Endoscopy
 

My aunt has had 4 Endoscopies in the last 3 months. She has broken blood vessels in her small intestines. The local hospital has cauderized has much as their equipment can reach. I didnt have the presents of mind to ask today who would have this equipment. Anyone familiar with this? Who might have this equipment? She keeps losing blood and having to have repeat blood transfusions.

Unsure of your question on who has the equipment. Any endo land has the same scopes, procedures only difference is the staff. Not knowing previous health issues to cause issues is a question. Endo is a procedure, doubles are done by the hundreds everyday, in outpatient facility. Hospitals deal with Repeat bleeders all the time, usually middle of the night.

Perhaps it is time for a second opinion. This sounds serious and should be evaluated by more than one provider just to be sure, IMHO.

Dr. Christina Covelli is a gastroenterologist at the Advent Hospital (formerly known as Waterman) in the Eustis-Tavares area. she is extremely talented and has done more than 10,000 combination colonoscopy/endoscopy procedures. I know because I put her through the third degree before she did one for my wife. Nothing in the colon or throat showed any bleeding (or cancer) fortunately. She then prescribed the Pill Camera (Capsule Endoscopy) which detects any bleeds in the small intestine. We learned that neither the colonoscopy nor the endoscopy can reach and diagnose the small intestines. It was in the small intestines that there were some non-bleeding AVM's. More on AVM's and the Pill Cam can be found at Arteriovenous Malformation Detected by Small Bowel Endoscopy

Although Dr. Christina Covelli doesn't have the right equipment for the necessary surgery for the small intestine bleeds, she is aligned with a center in Orlando that has the proper equipment and expertise. My wife didn't have any bleeding AVM's or transfusions and because iron pills seem to be working for my wife; she decided to forego the small intestine surgery.

I would try to get an appointment with Dr. Covelli or her very able assistant, Allison. Their number at Advent in Tavares is 352-742-2192.

I hope the sharing of our experience and research helps.

Your link describes my aunt situation. She has had the pill camera and I've heard AVM mentioned. Thanks for the info!

I would suggest going to the Mayo Clinic in Jacksonville. It is a three hour drive and well worth it.

Agreed about seeing another physician. Endoscopy is limited to the upper GI tract (esophagus, stomach, duodenum) and the lower tract (large intestine). The majority of the small intestine is simply not "reachable" by endoscopy. However, there are alternative diagnostics and treatment options that are best discussed with a board-certified gastro-enterologist. Best of luck to you and your aunt

I have been reading about a double balloon enterscopy. Next time her blood level drops we are going to the emergency room in a hospital in neighboring city that does this to see if they can help her. Thanks for the info

The next step after the Pill Camera is a DBE (Double Balloon Enteroscopy) if it can be done safely and successfully? Is that what was done for her to stop the bleeds? Here is a link that talks about the risks for the elderly.

Double-Balloon Enteroscopy in Elderly Patients: Is It Safe and Useful?

No, the DBE wasnt done. This hospital isnt set up with the correct equipment to do it. The doctor also said to go deeper into the intestine would be harder on her but, according to your posted link, should have a good outcome. They did take her off blood thinners, I just found out, so we're hopeful with that and all the cauterizing, she'll retain her blood. Should know within a couple of weeks. Thanks!

Please keep us informed!

Shands
 

Get her to Shands in Gainesville. An hour away and a teaching hospital. Full of the best!

Shands is a world-class hospital. The Villages is fortunate to have it so close by. Good luck with solving the bleeding problem.

Move her to Shands or there's a good hospital in Ocala or Marion County.

Take her to Shands (University of Florida Health)