Gastroenterology

Lower Endoscopic Ultrasound (EUS)

About Your Lower Endoscopic Ultrasound

What is a Lower Endoscopic Ultrasound?

A lower endoscopic ultrasound is an examination of the wall of the rectum and sigmoid colon through a flexible tube with an ultrasound device on its tip. This allows a specially trained physician to view this area and identify any abnormalities.

Plan to Do in Advance

  1. Medications, Vitamins and Supplements
    To properly prepare for your procedure, you may need to make certain changes to your daily medication routine.

    • If you take insulin, consult with your physician about making any necessary changes in you daily regimen.
    • If you take medications that contain aspirin or other anti-inflammatory drugs (such as Motrin, Advil, Indocin, or Feldene), we recommend that you stop taking them seven days before your procedure. They may increase your risk of bleeding after removal of a polyp or a biopsy during your upper GI endoscopy by interfering with the normal clotting of your blood.
    • IMPORTANT: IF YOU ARE CURRENTLY TAKING COUMADIN OR HEPARIN, YOU MUST CHECK WITH YOUR PRESCRIBING PHYSICIAN BEFORE CHANGING OR INTERRUPTING YOUR DAILY ROUTINE.
    • Stop taking iron supplements seven days before your procedure.
    • Certain medications should be continued prior to your lower endoscopic ultrasound. If you take cardiac (heart) or anti-hypertensive (high blood pressure) pills, take them as you normally do with small sips of water.
  2. In addition to changes to your medication, you'll also need to:

    • Purchase two Fleet's Enemas, a laxative to cleanse your bowel. They can be bought over-the-counter at any pharmacy.
    • Bring a list of all your medications (prescription medications, over-the-counter medications and eye drops) with you on the day of your procedure. You may bring the medication bottles themselves.
    • Be prepared to list and describe your ALLERGIES and REACTIONS to any medications.
  3. Because you may receive a relaxing medication during your procedure, you must arrange to have a responsible adult pick you up and/or accompany you home if you taking public transportation. University of Pennsylvania Health System policy requires that you make these arrangements, or your procedure will not be performed. If you receive relaxing medication you may not operate an automobile or other mechanical equipment until the day following your procedure.

On the Day Before Your Procedure

To ensure the most accurate results possible, it is important that you do not eat or drink anything after midnight on the day before your procedure, unless you are scheduled for an afternoon procedure (see "On the Day of Your Procedure"). The exception is medication taken with small sips of water.

On the Day of Your Procedure

  • If you are scheduled for a morning procedure:
    Take one Fleet's enema approximately 3 hours before your scheduled arrival time. One hour later, take the other Fleet's enema.
  • If you are scheduled for an afternoon procedure:
    You may have CLEAR LIQUIDS only for breakfast. Take one Fleet's enema approximately 3 hours before your schedules arrival time. One hour later, take the other Fleet's enema.

    Clear liquids: water, apple juice, ginger ale, sprite, beef or chicken broth WITHOUT noodles, coffee or tea WITHOUT cream or milk, most sodas, sherbet, pop-sicles, and Jell-O that is not red or orange. DO NOT DRINK ANYTHING RED OR ORANGE.

  • On the day of your lower endoscopic ultrasound, please come directly to the requested location at your scheduled arrival time and check in with the receptionist. Plan to spend several hours at the unit to allow time for your preparation, your procedure, and your recovery.
  • Before the procedure, a nurse will greet you and assist you with changing into a hospital gown. An IV will be placed in your arm. You will receive relaxing medications through the IV during the procedure. You will be lying on your side for your endoscopic ultrasound and the flexible tube will be passed into your rectum to view the wall of the rectum and sigmoid colon. The test takes approximately 15-30 minutes to complete.

After Your Procedure

  • If you do receive relaxing medications, you will be taken to the recovery area where you will be monitored until most of the effects of the relaxing medication have worn off.
  • You may have some cramping or bloating as a result of the air placed into your colon during the procedure.
  • The Endoscopist will discuss the results of your procedure with you prior to your discharge. You will receive discharge instructions on the day of the test.
  • Your endoscopy report and biopsy results will be sent to your referring physician.

If you would like to speak to a nurse regarding your procedure or preparation, or if you need to reschedule your procedure, please call the appropriate number:

  • Perelman Center for Advanced Medicine
    Procedure questions: 215-662-2122
    To reschedule: 215-349-8222
  • Penn Presbyterian Medical Center
    All questions: 215-662-8900

Please be aware that these instructions apply to patients scheduled for procedures at the Perelman Center for Advanced Medicine, Penn Presbyterian Medical Center and Penn Medicine Radnor. However, your doctor may give you different instructions or procedures. If you have any questions about your procedure, please contact your physician at the Digestive & Liver Center.