Frequently Asked Questions

St. John Children's Center Pediatric Gastroenterology


FREQUENTLY ASKED QUESTIONS

 

How do I contact you to make the first appointment?

First you contact your primary care physician to find out if a referral is needed and then call our office to schedule the appointment. Make sure that any laboratory tests or x-ray investigation performed prior to the first visit, are sent to us to avoid repetition of tests.

 

What do I expect in my first appointment?

You will fill out a medical questionnaire of two pages, then you will meet the Doctor who will take a complete history and will do a physical examination. Then the Doctor will discuss the diagnosis and management plan including further testing and or treatment. Since we are a teaching hospital affiliated with Wayne State University sometimes you may see a Doctor training in Pediatrics, but always the Pediatric Gastroenterologist will review the clinical history and examine your child. If any laboratory tests were performed during the first visit, the nurse practitioner or Pediatric Gastroenterologist will contact the parents or legal guardian of the patient regarding any abnormal results. We will not call if laboratory tests are normal.

 

When I will get results of x-rays performed?

We will contact you if x-rays investigations are abnormal. If you want to know the results you can contact our office one week after the x-ray was obtained.

 

Where should I call to have my prescription refilled?

You call 313-343-3481 and listen to the options for the refill line. Have all the personal information available including name, birth date, phone number plus name of medication, dose, and pharmacy phone number.

 

What to expect before, during and after an upper endoscopy?

 

What to expect — Prior to the endoscopy, the staff will review your medical and surgical history, including current medications. A physician will explain the procedure and ask you to sign a consent form. Before signing the consent, you should understand all the benefits and risks of the procedure, and should have all of your questions answered.

An intravenous line (a needle inserted into a vein in the hand or arm) will be started to delivery medications. You will be given a combination of a sedative (to help you relax), and a narcotic (to prevent discomfort).

Your vital signs (blood pressure, heart rate, and blood oxygen level) will be monitored before, during, and after the examination. The monitoring is not painful. Oxygen is often given during the procedure through a small tube that sits under the nose and is fitted around the ears.

 

The Procedure— the procedure typically takes between 10 and 20 minutes to complete. The endoscopy is performed while you lie on your left side. Sometimes the physician will give a medication to numb the throat (either a gargle or a spray). A plastic mouth guard is placed between the teeth to prevent damage to the teeth and scope.

The endoscope (also called a gastroscope) is a flexible tube that is about the size of a finger. The scope has a lens and a light source that allows the endoscopist to look into the scope to see the inner lining of the upper gastrointestinal tract, or to view it on a TV monitor. Most people have no difficulty swallowing the flexible gastroscope as a result of the sedating medications. Many people sleep during the test; others are very relaxed and generally not aware of the examination.

The endoscopist may take tissue samples called biopsies (not painful), or perform specific treatments (such as dilation, removal of polyps, treatment of bleeding), depending upon what is found during the examination. Air is introduced through the scope to open the esophagus, stomach, and intestine, allowing the scope to be passed through these structures and improving the endoscopist's ability to see all of the structures. You may experience a mild discomfort as air is pushed into the intestinal tract. This is not harmful and belching may relieve the sensation. The endoscope does not interfere with breathing. Taking slow, deep breaths during the procedure may help you to relax.

Recovery — after the endoscopy, you will be observed for one to two hours while the sedative medication wears off. The medicines cause most people to temporarily feel tired or have difficulty concentrating and you should not drive or return to work after the procedure.

The most common discomfort after the examination is a feeling of bloating as a result of the air introduced during the examination. This usually resolves quickly. Some patients also have a mild sore throat. Most patients are able to eat shortly after the examination.

Complications— Upper endoscopy is a safe procedure and complications are uncommon. The following is a list of possible complications:

Aspiration (inhaling) of food or fluids into the lungs, the risk of which can be minimized by not eating or drinking for the recommended period of time before the examination

The endoscope can cause a tear or hole in the tissue being examined. This is a serious complication but fortunately occurs only rarely.

Bleeding can occur from biopsies or the removal of polyps, although it is usually minimal and stops quickly on its own or can be easily controlled.

Reactions to the sedative medications are possible; the endoscopy team (doctors and nurses) will ask about previous medication allergies or reactions and about health problems such as heart, lung, kidney, or liver disease. Providing this information to the team ensures a safer examination.

The medications may produce irritation in the vein at the site of the intravenous line. If redness, swelling, or discomfort occurs, you should call your endoscopist or primary care provider, or the number given by the nurse at discharge.

The following signs and symptoms should be reported immediately:

  • Severe abdominal pain (more than gas cramps)
  • A firm, distended abdomen
  • Vomiting
  • Any temperature elevation
  • Difficulty swallowing or severe throat pain
  • A crunching feeling under the skin of the neck

After Upper Endoscopy— most patients tolerate endoscopy very well and feel fine afterwards. Some fatigue is common after the examination, and you should plan to take it easy and relax the rest of the day.

The endoscopist can describe the result of their examination before you leave the endoscopy unit. If biopsies have been taken or polyps removed, we will discuss the results in the follow-up appointment in one week.

 

What to expect before, during and after colonoscopy?

What to Expect— prior to the endoscopy, a nurse will ask questions to ensure the patient understands the procedure and the reason it is planned. The nurse will ask questions to ensure the patient has prepared properly for the procedure. A doctor will also review the procedure, including possible complications, and will ask patients to sign a consent form.

The nurse will start an intravenous line (insert a needle into a vein in the hand or arm) to administer medications. The intravenous line insertion feels like a pin prick, similar to having blood drawn. The vital signs (blood pressure, heart rate, and blood oxygen level) will be monitored before, during, and after the examination. The monitoring is not painful. Some patients will be given oxygen during the examination.

The Procedure— the colonoscopy will be performed while the patient lies on their left side. Medications will be administered through the intravenous line. Most endoscopy units use a combination of a sedative (to help patients relax), and a narcotic (to prevent discomfort). Many people sleep during the examination while others are very relaxed, comfortable, and generally not aware of the examination.

The colonoscope is a flexible tube, approximately the size of the index finger. It has a lens and a light source that allows the endoscopist to look into the scope or at a TV monitor. The image on the TV monitor is magnified many times so the endoscopist can see small changes in tissue.

The endoscope contains channels that allow the endoscopist to obtain biopsies (small pieces of tissue), remove polyps and to introduce or withdraw fluid or air. Polyps are extra growths of tissue that can range in size from the tip of a pen to several inches (doctors measure them in millimeters and centimeters). Most polyps are benign (not cancerous) but can become cancerous if allowed to grow for a long time. As a result, they are usually removed so they can be analyzed. This does not hurt since the lining of the colon does not sense pain. Air is introduced through the scope to open up the colon so that the scope can be moved forward and to allow the endoscopist to see. Patients may experience a feeling of bloating or gas cramps from the air as it distends the colon. Try not to be embarrassed about releasing the air through the rectum; patients should let their physician know if they are uncomfortable

Recovery — after the colonoscopy, the patient will be observed until the effects of the sedative medication are gone. The most common discomfort after colonoscopy is a feeling of bloating and gas cramps. Patients may also feel groggy from the sedation medications. Patients should not return to work that day. Most patients are able to eat a regular diet after the examination.

Complications— Colonoscopy is a safe procedure and complications are rare, but can occur:

  • Bleeding can occur from biopsies or the removal of polyps, but it is usually minimal and stops quickly or can be controlled.
  • The colonoscope can cause a tear or hole in the tissue being examined, which is a serious problem, but, fortunately, very uncommon.
  • Adverse reactions to the medications used to sedate you are possible. The endoscopy team will ask about previous medication allergies or reactions and about health problems such as heart, lung, kidney, or liver disease.
  • The medications can cause irritation in the vein at the site of the intravenous line. If redness, swelling, or warmth occurs, applying a warm wet towel to the site may relieve the discomfort. If the discomfort persists, notify the endoscopy unit.

The following symptoms should be reported immediately:

  • Severe abdominal pain (not just gas cramps)
  • A firm, distended abdomen
  • Vomiting
  • Fever
  • Rectal bleeding (greater than a few tablespoons).

After Colonoscopy— although patients worry about discomforts of the examination, most people tolerate it very well and feel fine afterwards. Some fatigue after the examination is common. Patients should plan to take it easy and relax the rest of the day.

The endoscopist can describe the result of their examination before the patient leaves the endoscopy unit. If biopsies have been taken or polyps removed, we will discuss the results in the follow-up appointment in one week.