Endoscopic Ultrasound (EUS)

Your test is scheduled as an outpatient in most cases. Rarely, you stay over night in the hospital. You will be told if this is possible. Be sure to follow the instructions below before your exam.

• Do not eat or drink for eight hours before your test. Your stomach must be empty.
• Tell your doctor if you…
  
  • have any allergies, heart or lung problems.
  • are or think you may be pregnant.
  • have had an endoscopy in the past and if you had problems with the medicine or dye used.
  • take antibiotics before having dental work.
• If you take medicine to thin your blood, (i.e., Heparin or coumadin) or aspirin compounds, contact us. In general, you must stop taking these pills for several days, but in some cases you may continue to take them.
• If you are a diabetic, please ask your doctor or nurse if you should take your insulin and/or pills before your test.
• You may take blood pressure and heart medicine as usual the morning of the test.
• If you take pills in the morning, drink only a small sip of water to help you swallow.
• Do not take any antacids.
• Bring with you a list of all prescription and over-the-counter medicines you are taking.
• Bring with you all medical records and X-ray films that relate to your current problem.
• Make sure an adult can take you home. The medicines used during the procedure will not wear off for several hours. You will NOT be able to drive. If you travel by public transportation, such as by bus, van or taxi, you will still need an adult to ride home with you.

If you come alone, your test will have to be rescheduled.

1. When you come for the EUS, the doctor will talk to you about the test and answer any questions. You should know why you are having an EUS and understand the treatment options and possible risks.
2. You will put on a hospital gown and be asked to remove any eye glasses, contact lenses or dentures. An IV will be started and blood may be drawn for lab studies. You may receive antibiotics through the IV.
3. You will be asked to sign a consent for which gives the doctor your permission to do the test.
4. You will be taken by stretcher to the procedure room. The nurse will help you get into the correct position, usually on your side, and make you comfortable. Anesthesia may be used or moderate sedation. A plastic guard will be placed in your mouth to protect your teeth during the test.
5. A blood pressure cuff will be put on your arm or leg. A small clip will be put on your finger. These will let the nurse check your blood pressure and heart rate frequently during the test.
6. You will be given medicine through the IV to make you relaxed and sleepy. When you are sleepy, the doctor will place a thin, flexible tube (endoscope) through the mouth guard and into your mouth. The endoscope has a small video camera on the end that lets the doctor see the inside of your G.I. tract.
7. The doctor will ask you to swallow. When you swallow, the endoscope will move down your esophagus, the same way food goes down when you eat. You may feel like gagging, but should not feel any pain. This will not interfere with your breathing.
8. The doctor will guide the endoscope through your G.I. tract. This will allow the doctor to see the lining of your upper digestive system and treat any problems found.
9. Sometimes the EUS exam involves passing the endoscope through the anus. The preparation and procedure are similar to flexible sigmoidoscopy.
10. The nurse monitors you carefully. The procedure can take anywhere from 5 to 90 minutes.

EUS may be used to treat your condition.

• Using EUS, tissue in the affected area can be removed, called mucosectomy. This may be all you need for treatment.
• It is also possible to inject medicine into certain areas of the GI tract.
• This instrument can be used to direct a tiny needle into any area of concern and take a sample of tissue. This is called a biopsy and it can help your doctors make a diagnosis.
• Stents placed into bile ducts or cysts.
• Place radiation markers.

If you need any of these treatments, the doctor will tell you.

1. After the EUS, you will be taken to the recovery area. Your blood pressure and heart rate are watched until you will wake up in about 30 to 90 minutes.
2. After removing your IV, the nurse will give you written instructions to follow when you go home. If you have any questions, please ask. The doctor will talk to you about your test before you leave.
3. Even if you feel awake, your judgment and reflexes will be slow. You will not be allowed to leave unless an adult takes you home. Again, you will not be able to drive.
4. If treatments were done during your test, you may need to be observed overnight so the doctors can check on you.

• You will need to rest quietly until the next day.
• After the test, you may feel bloated and pass gas. This is normal and will go away in a few hours.
• Your throat may be sore for a few days.
• You may resume your regular diet and medications after the procedure.
• Do not drive, operate machinery, sign legal documents or make important decisions.
• Do not drink alcohol or take sleeping/nerve pills.

• A tender lump may form where the IV was placed. The lump may not go away for several weeks. You will need to call your doctor if redness, pain or swelling in this hand or arm lasts for more than two days.
• The medicines may make you sick. You may have nausea, vomiting, hives, dry mouth, or a reddened face and neck.
• If biopsies are taken, there is a minimal risk of bleeding or infection.
• Perforation. Tearing or making a hole in the wall of the esophagus, stomach or intestines is very rare, but may require surgery.
• Pancreatitis.

Your doctor will discuss these risks with you.