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Gastroenterology

Middleton Family Medicine’s Gastroenterology team is dedicated to providing high-quality, compassionate, and cost-effective care for all digestive system disorders, including conditions affecting the esophagus, stomach, pancreas, liver, gallbladder, small intestine, and colon.

 

Our practice is built on the 3 A’s of success: Availability, Affability, and Ability, ensuring that we’re always here for you with expert care and a friendly, approachable team.

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From routine colonoscopies to advanced endoscopy and treatment for chronic conditions like acid reflux and IBS, we’re proud to serve patients across the North Shore at our convenient Middleton practice. Our goal is to ensure that every patient has a satisfying and informative experience while receiving the best in GI care.

Common GI conditions include, but are not limited to, the following:

 

  • Acid reflux

  • Dyspepsia

  • Esophagitis

  • Barrett's esophagus

  • Helicobacter pylori infection

  • Peptic ulcer disease

  • Celiac disease

  • Colon polyps

  • Diverticular disease

  • Irritable bowel syndrome

  • Inflammatory bowel disease

  • Diseases of the liver and bile ducts (fatty liver, hepatitis, cirrhosis, etc)

  • Diseases of the pancreas (pancreatitis, EPI, pancreatic cysts, etc)

Preparing for a colonoscopy?

Gastroenterology Team

Sedation Information for Upper GI Endoscopy & Colonoscopy 

Please review your insurance coverage carefully and contact your insurance provider if you are concerned that MAC anesthesia would not be covered for you.

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If MAC anesthesia is not covered, or if it is too costly, then you would need to be scheduled at a hospital based endoscopy center that offers conscious sedation.

Sedation for upper GI endoscopy and colonoscopy is divided into the following 3 categories:

 

1. Conscious Sedation

Narcotic (FENTANYL) + Benzodiazepine (VERSED)

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Administration: Intravenous (IV) by endoscopist and/or nurse

Goal: Comfort but not unconsciousness.

 

Used for most endoscopies done in a surgical center or hospital endoscopy unit.

 

 

2. MAC Anesthesia with PROPOFOL 

 

Administration: Intravenous (IV) by anesthesiologist or anesthetist

Goal: Deeper sedation than conscious sedation but not general anesthesia.  Usually unconscious for the entire procedure.

 

Recommended anesthetic for the following situations:

  • > 70 years old (or < 18 yo)

  • History of MI, severe ASCAD, stroke, TIA

  • Pregnant (schedule at hospital endoscopy)

  • History of an adverse reaction to conscious sedation

  • Known resistance to conscious sedation

  • Substance abuse (daily alcohol, marijuana, etc)

  • Psychiatric medications (depression, etc) - SSRIs, etc.

  • COPD (emphysema)

  • Sleep apnea

  • Morbid obesity (BMI > 40)

  • Active hepatitis

  • Cirrhosis

  • Poorly controlled diabetes

  • Poorly controlled hypertension

  • End stage renal disease

  • Pacemaker

  • Implantable defibrillator

 

 

3. General Anesthesia (Operating Room)

 

Administration requires tracheal intubation in the OR by an anesthesiologist.

Rarely required for performing endoscopy

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