Improving Diagnostic Accuracy

EMR is a technique used to obtain a larger and deeper specimen when compared to traditional biopsy during upper endoscopy (EGD). EMR allows for a larger specimen to be examined by the pathologist, which can improve the diagnostic accuracy of biopsies. EMR is less invasive than traditional surgery. EMR has higher bleeding and perforation risk than standard biopsies, but can be routinely done in a safe and effective manner in the outpatient setting.

EMR in Barrett's Esophagus

For areas within the Barrett's esophagus lining which are raised or depressed, and thus suspicious for cancer, a method called endoscopic mucosal resection (EMR) is used to remove the damaged lining. Using a snare delivered through an endoscope, tissue can be removed to a depth of about 2 mm and then evaluated to diagnose the seriousness of the disease. The benefit of EMR is that large biopsy specimens can be removed to render the lining flat. The disadvantage is that use of EMR for wide spread Barrett's has an unacceptable complication rate. Therefore, focal EMR for specific areas of concern has been followed 2 months later by BARRX-HALO to safely and effectively remove the remainder of the Barrett's esophagus.

What to Expect

Preparation for the Procedure
  1. I'm dizzy or have a headache, what should I do?

    Dizziness and headache could be signs of low blood sugar. Drinking a regular carbonated beverage (not diet) or apple juice may alleviate these symptoms.

  2. What if I start to feel nauseated or start vomiting?

    Wait 15-30 minutes before continuing prep then start back slowly. You may also take a Benadryl to help control the nausea.

  3. What is the best "clear" liquid to take?

    Gatorade, which comes in many flavors, is an excellent choice as it contains electrolytes such as potassium. Avoid RED/BLUE liquids. We also recommend beef and chicken bouillon made from cubes (not broth).

  4. Why avoid red/blue liquids?

    The color can persist in the colon and make an accurate diagnosis more difficult.

  5. Can I drink alcoholic beverages?

    We strongly suggest you do not drink any alcoholic beverages prior to your procedure since they can cause dehydration and some wines may thin your blood.

  6. Can I chew gum or suck candy?

    Yes, but nothing with soft centers or red color. No candy is allowed 4 hours prior to your procedure.

  7. I have been instructed not to take anti-inflammatories or blood thinners several days before the procedure. What can I take for headaches and pain relief?

    You may take Tylenol as directed.

Day of Procedure Questions
  1. What should I wear?

    Loose, comfortable clothing is recommended. You can wear make up but we advise patients not to wear jewelry. If you wear contacts please bring your case and solution so that you can remove them prior to your procedure.

  2. Can I drive myself home after the procedure?

    No, since sedatives are used, another driver is needed. This driver MUST stay during the procedure or the procedure will not be performed. This is for your personal safety. You may bring more than one person with you, but only one person can be with you in recovery due to space limitations.

  3. One of the medications I was instructed to take the morning of my procedure is red. Can I take it?

    Medication for blood pressure, heart conditions, and seizure should be taken the morning of your exam regardless of the color. Light blue and light pink medications are also fine for you to take.

  4. Can I brush my teeth?

    Yes.

  5. Can I wear my dentures?

    Yes, you may wear your dentures to the Endoscopy suite. However, you may be asked to remove them prior to the procedure.

  6. Why do I have to be there an hour before my scheduled procedure time? What if I am running late?

    We ask patients to arrive early so that we can do a pre-procedure assessment and start the IV. Please call 864.232.7338 if you are running more than 15 minutes late, so that we can work together to adjust the schedule so that we can accommodate this delay.

After the Procedure Questions
  1. I am still dizzy and lightheaded after my procedure, why?

    You may have residual anesthesia in your system, additional rest is recommended.

  2. May I go back to work after my procedure?

    No, please remain home the day of your procedure. Due to the sedatives, you may not think clearly for several hours. DO NOT DRIVE. You can return to work the day after your procedure, unless your physician specifically tells you otherwise.

  3. How do I get my results?

    Results are given by the doctor to you in the recovery room. You may or may not remember talking to the doctor so your results will also be in your discharge instructions. Pathology may take up to 2 weeks to get results.

    We have implemented our Patient Portal to enable you to receive your lab, pathology and radiology test results at your convenience. You may also ask your questions through the portal. 

    First - Get enrolled in the Portal at GastroAssociates.com

    Once Enrolled in the Portal, you will log into your account at nextmd.com

    For New Results: You will receive an email notice that new results are ready for your review. You will log into your Portal account to get those results. You must be enrolled within 3 days after your procedure for your results to be posted to the portal. 

    To Ask Questions, Request an Appointment or Request Copies of Previous Records: You will log into your Portal account and request those services. 


    **Please note: Enroll in our Patient Portal soon. Results can’t be sent automatically until you have created your portal account. If we have your email address, you will receive an email with the link to the enrollment site.