Have you been asked to have an Endoscopic Ultrasound (EUS)? Let's talk about this simply!

When a doctor tells you that you need to have an `(Endoscopic Ultrasound)` or `(EUS)` test, you can feel a little scared, right? "What new test is this?" "Will it hurt?" "Why is this being done?" Many questions like that probably come to mind. It's normal. So today, we'll talk about this `(EUS)` test in simple terms, just like you would talk to a friend. Then you can get a better understanding of it.

So, what is endoscopic ultrasound (EUS)?

Simply put, an EUS is a special test that looks inside your digestive system . This is done by a doctor who specializes in the digestive system (often called a gastroenterologist).

This ``(EUS)`` test uses a combination of two main things:

1. An endoscope: Think of it like a very thin, long, flexible tube with a small camera and light attached to one end. This is what allows the doctor to see clearly inside your body.

2. Ultrasound: At the end of the endoscope, along with a camera, is a small ultrasound device (probe). This uses sound waves to create pictures of your internal organs, tissues, and blood vessels . It's like the ultrasound scan your baby gets, but it's done inside your body.

So when these two are combined, the doctor can get a very clear picture of not only the walls (layers) of your digestive system, but also the other organs close to it (for example, the pancreas and gallbladder).

Who usually needs this EUS test?

Not everyone needs to have this ``(EUS)`` test. A doctor may recommend it to check for or confirm certain medical conditions. Here are a few examples:

• If you have persistent stomach ache or chest pain , find the cause.
• If there is a suspicion that a cancer has spread to other parts of the body (metastatic cancer) .
• If you have seen a lump, lesion, or growth on a previous CT scan or MRI scan, find out exactly what it is.
• If you have any problems with your digestive system , for example, conditions like Inflammatory Bowel Disease (IBD), colon cancer, or anal fissures.
• Gallbladder disease , meaning if you have gallstones or if you have inflammation of the gallbladder (cholecystitis).
• Find out about certain lung diseases , such as lung cancer.
• Pancreatic diseasesFind out about. This includes conditions such as pancreatic cancer, pancreatic cysts, and pancreatitis.
• If you have difficulty swallowing food , for example, conditions such as ``Barrett's esophagus''.

It is in cases like these that an EUS can help doctors see inside and make an accurate diagnosis.

What are the main types of EUS examination?

EUS tests can be divided into two main categories, depending on where the test is performed.

1. Upper EUS

This looks at the upper part of your digestive system. That is:

• The inner lining of your esophagus (food pipe), stomach (stomach), and upper part of your small intestine (duodenum).
• Associated lymph nodes, blood vessels, cysts, and tumors.
• It can also examine nearby organs such as the pancreas, gallbladder, and bile ducts.

2. Lower EUS

This test looks at the lower part of your digestive system. That is:

• The muscles around the anal opening (anal sphincter).
• Blood vessels, lymph nodes, cysts, and cancerous tumors in that area.
• The inner layer of the last part of the large intestine (rectum and colon).

The doctor will decide which of these two ``EUS'' to perform based on your symptoms and needs.

Are other tests performed along with the EUS?

Yes, sometimes, while performing the EUS, another important procedure can be done. That is, an Endoscopic Ultrasound-guided Fine-Needle Aspiration (FNA) .

This may seem like a long name, but it's simply this: While looking inside with the ``(EUS)``, the doctor can look at the ultrasound images, pass a very fine needle through the endoscope, and take a small piece of tissue or fluid from a suspicious area . This is called ``(FNA)``, and some people also call it ``(biopsy)``.

The sample is then sent to a lab, where a pathologist examines it under a microscope to look for any abnormal cells, such as cancer cells. This helps to confirm the exact nature of the disease .

What do I need to do before the EUS test?

When you are scheduled for an EUS test, your doctor or nurse will give you instructions on what to do and what not to do the day before. It is important to follow them exactly to ensure a successful test . They usually include things like:

• About the medications you take: If you are taking medications for things like diabetes mellitus, high blood pressure, or heart disease, especially blood thinnersIf you are taking blood thinners (e.g., Coumadin®, Plavix®) or insulin, you should tell your doctor in advance. Your doctor may want to change the dose or stop taking the medication for a few days.
• Food and Drink: You will be asked not to eat or drink anything for several hours before the test (usually 6-8 hours). It is essential to have an empty stomach to make the test clear.
• Bowel prep: If you have a lower EUS, your doctor will prescribe a special liquid called a ``bowel prep'' to clean out your colon. This will allow you to see the inside of your colon clearly.
• Other advice: You may be given more specific advice. Listen to all of it carefully and follow it.

What exactly happens during an upper EUS?

The upper EUS is usually an outpatient procedure. You will not be admitted to the hospital for this procedure. However, because you will be given a sedative (anesthesia) for this procedure, you will need someone to drive you home after the procedure. It is also a good idea to have someone with you for the rest of the day. The Upper EUS procedure usually takes about 60 minutes .

The following things happen during the test:

1. You will be turned to the left and made to lie down.

2. A nurse will put a small cannula in a vein in your arm and give you a sedative through it. This will help you relax and not feel the test.

3. I'll spray a medicine to numb your throat.

4. A plastic mouthguard will be placed in your mouth to prevent damage to your teeth and to prevent you from chewing on the endoscope.

5. The doctor will then slowly insert the ultrasound endoscope through your mouth, down your esophagus, into your stomach, and then into the upper part of your small intestine (duodenum). You will not feel any pain during this time . You will be able to breathe normally.

6. The doctor looks at ultrasound images on a monitor and examines the upper part of your digestive system, surrounding organs, lumps, and tumors.

7. If necessary, the previously mentioned `(FNA)`, which means taking a tissue sample, is done at this time.

8. When the examination is finished, the doctor will slowly remove the endoscope. The sedative will be stopped. Then you will be taken to a recovery room and waited for you to gradually regain consciousness.

What happens during a lower EUS?

The subtotal ultrasound (EUS) is the same as the supratotal ultrasound, and is a same-day test. You will also be given a sedative, so someone will need to drive you home.

This test usually takes less than 60 minutes.That's what's going on. In the case of the `(EUS)` that is done under the skin, the `(FNA)` is a little less common.

This is what happens during the test:

1. You will be turned to the left and made to lie down.

2. You will be given a sleeping pill through an IV to help you relax.

3. The doctor inserts the ultrasound endoscope through your anus and rectum and guides it along your colon. You will not feel any pain or discomfort during this procedure . You will be able to breathe normally.

4. The doctor looks at the ultrasound images on the monitor and examines the lower part of your digestive system, surrounding organs, and any lumps.

5. When the examination is finished, the endoscope will be slowly removed and the sedative will be stopped. You will gradually regain consciousness.

How do you feel after the EUS test?

The effects of the sedative you were given usually wear off within 30 minutes to an hour . After that, you may experience some minor discomfort, such as:

• If you have a lower EUS, you may experience: gas, bloating, or cramping .
• If you do an upper EUS: a sore throat .

These symptoms usually disappear completely within 24 hours , so there is nothing to worry about.

It is best to rest for the rest of the day after the test. You can resume your normal activities the next day.

What risks or complications can occur with an EUS test?

EUS is generally considered a very safe procedure . However, as with any medical procedure, there is a small chance that complications may occur, which are very rare. These include:

• An allergic reaction to anesthesia.
• Any damage to the digestive system or bleeding.
• In an upper EUS, fluid from the mouth or stomach enters the lungs (lung aspiration).
• Inflammation of the pancreas (pancreatitis) (this can happen especially after an upper endoscopy (EUS) and a needle biopsy).
• A hole (perforation/tear) in the intestinal wall.

These things don't happen very often , but it's good to be aware of them. If there is a problem, the doctor will treat it accordingly.

When will I know the results of the EUS test ?

As soon as the test is done, the doctor will give you a rough idea of ​​what was seen during the EUS. However, if a tissue sample (biopsy) was taken from the FNA and sent to the lab, it can take several weeks to get the full report . After that report comes, the doctor will bring you back and explain it to you.

When do you need to see a doctor urgently?

If you experience one or more of these symptoms after the test, call your doctor immediately or go to the nearest hospital:

• If there is blood in the stool (`blood in stool`).
• If you have difficulty or pain when going to the toilet.
• If you have a fever or other signs of infection (such as chills and body aches).
• If you have difficulty swallowing food.
• If you have persistent nausea and vomiting.
• Unbearable, severe, persistent stomach ache or chest pain.
• Shortness of breath.

If you have these things, it is very important to seek medical advice without delay.

Finally, things to remember

Okay, so I hope you now have a good idea about the `(Endoscopic Ultrasound - EUS)` test.

An endoscopic ultrasound (EUS) is a very safe and effective way to look inside your digestive system. It can help doctors find the cause of your symptoms, especially digestive problems, cancer, and the spread of cancer. If necessary, a tissue sample (biopsy / FNA) can be taken.

This is a ``minimally invasive`` test, meaning it is done without a large incision and you can go home the same day. So, if a doctor tells you to have an ``(EUS)``, don't be unnecessarily afraid of it. If you have any other questions, talk to your doctor about them.

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