This information is approved and/or reviewed by U-M Health System providers but it is not a tool for self-diagnosis or a substitute for medical treatment. You should speak to your physician or make an appointment to be seen if you have questions or concerns about this information or your medical condition. Complete disclaimer

Endoscopic Ultrasound (EUS)

You've been referred to have an endoscopic ultrasound, or EUS, which will help your doctor, evaluate or treat your condition. This brochure will give you a basic understanding of the procedure - how it is performed, how it can help, and what side effects you might experience.

What is EUS?
EUS allows your doctor to examine the lining and the walls of your upper and lower gastrointestinal tract. The upper tract is the esophagus, stomach and duodenum; the lower tract includes your colon and rectum. EUS is also used to study internal organs that lie next to the gastrointestinal tract, such as the gall bladder and pancreas.

Your endoscopist will use a thin, flexible tube called an endoscope. Your doctor will pass the endoscope through your mouth or anus to the area to be examined. Your doctor then will turn on the ultrasound component to produce sound waves that create visual images of the digestive tract.

Why is EUS done?
EUS provides your doctor more detailed pictures of your digestive tract anatomy. Your doctor can use EUS to diagnose the cause of conditions such as abdominal pain or abnormal weight loss. Or, if your doctor has ruled out certain conditions, EUS can confirm your diagnosis and give you a clean bill of health.

EUS is also used to evaluate an abnormality, such as a growth, that was detected at a prior endoscopy or by x-ray. EUS provides a detailed picture of the growth, which can help your doctor determine its nature and decide upon the best treatment.

In addition, EUS can be used to diagnose diseases of the pancreas, bile duct and gallbladder when other tests are inconclusive.

Why is EUS used for patients with cancer?
EUS helps your doctor determine the extent of certain cancers of the digestive and respiratory systems. EUS allows your doctor to accurately assess the cancer's depth and whether it has spread to adjacent lymph glands or nearby vital structures such as major blood vessels. In some patients, EUS can be used to obtain tissue samples to help your doctor determine the proper treatment.

How should I prepare for EUS?
For EUS of the upper gastrointestinal tract, you should have nothing to eat six (6) hours before the examination. You may have clear liquids (such as tea, water, black coffee, but nothing that is red orange or purple) up to two (2) hours before the EUS.

For EUS of the rectum, About an hour to an hour and one-half prior to leaving home, you will need to take two Fleet phosphate enemas (you can obtain these at any pharmacy).  Lying on your left side, remove the cap from the enema, gently insert one enema approximately 2 ½ to 3 inches into the rectum, squeeze the enema container and retain the water as long as possible (at least 15 minutes) then expel. Repeat the above steps for the second enema as soon as the first enema is expelled.

Be sure to use an enema product and not an oral or liquid laxative.

We suggest that you have a liquid breakfast and use your enemas after breakfast, unless otherwise directed. If your travel time is over two hours, please call us.

What about my current medications or allergies?
Bring a list of your current medications and allergies with you to your appointment.  Continue to take your prescribed medicines per usual right up until the exam with the following exceptions:

What can I expect during EUS?
For an EUS examination of the upper gastrointestinal tract, we will spray your throat with a local anesthetic before the test begins. Most often you will receive sedatives intravenously to help you relax. You will most likely begin by lying on your left side. After you receive sedatives, your endoscopist will pass the ultrasound endoscope through your mouth, esophagus and stomach into the duodenum. The instrument does not interfere with your ability to breathe. The actual examination generally takes between 15 to 45 minutes. Most patients consider it only slightly uncomfortable, and many fall asleep during it.

An EUS examination of the lower gastrointestinal tract can often be performed safely and comfortably without medications, but you will probably receive a sedative if the examination will be prolonged or if the doctor will examine a significant distance into the colon. You will start by lying on your left side with your back toward the doctor. Most EUS examinations of the lower gastrointestinal tract last from 10 to 30 minutes.

You must arrange for a responsible adult (over age 18) to accompany you home from the endoscopy unit if you have received sedation for the procedure.  Because your judgment can be impaired after this procedure, you WILL NOT BE RELEASED to public transportation, a taxicab driver, or even to walk home without another responsible adult to accompany you.

What happens after EUS?
If you received sedatives, you will be monitored in the recovery area until most of the sedative medication's effects have worn off. If you had an upper EUS, your throat might be sore. You might feel bloated because of the air and water that were introduced during the examination. You'll be able to eat after you leave the procedure area, unless you're instructed otherwise. 

Your doctor generally can inform you of the results of the procedure that day, but the results of some tests will take longer, and you will need to discuss these results with the doctor who ordered the test.

If you have questions or cannot keep your appointment please call the EUS Office at 734-615-5123 or toll free 877-334-2943. On the day of your appointment, please call the Medical Procedures Unit at 734-936-9250.

Information provided by Jennifer Raub, RN BSN, UMHS Gastroenterology, July, 2008.