Gastroenterology

St. Bernards GI Lab diagnoses and treats problems of the digestive system, from the throat (esophagus) to the colon, including organs involved in digestion—the stomach, liver, pancreas and gallbladder.

The GI Lab has four procedure rooms and a fluoroscopy room. The GI Lab physicians use devices that allow the interior of the colon and stomach to be viewed and biopsies to be taken for further testing. Under fluoroscopy, an imaging technique, disorders can be detected within the system that creates, stores and releases bile into the digestive system. 

Patients undergoing a procedure in the GI Lab should allow for two to three hours for their visit, including both the procedure and recovery time. Patients must stay in recovery and be monitored until the nurse determines they have reached an acceptable alertness score and are ready for discharge. 

GI Exams and Procedures:

• Sigmoidoscopy
• Paracentesis
• Colonoscopy
• Liver Biopsy
• Polypectomy
• Bravo Ph Capsule
• Esophagastrodudenoscopy
• Motility Studies
• M2A® Small Bowel Capsule
• Percutaneous Endoscopic Gastrostomy (PEG) Tube Placements
• Endoscopic Ultrasound
• Fecal Microbiota Transplant (FMT)
  • Fecal microbiota transplantation (FMT) is a procedure that delivers healthy human donor stool to a child via colonoscopy, enema, nasogastric (NG) tube or in capsule form (known as "poop pills"). It may be prescribed for debilitating gastrointestinal infections such as Colstridium difficile (C. diff), that keep recurring despite antibiotic therapy.
  • Not all children are good candidates for FMT. The procedure carries risks, particularly if your child is taking immunosuppressant medication or has had a recent bone marrow transplant. FMT can be beneficial to children who have specific GI conditions, such as Crohn's disease or ulcerative colitis. FMT is currently being tested for peanut allergy, based on evidence that transferring "good" bacteria can rebalance the immune system.
  • How does FMT Work?
    • The GI tract has an "ecosystem" of thousands of bacteria and other organisms that help keep the body healthy. When your child is given an antibiotic, this ecosystem is disrupted, allowing growth of the disease-causing bacteria, such as C. diff. With FMT, "good" microorganisms from the donor stool are infused into the patient. Healthy bacteria begin to grow and prevent C. diff from recurring. Stool donors are rigorously screened and stool samples are extensively tested before being used for FMT.
    • There are several different FMT techniques:
      • Colonoscopy: A thin hollow tube with an attached camera is placed up the colon and a catheter-tipped syringe is used to inject donor stool through the channel.
      • Enema: Although, less invasive than a colonoscopy, a fecal enema often needs to be performed more than once, because the donor stool doesn't reach the colon.
      • Nasogastric (NG) tube: Using a thin, flexible feeding tube, doctors insert donor stool through a patient's nostril, down the throat and into the stomach.
      • Oral capsules, known as "poop pills" 
    • Preparing for FMT:
      • Your child should have an empty GI tract. This often means drinking only clear fluids 24 hours before the procedure. No foods.
      • If your child has mild or moderate C.diff, they may also be asked to drink a liquid to encourage a bowel movement; however, children with more severe infection will not follow this same protocol. 
• Endoscopic Retrograde Cholagiopancreatography
  • ERC is  procedure that combines upper and gastrointestinal endoscopy and x-rays to treat problems of the bile and pancreatic ducts. SpyGlass is an innovative system that provides unprecedented, direct visualization of all bile-duct quadrants. With SpyGlass, a miniature 6,000-pixel fiber-optic probe is attached to a camera head. The probe is inserted through a single-use access and delivery catheter that can be steered in four directions to access and inspect the treatment area. This provides four-way steerability and dedicated irrigation channels in additional to a 1.2mm working channel through which diagnostic and therapeutic devices can be used.
  • Preparing for ERC procedures.
    • The patient's upper G.I. tract must be empty - no eating or dinking is allowed 8 hours before your procedure. Smoking and chewing gum is also prohibited during this time. Driving is not permitted for 12-24 hours after your procedure to allow sedatives time to completely wear off. Patients should make plans or a ride home prior to procedure
      • Nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen (Advil), and naproxen (Aleve).
      • Blood thinners
      • High blood pressure medications
      • Diabetes medications
      • Antidepressants
      • Dietary supplements
      • Patients should tell their healthcare provider about all health conditions, especially heart and lung problems, diabetes and allergies, along with all medications you take. Patients may be asked to temporarily stop taking medications that affect blood clotting or interact with sedatives, which are usually given during ERCP to help patients relax and stay comfortable. Medications that may be restriced are:
  • After ERCP
    • Patients are moved to recovery where they are monitored for 1 hour. The use of sedatives during procedure may cause patients to have a reduced memory of events during and after the procedure. During this time, patients may feel bloated or nauseous. Patients may also experience a sore throat, which can last for up to 48 hours. Patients can go home after sedatives wear off. Patients will likely feel tired and should plan to rest for the remainder of the day. 
    • Risks associated with ERCP:
      • Significant risks include:
        • Infection
        • Pancreatitis
        • Allergic reaction to sedatives
        • Excessive bleeding, called hemorrhage
        • Puncture of the G.I. tract or ducts
        • Tissue damage from radiation exposure
        • Death, in rare circumstances. 
        • When ERCP is performed by an experienced doctor, complications occur in about 6-10 percent of patients and these often require hospitalization. Patients who experience any of the following should contact their doctor immediately:
          • Swallowing difficulties
          • Throat, chest or abdominal pain that worsens
          • Vomiting
          • Bloody or dark stools
          • Fever

PRIOR TO PROCEDURE

Clear Liquid Diet

These are ok to eat or drink:

• Soda pop, ginger ale, and club soda
• Black coffer (no cream or sugar)
• Apple juice
• Clear sports drinks
• Tea
• Jell-O
• Popsicle
• Honey
• Clear Broth
• Bouillon

*It is important while you are on the clear liquid diet that you do not drink anything that has red, orange or purple color.

These are not ok to eat or drink

• Breads, grains, rice or cereal
• Soup with chunks of food
• Meat
• Dairy Products
• Vegetables
• Fruit
• Milkshakes
• Coffee with cream
• Pineapple Juice
• Orange Juice
• Milk or dairy drinks
• 2 days prior to procedure avoid the following:
  • Nuts
  • Seeds
  • Raw vegetables

***You should continue your blood pressure medication, seizure medication, and aspirin unless instructed not to***

Medications:

Prior to procedure, the following must be stopped at least 3-5 days. Contact provider for specific instructions.

• Vitamins
• Blood thinners-contact your prescribing doctor before stopping
• Iron pills
• Stool formers (Imodium, fiber supplements)
• Please bring a list of your current medicines and doses the day of your procedure.

Other Instructions

If you have a Pacemaker to Internal Defibrillator: Please bring your device information card with you on the day of the procedure. Give the device card to your assigned nurse at check-in. Your doctors will need to know your device brand name.

Patients with Diabetes

• Check your blood sugar the morning of your procedure.
• Important tips to prevent low blood sugar: During the clear liquid day, drink protein. A good source of protein is clear chicken, beef, or vegetable broth. Keep glucose tablets on hand for any sudden drop of blood sugar.
• Contact your endocrinologist or Primary Care Physician for further instructions.

DAY OF YOUR PROCEDURE:

• You will receive anesthesia medicines during this procedure to make you comfortable and sleepy. The medicines are given through an IV (a soft flexible tube in your arm)
• Since you will receive anesthesia medications, you may not drive home.
• You must have a responsible adult 18 years or older with a valid driver’s license who is on-site through your entire procedure.
• If your companion does not stay on site, you will need to reschedule your procedure.
• We recommend that an adult stay with you for several hours after your procedure.
• You may not drive for 24 hours after your procedure.

***We strive to perform the safest and most careful procedure for every patient. A procedure may take longer for some patients than for others. As a result, your procedure may not be performed at the exact time you were scheduled. We ask for your patience. Please at least 3 to 4 hours for your visit.***

If you use a Continuous Positive Airway Pressure (CPAP) or Bi-level Positive Airway Pressure (BiPAP0 machine to help you sleep: Bring your machine and mask with you. These may be used after the procedure.

St. Bernards Gastroenterology Doctors perform procedures at several locations:

Outpatient Surgery Center of Jonesboro
1100 East Matthews Avenue
Jonesboro, AR 72401
870.935.8500

St. Bernards Medical Center
225 East Washington Avenue
Jonesboro, AR 72401
870.207.7300

St. Bernards CrossRidge Community Hospital
310 North Falls Boulevard
Wynne, AR
870.238.3300

St. Bernards Five Rivers Medical Center
2801 Medical Center Drive
Pocahontas, AR 72455
870.892.6000

Great River Medical Center
1520 North Division Street
Blytheville, AR 72315
870.838.7300

Call 870.336.0472 for questions about your appointment or preparation.