The Gastroenterology Unit at Mayanei HaYeshua Medical Center diagnoses and treats gastroenterological disorders.

Unit Director Dr. Shoshana Kofnas     Mrs. Miri Shelef   Unit Secretary      Mrs. Shula Wienberg

Operating Hours Sunday, Tuesday, Wednesday: 08.00 – 18.00 Monday: (biweekly)    15.00 – 18.00 Friday:  (biweeky)    09.00 – 12.00   Location:   4th Floor    Telephones: Reception:  03-5771178 Fax:  03-5771191    What should I bring with me? Form 17 from Kupat Holim Relevant medical documents *Without Form 17 you will be charged a nominal fee of NIS 100.

Areas of activity

• Gastroenterology clinic
• Endoscopies
• PEG insertions
• Laboratory tests

The unit provides consultation and treatment for a range of gastroenterological disorders:

• Chronic liver disease
• Inflammatory intestinal diseases
• Intestinal tumors
• Gallbladder and biliary diseases
• Disorders connected to intestinal movement abnormalities:
• Irritable bowel syndrome, delayed gastric emptying, constipation, diarrhea, etc.

*The unit serves inpatients and outpatients.

Endoscopic tests

After examining you, the gastroenterologist will decide which diagnostic tests to perform.  Should he recommend direct inspection of the gastrointestinal tract, he will suggest an endoscopy, an important test in diagnosing your condition.

What is an endoscopy?

An endoscopy is a test performed by means of an endoscope - a long, thin, flexible lighted tube, about the thickness of a finger, with a camera inside that projects images from inside the stomach to a video monitor, showing any ulcers, bleeding, or lesions.  It is also used to perform biopsies, and remove polyps or tumors, without the need for surgery.

Gastroscopy

Gastroscopy is an examination of the inside of the esophagus, stomach and duodenum. It is performed using a thin, flexible fiber-optic instrument that is passed through the mouth and down the throat, and allows the doctor to inspect the lining of the esophagus or stomach.

A gastroscopy enables diagnosis of disorders such as peptic or duodenal ulcers and celiac disease; and to perform biopsies where necessary; investigation of bleeding in the upper digestive tract; esophageal dilation (to treat narrowing of the esophagus); removal of polyps (benign tumors); removal of foreign bodies; and other tests that can be performed without the need for surgery.

How is the test performed?

After the doctor explains the procedure, and the possible (rare) complications, you will be asked to sign an informed consent form.

The test will be performed with you lying on your left side, after receiving a sedative to reduce discomfort during the test.  In certain cases the back of your throat will be sprayed with a local anesthetic.  The endoscope will be gently inserted down the throat to the esophagus, passing from there to the stomach and duodenum.   Insertion of the instrument does not obstruct breathing.  The procedure is not painful; a few patients describe it as "somewhat unpleasant", but most fall asleep during the procedure.

Possible complications

There do exist complications concerning endoscopy, but they are rare.  There is occasionally light bleeding from the area of the biopsy or the polypectomy, which is usually light and stops of its own accord.  There may also be some local irritation and pain in your arm in the area of the nerve that the sedative was injected into.  These usually pass after a few days.

Preparation for the test

You must fast for 7 hours before the test (you may drink clear water up to 5 hours before the test), and eat only a light meal beforehand.  In certain cases you may be told to fast for a longer period.  You must inform your doctor of any medications that you are taking, and any drug allergies.  It is particularly important to inform your doctor of anti-coagulant drugs or aspirin.

Following the test

At the end of the examination you will rest in the recovery room until the effects of the sedation wears off.  The person accompanying you can stay with you.  As soon as the mouth and throat anesthetic wears off – usually in about 30 minutes after the procedure – and with the doctor's approval, you can have a warm drink, and then a light meal.

You may feel bloated as a result of the gas that was introduced into the stomach, but this feeling will pass after a short time.

Before being discharged, the doctor will give you the test results and instructions for continued treatment or monitoring.  If a biopsy was taken, you will receive the results in about two weeks.
Owing to the effects of the sedative, you must not drive for 6 hours after the test.

Colonoscopy

Colonoscopy is a procedure by which the doctor can inspect the lining of the large intestine.  It is performed using an endoscope - a long, thin, flexible lighted tube with a camera inside that projects images from inside the colon to a video monitor.  It is inserted through the anus and guided slowly through the rectum into the colon.
 
Colonoscopy can detect inflamed tissue, ulcers, and abnormal growths. The procedure is used to look for early signs of colorectal cancer, and can help doctors diagnose unexplained changes in bowel habits, abdominal pain, bleeding from the anus, and weight loss.

Polyps in the colon are common in adults and are usually harmless.  However, they can be removed during the colonoscopy, and later tested in the laboratory for signs of cancer. This is especially important for patients who are at increased risk for colorectal cancer.

The doctor can also take samples from abnormal-looking tissues during colonoscopy. The procedure, called a biopsy, allows the doctor to later examine the tissue with a microscope for signs of disease

How is the test performed?

After the doctor explains the procedure, and the possible (rare) complications, you will be asked to sign an informed consent form.

You will be asked to lie on your left side, after receiving a sedative to reduce the feeling of discomfort during the test.  You may feel pressure accompanied by some discomfort, as the doctor inflates the intestine with gas, to enable him to see better. The procedure takes about 30 minutes, the length of time depending on the cleanliness of the colon, its structure, and the patient's level of cooperation.

Possible complications

Complications arising from colonoscopies are rare.  During the procedure, there may be some slight bleeding from the area from which the biopsy was taken or the polyp removed.  The bleeding is usually light and stops spontaneously.  In rare cases there may be intestinal perforation, chiefly occurring during removal of a polyp.  There may be some local pain or irritation in the arm in the area surrounding the vein where the sedative was injected.  These pass after a few days.

Preparation for the colonoscopy

Preparation for a colonoscopy requires special diet and the taking of a laxative to clear the contents of the colon.  There are a number of laxatives on the market that are suitable for use as preparation for the test.  It is most important to ensure proper preparation for the test, which enables accurate results, and precludes the need for a repeat test. 

Instructions for preparing for a colonoscopy

After the test

After the procedure you can rest in the recovery room for about two hours, and the person accompanying you will be allowed to stay with you.    Eating and drinking will be allowed on the doctor's instructions (you are advised to bring a sandwich).  If you feel the need to pass wind, you should do so.  You should have someone accompany you to the bathroom.   Before you are discharged you will receive the test results, and instructions for continued treatment or monitoring.  If a biopsy was performed, you will receive the results in about two weeks.  You must not drive 6 hours after the test.

Sigmoidoscopy

Sigmoidoscopy is a test enabling the doctor to view the third and last section of the large intestine, called the "sigmoid" colon.  It is performed using an endoscope - a long, thin, flexible lighted tube with a camera inside that projects images from inside the colon to a video monitor.  It is inserted through the anus and guided into the colon.

How is the test performed?

The doctor will explain the procedure and the possible (rare) complications, and begin the test.  Since this test is a relatively simple medical procedure, most patients do not need to be sedated.   You will be asked to lie on your side, and a flexible endoscope will be inserted through the anus to the sigmoid section of the colon.  Air will be introduced to the colon with the endoscope to enable a better view, which may cause discomfort.

Possible complications

Complications resulting from sigmoidoscopies are rare.  Occasionally there is bleeding from the site of the biopsy or removal of the polyp.  This is light and stops spontaneously.  Only very occasionally is there a need for a blood infusion or surgical intervention.  Serious complications such as perforation of the intestine are very rare.  Should you experience symptoms such as fever, bleeding from the digestive tract, chest or abdominal pain on arriving home after the procedure, you should see your doctor or go to the emergency room immediately.

Preparation for the test:
Two enemas are required to be taken within half an hour of each other, about two hours before the test.

After the test

You only need to stay a few minutes in the recovery room for observation.  You can have a warm drink or eat immediately after the test.  If you feel bloated due to the insertion of air into the intestine during the procedure, this will pass by itself within a short time.  You will receive the results of the test and instructions about continued treatment before being discharged by the doctor. 
If a biopsy was performed, you will receive the results in about two weeks.