SERVICES

  • Colon Cancer Screening
  • Office Endoscopy Suite
  • Treatment of hepatitis and liver biopsies
  • Management of chronic pancreatitis
  • Management of irritable bowel disease
  • Peptic ulcer disease
  • Biliary disease
  • Hepatology
  • Hiatal hernia and reflux gastroesophageal disease
  • Endoscopic management of gallstones
  • Laser therapies for malignancies and gastrointestinal bleeding
  • Diagnosis and management of malabsorptive states including lactose intolerance
  • Upper endoscopy and colonoscopy with polypectomy
  • Capsule Endoscopy
  • Diagnostic and therapeutic ERCP
  • Fructose Test
  • Lactulose Test

UNDERSTANDING A COLONOSCOPY

WHAT IS A COLONSCOPY?

A colonoscopy is a potentially lifesaving diagnostic procedure that gives our doctors the opportunity to examine our patients’ colons and identify both pre-cancerous and cancerous tissues in their earliest stages. Our doctors can also detect non-cancerous tumors, ulcer and other abnormal tissues, all using minimally invasive endoscopic methods, Patients who undergo routine colonoscopies are being admirably proactive in terms of preserving their health. Colon cancer is one of the more aggressive cancers. However, it is survivable if it is caught and treated in its earliest stages.

While it is important that patient’s undergo a colonoscopy at least every five years one they reach the age of 50, and earlier than that if they are at risk for colon cancer, it is also important that they know what a colonoscopy appointment involves. There is a preparation that must go into a colonoscopy appointment. Patients must adopt a special diet in the days leading up to the procedure. For further information about a colonoscopy and the preparation process, please schedule your initial consultation with our of our gastroenterologists.

WHAT PREPARATION IS REQUIRED?

Your doctor will tell you what dietary restrictions to follow and what cleansing routine to use. In general, the preparation consists of either consuming a large volume of a special cleansing solution or clear liquids and special oral laxatives. The colon must be completely clean for the procedure to be accurate and complete, so be sure to follow your doctor's instructions carefully.

CAN I TAKE MY CURRENT MEDICATIONS?

Most medications can be continued as usual, but some medications can interfere with the preparation or the examination. Inform your doctor about all the medications you're taking, particularly aspirin products, arthritis medications, anticoagulants (blood thinners), insulin or iron products. Also, be sure to mention allergies you have to medications. Alert your doctor if you require antibiotics prior to dental procedures, because you might need antibiotics before a colonoscopy as well.

WHAT HAPPENS DURING A COLONOSCOPY?

Colonoscopies are generally well-tolerated by patients and rarely cause much pain. You might feel pressure, bloating or cramping during the procedure. Your doctor might give you a sedative to help you relax and better tolerate any discomfort.

You will lie on your side or back while your doctor slowly advances a colonoscope through your large intestine to examine the lining. Your doctor will examine the lining again as he or she slowly withdraws the colonoscope. The procedure itself usually takes 15 to 60 minutes, although you should plan on two to three hours for waiting, preparation and recovery.

In some cases, the doctor cannot pass the colonoscope through the entire colon to where it meets the small intestine. Although another examination might be needed, your doctor might decide the limited examination is sufficient.

WHAT IF THE COLONOSCOPY SHOWS SOMETHING ABNORMAL?

If your doctor thinks an area needs further evaluation, he might pass an instrument through the colonoscope to obtain a biopsy (a sample of the colon lining) to be analyzed. Biopsies are used to identify many conditions, and your doctor might order one even if he or she doesn't suspect cancer. If a colonoscopy is being performed to identify sites of bleeding, your doctor might control the bleeding through the colonoscope by injecting medications or by coagulation (sealing off bleeding vessels with heat treatment). Your doctor might also find polyps during colonoscopy, and he or she will most likely remove them during the examination. These procedures don't usually cause any pain.

WHAT ARE POLYPS?

Polyps are abnormal growths in the colon lining that are usually benign (noncancerous). They vary in size from a tiny dot to several inches. Your doctor can't always tell a benign polyp from a malignant (cancerous) polyp by its outer appearance, so he might send removed polyps to a laboratory for analysis. Because cancer begins in polyps, removing them is an important means of preventing colorectal cancer.

HOW ARE POLYPS REMOVED?

Your doctor might destroy tiny polyps by fulguration (burning), by removing them with wire loops called snares, or with biopsy instruments. Your doctor might use a technique called a "snare polypectomy" to remove larger polyps. That technique involves passing a wire loop through the colonoscope and removing the polyp from the intestinal wall using an electrical current. You should feel no pain during the polypectomy.

WHAT HAPPENS AFTER A COLONOSCOPY?

Your physician will explain the results of the examination to you, although it is likely you will have to wait for the results of any biopsies performed.

If you have been given sedatives during the procedure, someone must drive you home and stay with you. Even if you feel alert after the procedure, your judgment and reflexes could be impaired for the rest of the day. You might have some cramping or bloating because of the air introduced into the colon during the examination. This should disappear quickly when you pass gas.

You should be able to eat after the examination, but your doctor might restrict your diet and activities, especially after a polypectomy.

WHAT ARE THE POSSIBLE COMPLICATIONS OF A COLONOSCOPY?

Colonoscopies and polypectomies are generally safe when performed by doctors who have been specially trained and are experienced in these procedures.

One possible complication is a perforation, or tear, through the bowel wall that could require surgery. Bleeding might occur at the site of biopsy or polypectomy, but is usually minor. Bleeding can stop on its own or be controlled through the colonoscope, and rarely requires follow-up treatment. Some patients might have a reaction to the sedatives or complications from heart or lung disease.

Although complications after a colonoscopy are uncommon, it is important to recognize early signs of possible complications. Contact your doctor if you notice severe abdominal pain, fever and chills, or rectal bleeding of more than one-half cup. Please note that bleeding can occur for several days after the procedure.

UNDERSTANDING FLEXIBLE SIGMOIDOSCOPY

WHAT IS A FLEXIBLE SIGMOIDOSCOPY?

A flexible sigmoidoscopy lets your doctor examine the lining of the rectum and a portion of the colon (large intestine) by inserting a flexible tube about the thickness of your finger into the anus and slowly advancing it into the rectum and lower part of the colon. If one of our doctors recommends a flexible sigmoidoscopy, you will meet with one of our experienced staff members who will explain how it is performed, how it can help, and what side effects you might experience.

WHAT PREPARATION IS REQUIRED?

Your doctor will tell you what cleansing routine to use. In general, preparation consists of one or two enemas prior to the procedure, but could include laxatives or dietary modifications as well. However, in some circumstances your doctor might advise you to forgo any special preparation. Because the rectum and lower colon must be completely empty for the procedure to be accurate, it is important to follow your doctor's instructions carefully.

SHOULD I CONTINUE MY CURRENT MEDICATIONS?

Most medications can be continued as usual. Inform your doctor about medications that you're taking - particularly aspirin products or anticoagulants (blood thinners) - as well as any allergies you have to any medications. Also, tell your doctor if you require antibiotics prior to dental procedures, because you might need antibiotics prior to sigmoidoscopy as well.

WHAT CAN I EXPECT DURING A FLEXIBLE SIGMOIDOSCOPY?

Flexible sigmoidoscopies are usually well-tolerated and rarely cause much pain. You might experience a feeling of pressure, bloating or cramping during the procedure. You will lie on your side while your doctor advances the sigmoidoscope through the rectum and colon. As your doctor withdraws the instrument, your doctor will carefully examine the lining of the intestine.

WHAT IF THE FLEXIBLE SIGMOIDOSCOPY FINDS SOMETHING ABNORMAL?

If your doctor sees an area that needs further evaluation, your doctor might take a biopsy (sample of the colon lining) to be analyzed. Biopsies are used to identify many conditions, and your doctor might order one even if he or she doesn't suspect cancer.

If your doctor finds polyps, he or she might take a biopsy of them as well. Polyps, which are growths from the lining of the colon, vary in size and types. Polyps known as "hyperplastic" might not require removal, but benign polyps known as "adenomas" are potentially pre-cancerous. Your doctor might ask you to have a colonoscopy (a complete examination of the colon) to remove any large polyps or any small adenomas.

WHAT HAPPENS AFTER A FLEXIBLE SIGMOIDOSCOPY?

Your doctor will explain the results to you when the procedure is done. You might feel bloating or some mild cramping because of the air that was passed into the colon during the examination. This will disappear quickly when you pass gas. You should be able to eat and resume your normal activities after leaving your doctor's office or the hospital, assuming you did not receive any sedative medication.

WHAT ARE POSSIBLE COMPLICATIONS OF FLEXIBLE SIGMOIDOSCOPY?

Flexible sigmoidoscopy and biopsy are safe when performed by doctors who are specially trained and experienced in these endoscopic procedures. Complications are rare, but it is important for you to recognize early signs of possible complications. Contact your doctor if you notice severe abdominal pain, fevers and chills, or rectal bleeding of more than one-half cup. Note that rectal bleeding can occur for several days after the biopsy.

UPPER ENDOSCOPY

WHAT IS AN UPPER ENDOSCOPY?

An upper endoscopy lets your doctor examine the lining of the upper part of your gastrointestinal tract, which includes the esophagus, stomach and duodenum (first portion of the small intestine). Your doctor will use a thin, flexible tube called an endoscope, which has its own lens and light source, and will view the images on a video monitor. You might hear your doctor or other medical staff refer to upper endoscopy as upper GI endoscopy, esophagogastroduodenoscopy (EGD) or panendoscopy. If your doctor has recommended upper endoscopy, please read further so you get a basic understanding of the procedure - how it's performed, how it can help, and what side effects you might experience.

WHY IS AN UPPER ENDOSCOPY DONE?

An upper endoscopy helps your doctor evaluate symptoms of persistent upper abdominal pain, nausea, vomiting or difficulty swallowing. It's an excellent test for finding the cause of bleeding from the upper gastrointestinal tract. It's also more accurate than X-ray films for detecting inflammation, ulcers and tumors of the esophagus, stomach and duodenum.

Your doctor might use anupper endoscopy to obtain a biopsy (small tissue samples). A biopsy helps your doctor distinguish between benign and malignant (cancerous) tissues. Remember, biopsies are taken for many reasons, and your doctor might order one even if he or she does not suspect cancer. For example, your doctor might use a biopsy to test for Helicobacter pylori, bacterium that causes ulcers.

Your doctor might also use upper endoscopy to perform a cytology test, where he or she will introduce a small brush to collect cells for analysis.

An upper endoscopy is also used to treat conditions of the upper gastrointestinal tract. Your doctor can pass instruments through the endoscope to directly treat many abnormalities with little or no discomfort. For example, your doctor might stretch a narrowed area, remove polyps (usually benign growths) or treat bleeding.

HOW SHOULD I PREPARE FOR THE PROCEDURE?

An empty stomach allows for the best and safest examination, so you should have nothing to eat or drink, including water, for approximately six hours before the examination. Your doctor will tell you when to start fasting.

Tell your doctor in advance about any medications you take; you might need to adjust your usual dose for the examination. Discuss any allergies to medications as well as medical conditions, such as heart or lung disease. Also, alert your doctor if you require antibiotics prior to undergoing dental procedures, because you might need antibiotics prior to upper endoscopy as well.

WHAT CAN I EXPECT DURING AN UPPER ENDOSCOPY?

Your doctor might start by spraying your throat with a local anesthetic or by giving you a sedative to help you relax. You'll then lie on your side, and your doctor will pass the endoscope through your mouth and into the esophagus, stomach and duodenum. The endoscope doesn't interfere with your breathing. Most patients consider the test only slightly uncomfortable, and many patients fall asleep during the procedure.

WHAT HAPPENS AFTER AN UPPER ENDOSCOPY?

You will be monitored until most of the effects of the medication have worn off. Your throat might be a little sore, and you might feel bloated because of the air introduced into your stomach during the test. You will be able to eat after you leave unless your doctor instructs you otherwise.

Your doctor generally can tell you your test results on the day of the procedure; however, the results of some tests might take several days.

If you received sedatives, you won't be allowed to drive after the procedure even though you might not feel tired. You should arrange for someone to accompany you home because the sedatives might affect your judgment and reflexes for the rest of the day.

WHAT ARE POSSIBLE COMPLICATIONS OF AN UPPER ENDOSCOPY?

Although complications can occur, they are rare when doctors who are specially trained and experienced in this procedure perform the test. Bleeding can occur at a biopsy site or where a polyp was removed, but it's usually minimal and rarely requires follow-up. Other potential risks include a reaction to the sedative, complications from heart or lung diseases, and perforation (a tear in the gastrointestinal tract lining). It's important to recognize early signs of possible complications. If you have a fever after the test, trouble swallowing or increasing throat, chest or abdominal pain, tell your doctor immediately.

UNDERSTANDING A CAPSULE ENDOSCOPY

After an office consultation, your doctor may determine that a capsule endoscopy of the small bowel is necessary for further evaluation of your condition. A capsule endoscopy will provide your doctor with pictures of your small intestine.

WHAT IS A CAPSULE ENDOSCOPY?

A capsule endoscopy enables your doctor to examine your entire small intestine. You will ingest a vitamin-pill sized video capsule, which has its own camera and light source. During the 8-hour exam, you are free to move about. While the video capsule travels through your body, it sends images to a data recorder you will wear on a waist belt. Most patients find the test comfortable. Afterwards, your doctor will view the images on a video monitor.

WHY IS A CAPSULE ENDOSCOPY OF THE SMALL BOWEL PERFORMED?

A capsule endoscopy helps your doctor determine the cause for recurrent or persistent symptoms such as abdominal pain, diarrhea, bleeding or anemia. In certain chronic gastrointestinal diseases, this method can also help to evaluate the extent to which your small intestine in involved or monitor the effect of therapy. Your doctor might use capsule endoscopy to obtain motility data such as gastric or small bowel passage time.

HOW SHOULD YOU PREPARE FOR THE PROCEDURE?

You will receive preparation instructions before the examination. An empty stomach allows optimal viewing conditions, so you should start a liquid diet after lunch the day prior to the examination and have nothing to eat or drink, including water, for approximately 10 hours before a small bowel examination. Your doctor will tell you when to start fasting. Tell your doctor in advance about any medications you take, as you might need to adjust your usual dose for the examination. Tell your doctor of the presence of a pacemaker or other implanted electromedical devices, previous abdominal surgery, a swallowing problem or previous history of obstructions in the bowel.

WHAT CAN I EXPECT DURING A CAPSULE ENDOSCOPY?

The doctor or nurse will prepare you for the examination by applying a sensor array to your abdomen with adhesive sleeves. The capsule endoscope is ingested with water and passes naturally through your digestive tract while transmitting video images to a data recorder worn on a belt for approximately 8 hours. You will be able to eat 4 hours after the capsule ingestion unless your doctor instructs you otherwise.

WHAT HAPPENS AFTER A CAPSULE ENDOSCOPY?

At the end of the procedure, you will need to go back to your doctor to return the data recorder and sensor array. The images acquired during your exam will then be downloaded to a workstation for your doctor to review. After ingesting the capsule and until it passes through your body, you should not have a Magnetic Resonance Imaging (MRI) examination or be near an MRI machine.

HOW WILL I KNOW THE RESULTS OF THE CAPSULE ENDOSCOPY?

After you return the equipment, your doctor will process the information for the data recorder and will view a color video of the pictures taken from the capsule. After the doctor has looked at this video, you will be contacted with the results.

HOW DOES THE CAPSULE GET ELIMINATED AND WILL

I FEEL IT COME OUT?

The capsule is disposable and passes naturally with your bowel movement. You should not feel any pain or discomfort.

WHAT ARE THE POSSIBLE COMPLICATIONS OF A CAPSULE ENDOSCOPY?

Although complications may occur, they are rare when doctors who are specially trained and experienced in this procedure perform the test. A potential risk could be retention of the capsule. It is important for you to recognize early signs of possible complications. If you have a fever after the test, trouble swallowing or increasing chest or abdominal pain, tell your doctor immediately.

IF YOU ARE HAVING A/AN:

INSTRUCTIONS ON PREPS

LACTOSE MALABSORPTION TEST
HYDROGEN BREATH TEST
COLONOSCOPY
FLEXIBLE SIGMOIDOSCOPY
UPPER ENDOSCOPY
LACTOSE MALABSORPTION TEST
  1. Do not eat any slow digesting foods like beans, bran or other high fiber cereals the day before the test is performed.
  2. You must fast for 8 hours, with no food only water to drink before the test.
  3. Do not smoke, sleep, or exercise vigorously for at least 1/2 an hour before test.
  4. Drink 6 to 8 oz. of milk three hours before the office visit.
HYDROGEN BREATH TEST
  1. Do not eat or drink anything after midnight before the procedure.
  2. No escort is required because this test doesn’t use anesthesia.
  3. Do not dress elegantly. This way, we won’t have any problems with stains. Leave earrings and other jewelry at home.
  4. If you have any questions, please contact your doctor’s office.
COLONOSCOPY

Read carefully. Do not exceed recommended dosage as serious side effects may occur. Please read all instructions at least two days before your colonoscopy. Your physician may adjust your dosage schedule.

  1. Do not take anti-coagulants, Coumadin, aspirin or any anti- inflammatory medication (such as Motrin or Advil) for one week before the procedure. You may use Tylenol if needed.
  2. If you take anticoagulants (blood thinners), have a heart murmur, or have been advised to take antibiotics before dental work, please call for special instructions at least 5 days before your appointment.
  3. You may take your regular medications before the procedure with a sip of water except for insulin or other diabetic medications which may be taken after the procedure.
  4. If a polyp is removed, do not take anticoagulants (Coumadin), aspirin or any anti-inflammatory medication for one week after the procedure.

ESCORT: It is likely that sedating medication will be given for your colonoscopy, and you may be drowsy for quite a while. For your safety, we cannot perform the examination unless someone is here to accompany you home afterwards.

FLEXIBLE SIGMOIDOSCOPY
  1. You may have clear liquids for dinner only on the day before your procedure.
  2. Take one Fleet enema 2 hours before bedtime the day before the procedure.
  3. No breakfast the day of your procedure.
  4. Take another Fleet enema 1 hour before your appointment.
  5. Try to hold each enema for 10 minutes.
  6. You may take your regular medications with a small amount of water, unless otherwise directed by the physician, except insulin which may be taken after the procedure with food.
UPPER ENDOSCOPY
  1. Do not take anti-coagulants, aspirin or any anti-inflammatory medication (such as Motrin or Advil) for one week before the procedure. You may use Tylenol if needed.
  2. If you take anticoagulants (blood thinners), have a heart murmur, or have been advised to take antibiotics before dental work, please call for special instructions at least 5 days before your appointment.
  3. Do not eat or drink anything after midnight the day of the procedure.
  4. You may take your regular medications before the procedure with a sip of water except for insulin or other diabetic medications which may be taken after the procedure.

Information on Common Diseases can be found at the:

For information on specific diseases click on these links:

IF YOU ARE HAVING A/AN:

LACTOSE MALABSORPTION TEST
HYDROGEN BREATH TEST
COLONOSCOPY
FLEXIBLE SIGMOIDOSCOPY
UPPER ENDOSCOPY
LACTOSE MALABSORPTION TEST

INSTRUCTIONS ON PREPS

  1. Do not eat any slow digesting foods like beans, bran or other high fiber cereals the day before the test is performed.
  2. You must fast for 8 hours, with no food only water to drink before the test.
  3. Do not smoke, sleep, or exercise vigorously for at least 1/2 an hour before test.
  4. Drink 6 to 8 oz. of milk three hours before the office visit.
HYDROGEN BREATH TEST

INSTRUCTIONS ON PREPS

  1. Do not eat or drink anything after midnight before the procedure.
  2. No escort is required because this test doesn’t use anesthesia.
  3. Do not dress elegantly. This way, we won’t have any problems with stains. Leave earrings and other jewelry at home.
  4. If you have any questions, please contact your doctor’s office.
COLONOSCOPY

INSTRUCTIONS ON PREPS
Read carefully. Do not exceed recommended dosage as serious side effects may occur. Please read all instructions at least two days before your colonoscopy. Your physician may adjust your dosage schedule.

  1. Do not take anti-coagulants, Coumadin, aspirin or any anti- inflammatory medication (such as Motrin or Advil) for one week before the procedure. You may use Tylenol if needed.
  2. If you take anticoagulants (blood thinners), have a heart murmur, or have been advised to take antibiotics before dental work, please call for special instructions at least 5 days before your appointment.
  3. You may take your regular medications before the procedure with a sip of water except for insulin or other diabetic medications which may be taken after the procedure.
  4. If a polyp is removed, do not take anticoagulants (Coumadin), aspirin or any anti-inflammatory medication for one week after the procedure.

ESCORT: It is likely that sedating medication will be given for your colonoscopy, and you may be drowsy for quite a while. For your safety, we cannot perform the examination unless someone is here to accompany you home afterwards.

FLEXIBLE SIGMOIDOSCOPY

INSTRUCTIONS ON PREPS

  1. You may have clear liquids for dinner only on the day before your procedure.
  2. Take one Fleet enema 2 hours before bedtime the day before the procedure.
  3. No breakfast the day of your procedure.
  4. Take another Fleet enema 1 hour before your appointment.
  5. Try to hold each enema for 10 minutes.
  6. You may take your regular medications with a small amount of water, unless otherwise directed by the physician, except insulin which may be taken after the procedure with food.
UPPER ENDOSCOPY

INSTRUCTIONS ON PREPS

  1. Do not take anti-coagulants, aspirin or any anti-inflammatory medication (such as Motrin or Advil) for one week before the procedure. You may use Tylenol if needed.
  2. If you take anticoagulants (blood thinners), have a heart murmur, or have been advised to take antibiotics before dental work, please call for special instructions at least 5 days before your appointment.
  3. Do not eat or drink anything after midnight the day of the procedure.
  4. You may take your regular medications before the procedure with a sip of water except for insulin or other diabetic medications which may be taken after the procedure.

Information on Common Diseases can be found at the:

For information on specific diseases clink on these links:

ADDRESS

1 Arlington Ave., Suite 1
Malverne, NY 11565

PHONE