Services

Gastroenterology Services

Gastroenterology
The primary role of gastroenterologists is to take care of the digestive system – the gastro intestinal tract – which includes the esophagus, stomach, small bowel, colon, rectum, anus, liver, pancreas and gall bladder, and biliary duct system.

AnMed Health gastroenterologists offer:

  1. Office consultation and in-office procedures for gastrointestinal disorders: liver, pancreas and biliary tract diseases.
    • Smart Pill for pan GI motility including gastroparesis, colon inertia
    • Video capsule endoscopy for small bowel imaging
    • Hemorrhoid banding
    • Fibroscan
  2. Inpatient consultation for gastrointestinal emergencies.
  3. Diagnostic and therapeutic endoscopic procedures for prevention and management of for a wide variety of diseases including incisionless nonsurgical endoscopy for weight reduction and obesity related disease prevention. 

Bariatric Endoscopy
Bariatric endoscopy is incisionless, same-day procedures for weight loss and weight-related disease prevention.

ESG
ESG (endoscopic sleeve gastroplasty) also known as endoscopic sleeve For patients who have a BMI of at least 30 and have failed diet and exercise alone. It is also helpful for those who do not want bariatric surgery or those whose physical conditions make them unfit for surgery.


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ESG is an outpatient, same-day endoscopic suturing of the stomach to create a banana-sized sleeve and reducing the size of the stomach by 80%. The procedure is well tolerated and patients return to a normal routine after a few days of at-home recovery. The procedures limit the amount of food that is eaten before feeling full, limits the amount of calories absorbed by the stomach, and also prolongs the time food remains in the stomach, extending the feeling of fullness.

Commitment to the program to long-term changes in nutrition and exercise is the single greatest factor for success. Typically, patients can lose as much as 50% of their excess body weight at six months post-surgery and at the one-year mark, many patients experience an 80% loss of excess weight or 20% of total body weight.

Bariatric Revision

Endoscopic incisionless suturing is for those who have regained weight after previous gastric bypass surgery or surgical sleeve. Over time, the hole (gastrojejunal anastomosis or “outlet”) or the gastric sleeve becomes larger, which causes patients not to feel “full” while eating. Because patients do not feel full, they continue to eat past the point where they should, which contributes to weight gain after the surgery.

Post-gastric Bypass Surgery Weight Gain

Endoscopic suturing system is used to reduce the size of the gastrojejunal anastomosis to its original size (the size it was immediately after gastric bypass). The procedure takes under one hour. After the procedure, patients will feel “full,” which helps them to eat less.

Post-surgical Sleeve Weight Gain

The endoscopic suturing system is used to reduce the size of the now enlarged gastric sleeve to its original small size. The procedure can take up to two hours. After the procedure, patients will feel “full”, which helps them to eat less. It is rare to have serious complications but pneumothorax and peri gastric fluid collection may occur.

Long-term commitment to changes in nutrition and exercise is the single greatest factor in success. On an average, 10% of total body weight loss is achieved.

Orbera

Orbera is a small, silicone balloon placed under mild sedation. Orbera is for moderately overweight individuals who haven’t succeeded with diet and exercise and want to lose weight without surgery.

A board-certified gastroenterologist endoscopically places the thin, deflated balloon in place in the stomach, and it is then inflated. After six months, the balloon is removed the same way it was placed.

The average person loses 3 times more weight than with exercise and diet alone or an average of 21.8 pounds. Motivated patients may lose far more over the next 12 months with diet, exercise, nutrition and behavioral changes.

Orbera cannot be placed after stomach or bariatric surgery, including hiatal hernia repair, lap band or gastric bypass.

Weight loss is rapid, with most weight loss occurring in the first three to four months. People lost an average of 13% of their body weight at six months. The range of weight loss depends on the person and their motivation.

Over 270,000 Orbera balloons have been placed worldwide. The risk of a serious side effect is about 1 in 10,000 and include stomach ulceration, balloon deflation, bowel obstruction, intestinal perforation and death.

AspireAssist

The AspireAssist is a non-surgical weight loss solution. It safely and effectively removes food from the stomach after eating.

Under sedation, a small tube is inserted through the belly into the stomach, leaving a small port on the skin. The port will be right up against the skin of the abdomen. It is not noticeable under clothing. After each meal, in the privacy of a restroom, a small pump – about the size of a smartphone – is attached to the button.

The device can remove about 30% of the meal directly into the toilet. The process takes about five to ten minutes. Because it’s necessary to eat slowly and chew more thoroughly, the AspireAssist helps reinforce healthy eating habits.

The AspireAssist works well for obese adults – with a body mass index (BMI) of 35 to 55 – who have been unable to lose weight through diet and exercise.

The same-day procedure only takes about 15 minutes There may be a day or two of minimal discomfort as you adjust to the tube. The AspireAssist is safe for long-term use and can be removed at any time in a 10-minute, same-day procedure.

In a clinical trial, patients lost three times more weight with the AspireAssist than those receiving only diet and exercise counseling. The most successful patients are known to lose up to 100 pounds in the first year.

Other Diagnostic and Therapeutic Procedures Offered

Esophagus, Stomach and Small bowel
Esophageal dilation
Varices banding
Control of bleeding with APC, clips, Ovesco clips, Hemospray
48 hour wireless Ph test (Bravo) for acid reflux disease
Radiofrequency ablation (Halo) of dysplastic Barrett’s disease
Endomucosal resection (EMR) for dysplastic Barrett’s, gastric and duodenal neoplasm
Endoscopic submucosal dissection (ESD)
Endoscopic stent placement
Gastrostomy (PEG) placement for enteral feeding
Esophageal manometry and 24 hour pH test

Pancreas, Biliary Tract
ERCP with sphincterotomy, stone extraction, stent placement, cholangioscopy with Spyglass

Liver
Fibroscan

Small Bowel
Video capsule endoscopy, push enteroscopy, double balloon enteroscopy

Colonoscopy
Screening and diagnostic colonoscopy
Routine polypectomy for colon cancer prevention
Endomucosal resection (EMR) for removal of and flat large polyps, which would otherwise need colon resection surgery for cancer prevention
Endoscopic submucosal dissection (ESD) for complete removal of large polyps