Have you ever had an endoscopy? Perhaps your doctor has asked you to have this test for a stomach ulcer or other discomfort. When doing this test, sometimes the doctor sees bleeding from a small wound in your stomach or intestines, or small growths (polyps) have formed. In the past, this would have required minor surgery, but with today's advanced technology, there are ways to treat these things without even making an incision. That's one of the advanced treatments we're talking about today. It's called Argon Plasma Coagulation, or APC for short.
Simply put, what is APC (Argon Plasma Coagulation)?
Okay, this name may sound a bit complicated, but what happens in this is very simple. Imagine that a small hole in a tube inside our body (like the digestive tract) is bleeding. In this method called APC, the doctor sends another thin tube through the endoscope tube (scope), and a special gas called 'Argon' is injected through it. Then, a very small electric current is used to ignite the gas. The high heat generated by this burns the bleeding area and stops the bleeding. Also, if there are unwanted small growths (polyps), this method can completely destroy them.
This is like solving a problem inside the body, without cutting into the body, but very delicately from the outside. This means that there is no need to go for major surgery. That's what we call 'minimally invasive' in medicine.
This treatment is performed by a gastroenterologist or a pulmonologist.
In what cases is this treatment necessary?
APC therapy is used for a variety of reasons. Let's take a look at what it mainly does.
| Condition being treated | A simple explanation |
|---|---|
| Stopping bleeding in the body | It is used to treat bleeding caused by lesions in the stomach and intestines, rectal bleeding, or a condition called 'watermelon stomach' (Gastric Antral Vascular Ectasia Syndrome). |
| Removal of unwanted tissue/tumors | This procedure is used to remove small growths (polyps) or tissue that could become cancerous in the intestines. It can also be used to shrink a cancerous tumor in someone who cannot undergo major surgery. |
| Treating Barrett's Esophagus | This is caused by long-term gastritis (GERD) causing changes in the cells of the esophagus. APCs are used to remove these changed cells before they turn into cancer. |
| Weight gain after weight loss surgery | After some weight loss surgeries, the area where the stomach was attached can stretch and enlarge over time. Then the weight will be regained. APC treatment is used to tighten and shrink that stretched area again. |
| Lung and respiratory problems | This method is also used in conjunction with a bronchoscopy to treat small tumors or bleeding areas in the airways. |
How does this treatment work?
There is a little preparation you need to do before this treatment. It depends on how you want to do it.
- Upper Endoscopy: This involves inserting a tube through the mouth to examine the stomach and esophagus.
- Colonoscopy: This involves inserting a tube through the rectum to examine the large intestine.
- Bronchoscopy: This involves inserting a tube through the nose or mouth to look at the lungs.
Before this, your doctor will ask you to avoid eating or drinking for a few hours . With a colonoscopy, you will be given a bowel preparation to help cleanse your colon. Also, if you are taking blood-thinning medications like aspirin, you may be asked to stop taking them for a few days.
During treatment...
1. You will be given anesthesia to make you feel comfortable and not feel any pain. This involves putting a small tube (IV line) into a vein in your arm and giving you medication through it.
2. Then you will be made to lie down on the treatment bed.
3. The doctor inserts a thin, flexible tube (scope) with a camera attached into the body as appropriate (through the mouth, nose, or anus).
4. To prevent any damage to your body from electrical current, a flat pad (grounding pad) is attached to your body (usually your thigh).
5. Next, the catheter containing the APC device is passed through the scope to the appropriate location.
6. Argon gas is first injected, then an electric current is used to ignite it. Then the targeted tissue is burned.
7. The doctor completes the treatment by moving the device as needed, controlling the amount of gas and electrical current.
8. When the work is finished, the scope, catheter, and grounding pad are removed.
This entire process usually takes about 15 minutes to an hour .
What happens after the treatment? Are there any side effects?
After the treatment, you will be kept in a recovery room for a while and will be sent home after the effects of the anesthesia wear off. Some minor discomfort may occur.
- Feeling like your stomach is full.
- Gas passing and the resulting slight stomach ache.
- A little tired, a bit dizzy.
These are usually normal. There is nothing to worry about. These discomforts will go away in a few hours. You will not feel any pain during the treatment because you will be given anesthesia.
APC is a very safe procedure. Complications are rare. However, as with any medical procedure, there are some minor risks. Bleeding, problems with anesthesia, narrowing of the esophagus (stenosis), or tissue rupture can occur very rarely. That's why it's important to have these procedures performed by an experienced doctor.
Symptoms that require immediate medical attention
After returning home, if you experience any of the symptoms below, you should go to a hospital immediately, especially the Emergency Department (ETU). These could be signs of something serious, so it's important to act quickly.
| Warning signs to watch out for! | |
|---|---|
| 🔴 | Severe stomach pain that does not subside even after passing gas. |
| 🔴 | Chest pain . |
| 🔴 | Difficulty breathing . |
| 🔴 | Vomiting blood (red or coffee grounds-like). |
| 🔴 | Rectal bleeding (red or dark black blood in the stool). |
| 🔴 | Fever or chills. |
| 🔴 | Difficulty swallowing or increased throat pain. |
After you go home, follow the doctor's instructions exactly.
- Due to the effects of the anesthetic medication, do not drive or operate heavy machinery that day.
- Bring someone to take you home. It's best if someone stays with you for a few hours after you get home.
- Avoid drinking alcohol.
- The doctor will advise you on what you can eat and when you can start eating normally.
Take-Home Message
- Argon Plasma Coagulation (APC) is an advanced, non-invasive treatment used to stop bleeding inside the body and remove unwanted tissue.
- This is done under anesthesia, so you won't feel any pain.
- After treatment, you may experience minor discomfort, such as bloating and gas, but these usually go away quickly.
- When you go home after treatment, follow the doctor's instructions exactly.
- If you experience any warning signs such as severe stomach pain, chest pain, difficulty breathing, or vomiting blood, go to a hospital's Emergency Department (ETU) immediately.
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