Depending on your clinical needs we can initiate the following diagnostic procedures
Diagnostic Procedures
Guaiac Fecal Occult Blood Test
Guaiac fecal occult blood testing (gFOBT) uses a reagent that changes color in the presence of human blood, animal blood, and other dietary sources. Test performance requires collection of samples from three consecutive stools. Samples can be obtained at home and mailed in to our office for processing and analysis. Randomized, controlled studies have shown statistically significant reductions in colorectal cancer incidence (17% to 20%) and mortality (15% to 33%) with regular gFOBT screening. Limitations of gFOBT screening are low sensitivity for advanced adenomas (11% to 41%). For any positive screening gFOBT result, colonoscopy is the indicated diagnostic test.
Fecal Immunochemical Test
Fecal immunochemical test (FIT) assays incorporate antibodies directed against the human globin protein. In cross-sectional studies, single-episode screening estimates of FIT sensitivity have ranged from 60% to 85% for colorectal cancer and 25% to 50% for advanced adenomas. Sample collection can be completed at home, and pretest dietary restrictions are not necessary. Colonoscopy is the indicated diagnostic test for a positive result.
Stool DNA Test
Stool DNA (sDNA) tests target molecular alterations that originate directly from the lesion of interest. Stool specimens (30 g minimum) are submitted for evaluation. Multi-marker sDNA assays studies demonstrated moderate sensitivity for colorectal cancer (25% to 58%) and lower sensitivity for adenomas 1 cm or larger (8% to 45%). At present, sDNA testing is not routinely available for colorectal cancer screening.
CT Colonography
CT colonography provides radiologic evaluation of the entire colorectum, as well as limited evaluation of extracolonic structures in the abdomen and pelvis. Full colonic preparation, and oral contrast ingestion are required prior to CT colonography. During the examination, a small rectal catheter is placed to insufflate the colon with room air or carbon dioxide. Conscious sedation is not required. Compared with colonoscopy, CT colonography has estimated sensitivities of greater than 90% for colorectal cancer and 85% to 93% for polyps 1 cm or larger. Colonoscopy is recommended for one or more polyps 1 cm or larger, or three or more polyps 6 mm or larger.
Single- and Double-Balloon Enteroscopy
Single- or double-balloon enteroscopy is used to visualize the small bowel. Latex balloons are mounted on an overtube that can deliver the enteroscope into the small bowel through successive inflation and deflation. Balloon enteroscopes can deliver the enteroscope orally or rectally and can be used for diagnosis and therapy. Complications of balloon enteroscopy are perforation and bleeding.
Small-Bowel Radiography
Small-bowel barium radiography studies are xray technologies to visualize the Small Bowel luminal masses, diverticula, strictures and inflammatory changes of the Small Bowel mucosa. Radiographic imaging plays a key role in evaluating the small bowel in Inflammatory Bowel Disease and in identifying complications of Crohn disease and Ulcerative Colitis. A small-bowel follow-through can reveal small-bowel Crohn disease out of the reach of upper endoscopy or colonoscopy. CT enterography and Magnetic Resonance Enterography offer luminal images and can also reveal extraluminal findings such as lymphadenopathy, mesenteric fat inflammation, or abscess formation.
Bravo pH Monitoring System
Bravo is a catheter-free pH monitoring system of the esophagus that allows the patient to have a normal diet and maintain regular activities without the hassle of other catheter pH monitoring systems.
For patients who suffer from chronic heartburn or gastroesophageal reflux disease this test will help determine the source of symptoms and therefore determine the best treatment options. A miniature pH capsule is attached to the esophagus which transmits information to a pager, worn on the belt. A journal is kept for each time there is heartburn and once the testing period is over, the journal and the Bravo receiver are studied to help determine what treatment will work best.
Esophageal Manometry
Esophageal testing or manometry measures the pressures and the pattern of muscle contractions in the esophagus. Abnormalities in the contractions and strength of the muscle or in the sphincter at the lower end of the esophagus can result in pain, heartburn, and/or difficulty swallowing. Esophageal manometry is used to diagnose the conditions that can cause these symptoms.
Guaiac fecal occult blood testing (gFOBT) uses a reagent that changes color in the presence of human blood, animal blood, and other dietary sources. Test performance requires collection of samples from three consecutive stools. Samples can be obtained at home and mailed in to our office for processing and analysis. Randomized, controlled studies have shown statistically significant reductions in colorectal cancer incidence (17% to 20%) and mortality (15% to 33%) with regular gFOBT screening. Limitations of gFOBT screening are low sensitivity for advanced adenomas (11% to 41%). For any positive screening gFOBT result, colonoscopy is the indicated diagnostic test.
Fecal Immunochemical Test
Fecal immunochemical test (FIT) assays incorporate antibodies directed against the human globin protein. In cross-sectional studies, single-episode screening estimates of FIT sensitivity have ranged from 60% to 85% for colorectal cancer and 25% to 50% for advanced adenomas. Sample collection can be completed at home, and pretest dietary restrictions are not necessary. Colonoscopy is the indicated diagnostic test for a positive result.
Stool DNA Test
Stool DNA (sDNA) tests target molecular alterations that originate directly from the lesion of interest. Stool specimens (30 g minimum) are submitted for evaluation. Multi-marker sDNA assays studies demonstrated moderate sensitivity for colorectal cancer (25% to 58%) and lower sensitivity for adenomas 1 cm or larger (8% to 45%). At present, sDNA testing is not routinely available for colorectal cancer screening.
CT Colonography
CT colonography provides radiologic evaluation of the entire colorectum, as well as limited evaluation of extracolonic structures in the abdomen and pelvis. Full colonic preparation, and oral contrast ingestion are required prior to CT colonography. During the examination, a small rectal catheter is placed to insufflate the colon with room air or carbon dioxide. Conscious sedation is not required. Compared with colonoscopy, CT colonography has estimated sensitivities of greater than 90% for colorectal cancer and 85% to 93% for polyps 1 cm or larger. Colonoscopy is recommended for one or more polyps 1 cm or larger, or three or more polyps 6 mm or larger.
Single- and Double-Balloon Enteroscopy
Single- or double-balloon enteroscopy is used to visualize the small bowel. Latex balloons are mounted on an overtube that can deliver the enteroscope into the small bowel through successive inflation and deflation. Balloon enteroscopes can deliver the enteroscope orally or rectally and can be used for diagnosis and therapy. Complications of balloon enteroscopy are perforation and bleeding.
Small-Bowel Radiography
Small-bowel barium radiography studies are xray technologies to visualize the Small Bowel luminal masses, diverticula, strictures and inflammatory changes of the Small Bowel mucosa. Radiographic imaging plays a key role in evaluating the small bowel in Inflammatory Bowel Disease and in identifying complications of Crohn disease and Ulcerative Colitis. A small-bowel follow-through can reveal small-bowel Crohn disease out of the reach of upper endoscopy or colonoscopy. CT enterography and Magnetic Resonance Enterography offer luminal images and can also reveal extraluminal findings such as lymphadenopathy, mesenteric fat inflammation, or abscess formation.
Bravo pH Monitoring System
Bravo is a catheter-free pH monitoring system of the esophagus that allows the patient to have a normal diet and maintain regular activities without the hassle of other catheter pH monitoring systems.
For patients who suffer from chronic heartburn or gastroesophageal reflux disease this test will help determine the source of symptoms and therefore determine the best treatment options. A miniature pH capsule is attached to the esophagus which transmits information to a pager, worn on the belt. A journal is kept for each time there is heartburn and once the testing period is over, the journal and the Bravo receiver are studied to help determine what treatment will work best.
Esophageal Manometry
Esophageal testing or manometry measures the pressures and the pattern of muscle contractions in the esophagus. Abnormalities in the contractions and strength of the muscle or in the sphincter at the lower end of the esophagus can result in pain, heartburn, and/or difficulty swallowing. Esophageal manometry is used to diagnose the conditions that can cause these symptoms.
As always, if you are experiencing a life threatening emergency, and you are not able to reach our office at 617-527-6200 please dial 9-1-1 or go to the Newton-Wellesley Hospital or your local emergency room.
Privacy Notice:
We are HIPPA compliant and any information provided by you will not be shared with any third party without your consent.
Privacy Notice:
We are HIPPA compliant and any information provided by you will not be shared with any third party without your consent.