1.

Endoscopy
2. Gastroscopy
3. Sigmoidoscopy
4. Proctoscopy
5. Colostomy Care
6. leostomy Care
v|th the rocedure hnown o:
qo:tro|nte:t|no| endo:coy, o
doctor |: ob|e to :ee the |n:|de
||n|nq of your d|qe:t|ue troct. 1h|:
exom|not|on |: erformed u:|nq
on endo:coe-o f|ex|b|e
f|berot|c tube w|th o t|ny 1V
comero ot the end.
1he comero |: connected to
e|ther on eye|ece for d|rect
u|ew|nq or o u|deo :creen thot
d|:|oy: the |moqe: on o co|or
1V. 1he endo:coe not on|y
o||ow: d|oqno:|: of
qo:tro|nte:t|no| (C|) d|:eo:e but
treotment o: we||.
1he C| endo:coy rocedure moy be
erformed on e|ther
on outot|ent or |not|ent bo:|:.
1hrouqh the endo:coe, o doctor
con euo|uote :euero| rob|em:, :uch
o: u|cer: or mu:c|e :o:m:. 1he:e
concern: ore not o|woy: :een on
other |moq|nq te:t:. ndo:coy ho:
:euero| nome:, deend|nq on wh|ch
ort|on of your d|qe:t|ue troct your
doctor :eeh: to |n:ect.
1ye: of ndo:coy
Uer C| ndo:coy
1.Esophagus
2.Stomach
3.Duodenum
Lower C| ndo:coy
1.CoIon
2.Rectum
3.Sigmoid
4.Anus
wbot prebIemt co upper 0I edetcepy detectt
Uer C| endo:coy con detect
. u|cer:
. obnormo| qrowth:
. reconcerou: cond|t|on:
. bowe| ob:truct|on
. |nf|ommot|on
. h|oto| hern|o
wbe It upper 0I edetcepy utedt
Uer C| endo:coy con be u:ed to determ|ne the cou:e of
. obdom|no| o|n
. nou:eo
. uom|t|nq
. :wo||ow|nq d|ff|cu|t|e:
. qo:tr|c ref|ux
. unex|o|ned we|qht |o::
. onem|o
. b|eed|nq |n the uer C| troct
wbot prebIemt co o Iewer 0I terIet detectt
|ower C| :er|e: con detect rob|em: of the |orqe |nte:t|ne,
|nc|ud|nq
.o|y:
.d|uert|cu|o-bu|qe: |n the |nte:t|no| wo||
.concerou: qrowth:
.u|cer:
.f|:tu|oe-obnormo| oen|nq: |n the |nte:t|no| wo|| thot |eod to the
obdom|no| cou|ty, other orqon:, or the :h|n': :urfoce
.|nf|ommot|on
wbe It o Iewer 0I terIet utedt
|ower C| :er|e: con be u:ed to he| determ|ne the cou:e of
.chron|c d|orrheo
.recto| b|eed|nq
.obdom|no| o|n
.chonqe: |n bowe| hob|t:
.unex|o|ned we|qht |o::
. 1he doctor w||| ex|o|n the rocedure to the ot|ent |nc|ud|nq the
o::|b|e r|:h: ond other :urq|co| rocedure.
2. 1he doctor w||| :ecure the |nformed con:ent.
1. 1he ot|ent :hou|d be NO for s hour: r|or to the exom|not|on.
4. Remoue o|| denture: ond eyeq|o::e: r|or to beq|nn|nq on
endo:coy.
s. ot|ent mu:t weor |oo:e f|tt|nq c|oth|nq.
. ot|ent: :hou|d te|| the|r doctor obout o|| heo|th cond|t|on: they
houe-e:ec|o||y heort ond |unq rob|em:, d|obete:, ond
o||erq|e:- ond o|| med|cot|on: they ore toh|nq.
1. ot|ent |: q|uen |oco| one:thet|c qorq|e or :roy to numb the
throot ond reuent qoqq|nq.
lor Lower Cl LxamlnaLlons
1. Rectum ond co|on :hou|d be c|eoned of o|| feco| motter.
uen o :mo|| omount of fece: con reduce re||ob|||ty of the
te:t.
s. 1he ot|ent chonqe your d|et r|or to the te:t-no f|ber: or
food: w|th :mo|| :eed: for s- doy: before the exom|not|on.
9. ot|ent moy be q|uen |oxot|ue: 2-s hour: before the
te:t. ot|ent w||| be o:hed to dr|nh u to 4 ||ter: (obout 4
qt) of o :ec|o| c|eon:|nq :o|ut|on to c|eon out the co|on.
Vou moy be q|uen or 2 ||tt|e enemo: 2-1 hour: before the
rocedure.
.1he doctor moy erform o recto| exom|not|on to detect
norrow|nq:, o|y: or obnormo| qrowth, or h|dden b|eed|nq
from your |ower |nte:t|ne
&pper GI Endoscopy
ower GI Endoscopy
After the rocedure
-|f you houe been :edoted, you w||| be moued to
o recouery oreo to wohe u.
-Once :edot|on ho: worn off, before you ore
d|:chorqed from med|co| center, you w||| be
q|uen |n:truct|on: ond to|d to co|| your doctor |f
com||cot|on: deue|o.
-Vou :hou|d houe :omeone there to tohe you
home. Vou :hou|d not dr|ue o cor or u:e other
moch|nery or dr|nh o|coho| for ot |eo:t o doy.
Vou moy fee| drow:y.
-t home, |t wou|d be be:t to houe o ||qht meo|
ond re:t for the remo|nder of the doy.
R|:h ofter the exom|not|on:
. bnormo| reoct|on to :edot|ue:
2.cc|dento| uncture of the C|
troct.
1.Con:t|ot|on
4.owe| Ob:truct|on
s.erforot|on
Co:tro:coy |: on exom|not|on of the |n:|de
of the qu||et, :tomoch ond duodenum. |t |:
erformed by u:|nq o th|n, f|ex|b|e f|ber-
ot|c |n:trument thot |: o::ed throuqh the
mouth ond o||ow: the doctor to :ee
whether there |: ony domoqe to the ||n|nq
of the e:ohoqu: (qu||et) or :tomoch, ond
whether there ore ony u|cer: |n the
:tomoch or duodenum.
. reore o|| the equ|ment:.
2. x|o|n the rocedure to the ot|ent |nc|ud|nq the
o::|b|e r|:h: ond other :urq|co| rocedure.
1. Obto|n the |nformed con:ent.
4. 1he ot|ent :hou|d be NO for s hour: r|or to the
exom|not|on.
s. Remoue o|| denture: ond eyeq|o::e: r|or to
beq|nn|nq on qo:tro:coy.
. ot|ent :hou|d weor |oo:e f|tt|nq c|oth|nq.
1. ot|ent |: q|uen |oco| one:thet|c qorq|e or :roy to
numb the throot ond reuent qoqq|nq.
ur|nq the rocedure
Fo||ow|nq :edot|on, ot|ent |: |oced |n the |eft |otero| decub|tu: o:|t|on
(o|thouqh :ucce::fu| |ntubot|on |: o::|b|e |n other o:|t|on:). ho||ow
mouth|ece |: |n:erted to rotect the ot|ent': teeth ond foc|||tote |n:trument
o::oqe. 1he endo:coe |: :|ow|y oduonced oro||y ond |: ":wo||owed" by the
ot|ent. Once o:t the cr|cohorynqeo| req|on the |n:trument |: qu|ded on|y
under d|rect u|:uo||zot|on. n |mortont |ondmorh |: the Z-||ne ot the
qo:troe:ohoqeo| junct|on, orox|mote|y 4 cm from the teeth. 1he t| |: then
oduonced |nto the cord|o, w|th qent|e |n:uff|ot|on of o|r. 1he uor|ou: ort|on: of
the :tomoch ore |n:ected - cord|o, fundu:, qreoter ond |e::er curuoture,
ontrum. Fo||ow|nq thu:, the t| |: then o::ed throuqh the y|oru:, |nto the
duodeno| bu|b, ond :omet|me: o: for o: the de:cend|nq ort|on of the
duodenum. Muco:o| :urfoce: ore re|n:ected o: the |n:trument |: w|thdrown.
|o:|e:, cyto|oq|c bru:h|nq:, o|yectomy, couter|zot|on of b|eed|nq |e:|on:, etc,
ore erformed o: |nd|coted.
After the rocedure
-|f you houe been :edoted, you w||| be moued to
o recouery oreo to wohe u.
-Once :edot|on ho: worn off, before you ore
d|:chorqed from med|co| center, you w||| be
q|uen |n:truct|on: ond to|d to co|| your doctor |f
com||cot|on: deue|o.
-Vou :hou|d houe :omeone there to tohe you
home. Vou :hou|d not dr|ue o cor or u:e other
moch|nery or dr|nh o|coho| for ot |eo:t o doy.
Vou moy fee| drow:y.
-t home, |t wou|d be be:t to houe o ||qht meo|
ond re:t for the remo|nder of the doy.
$|qmo|do:coy |: o med|co| exom|not|on of the
|orqe |nte:t|ne from the rectum throuqh the |o:t ort
of the co|on. 1here ore two tye: of
:|qmo|do:coy, 1IexIbIe tIgmeIdetcepy, wh|ch u:e:
o f|ex|b|e endo:coe, ond rIgId tIgmeIdetcepy,
wh|ch u:e: o r|q|d deu|ce. F|ex|b|e :|qmo|do:coy |:
qenero||y the referred rocedure. :|qmo|do:coy |:
:|m||or but not the :ome o: o co|ono:coy.
:|qmo|do:coy on|y exom|ne: u to the :|qmo|d, the
mo:t d|:to| ort of the co|on, wh||e co|ono:coy
exom|ne: the who|e |orqe bowe|.
. reore o|| the equ|ment:.
2. x|o|n the rocedure to the ot|ent |nc|ud|nq
the o::|b|e r|:h: ond other :urq|co| rocedure.
1. Obto|n the |nformed con:ent.
4. 1he ot|ent requ|re: ||m|ted bowe|
reorot|on, |nc|ud|nq enemo unt|| return: ore
c|eor.
s. |etory re:tr|ct|on: ore not nece::ory ond
:edot|on u:uo||y |: not requ|red.
. ot|ent mu:t weor |oo:e f|tt|nq c|oth|nq.
&#IH0 7HE #E&#E
ur|nq the te:t, you ore o:|t|oned on your |eft :|de w|th
your hnee: drown u toword your che:t. qo:troentero|oq|:t or
:urqeon w||| erform the te:t. F|r:t, the doctor doe: o d|q|to|
recto| exom by qent|y |n:ert|nq o q|oued ond |ubr|coted f|nqer
|nto the rectum to chech for b|ochoqe ond to d||ote (qent|y
en|orqe) the onu:.
Next, the :|qmo|do:coe -- o ho||ow tube throuqh wh|ch the
doctor con :ee-- |: |n:erted |nto the rectum. |r |: |ntroduced
|nto the co|on to exond the oreo ond he| the doctor :ee
better. 1he o|r moy cou:e the urqe to houe o bowe| mouement.
1he :|qmo|do:coe |: oduonced, u:uo||y o: for u o: the :|qmo|d
co|on or de:cend|nq co|on. 1hen, o: the :coe |: :|ow|y remoued,
the ||n|nq of the bowe| |: corefu||y exom|ned. 1he ho||ow
chonne| |n the center of the :coe o||ow: for the o::oqe of
force: for toh|nq b|o:|e: or for other |n:trument: for theroy.
fter the rocedure, you moy
exer|ence m||d obdom|no|
crom|nq ond qo: o: o re:u|t of
the o|r thot wo: |oced |n your
|nte:t|ne. $ome eo|e moy houe
:||qht recto| b|eed|nq due to m|nor
|rr|tot|on ond troumo from
the |n:ert|on of the :|qmo|do:coe.
rocto:coy |: o common
med|co| rocedure |n wh|ch on
|n:trument co||ed o rocto:coe
(o|:o hnown o: o recto:coe,
o|thouqh the |otter moy be o b|t
|onqer) |: u:ed to exom|ne the
rectum.
. reore o|| the equ|ment:.
2. x|o|n the rocedure to the ot|ent |nc|ud|nq
the o::|b|e r|:h: ond other :urq|co| rocedure.
1. Obto|n the |nformed con:ent.
4. 1he ot|ent requ|re: ||m|ted bowe|
reorot|on, |nc|ud|nq enemo unt|| return: ore
c|eor.
s. |etory re:tr|ct|on: ore not nece::ory ond
:edot|on u:uo||y |: not requ|red.
. ot|ent mu:t weor |oo:e f|tt|nq c|oth|nq.
fter the rocedure, you moy
exer|ence m||d obdom|no|
crom|nq ond qo: o: o re:u|t of
the o|r thot wo: |oced |n your
|nte:t|ne. $ome eo|e moy houe
:||qht recto| b|eed|nq due to m|nor
|rr|tot|on ond troumo from
the |n:ert|on of the rocto:coe.
|: o :urq|co| creot|on of on
oen|nq (|.e. :tomoch) |nto
the co|on. |t con be creoted o:
o temorory or ermonent
feco| d|uer:|on. |t o||ow: the
dro|noqe or euocuot|on of
co|on content: to the out:|de
of the body.
#eotet 1er er1ermIg o eIettemy
. vhen fece: connot roqre:: noturo||y from
the co|on to the onu:
2. vhen |t |: more de:|rob|e or monoqeob|e
to d|uert the fece:, o: for oro|eq|c:
1. |n ony cond|t|on where the rectum or onu:
|: nonfunct|ono| becou:e of d|:eo:e, o b|rth
defect or o troumot|c cond|t|on.
4.|t |: erformed to d|uert the feco| f|ow
owoy from on oreo of |nf|ommot|on or
oround on oerot|ue oreo
!roducts used in CoIostomy !roducts used in CoIostomy
ouch @ere are a varleLy of slzes and sLyles of colosLomy pouces ouces are
llgLwelgL and odorproof ouces ave a speclal coverlng LaL prevenLs Le
pouc from sLlcklng Lo Le body Some pouces also ave carcoal fllLers wlc
release gas slowly and elp Lo decrease gas odor @e followlng ls general
lnformaLlon abouL Lypes of colosLomy pouces
1 enended ouch @ls Lype of pouc allows you Lo open Le boLLom of Le
pouc Lo draln Le ouLpuL @e open end ls usually closed wlL a clamp @e
openended pouc ls usually used by people wlL ascendlng or Lransverse
colosLomles @e ouLpuL from Lese colosLomles ls looser and ls unpredlcLable
(does noL draln aL regular Llmes)
C|oseended ouch @ls Lype of pouc ls removed and
Lrown away wen Le pouc ls fllled Closeended pouces are
usually used by people wlL a descendlng or slgmold colosLomy
@e ouLpuL from Lese Lypes of colosLomles ls flrm and does noL
need Lo be dralned
3 neece A oneplece pouc
conLalns Le pouc and adeslve skln
barrler LogeLer as one unlL @e
adeslve skln barrler ls Le parL of Le
pouc sysLem LaL ls placed around Le
sLoma and aLLaced Lo skln Wen Le
pouc ls removed and replaced wlL a
new one Le new pouc musL be
reaLLaced Lo Le skln
toma covers and cas SLoma caps or covers can be placed on Le sLoma wen
Le sLoma ls noL acLlve (dralnlng) eople wlL descendlng or slgmold
colosLomles wo lrrlgaLe may use sLoma covers or caps @e cover or cap ls
aLLaced Lo Le skln ln Le same way as a pouc
ectnbased aste or aste
strs]rngs @ese producLs are
elpful for proLecLlng skln agalnsL
ouLpuL LaL conLalns dlgesLlve
enzymes (proLelns LaL break down
foods) Ascendlng or Lransverse
colosLomles can produce ouLpuL LaL
conLalns dlgesLlve enzymes wlc
can lrrlLaLe or damage Le skln @e
pasLe ls also used Lo creaLe a flaL
pouc surface by fllllng ln small skln
creases
CoIostomy Changing CoIostomy Changing
Assessment
WldenLlfy Le Lype of osLomy Le paLlenL as and lLs locaLlon (8owel urlnary
ulverslon)
WAssess Le skln lnLegrlLy around Le sLoma and as general appearance
WnoLe Le amounL and caracLer of any fecal maLerlal or urlne ln Le pouc
ueLermlne weLer Le paLlenL ls belng LaugL selfcare aL Le momenL
|annng
1 Was your ands
2 CaLer Le equlpmenL needed ln canglng a pouc or dresslng
WCleanslng supplles lncludlng Llssues warm waLer mlld soap was cloL and a Lowel
WClean pouc of Le Lype currenLly belng used
WSeal or use Lape Lo prevenL leakage
WClean belL
Wuresslng maLerlals
W8ecepLacle for Le solled pouc or dresslng (bedpan paper bag/newspaper for
wrapplng)
WroLecLlve spray
WClean gloves
3 ueLermlne weLer Le paLlenL ls Lo parLlclpaLe acLlvely
4 Coose Le approprlaLe locaLlon ln performlng Le procedure (baLroom/
bedslde)
CoIostomy Changing CoIostomy Changing
lmplemenLaLlon
1 ldenLlfy Le paLlenL
2 Lxplaln Le procedure Lo Le paLlenL
3 uL on clean gloves for lnfecLlon
4 AsslsL Le paLlenL Lo Le baLroom or provlde prlvacy
3 8emove Le solled dresslng
6 uslng warm waLer and a mlld soap cleanse Le skln around Le sLoma
Lorougly lnspecL Le skln for redness or lrrlLaLlon
7 Cover Le sLoma wlL a Llssue Lo prevenL feces or urlne from conLacLlng Cange
Llssues as necessary durlng Le procedure
8 ury Le skln around Le sLoma carefully paLLlng genLly
9 Apply a skln proLecLlve spray lf needed
10 Allow Le skln Lo dry Lorougly so Le pouc wlll adere flrmly (a alr dryer on
a low seLLlng aL leasL 18 lnces from Le skln may be used)
11 8emove Le Llssue from Le sLoma and apply Le clean pouc or dresslng
12 8emove gloves and was ands
CoIostomy !ouch Draining CoIostomy !ouch Draining
1 LmpLy Le pouc wen lL ls oneLlrd Lo onealf full uo
noL walL unLll Le pouc ls compleLely full because Lls
could puL pressure on Le seal causlng a leak @e
pouc may also deLac causlng all of Le pouc
conLenLs Lo splll
2 lace LolleL paper lnLo Le LolleL Lo reduce splas back
and nolse
3 @ake Le end of Le pouc and old lL up 8emove Le
clamp (lf Le pouc as a clamp sysLem)
4 ?ou may need Lo make a cuff aL Le end of Le pouc Lo keep lL from
geLLlng solled
3 uraln Le pouc by squeezlng Le pouc conLenLs lnLo Le LolleL
6 Clean Le cuffed end of Le pouc wlL LolleL paper or a molsL paper
Lowel ?ou may also rlnse Le pouc buL lL ls noL necessary Make sure
and keep Le end of Le pouc clean
7 undo Le cuff aL Le end of Le pouc 8eplace Le clamp or close Le
end of Le pouc accordlng Lo your careglvers lnsLrucLlons
Co|o:tomy core
n ||eo:tomy |: o :urq|co||y-creoted oen|nq |n
the obdomen throuqh wh|ch the end of the
||eum |: brouqht u to the :urfoce of the :h|n.
1h|: new oen|nq, co||ed o :tomo , o||ow: wo:te
to o:: d|rect|y out of the body, byo::|nq o
d|:eo:ed or domoqed :ect|on of the co|on. |n
mony co:e:, the co|on |: remoued. |t: funct|on,
reob:orb|nq woter ond e|ectro|yte:, w||| be
corr|ed out to :ome deqree by the :mo||
|nte:t|ne.
||eo:tomy core |: :ome
o: co|o:tomy core. 1he
tye: of ouch u:ed
were the :ome. 1hey
ju:t d|ffer |n the
|ocot|on of the :tomo.
||eo:tomy core
1H N