Endoscopic Ultrasound: Procedure, Preparation and Results

An endoscopic ultrasound (EUS) is an internal imaging procedure that provides your healthcare team with important information about your digestive or gastrointestinal tract and other nearby internal organs. This article will examine what an endoscopic ultrasound is and why you might have one, what to expect when the procedure is performed, how to prepare, and how to access and understand your results.

 

 

What is an endoscopic ultrasound?

An endoscope is a thin and flexible tube tipped with a small camera and a light that can be inserted into the digestive tract. A tiny ultrasound device on the end of the probe emits high-frequency sound waves which bounce off your internal organs, tissues and blood vessels. The ultrasound device captures and translates these ‘echoes’ as live images.

 

Why would a doctor order an endoscopic ultrasound?

Endoscopic ultrasonography is ordered to diagnose, identify or monitor the treatment of conditions located in or near the digestive tract, including the following:

• Bile duct/s
• Esophagus
• Gallbladder
• Liver
• Lungs
• Nearby lymph nodes
• Pancreas

An upper endoscopic ultrasound explores organs and tissues in the upper gastrointestinal tract, including the esophagus, stomach, small intestine, pancreas, bile ducts, gall bladder and all the associated blood vessels and lymph nodes.

A lower endoscopic ultrasound examines the organs and tissues in the bottom part of the digestive system, such as the large intestine, anal sphincter and the blood vessels and lymph nodes located nearby.

 

What is an endoscopic ultrasound used for?

In addition to investigating persistent abdominal pain or digestive issues such as inflammatory bowel disease (IBD), endoscopic ultrasounds are also used to diagnose, evaluate or rule out:

• Cancer
• Cysts
• Dysphagia (problems with swallowing)
• Fissures or ulcers
• Gallstones or cholecystitis (inflamed gallbladder)
• Internal cancers (e.g. colon cancer, pancreatic cancer)
• Lesions and/or lumps
• Pancreatitis
• Peristalsis issues (the movement of food through the digestive system)

Sometimes endoscopic ultrasounds are also used to guide a small needle. Those needles might take tissue samples for biopsies, drain fluid or deliver medicine to specific internal sites.

 

How is an endoscopic ultrasound performed?

An endoscopic ultrasound is an outpatient procedure at an imaging clinic or hospital. Including set up, the procedure usually takes 60-90 minutes. A sedative or anesthesia will be administered, generally by IV, and you will lie on your left side on an exam table.

If you’re having an upper EUS procedure:

• You’ll be given a protective mouthguard to wear, and your throat will be sprayed with a numbing agent.
• The ultrasound endoscope will be inserted into your mouth and gently pushed down your esophagus through your stomach until it reaches your small intestine.
• The procedure can be uncomfortable, but it is not painful. You may not be conscious.
• The technician will move the ultrasound endoscope to examine the area of interest, emit sound waves and capture the required images.
• If a biopsy is part of your procedure, the doctor or technician will use the live image to properly place the needle.
• When the images are captured or the biopsy is performed, the ultrasound endoscope will be carefully withdrawn.
• After the ultrasound endoscope has been removed, your sedative or anesthesia will cease.
• You’ll have a short recovery period in a recovery room after the procedure.

If you’re having a lower EUS procedure:

• The ultrasound endoscope will be inserted through the anus.
• This procedure might cause discomfort, but it should not cause pain. You may be unconscious, or less than fully awake.
• The technician will carefully thread the ultrasound endoscope through your rectum into your large intestine, moving as needed, emitting sound waves to capture the required images.
• Biopsies are not often performed during lower endoscopic ultrasounds.
• When all the images are captured, the ultrasound endoscope will be gently withdrawn, and your sedative or anesthesia will be stopped.
• You’ll spend time in a recovery room after the procedure.

Both procedures involve sedatives or anesthesia. You should have someone accompany you to drive you home after the procedure and stay with you for a while.

 

How to prepare for an endoscopic ultrasound?

Because EUS procedures involve the digestive system, they require preparation. Check the preparation protocol with your hospital or imaging clinic and follow the steps faithfully.

Those steps will include instructions about:

• Fasting: You may need to refrain from eating for at least 6 hours before your procedure. Depending on the circumstances, it might be longer.
• Internal cleansing: Lower endoscopic ultrasounds require bowel cleansing. You’ll be given a preparatory solution to drink or laxatives to take at prescribed intervals. You might also have to follow a liquid diet for a short period.
• Medication: Inform your doctor and the imaging clinic about any medications you are taking, including vitamins and supplements. You may need to refrain from taking your medication before your procedure, for periods lasting anywhere from several hours to a week. Ask what medications you can safely take on the day of your procedure.
• Allergies: Inform your healthcare team if you have any allergies to sedatives, anesthetic agents or latex well before your procedure.

 

Getting my results

The hospital or imaging clinic will send the results of your endoscopic ultrasound to your referring physician, who will discuss them with you at a follow-up appointment.

When will I get my results?

If your endoscopic ultrasound was for imaging purposes only, the imaging clinic will usually send your results to your doctor within a few days. However, if your endoscopic ultrasound exam included a biopsy, your results will include a lab report about the tissue sample, which can take anywhere from several days to several weeks depending on your location.

PocketHealth gives you secure, early access to your images and reports, often as soon as they’re released. With early access, you will be fully informed and prepared for your follow-up appointment, and better able to discuss any next steps.

 

 

Who interprets my results?

Imaging results are normally interpreted by a radiologist in a written report. The report and the images are then sent to your referring physician or specialist.

The more you understand about your results, the more confident you will be going forward. PocketHealth’s My Care Navigator highlights any follow-up recommendations contained in your report and provides you with personalized questions to ask your doctor based on your report, to help direct discussion in your follow-up appointment.

Understanding my results

The result of your endoscopic ultrasound will include images and a report from the radiologist. Endoscopic images appear in shades of white, gray and black. We have an article to help you read your ultrasound images. If a biopsy was performed, a lab report will also be included.

When it comes to understanding the medical terms in your reports, PocketHealth can help. Report Reader provides definitions of complex terminology in simple language, giving you the knowledge you need to move forward.

A normal vs abnormal endoscopic ultrasound

In a normal endoscopic ultrasound, tissues and organs will present in normal size, shape, location and density. Any other presentation will be considered abnormal.

What abnormal means depends entirely on the findings in each specific situation. It could mean that more or other imaging tests are needed, new medication is suggested, a biopsy should be performed, or other actions should be taken.

 

Frequently asked questions

Are you awake during an endoscopic ultrasound?

You will receive either anesthesia or a sedative before an endoscopic ultrasound. With anesthesia, you will not be awake during the procedure. You might be awake with a sedative, depending on your susceptibility, but you will not be fully alert.

What are the side effects of an endoscopic ultrasound?

Endoscopic ultrasounds are considered safe procedures. You may have a slight sore throat or feel bloated after the procedure, but that should quickly pass.

Serious side effects are uncommon, but can include:

• An allergic reaction to the sedative or anesthesia (very rare)
• Aspiration in the lungs, if fluid from the mouth or stomach enters the lungs
• Bleeding caused by damage to the digestive tract
• Pancreatitis (if a needle is inserted into the pancreas during the procedure)
• Small tears in the intestinal wall

How long does it take to recover from an endoscopic ultrasound?

Though bed rest is not required, it is generally recommended that you relax and rest for 24 hours after an endoscopic ultrasound. You should be able to resume your normal level of activity the following day.

 

Take control of your health with PocketHealth

Your gastrointestinal tract and digestive system efficiently provide your body with the nutrients it needs to stay active and healthy. Proper digestion involves several different organs and processes, each of which can be subject to illness or injury. Endoscopic ultrasounds can help your healthcare team assess the function of your digestive tract to diagnose and treat any conditions or issues located within or in nearby organs or tissues.

PocketHealth keeps you up to date on your endoscopic ultrasound images and reports. With PocketHealth you are not only easily able to share your images with digestive specialists in diagnostic quality if needed, but you’ll also stay in the know and in control of your health journey.