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Services / Procedures

At the California Digestive Diseases Institute, we provide specialized services for a wide range of gastrointestinal conditions, including Hepatitis C treatment and Anemia. You can rest assured in the knowledge that our GI team will provide you with the most comfortable experience throughout your entire procedure. Below are educational tools of the procedures and services we provide. If you have any additional questions or concerns, feel free to contact our office at 310.556.7747.


Will ERCP be painful?
The procedure itself will not cause you pain since you are sedated and asleep during the procedure. Sphincterotomy and dilatation of strictures may cause abdominal pain following the procedure. If this is occurs, we will provide you with adequate pain medication.

Can I eat or drink before the procedure?
No. You should not have any food or water for at least six hours prior to your procedure, generally speaking from midnight, the evening prior to the procedure. You may have a small sip of water with important medications, but please discuss with the nurse practitioner prior to doing so.

May I go home after the procedure?
Please discuss with your physician.

When can I return to work after ERCP?
Please discuss with your physician.

Will I have to take medication after the ERCP procedure?
You will be given pain medication to use should you need it. You will also probably be given either oral or intravenous antibiotics for approximately three to five days following the procedure.

When do I have to come back for a follow-up visit?
Generally speaking we like to see you in one to two weeks for a follow-up visit to see how you are feeling and to review the findings with you. This will in part depend on how far away you live from our office, and other plans we may have in the future for your medical management.

If I have stents placed, when do they need to be removed?
Generally speaking we like to see you in one to two weeks for a follow-up visit to see how you are feeling and to review the findings with you. This will in part depend on how far away you live from our office, and other plans we may have in the future for your medical management.

EUS (Endoscopic Ultrasound)

EUS (endoscopic ultrasound) combines the art of endoscopy with sonography. Currently, EUS is the gold standard for staging of most gastrointestinal (GI) and some non-GI malignancies, including esophagus, pancreas, stomach, rectal, cholangiocarcinoma (bile duct cancer) and lung cancer. A combination of EUS/FNA (fine needle aspiration) allows us to sample some of the tumors and lymph nodes that formerly were not reachable except by a surgical approach. This allows for tumors to be diagnosed and staged faster, less invasively, and more accurately. Accurate staging prevents many unnecessary surgeries and channel patients much faster for appropriate therapy.


What are the indications for EUS (Endoscopic Ultrasound)?

  1. Tumor staging and diagnosis
  2. Diagnosis of pancreatitis or common bile duct stones
  3. Celiac plexus nerve block to treat pain (in patients with chronic pancreatitis or pancreatic cancer pain)
  4. Drainage of pseudocysts
  5. Evaluation of upper abdominal pain

How is the EUS performed?
EUS is the most advanced technology using ultrasound scanning with an endoscope to evaluate various structures within the gastrointestinal tract.  An endoscope is a flexible tube that works like a video camera.  It is passed through your mouth into your stomach.  If the area of concern is in the rectum, the endoscope is passed from the rectum into the large intestine.  The doctor can examine tissue underneath the surface lining of the gut.

How long is the EUS procedure?
The procedure itself usually lasts about an hour.  You should expect to spend about 2-3 hours in the endoscopy unit.

Does this procedure require sedation?
Yes.  Patients who undergo the EUS will require sedation, which is given by an anesthesiologist.  Patients are monitored throughout the procedure.  After the patient is recovered from the sedation, the patient is discharged home on the same day.

Is there any pain associated with the EUS?
No.  Your doctor may take samples of tissue (biopsy) for examination or inject medications through the endoscope.  None of these actions should cause you any pain.  You may experience a sore throat after the procedure.

What are potential complications from EUS?
Complications from the EUS are very rare.  The potential complications include infection, gut perforation, pancreatitis, aspiration, or bleeding can occur with this procedure.

Are there any antibiotics given during the EUS?
If your doctor performs a fine needle aspiration (FNA) where samples of the tissue are taken for microscopic examination by a use of a needle, you will receive antibiotics through the IV (intravenous) prior to the procedure.

Is there any diet restrictions prior or after the EUS?
No special diet is necessary on the day before the procedure.  Do not eat or drink anything after midnight the night prior to the procedure.  If your doctor needs to perform this procedure to examine the rectum, you will be given a laxative or an enema the night before the procedure.

Should I stop my medications before the procedure?
If you are taking any blood thinners or any medications for diabetes or for heart disease, please let your doctor know so that he can advise what medications you should continue and what medications you should stop prior to the procedure.

Dr. Mehrdad Vosoghi is a board certified gastroenterologist who has been trained in ERCP and EUS.  He has performed numerous EUS at Olympia Medical Center.  With this advanced diagnostic and therapeutic method, numerous cancers are caught early and referrals are made timely.



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