Digestive (Gastroenterology)

Endoscopy Service 

Gastroenterology (GI) is a premier service of Beverly and Addison Gilbert hospitals offering consultation and comprehensive care for individuals with diseases of the esophagus, bowel, liver and pancreas, as well as gastrointestinal infections, gallstones, nutritional disorders, and other disorders of the digestive system. Our staff of gastrointestinal specialists is comparable in expertise and experience to those found in Boston, and are committed to bringing the latest advances in GI care to the North Shore. This affords residents of the North Shore the opportunity to have all their GI needs met locally. There is no need to travel to Boston for this level of expertise. 

Endoscopy Suite

Most GI studies and procedures are performed on an outpatient basis in Beverly Hospital's state-of-the-art Endoscopy Suite. The Endoscopy Suite offers a welcoming and comfortable environment for patients and supports our GI providers with the latest technology for a variety of procedures. The following are a few of the procedures. 

| Capsule Endoscopy | Endoscopic ultrasound | Transeophageal echocardiogram |
| Gastroscopy | Colonoscopy | Manomety | pH Study |
| Endoscopic retrograde cholangio-pancreatography (ERCP) | 

Endoscopy procedures are performed for patients suffering from stomach or intestinal problems. During an endoscopy, a doctor inserts a lighted, flexible tube called an endoscope into a natural body opening. A camera in the endoscope allows the doctor to examine inside the patient's body without invasive surgery. Many people know about colonoscopy, an examination of the entire colon and gastroscopy, a visual examination of the stomach. 

• Capsule endoscopy is a painless diagnostic procedure largely used to detect disorders of the small bowel such as bleeding, inflammatory bowel disease, and cancer. The procedure involves swallowing a vitamin-sized video capsule equipped with its own camera and light source. As the capsule is ingested and travels through the small bowel, digital images are taken at a rate of two-per-second in order to detect any abnormalities. Up to 60,000 images are taken during the course of the study. The images are transmitted to a data recorder, which individuals wear on a belt for approximately eight hours. Gastroenterologists then view the images looking for and marking abnormalities requiring further study or treatment. Capsule endoscopy requires little patient prep and virtually no side effects. The capsule passes out of the body naturally.
• Endoscopic ultrasound (EUS) offers the opportunity to diagnose and stage abnormalities in the esophagus, stomach, and pancreas by obtaining specimens via fine needle aspiration. It is one of the most accurate tests to determine the stage of cancers of the gastrointestinal system. A slender, tube-like endoscope is inserted either through the esophagus or rectum. An ultrasound transducer at the end of the scope produces sound waves that create digital, high-resolution images. In addition to the ability to see the cancerous area in detail, EUS allows the gastroenterologist to collect cell or fluid samples using a needle at the end of the scope. EUS is also used to diagnose and monitor non-cancerous conditions such as pancreatitis and gallstones.
• Transeophageal echocardiogram (TEE) is performed by a cardiologist using a flexible scope inserted into the esophagus to detect blood clots in heart chambers and to assess defects in blood flow.
• Gastroscopy is a test that involves examining the lining of the esophagus, stomach, and upper small intestine with a small camera which is inserted down the throat. This test is helpful in determining the cause of internal bleeding, swallowing difficulties or abdominal pain. The condition of the esophagus, stomach and small intestine after an operation may be determined via gastroscopy, as well as the presence of tumors or other abnormalities of the stomach, small intestine or esophagus.
• Colonoscopy is used to look for early signs of cancer in the colon and rectum. It is also used to diagnose the causes of unexplained changes in bowel habits. If anything abnormal is seen in the colon, such as a polyp or inflamed tissue, the physician can remove all or part of it using tiny instruments passed through the scope. If there is bleeding in the colon, the physician can pass a laser, heater probe or electrical probe, or inject special medications through the scope to stop the bleeding.
• Endoscopic retrograde cholangio-pancreatography (ERCP) is done in the Radiology Department, assisted by the endoscopy staff. It allows removal of gallstones and placement of stents in bile and pancreatic ducts to relieve obstruction. Instruments are threaded through the channels of the scopes and into the ducts. ERCP is one of the most challenging but rewarding procedures because a patient's condition improves rapidly with this intervention.
• Manometry is a study performed by nursing staff to assess abnormalities in contractions of the esophagus and lower esophageal sphincter pressures. The procedure is useful in diagnosing conditions in patients complaining of chest pain or difficulty swallowing.
• In pH studies, a catheter is placed into the esophagus to determine if the esophagus has been exposed to acid and for how long.

The endoscopy staff are highly trained and dedicated to patient care. Nurses are required to become experts in moderate sedation medications and develop the technical skills to care for a variety of patients with many different disease processes. 

Endoscopy procedures are performed at Addison Gilbert and Beverly hospitals. For any of these procedures, patients need to be referred by their physician.