Esophagogastroduodenoscopy (EGD)

There are many ailments that can be evaluated with an EGD. Dr. Desai can assist with your care by taking biopsies of your esophagus, stomach or duodenum to look for abnormalities that can guide in your care. This procedure can find inflammation in the esophagus, esophageal cancer, stomach inflammation, ulcers, infections, cancer and celiac disease. Therapy can be administered to treat difficulties with swallowing or evaluate acid levels and even remove small tumors.

You should not eat or drink, usually for six hours before the examination. Your doctor will tell you when to start this fasting and whether it is advisable to take your regular prescription medications.

Risks are low but risks include but not limited to infection, bleeding, aspiration, perforation, sore throat, coughing and anesthesia complications

Most patients feel normal after the anesthesia wears out of your system. Common symptoms include bloating, sore throat, jaw discomfort and abdominal soreness.


Colon cancer can affect both men and women and is the third leading killer cancer type.

The goal is a clean colon so we can find precancerous lesions or tissue abnormalities. It requires team work please follow the colon preparation directions that are given and if you need assistance contact our team.

Risks are very low, this is the standard of care for colon cancer screening across the globe. Risks include but not limited to infection, bleeding, bowel perforation and anesthesia complications

Biopsies taken will be reviewed by the doctor and repeat evaluation will be planed based on your personal history and family history. With in 5-7 days our office will notify you or will plan an in office visit to discuss the next steps.

Colon cancer can be easily prevented with a colonoscopy where pre-cancerous polyps and cancer in its early stages can be found and treated.

You should begin screening for colorectal cancer soon after turning 50, and then continue getting yourself screened at regular intervals.

However, you may need to be tested earlier than 50 or more often than other people if you or a close relative has had colorectal polyps or colorectal cancer and you have inflammatory bowel disease (Crohn’s disease or ulcerative colitis), which means you have genetic syndromes such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer.

Dr. Desai is driven to decrease the rate of colon cancer-related complications and deaths in Ventura county.

Advanced Endoscopy

Endoscopic Ultrasound (EUS) combines endoscopy and ultrasound to obtain images and information about the digestive tract and the surrounding tissue and organs.

Endoscopy refers to the procedure of inserting a long flexible tube via the mouth or the rectum to visualize the digestive tract. In contrast, ultrasound uses high-frequency sound waves to produce images of the organs and structures inside the body, such as ovaries, uterus, liver, gallbladder, pancreas, aorta, and lymph nodes.

Traditional ultrasound sends sound waves to the organ(s) and back with a transducer placed on the skin overlying the organ(s) of interest. Images obtained by traditional ultrasound are not always of high quality.

In EUS, a small ultrasound transducer is installed on the tip of the endoscope. By inserting the endoscope into the upper or the lower digestive tract, one can obtain high-quality ultrasound images of the organs inside the body.

Placing the transducer on the tip of an endoscope allows the transducer to get close to the organs inside the body. Because of the proximity of the EUS transducer to the organ(s) of interest, the images obtained are frequently more accurate and more detailed than the ones obtained by traditional ultrasound. The EUS also can obtain information about the layers of the intestinal wall as well as adjacent areas such as lymph nodes and the blood vessels.

Other uses of EUS include studying the flow of blood inside blood vessels using Doppler ultrasound and to obtaining tissue samples by passing a special needle, under ultrasound guidance, into enlarged lymph nodes or suspicious tumors. A pathologist can examine the tissue or cells obtained by the needle under a microscope. The process of obtaining tissue with a thin needle is called a fine-needle aspiration (FNA).

Being a relatively new diagnostic tool, the uses for EUS are still being developed, and it is being utilized in the situations mentioned below.

  • Staging of cancers of the esophagus, stomach, pancreas, and rectum
  • Staging of lung cancer
  • Evaluating chronic pancreatitis and other masses or cysts of the pancreas
  • Studying bile duct abnormalities, including stones in the bile duct or gallbladder, or bile duct, gallbladder, or liver tumors
  • Studying the muscles of the lower rectum and anal canal in evaluating reasons for fecal incontinence
  • Studying 'submucosal lesions' such as nodules or 'bumps' that may be hiding in the intestinal wall covered by normal appearing lining of the intestinal tract
  • Staging of cancer is becoming an important use of EUS. The prognosis of a cancer victim is related to the stage of cancer at the time of cancer detection. For example, early-stage colon cancer refers to cancer confined to the inner surface of the colon before it is spread to adjacent tissues or distant organs. Therefore early-stage colon cancer can be completely resected with good chances for a cure

However, if cancer is detected at later stages, the cancer tissues have already penetrated the colon wall and invaded neighboring organs, and lymph nodes or have spread to distant organs such as the liver and lungs.

Complete surgical excision becomes highly unlikely. EUS can provide information regarding the depth of penetration of cancer and the spread of cancer to adjacent tissues and lymph nodes. This information is useful for staging.

EUS helps your doctor determine the extent of the spread of certain cancers of the digestive and respiratory systems. EUS allows your doctor to assess cancer’s depth accurately 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 a needle biopsy of a lump or lesion to help your doctor determine the proper treatment.

For EUS of the upper gastrointestinal tract, you should not eat or drink, usually for six hours before the examination. Your doctor will tell you when to start this fasting and whether it is advisable to take your regular prescription medications.

For EUS of the rectum or colon, your doctor will instruct you to either consume a colonic cleansing solution or follow a clear liquid diet combined with laxatives or enemas prior to the examination. The procedure might have to be rescheduled if you don’t follow your doctor’s instructions carefully.

When FNA is performed, complications occur more often but are still uncommon (0.5-1.0%). Passing a needle through the gut wall may cause minor bleeding. If unusual bleeding occurs, the patient may be hospitalized briefly for observation, but blood transfusions are rarely needed. Infection is another rare complication of FNA. Infection can occur during the aspiration of fluid from cysts, and antibiotics may be given before the procedure.

If the FNA is performed on the pancreas, pancreatitis (inflammation of the pancreas) can rarely occur. Pancreatitis calls for hospitalization, observation, rest, IV fluid, and medication for abdominal pain. It usually resolves spontaneously in a few days.

If you received sedatives, you would be monitored in the recovery area until most of the sedative effects have worn off. If you had an upper EUS, your throat might be a little sore. You might feel bloated because of the air and water that were introduced during the examination.

Endoscopic retrograde cholangiopancreatography, or ERCP, is a specialized technique used to study the bile ducts, pancreatic duct, and gallbladder. Ducts are drainage routes; the drainage channels from the liver are called bile or biliary ducts. The pancreatic duct is the drainage channel from the pancreas.

During ERCP, your doctor will pass an endoscope through your mouth, esophagus, and stomach into the duodenum (first part of the small intestine). An endoscope is a thin, flexible tube that lets your doctor see inside your bowels.

After your doctor sees the common opening to the ducts from the liver and pancreas, called the major duodenal papilla, your doctor will pass a narrow plastic tube called a catheter through the endoscope and into the ducts. Your doctor will inject a contrast material (dye) into the pancreatic or biliary ducts and will take X-rays.

You should fast for at least six hours (and preferably overnight) before the procedure to make sure you have an empty stomach, which is necessary for the best examination. You should talk to your doctor about medications you take regularly and any allergies you have to medications or to intravenous contrast material (dye).

Inform your doctor about medications you’re taking, particularly aspirin products, arthritis medications, anticoagulants (blood thinners, such as warfarin or heparin), clopidogrel, or insulin. Also, be sure to tell your doctor if you have heart or lung conditions or other major diseases which might prevent or impact the decision to conduct endoscopy.

An anesthesiologist will administer sedation to keep you comfortable during the procedure. Some patients also receive antibiotics before the procedure. You will lie on your abdomen (belly) on an X-ray table. The instrument does not interfere with breathing, but you might feel a bloating sensation because of the air introduced through the instrument.

ERCP is a well-tolerated procedure when performed by doctors who are specially trained and experienced in the technique. Although complications requiring hospitalization can occur, they are uncommon.

Complications can include pancreatitis (inflammation of the pancreas), infections, bowel perforation, and bleeding. Some patients can have an adverse reaction to the sedative used. Sometimes the procedure cannot be completed for technical reasons.

If you have ERCP as an outpatient, you will be observed for complications until most of the effects of the medications have worn off before being sent home. You might experience bloating or pass gas because of the air introduced during the examination. You can resume your usual diet unless you are instructed otherwise.

Capsule Endoscopy

Capsule endoscopy allows examination of the middle part of the gastrointestinal tract by swallowing a small pill camera that travels around the small bowel minimally invasively while taking thousands of pictures looking for abnormalities. Pictures are sent back wirelessly into a recorder and then downloaded for review.

Capsule endoscopy helps your doctor evaluate the small intestine. This part of the bowel cannot be reached by traditional upper endoscopy or by colonoscopy. The most common reason for doing capsule endoscopy is to search for a cause of bleeding from the small intestine. It may also be useful for detecting polyps, inflammatory bowel disease (Crohn’s disease), ulcers, and tumors of the small intestine.

This is usually not covered unless upper endoscopy and colonoscopy are negative. Some insurances require a small bowel series (radiology test) prior to approving a capsule. We will work with your insurance for approval if this is a necessary step for your care.

The office will give you a set of instructions to help maximize the visualization.

There is potential for the capsule to be stuck at a narrowed spot in the digestive tract resulting in bowel obstruction. This usually relates to a stricture (narrowing) of the digestive tract from inflammation, prior surgery, or tumor. Signs of obstruction include unusual bloating, abdominal pain, nausea or vomiting.

Hemorrhoid Banding

Banding is a painless, proven effective solution to the problems associated with hemorrhoids through a unique take on a procedure called hemorrhoid banding, or rubber band ligation.

Gentle suction is used to place a small rubber band at the base of the hemorrhoid in an area where there aren’t any nerve endings. This only takes about 60 seconds. After a few days, the hemorrhoid will begin to shrink and fall off – you probably won’t even notice when it does!