What is EUS?

Endoscopic Ultrasonography (EUS) allows your doctor to examine your esophageal and stomach linings as well as the walls of your upper (esophagus, stomach, duodenum) and lower (colon and rectum) gastrointestinal tract. Other organs near the gastrointestinal tract such as the liver, lungs, gall bladder, and pancreas can also be studied using EUS.

Your doctor will insert a thin, flexible tube called an endoscope that has a built-in miniature ultrasound probe into your mouth or anus, depending on the test ordered, to the area to be examined. The ultrasound waves will be used to create visual images of the digestive tract.

Why is EUS done?

EUS provides your doctor with detailed images of the digestive tract which can be used to diagnose certain conditions that may cause abdominal pain or weight loss.

EUS is also used to evaluate abnormalities such as lumps or lesions detected by prior endoscopy or x-rays. It provides a detailed image of the lump or lesion, which can help your doctor determine its origin and assist with treatment decisions. When other tests are conflicting or inconclusive, EUS can be used to diagnose diseases affecting the pancreas, bile duct, and gallbladder.

EUS is also used to assist your doctor in determining the extent of spread of certain cancers of the digestive or respiratory systems. The depth of a cancer and whether it has spread to adjacent lymph nodes or nearby vital structures can be accurately determined using EUS. In some cases, EUS is used to obtain a needle biopsy (tissue sample) of a lump or lesion.

How should I prepare for EUS?

For an upper EUS, the preparation consists of nothing to eat or drink for six hours prior to the procedure. Your doctor will notify you when to start fasting and give you any additional instructions.

For a lower EUS, you will need to have a clear colon. To clean out your colon you will be given instructions specifically chosen for you. These instructions will include information on special diet, laxative use, and medications.

It is important pre-procedure instructions are followed to ensure your procedure can proceed as scheduled.

What about my medications and allergies?

Notify the doctor of all the medications you are taking. Most medications can be continued as usual, but some medications may need to be adjusted or stopped temporarily prior to the exam. The doctor’s office will discuss any medication changes with you prior to the EUS.

It is important to inform your doctor of all your allergies including any allergies to latex.

Do I need to take antibiotics?

Your doctor may prescribe antibiotics if you are having a specialized EUS, such as having a cyst or fluid collection drained.

What can I expect during EUS?

You will be given sedation through an IV by a nurse or anesthesia professional to make you comfortable. You will begin lying on your left side and the doctor will pass the ultrasound endoscope though your mouth or anus depending on which procedure you are having. The endoscope does not interfere with your ability to breath during an upper exam.

Most procedures take 45 to 60 minutes but can last as long as 2 hours if biopsies or drainage of a cyst is performed.

What can I expect after EUS?

You will be monitored in the recovery area until most of the sedative medication’s effects have worn off. You might feel bloated because of the air and water introduced during the procedure and if you had an upper EUS, you may experience a sore throat.

Unless you are instructed otherwise, you may eat after you leave.

Your doctor will notify you of the findings, but any test or tissue sample results may take several days.

It can take up to a full day for the effects of the sedation to wear off. Because of the sedation, you will need to have someone to take you home and you are not to go back to work for the rest of the day.

What are the possible complications of EUS?

Complications are rare when doctors with specialized training and experience perform the EUS examination. Although rare, complications can occur and they include:

  • Bleeding at a biopsy site (usually minimal and rarely requires follow-up)
  • Slight sore throat for a day or two
  • Reaction to the sedation
  • Aspiration of your stomach contents into your lungs
  • Infection
  • Complications from underlying medical conditions
  • Perforation (may require surgical repair)

If a needle biopsy is performed, the risk of complications, including infection and pancreatitis, increases slightly.

Your doctor will discuss your risk for complications before the procedure.