Upper endoscopy or co.onoscopy

Endoscopy

by Julros - 2023-03-16 12:05:33

Hi PMgirl. I had a colonoscopy last year at an outpatient surgery center and it went smoothly. They had me do an additional screening visit with a nurse practitioner, who gave me directions for hold my anticoagulant. On the day of the procedure I met with the doctor and he reassured me that any cautery needed would be safe. There was an anethesiologist present and I felt completely at ease. I need to go every 5 years due to having reoccurent polyps. 

Endoscopies

by Marybird - 2023-03-16 12:47:42

I had an EGD and colonoscopy last year and there were no issues at all with the pacemaker. Had it done in an outpatient surgery center. The doctor took biopsies in both the stomach and colon, as well as tattooing the area to mark the area where they found the tumor in my colon.

I had no problems at all, they used conscious sedation ( Versed and propofol) to the point where I slept through the whole thing and was awake and aware when they woke me up afterwards.

I take Eliquis, and was instructed by the doctor during the pre-endoscopy visit NOT to discontinue taking it, mainly because they wanted to make sure they found the source of bleeding that was the reason for this endoscopy. I was instructed just to withhold the morning dose of Eliquis on the day of the endoscopy  till after the procedure was done.

I'm in colon cancer surveillance mode here, so will be having repeat endoscopies this coming summer, and every 2-3 years after that depending on the results.

Endoscopies

by AgentX86 - 2023-03-16 17:01:06

Not just related to colonoscopies but any procedure.  Make sure everyone knows (tell them) that you have a pacemaker and are on <name your anticoagulant here>. You don't have to be an a$$ about it but just mention it in passing so it sticks in their head.  You can just make it part of the conversation. Just make the suggestion. Insurance.

It's kinda like marking your good arm "THE OTHER  ONE" if you're having surgery on an arm. They often mark the one for surgery but, belt meet suspenders.

Also, as part of the surgical clearance from your cardiologist, he should have anticoagulation and sometimes even prophylactic antibiotic instructions (sometimes the instructions leave it up to the surgeon).

Don’t worry in advance

by Lavender - 2023-03-16 18:38:06

That's a long time off and rules can change by then. I had my endoscopy and colonoscopy in a hospital. All was fine. Maybe wait til closer to next year to see what your cardiologist recommends. 

Pacemaker And Anticoagulant Info

by Marybird - 2023-03-16 19:48:20

I have always mentioned both to providers pre-surgery, just so they get the information and it's in my records. Then I figure they will know what they need to do with it, and what instructions might be needed to pass along to me for the anticoagulant. Then I don't worry about it anymore. 

I had laparoscopic colon resection surgery last summer, they told me no provisions for my pacemaker were needed, due to the distance ( greater than 6 inches) from the operative site, even with all the electrocautery going on, I assume. They got cardiac clearance to stop the Eliquis 3 days prior to surgery, and it was resumed 2 days afterwards. The order and prescription for presurgical antibiotics came from the surgeon. 

good advices

by brady - 2023-03-17 18:01:15

I learned something as all the advices are good, especially "greater than 6 inches from the operative site, even with all the electrocautery going on" .

Also the advice to be cautious is also a good one as the p-wave amplitue could be as small as 1.5mV. A small EMI could corrupt the signal.

No need to be nurvous. Since it is safe, it does not matter where to have the operation. But if you are concerned, do it in the hospital to make you feel better. 2024 is a long time from now. By then u will feel more comfortable with the pacemaker.

There is a study done in 2015 confirming coronoscopy is safe with a pacemaker. 

Abstract

Background: Endoscopic polypectomy is believed to reduce the incidence of colorectal cancer, and it has become a standard practice for the removal of gastrointestinal polyps. However, for patients with implanted cardiac devices, endoscopic polypectomy is thought to be relatively contraindicated. Aside from two case reports from around 10 years ago, few studies have evaluated the safety of endoscopic polypectomy for this population. In this study, polypectomy was performed in 14 consecutive pacemaker patients to determine the safety of endoscopic polypectomy using high-frequency current in patients with implanted cardiac devices.

Methods: Fourteen patients with gastrointestinal polyps and implanted cardiac devices were evaluated, and endoscopic polypectomy was performed. Continuous monitoring of heart rate, blood pressure, oxygen saturation and electrocardiographic tracing was conducted. A trained cardiologist was present during the procedures. At the end of the procedures, the cardiac devices were reinterrogated to check for any changes.

Results: Our results showed that a total of 61 procedures in 14 patients were all successfully completed, and no abnormalities were identified during continuous monitoring. There were no statistically significant differences in the preoperation, intraoperation and postoperation data. None of the patients suffered any arrhythmias or functional disruption to their cardiac devices.

Conclusions: Endoscopic polypectomy using high-frequency current appears to be safe when performed in patients with pacemakers. However, larger multicentre studies are needed to confirm the safety of this procedure in this patient population.

"Endoscopic polypectomy for pacemaker patients: is it safe?" by Yue Li  and others.