The Iowa Clinic Endoscopy Center is our ambulatory surgery center dedicated to gastrointestinal endoscopy. We offer state-of-the-art services, equipment and technology for adult patients. The physicians on our staff are highly qualified, bringing you the best possible care in both diagnostic and therapeutic endoscopic procedures.
We are a AAAHC certified ambulatory surgery center which means you can be assured that we are committed to exceling in standards that promote and ensure a high level of patient safety and high quality care.
- Endoscopy Center Virtual Tour
- Procedure Prep Center
- What to Bring With You
- Going Home Recommendations
- Current Guidelines For Screening Colonoscopy
- Discomfort Expected From GI Endoscopy
- Polyp Removal and Biopsy
- What Is a Digestive Tract?
- Why Are Examinations Done?
- FAQ About Colonoscopy
- Bowel Preparation FAQ
Welcome to The Iowa Clinic Endoscopy Center
We welcome you as a patient to The Iowa Clinic Endoscopy Center. Our physicians and staff are dedicated to providing patients and their family members with personal attention. We will make every effort to ensure that you and your loved ones are made as comfortable as possible from the time of admission until your release to home. We believe that communication is essential to good healthcare. Please read through our information carefully. If you have any questions we will be happy to discuss them with you.
Please let us know, at any time, if there is something more that we can do for you to make your experience as pleasant as possible.
The Iowa Clinic Endoscopy Center is accredited by the Accreditation Association for Ambulatory Health Care (AAAHC).
The Iowa Clinic Endoscopy Center is an ambulatory surgery center dedicated to gastrointestinal endoscopy. We offer state-of-the-art services, equipment and technology for adult patients. The physicians on our staff are highly qualified gastroenterologists. Our physicians and staff are dedicated to providing you with the best possible care, both in diagnostic and therapeutic endoscopic procedures. Click here to take a tour of The Iowa Clinic Endoscopy Center.
Endoscopy Center Virtual Tour
Procedure Prep Center
Please read through carefully prior to procedure.
Your stomach should be empty. This is important for both upper GI endoscopy and for colonoscopy, because vomiting during sedation can cause serious complications. Your instructions will include the information you need to understand what you may eat or drink and when you should stop taking anything by mouth.
Please make sure to follow all instructions regarding what medications to stop before the procedure. Many medications can be continued, however please read all instructions to see which medications are ok and which need to be stopped ahead of time.
It is very important to clear the large intestine of stool before colonoscopy. Any material left in the colon will interfere with the physician’s ability to see the entire lining (mucosa) of the large intestine. It is also important to know that incomplete cleansing of the bowel will prolong the examination, and may result in more discomfort either during or after the procedure. Your physician will prescribe the laxative preparation that is best suited to be effective with low risk of harmful effects.
You must arrange for transportation, you will not be allowed to drive after your procedure. Sedating medications are given during the procedure which can have the effect of impairing your judgment, alertness and coordination for the rest of the day. You must not drive, operate machinery, fly an airplane, make important decisions or engage in risky activities for the remainder of the day and evening after this sedation.
What to Bring With You
Please bring the following when coming for a procedure:
- Insurance Card
- Warm socks
- List of previous surgeries and medical conditions
- Inhaler (if you use one)
- List of all medications and dosages, including over-the-counter medications, vitamins and supplements
***Please leave ALL jewelry at home
Going Home Recommendations
After a procedure you cannot drive home and will need an adult driver (over the age of 18) to take you home. Taking a taxi cab, bus or any other public transportation is not acceptable, unless accompanied by another adult.
You will be given written discharge instructions.
Since it is normal to feel drowsy, dizzy or lightheaded after receiving sedation, we encourage you to refrain from the following activities for 24 hours:
- Signing important papers or making important decisions
- Driving or operating any equipment or machinery
- Drinking alcoholic beverages
Current Guidelines For Screening Colonoscopy
Guidelines have been developed as a way to make recommendations for screening colonoscopy based on known risk factors for colorectal cancer. The risk factors used for this “risk stratification” are age, family history of colorectal cancer and past history of colorectal adenoma or cancer. Risk stratification is not an exact science, but the guidelines are based on the known characteristics of colorectal cancer and the opinions of knowledgeable experts.
Average risk individuals:
A patient is considered average risk if he or she (1) has no family history of colorectal cancer or colorectal adenomas, (2) has no personal past history of colorectal cancer or colorectal adenomas, (3) has no complaints about his/her bowels (passing blood with a bowel movement, recent change in bowel habit, unexplained weight loss or abdominal discomfort), (4) has no findings on physical examination suspicious for an abnormal growth in the rectum or mass in the abdomen, and (5) has no unexplained iron deficiency anemia. Under current guidelines it is recommended that average risk individuals begin screening for colorectal adenomas at 50 years of age. If colonoscopic examination of the rectum, colon and cecum is satisfactory and no adenoma is found, the next examination for screening is done in 10 years. If polyps are found, follow up will be dictated by the number and type. Your provider will let you know what follow up is needed after the pathology is completed.
Family history of colorectal cancer:
There are several known genetic traits that may be inherited which increase the risk for development of colorectal cancer. Individuals who have a family history colorectal cancer or adenoma are at higher than average risk for colorectal cancer. It is important that you talk to your primary care provider if you have a family history of colorectal cancer or adenomatous polyps to see when you should have your colonoscopy scheduled.
In some families there are genetic traits that greatly increase the risk for developing colorectal cancer. The Hereditary Non-Polyposis Colorectal Cancer (HNPCC) Syndrome is of particular concern, because it accounts for 6 to 8 percent of colorectal cancer deaths in the United States. HNPCC may be suspected if the family history includes three or more relatives in two or more generations (at least one a first degree relative), one of whom developed colorectal cancer before the age of 50. There are additional factors that can be taken into account, including a family history of endometrial cancer, small intestine cancer, and cancer of the ureter or renal pelvis. Under current guidelines it is recommended that individuals at risk for HNPCC should undergo colonoscopy every 1-2 years starting at age 20-25 or 10 years younger than the age of the earliest diagnosis of cancer in the family, whichever is earlier. Those individuals who inherit a gene for HNPCC are at high risk (85% or more) of developing colorectal cancer, and cancers develop more rapidly than is typical for most colorectal tumors.
Familial polyposis coli:
A less common genetic trait is characterized by the development of colorectal adenomas early in life and the development of hundred or even thousands of adenomatous polyps that carry a high risk for colorectal cancer at a young age. Under current guidelines it is recommended that individuals at risk for familial polyposis coli begin screening with flexible sigmoidoscopy at age 10-12.
Discomfort Expected From GI Endoscopy
What Discomfort Should I Expect from GI Endoscopy?
At The Iowa Clinic Endoscopy Center we always start an IV for infusion of fluid by insertion of a small needle into a vein of the arm. Through this IV we can give both a sedative medication and an analgesic or pain reducing medication.
These medications will make you drowsy, but not so sleepy you cannot be aroused or tell us if you are uncomfortable. It is likely, however, that you will have little recall of the procedure or of any discomfort during the examination.
The nurses will also apply the instruments that allow us to monitor your heartbeat, blood pressure and the adequacy of your breathing (oxygen content of your blood). These monitors will be used before, during and after the procedure, until you are fit to go home.
You should expect that, from the time you arrive until you go home, it will take about 2 ½ 3 hours. It will take time to get some details of your history, to start the IV, to talk with the physician about the procedure, to recover from the sedative, to talk again with the physician about the findings or results, and to receive your instructions.
You can expect to feel some discomfort like “gas” following your exam. This discomfort results from the air used to inflate the stomach or colon. In order to see well, the physician will introduce air, and some of this air will remain after the procedure. This air will pass, but you should be careful not to overeat until this discomfort is gone.
Polyp Removal and Biopsy
A polyp is a deformity of the gastrointestinal tract lining which protrudes into the interior or lumen and appears to be abnormal tissue is termed a polyp. The term “polyp” is a general descriptive term that is applied to both those with the potential to become malignant or cancerous and to those which do not.
The benign growths from which most cancers adenocarcinoma or adenomas develop in the digestive tract. In the large intestine these typically develop as polyps (that is they are abnormal tissue protruding from the lining). The purpose of identifying those individuals who may be forming colorectal adenomas is to both remove these benign, but potentially malignant lesions, and to develop a plan for future surveillance.
The most common intervention during GI Endoscopy is biopsy. During your time spent at The Iowa Clinic Endoscopy Center you might be asking yourself what is a biopsy? The professional team at this West Des Moines office will answer your questions and go through the procedure with you. The endoscopy biopsy is the collection of a small sample of tissue from the lining (mucosa) of the esophagus, stomach, small intestine or large intestine. These samples are taken with a small pincer-like forceps, thus making the endoscopic biopsy a non-painful procedure. Any area where there is suspicion of abnormality or disease may require an endoscopy with biopsy. These biopsies are usually submitted to a pathologist for examination with a microscope, but they may also be taken for microbiologic (bacterial, viral, fungal) testing. Biopsies are not taken only to look for cancer, but more common that the biopsies are taken for evaluation of inflammation or other benign (non-cancerous) abnormalities.
What is a polypectomy? The physician will try to identify and remove any polyps which are suspicious for adenoma. A polypectomy is the surgical removal of a polyp. Most of these are diminutive (smaller than 5 mm, a little less than ¼ inch), and these can often be removed without the need for cautery. Polyps are typically found as colon polyps, in the stomach, nose, sinus, urinary bladder, and uterus. For small (5 to 10 mm) or large (greater than 10 mm) polyps, the risk of bleeding usually requires cauterization. To remove and cauterize a polyp, the physician uses a wire snare (a wire loop that can be tightly closed on the polyp) and a specialized electric current is passed to heat and seal the blood vessels of the tissue.
What Is a Digestive Tract?
A system of organs make up the digestive system, and those that form the digestive tract (also called the alimentary tract or GI tract) are a series of hollow, roughly tubular organs through which a meal passes in the process of digestion, nutrient absorption and elimination of indigestible wastes. In all parts of the digestive tract, the interior hollow of the tube is called the lumen.
The esophagus (or food tube) lies in the chest, and it connects the throat to the stomach. The stomach lies in the abdomen (below the diaphragm, which separates the chest from the belly), and it is large enough to hold an entire meal. Specialized cells in the stomach lining (mucosa) secrete highly concentrated acid which, combined with the churning action of the stomach, helps break up the food and begin the process of digestion.
The small intestine is quite long (about 6 feet), and it is here that a meal is digested and that nutrients and water are absorbed into the system. The first section of the small intestine is the duodenum, it is roughly C-shaped and is about 10 inches in length. A short segment of the duodenum just beyond the stomach is bulb-shaped, and it is here that the garden variety duodenal ulcer occurs. It is in the duodenum that digestive juices from the pancreas and bile from the liver are added to the meal to digest protein, starches and fat. The second section of the small intestine, the jejunum, is about two feet in length. The third section, the ileum, is about 3 feet long. The end of the ileum (the terminal ileum) joins the large intestine at the ileocecal valve.
The large intestine includes the cecum (with its appendix), the colon and the rectum. The cecum is the roughly U-shaped portion lying below the ileocecal valve, and its appendix is the thin, worm-shaped organ well known for becoming inflamed (appendicitis). The colon is about 3 feet long, and it is here that excess water is removed from the stream of feces. Its serpentine shape and partially fixed position allow descriptive divisions of the colon into the ascending colon, the right colic (hepatic) flexure, the transverse colon, the left colic (splenic) flexure, the descending colon and the sigmoid colon. The S-shaped sigmoid colon functions with the rectum to control defecation. The anus is the outlet of the rectum.
Why Are Examinations Done?
GI endoscopy is a powerful tool for diagnosis of diseases of the digestive tract, and there are a variety of reasons for endoscopic examination of the digestive tract.
A physician may want to use GI endoscopy to investigate a symptom (a complaint that concerns the patient such as pain, nausea, difficulty swallowing, bleeding or a recent change in bowel habit), a physical finding (an abnormality such as tenderness, a mass or signs of nutritional deficiency found by the physician on physical examination), or a laboratory finding (such as anemia, a low blood count).
A physician may also recommend GI endoscopy because of his/her concern that a patient is at increased risk of certain disorders due to family history or the patient’s past history.
Finally, GI endoscopy may be utilized as a screening procedure for patients at average risk for a common disease, especially colorectal cancer. Since the great majority of colorectal cancers form from a benign growth or polyp of the type called adenoma, screening is done to find those individuals who are forming adenomas. Since colonoscopy is the most effective way to find adenomas, and it permits removal of any polyp suspicious for adenoma, it is favored by many physicians over a more limited endoscopic examination (flexible sigmoidoscopy), colon x-ray (barium enema) or chemical testing for invisible traces of blood in the stool (fecal occult blood testing).
Charges at The Iowa Clinic Endoscopy Center are based on a facility fee for each procedure performed as well as a provider fee. We ask that you pay co-insurance fees on the day of your procedure. For your convenience, we accept cash, personal checks, Visa, MasterCard. Following your procedure, we will file your claim to insurance. If the facility fee or provider fee is more than your insurance plan allows, you will billed for the difference.
If you have questions about the cost of your procedure please feel free to call our staff in the Central Billing Office for a Cost Estimation. You can reach them at 875-9604.
FAQ About Colonoscopy
- Why do I need a colon if I feel fine and nothing is wrong?
Colon cancer is the third leading cause of death in the United States, but highly preventable. Colorectal cancer usually has no noticeable symptoms until advanced stages and then it’s much harder to treat. Detecting and removing polyps greatly reduces the likelihood of developing colorectal cancer in the future. Should cancer be present, detecting it early before symptoms occur can increase your chances of survival and effective treatment.
- When should I have a colonoscopy?
Screening colonoscopy exams are recommended for men and women starting at age 50, unless you are African-American, screenings should start at age 45. If you have a family history of colon cancer or polyps, screenings may start at an earlier age. Individuals with other conditions such as Crohns Disease or Ulcerative Colitis are recommended to have more frequent screening.
- Do I just need one exam and then I’m done?
For men and women without family history or other risk factors, colonoscopy screening should be repeated every 10 years. Should your physician find and/or remove polyps during your screening, you may be asked to return sooner than 10 years based on what type of polyp was removed.
- What are colon polyps?
Polyps are noncancerous growths in the lining of your bowel. They are most common in adults over 50 years of age and in individuals with a family history of polyps. No known cause exists for why we develop polyps, but if not removed, some polyps can develop into cancer.
- Are all polyps the same?
Polyps are not the same. Two common types exist; hyperplastic or adenomatous. Hyperplastic polyps are not at risk for developing into cancer. Adenomatous polyps, however, are a risk factor and thought to be the origin of almost all colon cancers. Many adenomatous polyps will not turn into cancer, but it’s not certain which ones will or will not, so removal is recommended for any polyp found on colonoscopy. Any polyps found and removed during colonoscopy will be sent to the lab for evaluation. Your physician will let you know the type of polyp removed and when to follow up with your next colonoscopy.
- Does it hurt after a polyp is removed?
Not at all! Your bowel’s lining is not sensitive to cutting or heat so polyp removal is painless. While uncommon, some individuals may experience small amounts of bleeding from the site of polyp removal, but almost always this can be stopped during the colonoscopy.
Bowel Preparation FAQ
- Why do I have to drink all the bowel prep?
To ensure you have a complete and thorough colonoscopy, your bowel must be entirely cleared out. The preparation is difficult for some patients, but very important for your exam and to identify any polyps or areas of concern.
- I was given a different preparation than my neighbor? Why?
Your specific medical history determines what type of preparation your physician will prescribe. Individuals with health conditions such as kidney disease or seizure disorder require a different type of preparation than an individual with no health concerns. Other factors that influence type of preparation can include your time of exam, individual preference or even out of pocket expense.
- Does the preparation have any side effects?
The preparation is a medication that causes diarrhea to empty and clean the colon prior to your exam. Some individuals experience symptoms similar to diarrhea including nausea, vomiting and abdominal cramping.
- What if I forget to take the medicine?
Call the office right away. The physician or staff will assist you in how to proceed.
- Can I take my other medications?
Inform us of the medications you take when you schedule your exam. Most medications can be continued, but we may ask you to hold certain medications such as blood thinners or anti-inflammatory medicines. We will discuss this with you during scheduling and send you written instructions on what medicines you can take or should hold. If you have any questions about the information, please let us know!
- My letter says I can have clear liquids. Does that mean just water?
Not at all! You can drink various clear liquids and we encourage you to drink plenty to avoid nausea and dehydration during your preparation. Clear liquids include some soda (such as Sprite or ginger ale), broth, juices (without pulp), coffee or team without creamer, jell-o, sports drinks, etc. Avoid any of these items that are red or purple and make sure you can see through them to ensure they are “clear”.
- Why can’t the liquids I drink be red or purple?
These colors can stain the walls of your colon similar to how they can stain your tongue. During your colonoscopy, these stains can look like blood or other abnormalities. To avoid this, the physicians ask that you avoid drinking anything red or purple during your preparation.
- Can I drink alcohol if it is clear?
We ask that you do not. Alcohol can cause more dehydration and lead to complications. Additionally, alcohol can impair your judgment and may cause you to complete your preparation incorrectly.
- Why do I have to stop drinking two hours before I check-in?
This is to allow your stomach to empty prior to receiving sedation for your procedure. If you still have liquid in your stomach during sedation, that liquid could travel to your lungs and cause complications.
- Why can’t I drive myself home or take a taxi or Uber?
We will be giving you sedation for your procedure and because of this, you are considered legally impaired. To ensure your safety, you must have a responsible adult driver to drive you and ensure you make it into your home. Because sedation can impair your judgment and reflexes, you may not drive or work for 12 hours after your procedure.
- Can I eat after my procedure?
Yes! You may experience some mild nausea or feel groggy after your procedure. You also may not have a full appetite, but you may eat. We advise that you avoid greasy or spicy food right away to avoid nausea or upset stomach. We prefer you pick a light meal.
- When will I have normal bowel movements after the procedure?
Because your bowel was completely emptied and you did not eat solid food a day before your procedure, you may not have a normal bowel movement for a couple days. This is nothing to be alarmed about.
Services & Treatments
Our Approach to Endoscopy
We welcome you as a patient to The Iowa Clinic Endoscopy Center. Our physicians and staff are dedicated to providing patients and their family members with personal attention. We will make every effort to ensure that you and your loved ones are made as comfortable as possible from the time of admission until your release to home. We believe that communication is essential to good healthcare, so if you have any questions throughout the process, we will be happy to discuss them with you.
Our accredited Endoscopy Center offers comprehensive treatment for gastrointestinal issues affecting the digestive system. Diagnostic, therapeutic, and screening gastrointestinal endoscopic procedures include, but are not limited to:
- Esophageal Dilation
- Removal of Colon Polyps
The Iowa Clinic Endoscopy Center is located in West Des Moines