Procedures We Offer

A colonoscopy is a procedure that allows your doctor to examine the entire length of the colon and rectum using a flexible, lighted tube called a colonoscope. It is the gold standard for colorectal cancer screening and can also be used to diagnose IBD, polyps, and other conditions. Polyps can be removed during the same procedure. Most patients are under sedation and experience no discomfort.

Preparation: You will need to follow a clear liquid diet the day before and take a bowel preparation to empty the colon. Specific prep instructions will be provided prior to your appointment.

An upper endoscopy examines the esophagus, stomach, and upper small intestine using a thin, flexible tube with a camera. It is used to diagnose GERD, ulcers, Barrett's esophagus, celiac disease, and EoE. Tissue biopsies can be taken during the procedure for laboratory analysis.

Preparation: You will need to fast (nothing to eat or drink) for at least 8 hours before the procedure.

Similar to a colonoscopy but shorter in scope, a flexible sigmoidoscopy examines the lower portion of the colon and rectum. It may be used to evaluate rectal bleeding, hemorrhoids, or to monitor certain conditions.

For this procedure, you swallow a small, pill-sized camera that takes thousands of photos as it travels through your digestive tract. It is especially useful for examining the small intestine, which cannot be reached by standard endoscopes. There is no sedation required.

Preparation: You will fast overnight before swallowing the capsule and wear a small recording device for approximately 8 hours.

These tests evaluate how well the esophagus and stomach are functioning. pH monitoring measures acid exposure in the esophagus over 24–48 hours, while esophageal manometry measures pressure in the esophagus during swallowing. These tests are used to diagnose GERD and motility disorders such as achalasia.

Preparation: Fasting and stopping acid-reducing medications may be required beforehand. Detailed instructions will be given prior to your visit.

Anorectal manometry is a diagnostic test that measures the pressures and muscle function of the rectum and anal sphincter. It helps evaluate conditions such as fecal incontinence, chronic constipation, pelvic floor dysfunction, and Hirschsprung's disease. A small, flexible tube is gently inserted into the rectum, and you will be asked to squeeze, relax, and bear down while pressure readings are recorded. The test is not painful and typically takes 30–60 minutes.

Preparation: A small enema is usually administered 1–2 hours before the procedure to clear the lower rectum. No full bowel prep or sedation is required.

Breath tests are simple, non-invasive tests used to diagnose conditions related to abnormal bacterial activity in the gut. The most common types include the H. pylori breath test (to detect the bacteria that causes ulcers) and the lactulose or glucose breath test (to diagnose small intestinal bacterial overgrowth, or SIBO). You will drink a small amount of a test solution and then breathe into a collection tube at regular intervals. The hydrogen and methane levels in your breath indicate whether abnormal fermentation is occurring in your digestive tract.

Preparation: Follow a low-fermentation diet for 24 hours before the test, avoiding high-fiber foods, complex carbohydrates, and dairy. Fast for at least 12 hours beforehand and avoid antibiotics for 4 weeks prior. No sedation is required.

FibroScan is a non-invasive ultrasound-based test used to assess liver health — specifically the degree of liver stiffness and fat content. It helps diagnose and monitor conditions such as fatty liver disease (NAFLD/NASH), hepatitis B and C, and cirrhosis without the need for a liver biopsy. The test is painless, takes about 10–15 minutes, and is performed in the clinic by placing a small probe on the skin over the liver.

Preparation: Fast for at least 2 hours before the test. Avoid strenuous exercise the day before. No sedation is needed.

EUS combines endoscopy with ultrasound to produce detailed images of the digestive tract and surrounding organs, including the pancreas, bile ducts, and liver. It can be used to evaluate tumors, cysts, and lymph nodes, and to guide biopsies.

ERCP is a specialized procedure used to diagnose and treat problems in the bile ducts and pancreatic duct — including gallstones, strictures, and blockages. It combines endoscopy with fluoroscopy (X-ray) and can be both diagnostic and therapeutic.

ESD is a minimally invasive technique used to remove large polyps or early-stage cancers from the GI tract lining, using endoscopic knives, without open surgery. It offers a precise, organ-preserving option for carefully selected patients.

POEM is an incision-free procedure performed through the mouth to treat achalasia — a condition where the lower esophageal muscle fails to relax properly, making swallowing difficult. It offers high success rates with minimal recovery time.

GPOEM is an incision-free procedure performed through the mouth to treat gastroparesis — a condition where the pylorus muscle fails to relax properly, causing nausea and vomiting. It offers good success rates with minimal recovery time.

EMR is used to remove abnormal tissue from the lining of the digestive tract, including pre-cancerous Barrett's esophagus and flat polyps. It can often eliminate the need for surgery.

This advanced technique uses a tiny camera to directly visualize the bile ducts, helping diagnose and treat conditions such as bile duct stones, strictures, and tumors with greater precision.

A celiac plexus block is an endoscopic ultrasound-guided procedure used to relieve severe abdominal pain caused by pancreatic cancer or chronic pancreatitis. Using EUS for precise visualization, a needle is guided through the stomach wall to inject pain-relieving medication directly into the celiac plexus — a network of nerves near the pancreas. This targeted approach can provide significant and lasting pain relief, reducing or eliminating the need for high-dose opioid medications.

Zenker's diverticulotomy is a minimally invasive endoscopic procedure to treat Zenker's diverticulum — a pouch that forms at the back of the throat causing food regurgitation, difficulty swallowing, and chronic cough. Using a specialized endoscope, our team divides the muscular wall separating the diverticulum from the esophagus, allowing food to pass normally. This technique avoids the need for open neck surgery, carries a low risk of complications, and offers rapid recovery with immediate symptom relief for most patients.

TIF is a minimally invasive, incision-free procedure for the treatment of chronic GERD. Using a specialized device passed through the mouth, the gastroesophageal junction is reconstructed and tightened from the inside, restoring the natural barrier between the stomach and esophagus. TIF is an excellent option for patients who have not responded adequately to medications and wish to avoid traditional anti-reflux surgery. Most patients experience significant reduction in heartburn and can discontinue or reduce acid-suppressing medications after the procedure.

Endoscopic ultrasound-guided cyst drainage is a minimally invasive alternative to surgery for draining fluid collections and cysts associated with the pancreas — such as pseudocysts or walled-off necrosis following pancreatitis. Using real-time EUS imaging, a small opening is created between the stomach or small intestine and the cyst, allowing fluid to drain internally. This approach avoids the need for external drains or open surgery and can be combined with direct endoscopic necrosectomy when needed.

When standard ERCP is not technically feasible — due to altered anatomy from prior surgery or a tumor obstructing access to the bile duct — EUS-guided biliary drainage offers a powerful alternative. Under real-time ultrasound guidance, our advanced endoscopists create a new drainage pathway directly from the stomach or small intestine into the bile duct, relieving dangerous bile duct obstruction. This approach can prevent or treat jaundice and infection caused by blocked bile flow, often avoiding the need for surgical or radiologic drainage.

Endoscopic ablation refers to procedures that use energy — most commonly radiofrequency energy (RFA) — to destroy abnormal or precancerous tissue in the GI tract lining. RFA is the gold-standard treatment for Barrett's esophagus with dysplasia and is also used to treat certain vascular lesion. A balloon or probe is passed through the endoscope and delivers precisely controlled heat energy to eliminate abnormal cells while preserving the healthy underlying tissue. RFA is typically performed over a series of sessions, with endoscopic surveillance to confirm successful eradication.

Balloon-assisted enteroscopy allows deep visualization and treatment of the small intestine — a segment of the GI tract too long and looped to be reached by standard endoscopes. Using a specialized overtube with an inflatable balloon, the endoscope is advanced in a controlled, accordion-like fashion deep into the small bowel. This technique is used to diagnose and treat obscure GI bleeding, Crohn's disease lesions, small bowel polyps and tumors, and to perform ERCP in patients with surgically altered anatomy. Both antegrade (through the mouth) and retrograde (through the rectum) approaches are available.

Endoluminal suturing uses a specialized suturing device attached to the endoscope to place stitches inside the GI tract — without any external incisions. At UNM, this technique is used for a variety of applications including closure of perforations or post-procedural leaks, revision of prior bariatric surgery (transoral outlet reduction), reinforcement after endoscopic resection, and as part of the TIF procedure for GERD. Endoluminal suturing represents a major advance in the ability to perform complex repairs and reconstructions entirely through the mouth.

Enteral stent placement involves deploying a small, expandable metal tube (stent) inside the esophagus, stomach, or intestine to relieve obstructions caused by cancer, strictures, or compression from adjacent tumors. Stents are placed endoscopically under fluoroscopic guidance and can restore the ability to eat and drink when the GI tract is blocked. They are used in both curative and palliative settings — providing rapid, meaningful improvement in quality of life for patients who are not candidates for surgery, or as a bridge to surgery. Esophageal, duodenal, and colonic stents are all available at UNM.