What is EUS?

An EUS procedure uses an endoscope with a tiny ultrasound unit on the end to provide more information than the camera on an endoscope can. An EUS procedure is particularly useful for providing additional detail of the gastrointestinal tract as well as nearby organs such as the lungs, liver, gallbladder and pancreas.

It’s performed while you are under sedation, and you’ll likely go home the same day as your procedure. The endoscope is used to examine the upper gastrointestinal tract (esophagus, stomach and duodenum) by entering through your mouth, or through the rectum to evaluate the lower gastrointestinal tract.

Board-certified and fellowship-trained gastroenterologists at Norton Healthcare Gastroenterology have been performing the EUS procedure in Louisville and Southern Indiana for years.

Frequent uses of the EUS procedure include examining:

• Known abnormalities (lumps, lesions) detected during previous endoscopy or on X-ray tests such as computed tomography (CT) scans or magnetic resonance imaging (MRI).
• Diseases of the pancreas, bile duct and gallbladder
• The extent of spread of certain cancers of the esophagus, stomach, rectum, ampulla and respiratory system. EUS can determine the cancer’s depth and if it has spread to adjacent lymph nodes, major blood vessels or other organs.
• Causes of abdominal pain and weight loss

The EUS procedure also allows your physician to collect a tissue sample with fine-needle aspiration for testing in the laboratory.

EUS also can treat conditions by delivering medication to a specific spot or allow drainage of the biliary system.

How to Prepare for an EUS

Your physician will provide you with instructions you will need to follow in the days before your procedure. Following these instructions is essential to limit surgery risks and provide the best results.

Make sure your providers are aware of all medications that you are taking, especially the following:

• Plavix (clopidogrel)
• Effient (prasugrel)
• Brilinta (ticagrelor)
• Ticlid (ticlopidine)
• Coumadin (warfarin)
• Eliquis (apixaban)
• Aggrenox (aspirin/dipyridamole)
• Pradaxa (dabigatran)
• Persantine (dipyridamole)
• Xarelto (rivaroxaban)

We will advise you to discontinue or adjust your dosage of these medications. We may have you consult with your primary care physician or cardiologist prior to your procedure. Also let us know of any allergies to medications.

If you are using insulin, the dosage or timing will also need to be adjusted the day of the procedure.

Refrain from eating anything starting the midnight before your procedure is scheduled.

For an EUS by colonoscopy, your cleansing routine or prep will start the day before your procedure. This laxative will prepare your bowels and is the most important part of your preparation. Following the instructions and having a good cleanse can decrease the need for an repeat colonoscopy.

Once you’ve recovered from the sedation, your physician will provide a preliminary report. Any biopsy results may take several days.

Because of heavy sedation, patients are instructed not to drive, operate machinery, or make important decisions for 24 hours. The nursing staff will review all of the instructions before you leave the hospital. You’ll need someone to drive you home.

After the procedure, you can drink clear liquids and then start with a bland diet. Generally, antibiotics are not required before but may be needed after an EUS procedure.

Call your physician if you get a fever, have trouble swallowing or have pain in the throat, chest or abdomen.

If you are unable to keep your appointment or need to reschedule, call our office at (502) 896-4711 at least 48 hours prior to your procedure.

If you are going to be late for your procedure, call the hospital’s endoscopy department. If you are scheduled at Norton Women’s & Children’s Hospital, call (502) 893-1277. If you are scheduled at Norton Brownsboro Hospital, call (502) 446-8200.