination.
Q: What happens after EUS?
examined. The ultrasound component is then utilized to produce
A: If you receive intravenous sedation, you will be monitored until
sound waves that create images of the digestive tract.
Q: Do I need to take antibiotics?
most of the medication effect has worn off. If you had an upper EUS
A: Antibiotics are generally not required before or after an EUS
examination, your throat might be sore. You might also feel bloated
Q: Why is EUS needed?
examination. Inform your physician and/or the Endoscopy Center staff
because of the air that was introduced during the examination. You
A: EUS provides detailed images of the digestive tract anatomy. EUS
if you take antibiotics before dental procedures. Antibiotics may be given
will be able to eat after you leave the procedure area unless otherwise
can be performed to further evaluate the pancreas when abnormalities
prior to an EUS examination or after the procedure to help prevent
instructed. You will be notiﬁed of the results of the examination prior
are noted on CT or conventional abdominal ultrasonography. EUS can
infection. Antibiotics may be prescribed if you having a specialized EUS
to your discharge. The results of biopsy or other pathological specimens
also be performed to evaluate abnormal areas in the stomach noted on
procedure such as one where a ﬂuid collection or cyst is drained.
obtained will take several days.
either endoscopy or an X-ray examination.
Q: Should I arrange for help after the examination?
Q: What are the possible complications of EUS?
Q: Why is EUS used for patients with cancer?
A: If you receive sedatives, you will not be allowed to drive home after
A: Although complications can occur, they are rare when physicians
A: EUS can help determine the extent of certain malignancies of
the procedure. While you will be alert and be able to ambulate, you are
with specialized training and experience perform the EUS exam.
the gastrointestinal tract. These include cancer of the esophagus,
considered legally intoxicated and driving an automobile or operating
Bleeding might occur at the biopsy site, but it is usually minimal
pancreas, stomach, and rectum. Together with a ﬁnal needle aspiration,
other potentially dangerous equipment is not permitted. You should
and rarely requires intervention. You might also have a sore throat
EUS can be a valuable tool in the diagnosis and accurate staging of lung
make necessary arrangements so that someone can drive you home
for a day or two. Non-prescription anesthetic type throat lozenges
cancer. EUS provides information as to the depth that certain
following your recovery period. You should also consider having
and over-the-counter analgesics such as acetaminophen can help
malignancies have invaded the walls of the GI tract or whether
someone stay with you at home after the examination because the
to relieve these symptoms. Other potential but less common side
malignancy has spread to adjacent lymph nodes or nearby vital
sedatives can affect your judgment and reﬂexes for the rest of the day.
effects of EUS include: reaction to one of the sedatives used,
structures such as major blood vessels. In certain situations, EUS can be
backwash of stomach contents into the lungs (aspiration), infection
used to obtain tissue samples to help determine the proper treatment.
Q: What can I expect during EUS?
and/or complications from heart or lung disease. One major but
EUS can dictate the need for or avoidance of surgical procedures.
A: Patients undergoing an EUS exam of the upper gastrointestinal tract
uncommon complication of EUS is perforation. This is a tear
are given intravenous sedation. Their throat is also sprayed with a local
through the wall of the gut that usually requires surgery to repair.
Q: How should I prepare for EUS?
anesthetic to numb the gag reﬂex. The examination is done with you
Finally, when testing involves a biopsy of the pancreas,
A: For EUS of the upper GI tract, you should have nothing to eat or
laying on your left side. The type of sedation utilized for EUS is called
inﬂammation of the pancreas (pancreatitis) can rarely occur.
drink after midnight the evening before the procedure. Depending on
“procedural sedation.” Two types of medications are typically given,
The possibility of complications increases slightly if ﬁne needle
when the exam is scheduled, you may be allowed to have a clear liquid
one a narcotic, another a Valium-like compound called Versed. The
aspiration is performed during the EUS examination. These risks
breakfast. You will be given speciﬁc instructions on when to start fasting.
vast majority of patients have no recollection of the procedure after its
must be balanced against the potential beneﬁts of the procedure
The prep for EUS of the lower gastrointestinal tract can vary determining
completion. After you receive intravenous sedation, the endoscope is
and the risk of alternative approaches to the condition.
on the extent of the exam. You will be given speciﬁc instructions by the
passed through your mouth and advanced to the area of interest.
Endoscopy Center staff as to which prep to use.