ERCP Explained and Why It’s Done
If you have had persistent abdominal pain, jaundice, or your doctor says there might be a problem in your bile ducts or pancreas after a test like a CT or MRI scan, they may suggest that you have an ERCP. This test is different from others because it can diagnose and treat certain conditions during the same procedure. In the section on risks, we explain those and tell you how to find ERCP in your area. At Associates in Gastroenterology, PC, we do this test regularly for people in Colorado Springs and the area, so if you know what it involves, you will likely have less anxiety about it.
Resource: my.clevelandclinic.org
Table of contents
Estimated reading time: 7 minutes
What is ERCP?
ERCP stands for endoscopic retrograde cholangiopancreatography. While the name is a mouthful, the concept is simple. It combines endoscopy and X-rays. During the procedure, the doctor passes a thin, flexible tube (an endoscope) through your mouth, down your esophagus, and into the first part of your small intestine (the duodenum). The doctor then injects a special dye to highlight your ducts on an X-ray, allowing them to locate any stones or strictures.
How ERCP Differs from Other Tests
Other common tests to examine the upper and lower gastrointestinal (GI) tract do not do much of this. A colonoscopy examines the lower GI tract, while an upper endoscopy looks at the esophagus and stomach, but not the bile or pancreatic ducts. An MRCP test will look at those ducts using magnetic resonance imaging, but it does not allow for treatment. ERCP does allow for treatment to be performed as the procedure is done. This treatment aspect makes ERCP different than the other tests we described.
Resource: pancan.org
Why is ERCP Performed?
ERCP is used when a doctor needs to see what’s going on within the bile or pancreatic ducts, and usually to treat the problem once they have located it. Several common conditions that ERCP can address include:
Gallstones and Blocked Bile Ducts
Once a gallstone gets out of the gallbladder, it may get stuck in the bile duct, where it will be a block to the normal movement of bile. If a duct is blocked, the bile will back up, causing intense pain, jaundice, or other problems and possibly infection. An ERCP can find where the gallstone is and remove it, relieving the blockage and the pain or other problem. This is probably the most common reason for an ERCP.
Bile Duct Narrowing (or Strictures)
Scarring, inflammation, or tumors can narrow the bile ducts (a stricture). To restore proper bile flow, the physician can place a small tube (a stent) inside the duct during the ERCP to widen it.
Pancreatitis and Pancreatic Duct Issues
Sometimes the pancreatic duct will have stones or strictures within it that may lead to inflammation called pancreatitis. ERCP can be used to diagnose and treat pancreatitis when there is biliary obstruction or cholangitis. Using it to pinpoint the cause of the problem, your doctor may be able to treat the issue directly. In some situations, unclogging the ducts might help prevent recurrent attacks.
Checking for Jaundice or Irregular Scan Findings
If you have unexplained jaundice or irregular scan results, you might be sent in for an ERCP. When your blood tests or scan results show that something could be blocking the ducts, ERCP could be the answer. This procedure enables your doctor to take a detailed look at your ducts and, if needed, treat the blockage in the same session. Your doctor will explain why ERCP is a reasonable option for your case.
Resource: my. clevelandclinic.org
What to Expect
You’ll consult with a doctor before you undergo ERCP. Your primary care provider or a gastroenterologist will review your symptoms, test results, and medical history to determine whether you need an ERCP. At Associates in Gastroenterology, PC, we will discuss your options with you in advance to make sure it’s right for you.
Pre-Procedure Getting Ready
Prepare by avoiding food or drink for 4 to 8 hours before the procedure, depending on the facility. Tell us about all your medications, supplements, and allergies (especially to dye or iodine). You may need to temporarily stop taking blood thinners, diabetes medications, or drugs that affect clotting.
Getting a Ride Home
During an ERCP, you’ll be sedated, and you should arrange for a responsible adult to take you home. This person may want to stay with you until the following day. If you travel to us from Monument, Fountain, or other local areas, you should plan ahead to make sure you’ll have a ride home.
What Happens During an ERCP?
Knowing what will happen during the procedure will make you more comfortable on the day of your appointment. Here is how you can expect your ERCP procedure to go.
Sedation and Comfort
The medical team will sedate you during the procedure to help you relax and feel drowsy. While many patients remember nothing, conscious sedation allows you to feel some sensations or hear instructions, so you may not fall completely asleep. Once the sedation takes effect, you will not feel the doctor insert the endoscope, and you will likely remember nothing about the procedure itself.
During the Procedure
After the medical team administers your sedation, your doctor will insert an endoscope down through your throat and into your small intestine. Once the scope reaches the right location, your doctor will inject contrast dye into your ducts and take X-rays to capture images of them. If your doctor finds a blockage such as a stone or a stricture, they may attempt to perform a treatment during the same procedure, such as removing the blockage or inserting a stent.
How Long the Procedure Takes
The actual procedure will typically take between 30 minutes and one hour, depending on what your doctor finds and treats. Afterward, you should spend about an hour to two hours in a recovery area as the sedation wears off and your doctor checks in with you.
Recovery and Aftermath
After you undergo an ERCP, the procedure will require a few days of recovery. Here is what you can expect afterward.
Immediately After ERCP
Our staff will monitor your vital signs as your sedation wears off. Mild bloating, gas, and a sore throat are normal and temporary. It usually takes 2 to 6 hours after the procedure to be fully awake and comfortable enough to go home.
Returning to Normal Activities
Take it easy for the rest of the day. You may try eating soft or light foods, then resume your normal diet as tolerated. You can return to your daily activities or your job the next day, but if your procedure included a therapeutic intervention (like a stent placement), this guidance may vary.
Warning Signs
Contact us immediately if you develop a fever, intense or worsening abdominal pain, persistent vomiting, or bloody, tarry, or dark stools. These symptoms are rare, but if they do occur, early recognition is important.
Risks and Possible Complications
It’s important for patients to have a full understanding of the potential risks before deciding on whether to proceed with an ERCP. Fortunately, serious complications are rare.
Common Effects
Mild side effects, including bloating, gas, and a mild sore throat, are to be expected and typically resolve within a day with no special treatment required.
Less Common Risks
Risks that occur less frequently include pancreatitis, infection, bleeding, or perforation of the intestinal wall. We make every effort to minimize these risks by reviewing your full medical history and by carefully observing the procedure and your post-procedure recovery period.
ERCP Colorado Springs
ERCP should be performed at an experienced GI specialist’s office in Colorado Springs. Be sure to select a gastroenterologist who is board-certified, works in an accredited facility, and has a well-documented record of performing the procedure.
Final Thoughts
ERCP is a useful procedure that can identify and treat issues with the bile ducts and the pancreas with just one procedure. If you are having symptoms or have been recommended to get ERCP, the next step is straightforward. Contact Associates in Gastroenterology, PC at any time to set up a consultation to consult with a seasoned digestive health doctor in Colorado Springs and find out if ERCP is right for you.
