You've been referred to have an endoscopic
ultrasonography, or EUS, which will help your doctor,
evaluate or treat your condition. This brochure will give
you a basic understanding of the procedure - how it is
performed, how it can help, and what side effects you
might experience. It can't answer all of your questions,
since a lot depends on the individual patient and the
doctor. Please ask your doctor about anything you don't
understand. Endoscopists are highly trained specialists
who welcome your questions regarding their credentials,
training and experience
What is EUS?
EUS allows your doctor to examine the lining and the walls
of your upper and lower gastrointestinal tract. The upper
tract is the esophagus, stomach and duodenum; the lower
tract includes your colon and rectum. EUS is also used to
study internal organs that lie next to the
gastrointestinal tract, such as the gall bladder and
pancreas.
Your endoscopist will use a thin, flexible tube called
an endoscope. Your doctor will pass the endoscope through
your mouth or anus to the area to be examined. Your doctor
then will turn on the ultrasound component to produce
sound waves that create visual images of the digestive
tract.
Why is EUS done?
EUS provides your doctor more detailed pictures of your
digestive tract anatomy. Your doctor can use EUS to
diagnose the cause of conditions such as abdominal pain or
abnormal weight loss. Or, if your doctor has ruled out
certain conditions, EUS can confirm your diagnosis and
give you a clean bill of health.
EUS is also used to evaluate an abnormality, such as a
growth, that was detected at a prior endoscopy or by
x-ray. EUS provides a detailed picture of the growth,
which can help your doctor determine its nature and decide
upon the best treatment.
In addition, EUS can be used to diagnose diseases of
the pancreas, bile duct and gallbladder when other tests
are inconclusive.
Why is EUS used for patients with cancer?
EUS helps your doctor determine the extent of certain
cancers of the digestive and respiratory systems. EUS
allows your doctor to accurately assess the cancer's depth
and whether it has spread to adjacent lymph glands or
nearby vital structures such as major blood vessels. In
some patients, EUS can be used to obtain tissue samples to
help your doctor determine the proper treatment.
How should I prepare for EUS?
For EUS of the upper gastrointestinal tract, you should
have nothing to eat or drink, not even water, usually six
hours before the examination. Your doctor will tell you
when to start this fasting.
For EUS of the rectum or colon, your doctor will
instruct you to either consume a large volume of a special
cleansing solution or to follow a clear liquid diet
combined with laxatives or enemas prior to the
examination. The procedure might have to be rescheduled if
you don't follow your doctor's instructions carefully.
What about my current medications or allergies?
Tell your doctor in advance of the procedure about all
medications that you're taking and about any allergies you
have to medication. He or she will tell you whether or not
you can continue to take your medication as usual before
the EUS examination. In general, you can safely take
aspirin and nonsteroidal anti-inflammatories (Motrin,
Advil, Aleve, etc.) before an EUS examination, but it's
always best to discuss their use with your doctor. Check
with your doctor about which medications you should take
the morning of the EUS examination, and take essential
medication with only a small cup of water.
If you have an allergy to latex you should inform your
doctor prior to your test. Patients with latex allergies
often require special equipment and may not be able to
have an EUS examination.
Do I need to take antibiotics?
Antibiotics aren't generally required before or after EUS
examinations. But tell your doctor if you take antibiotics
before dental procedures. If your doctor feels you need
antibiotics, antibiotics might be ordered during the EUS
examination or after the procedure to help prevent an
infection. Your doctor might prescribe antibiotics if
you're having specialized EUS procedures, such as to drain
a fluid collection or a cyst using EUS guidance. Again,
tell your doctor about any allergies to medications.
Should I arrange for help after the examination?
If you received sedatives, you won't be allowed to drive
after the procedure, even if you don't feel tired. You
should arrange for a ride home. You should also plan to
have someone stay with you at home after the examination,
because the sedatives could affect your judgment and
reflexes for the rest of the day.
What can I expect during EUS?
Practices vary among doctors, but for an EUS examination
of the upper gastrointestinal tract, your endoscopist
might spray your throat with a local anesthetic before the
test begins. Most often you will receive sedatives
intravenously to help you relax. You will most likely
begin by lying on your left side. After you receive
sedatives, your endoscopist will pass the ultrasound
endoscope through your mouth, esophagus and stomach into
the duodenum. The instrument does not interfere with your
ability to breathe. The actual examination generally takes
between 15 to 45 minutes. Most patients consider it only
slightly uncomfortable, and many fall asleep during it.
An EUS examination of the lower gastrointestinal tract
can often be performed safely and comfortably without
medications, but you will probably receive a sedative if
the examination will be prolonged or if the doctor will
examine a significant distance into the colon. You will
start by lying on your left side with your back toward the
doctor. Most EUS examinations of the lower
gastrointestinal tract last from 10 to 30 minutes.
What happens after EUS?
If you received sedatives, you will be monitored in the
recovery area until most of the sedative medication's
effects have worn off. If you had an upper EUS, your
throat might be sore. You might feel bloated because of
the air and water that were introduced during the
examination. You'll be able to eat after you leave the
procedure area, unless you're instructed otherwise.
Your doctor generally can inform you of the results of
the procedure that day, but the results of some tests will
take longer.
What are the possible complications of EUS?
Although complications can occur, they are rare when
doctors with specialized training and experience perform
the EUS examination. Bleeding might occur at a biopsy
site, but it's usually minimal and rarely requires
follow-up. You might have a sore throat for a day or more.
Nonprescription anesthetic-type throat lozenges and
painkillers help relieve the sore throat. Other potential,
but uncommon, risks of EUS include a reaction to the
sedatives used; backwash of stomach contents into your
lungs; infection; and complications from heart or lung
diseases. One major, but very uncommon, complication of
EUS is perforation. This is a tear through the lining of
the intestine that might require surgery to repair.
The possibility of complications increases slightly if
a deep needle aspiration is performed during the EUS
examination. These risks must be balanced against the
potential benefits of the procedure and the risks of
alternative approaches to the condition.
