With the help of gastric endoscopy (gastroscopy), diseases of the oesophagus, stomach and duodenum can be diagnosed. Common reasons for performing a gastroscopy include upper abdominal pain, heartburn, belching, idiopathic anaemia, or idiopathic weight loss. The ailments which stem from the underlying disease can be generally detected by gastroscopy and thus be treated.

Gastroscopy preparation:

Gastroscopy is performed in the fasting state, with the last meal to be taken at least six hours prior to the procedure. Drugs such as Aspirin, Plavix, or clopidogrel should not be discontinued. If the patient is taking the blood thinning drugs warfarin or Falithrom, a consultation with a physician prior to the examination is important.

Gastroscopy procedure:

At first, your symptoms will be discussed with the doctor. You will also have the opportunity at this stage to pose any questions in regards to gastroscopy. In the interview, you will also be asked whether you want to be sedated during the procedure. If this is the case, then you will be sedated prior to gastroscopy. The investigation can also be conducted without a sedative, and in this case only the throat will be anaesthetized. The endoscopy takes approximately five to ten minutes. Afterwards, you will be able to relax in our recovery room.
The outcome of the examination and further treatment options will be explained in the final discussion.

Following the examination:

The average length of the stay in the surgery is one to two hours. If you have received a sedative, a chaperone is required pick you up from the practice. In addition, you are prohibited from driving (car, motorcycle, bike) for 24 hours following the procedure due to legal reasons.

With the help of a colonoscopy, diseases of the large intestine and the last section of the small intestine (terminales Ileum) can be diagnosed. Ailments, which make a colonoscopy necessary to perform, are, e.g. diarrhoea, stomach ache, blood in the stool or idiopathic weight loss. Furthermore, a colonoscopy is an important screening procedure for the discovery and prevention of colorectal cancer (see screening coloscopy).

Colonoscopy preparation:

In order for the adequate characterisation of the intestinal mucosa and eventual changes, it is important that the bowel be cleansed beforehand. You are advised to strictly adhere to our protocol as accurately as possible (the protocol can be accessed by clicking on PROTOCOL ). Drugs such as Aspirin, Plavix, or clopidogrel should be discontinued five days prior to the procedure. Please consult your local GP or cardiologist as to whether this is possible. If the patient is taking the blood thinning drugs warfarin or Falithrom, a consultation with us prior to the examination is important.

Procedure:

At first, your symptoms will be discussed with the doctor. You will also have the opportunity at this stage to pose any questions in regards to the colonoscopy. As the procedure can be perceived as painful, we recommend the administration of a sedative. The procedure takes approximately 15 minutes. If polyps are to be removed, this usually requires more time. Following completion of the procedure, you will be able to relax in our recovery room.

The doctor will then summon you for a further consultation in the consulting room. The results of the examination will be explained and further treatment options will be presented.

Following the examination:

The average length of the stay in the surgery is two hours. If you have received a sedative, a chaperone is required to pick you up from the practice. In addition, you are prohibited from driving (car, motorcycle, bike) for 24 hours following the procedure due to legal reasons.

Colorectal cancer is the second most common cancer in Germany. 70,000 people are afflicted and 30,000 people die each year from this tumour. Almost all colorectal cancer cases (about 90%) stem from polyps. These are initially benign, and may develop to malignant carcinomas within a period of 10-20 years.

The removal of polyps during a colonoscopy screening can be very effective at preventing the re-emergence of a cancer in the future. Starting from the age of 55, a free screening colonoscopy is available for any legally insured patient. A referral is not necessary and no practice fee is to be paid. Private health insurance companies will cover the costs of a screening colonoscopy at any age.

For a sigmoidoscopy, only the last third of the colon is endoscopically examined. Bowel cleansing is not necessary, as is the case for a complete colonoscopy.

In preparation, a necessary enema is to be conducted immediately prior to the procedure. Via sigmoidoscopy, pathological changes of the lower intestine such as inflammation, polyps, tumours or haemorrhoids can be identified.

Since gastroscopy and colonoscopy are perceived as variably physically draining, we offer each patient the opportunity to be sedated during the examination. Prior to the procedure, you will receive a sedative. During the endoscopy, your pulse, blood pressure and oxygen levels will be continuously measured in the blood. Following the examination, you will be given the opportunity to relax in our recovery room.

Since your reactivity following the sedative is limited, a chaperone is required pick you up from the practice. On the day of the procedure, you will not be allowed to actively drive any type of vehicle.

On request, it is also possible to perform the gastroscopy or colonoscopy under general anaesthesia by an anaesthesiologist.

We have a cooperation with the clinc Dr. Jan Bek.

WEBSITE DR. BEK

The cost will be reimbursed only by private health insurance companies.

The capsule endoscopy is a new and approximately 10 year old method. A 26 x 11 mm large capsule is swallowed, which takes approximately 80 000 images during the course of eight hours in the small intestine and sends these to an electronic receiver, which is attached to a waist belt worn by the patient. The doctor then evaluates the video into a one hour film.

Capsule endoscopy is ideal for the diagnosis of small bowel diseases, mainly in cases of obscure bleeding from the gastrointestinal tract or for the evaluation of chronic anaemia, if the preceding gastroscopy and colonoscopy does not result in a sufficient explanation of the cause of the symptoms. The capsule examination can also be performed for the diagnosis of diseases of the colon. However, it still remains in the test trial phase.

During our gastroenterological training, we also were scientifically engaged with capsule endoscopy and have extensive expertise in the evaluation of capsule videos.

Procedure:

For capsule endoscopy, the colon is prepared with a flushing solution. You are required to drink two litres of the flushing solution one day prior to the examination – which is similar to the procedure for colonoscopy. On the day of the procedure, you are required to fast prior to arriving at the surgery. Eight electrodes will be initially attached to the abdominal skin, which serve as a receiving antenna (similar to a long-term ECG). You are then required to swallow the capsule with some liquid. Experience demonstrates that this is usually achieved without any problems. You are then free to move about as you wish. You are allowed to drink following a period of two hours and eat following four hours. After a period of eight hours, you are required to bring the electronic receiver to the practice, and the electrodes will be removed from your body. The capsule may then be disposed of via natural means.

Limitations:

Capsule endoscopy should not be performed, if you have problems swallowing tablets or suffer from other forms of dysphagia. In addition, the capsule should not be swallowed if you have a confirmed narrowing in the area of the oesophagus, stomach, small or large intestine. If you are in doubt, an x-ray of the small intestine (enteroclysis technique) must be carried out prior to swallowing the capsule.

With the help of ultrasound, the following organs are examined: liver, gall bladder and biliary tract, pancreas, spleen and kidneys. Ultrasound is not accurate enough to examine the stomach and intestine. The most optimal method of examination is the endoscopy.

Procedure:

The ultrasound examination of the abdominal organs has no risks and is not straining for the patient. A sedative is not required. The procedure takes approximately 10 to 15 minutes. In order to achieve optimal scanning conditions, you are required to come fasting on the day of the procedure. If the procedure is to take place in the afternoon, you are allowed to consume a small breakfast. Following the exam, you are able to eat and drink as usual.

In our practice we offer breath tests in order to demonstrate disorders of the digestive tract. The inhaled oxygen spreads via the lungs and bloodstream throughout the rest of the body. When exhaling, many substances are transported back in order to be excreted. In the exhaled air, substances can be detected which are produced via cleavage of the bacteria which is located in the stomach or intestine. Breath tests are a little demanding for the patient and one should precisely abide by the rules.

One of the largest areas of internal medicine is gastroenterology. In our practice, we treat patients with disorders of the oesophagus, stomach, small intestine, colon, pancreas and liver. We offer a wide range of diagnostic and therapeutic options. For diseases of the liver, we offer a separate special consultation hour.

In this special consultation, we perform diagnostics, therapy and long-term care of patients with liver diseases. The first indicator of the presence of liver disease is usually via elevated liver enzymes values. In order to administer appropriate therapy, the cause of liver damage must be identified. The majority of liver diseases can be diagnosed using blood tests and a liver sonography. A secondary diagnosis is seldomly necessary. Common causes of disease include hepatitis B and C, alcoholic and non alcoholic fatty liver as well as autoimmune and metabolic diseases. If the liver values increase over a period of time, this can lead to cirrhosis of the liver. Our main goal of treatment is the prevention of cirrhosis of the liver and their precursors via early diagnosis and specific treatment of the liver disease.