Dr. Jeffrey Shum MD, FRCSC, FACS
HPB Surgery & Critical Care Medicine

Endoscopy Information

Dr. Shum performs different types of endoscopic procedures for various conditions and indications. All procedures are completed in the Endoscopy Unit located on Level 2 at Health Sciences North. If you are unsure of the location, ask a volunteer at the main desk to escort you there.

 

After your procedure is completed, you will spend approximately 45 minutes in the recovery area and then be discharged home. Occasionally, there are circumstances in which hospital admission is required. Patients sedated with intravenous medications require someone to drive home. Dr. Shum will provide you with specific instructions prior to discharge.  

 

Colonoscopy

 

 

 

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Colonoscopy is a medical procedure that allows a physician to examine the inside of the colon (large intestine) using a long, flexible tube called a colonoscope. It is an effective diagnostic and therapeutic tool used to detect and treat various conditions affecting the colon.

 

Benefits
1. Early detection of colorectal cancer: Colonoscopy is considered the gold standard for detecting colorectal cancer and precancerous polyps. By identifying these abnormalities at an early stage, colonoscopy can help prevent the development of cancer or catch it in its early, more treatable stages.
2. Diagnosis of gastrointestinal conditions: Colonoscopy can assist in diagnosing various gastrointestinal disorders such as inflammatory bowel disease (IBD), diverticulosis, and Crohn's disease.
3. Removal of polyps: During colonoscopy, polyps can be detected and removed, reducing the risk of polyps developing into cancerous growths.
4. Evaluation of unexplained symptoms: If a person experiences unexplained symptoms such as abdominal pain, rectal bleeding, or changes in bowel habits, a colonoscopy can help identify the cause.
5. Surveillance for high-risk individuals: Individuals with a family history of colorectal cancer or certain genetic conditions may undergo regular colonoscopies for surveillance to detect and prevent the development of cancer.

 

Indications
1. Screening: Colonoscopy is recommended as a screening tool for individuals aged 45-75 (earlier for those with risk factors) to detect colorectal cancer and precancerous polyps.
2. Diagnostic evaluation: Colonoscopy is used when there are symptoms or indications of colon-related disorders, such as rectal bleeding, unexplained abdominal pain, changes in bowel habits, or anemia.
3. Surveillance: High-risk individuals, including those with a family history of colorectal cancer or certain genetic conditions, may require regular colonoscopies for surveillance.
4. Follow-up after previous findings: If a previous colonoscopy detected polyps or other abnormalities, a follow-up colonoscopy may be necessary to monitor and ensure proper management.

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Risks for Complications
1. Perforation: In rare cases, the colonoscope can cause a perforation or puncture in the colon wall, which may require surgery to repair.
2. Bleeding: Polyp removal or biopsies can occasionally cause bleeding, typically minor and manageable during the procedure. However, severe bleeding may occur in rare cases, requiring further intervention.
3. Adverse reactions to sedation: The use of sedation during colonoscopy carries some risks, such as allergic reactions or respiratory problems.
4. Incomplete examination: Difficulties in maneuvering the colonoscope or excessive bowel preparation may result in an incomplete examination, necessitating a repeat procedure.
5. Discomfort and bloating: Some individuals may experience temporary discomfort, bloating, or gas after the procedure due to the air introduced into the colon during the examination.

 

It is important to note that the benefits of colonoscopy generally outweigh the risks, and serious complications are rare. 

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Esophago-Gastro-Duodenoscopy (EGD)

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The EGD procedure involves examining the lining of the esophagus, stomach and duodenum with a flexible, fibre optic camera. Indications for EGD include:

• signs of upper GI bleeding from a gastric or duodenal ulcer

• difficulty swallowing, heart burn or symptoms of reflux disease

• anemia

• screening or surveillance for upper GI cancers

• bloating, dyspepsia and screening for H. pylori infection

• removal of a swallowed foreign body

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To prepare for the EGD, the stomach needs to be empty of solid food. Ensure that you have nothing to eat after midnight the day before the procedure. The EGD can be completed with topical anaesthetic to the oropharynx. If you are administered intravenous sedation you are not allowed to drive afterwards. Please ensure that you have a ride or a means to get home following your EGD.

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Endoscopic Retrograde Cholangio-Pancreatography (ERCP)

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The ERCP procedure involves examining the common bile duct, the pancreatic duct and surrounding structures with a side-viewing duodenoscope. Indications for ERCP include:

• signs and symptoms of obstructive jaundice from cancer or from gallstones

• insertion of temporary or permanent stents for bile duct obstruction

• bile leak after cholecystectomy

• biliary cirrhosis or sclerosing cholangitis

• ascending cholangitis

• periampullary lesions

• choledocholithiasis

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To prepare for the ERCP, the stomach needs to be empty of solid food. Ensure that you have nothing to eat after midnight the day before the procedure. ERCP requires conscious sedation which is administered by an anaesthesiologist. Please ensure that you have a ride or a means to get home following your ERCP.

 

ERCP has a specific risk of pancreatitis of up to 10%. This may require hospitalization. 

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