Endoscopic ultrasound of lower gastrointestinal tract

What you need to know before the examination?

Endoscopic ultrasound (EUS) of the lower gastrointestinal tract is an examination to accurately assess the wall and surrounding area of the rectum and anus. The examination allows the layers of the rectal wall to be examined and the extent and depth of the lesions to be determined. It is mainly used to identify submucosal changes in the rectal wall, which are mostly benign. In some cases, it is needed to assess polyps before deciding on the method of removal, and to assess the stage of tumours in cases where the patient has a contraindication to an MRI scan, to assess whether there is a bowel endometriosis. 

An echoendoscope is a thin, flexible endoscope with an ultrasound probe and camera at the tip, allowing ultrasound to be used to examine the wall of a specific part of the gastrointestinal tract and the surrounding area, and to directly examine the inside of the gastrointestinal tract. 

A thorough gastrointestinal cleansing using laxatives or enemas is necessary before the examination. It is important to inform your doctor about any sensitivity to medicines, local anaesthetics, chronic illnesses, haemophilia or a tendency to bleed profusely after minor injuries. 

More about examination

Endoscopic ultrasound of the lower gastrointestinal tract (EUS) is a diagnostic procedure that allows the doctor to examine the rectal wall and assess the depth of any lesions using an ultrasound probe at the tip of an endoscope. 

During the examination, the doctor introduces the machine through the buttocks into the lower part of the gastrointestinal tract. The test is not painful as we do not blow air and do not go through the whole colon. 

The examination usually takes 10–20 minutes and is performed in a lying position on the left side. Preliminary bowel cleansing is crucial for the accuracy of the examination. 

Preparation for the examination

Preparation for the examination involves thoroughly cleaning the bowel with laxatives or enemas. Eat a light lunch the day before the examination and after that no solids are allowed prior to examination. The evening before the examination drink 1–2 litres of Donat and take 1–2 Dulcolax pills. If you have problems with constipation, you may additionally take 5 tablespoons of lactose syrup (Portalac, Prorectal, Lactecon). On the day of the examination, take 2–3 Dulcolax suppositories to ensure complete emptying of the hindgut.