Procedures and Treatments Cancer survival rates significantly improve when diagnosed and treated at an early stage; therefore, early detection and treatment are critical. A wide range of services are offered at the St. Jude's Knott Family Endoscopy Center offers a wide range of diagnostic services and advanced, minimally invasive treatments including: Ablative Therapy using the HALO system allows for the treatment of Barrett's esophagus, a pre-cancerous condition of the esophagus that is commonly caused by chronic esophageal irritation or gastroesophageal reflux disease (GERD). Results from a recent clinical trial published in the New England Journal of Medicine in May 2009, revealed that non-surgical treatment for this condition is effective and reduces the risk of cancer development. The HALO systems used in the clinical trials are cleared by the U.S. Food and Drug Administration and are commercially available at only a few hospitals, including St. Jude Medical Center. Capsule endoscopy allows the physician to examine the lining of the middle of a patient's gastrointestinal tract and see into the small intestine. Capsule endoscopy requires a patient to swallow a pill-sized video capsule that has a camera and light inside of it, and allows the physician to search for bleeding, polyps or other irregularities that cannot be reached by a colonoscopy. Colonoscopy is one of the most important procedures for colon cancer screening. A flexible scope is passed through the rectum to allow the physician to have direct visualization of the colon. During the colonoscopy, the physician is able to view the patient's colon, obtain biopsies and remove potentially cancerous polyps. Endomucosal Resection (EMR) is a procedure to remove cancerous or other abnormal tissues (lesions) from the digestive tract. Endoscopic retrograde cholangiopancreatography (ERCP) is used to detect gastrointestinal disorders such as gallstones, bile duct or pancreatic duct blockages and for placement of biliary stents for benign or malignant strictures. It requires special equipment and the use of fluoroscopy. Some small gallstones may be removed through this therapy. Esophageal studies (pH/motility/ impedance) allow physicians to evaluate the acidity of the esophagus as well as the muscular function. Esophagogastroduodenoscopy (EGD) allows a physician to view the esophagus, stomach and first part of the small bowel (duodenum) through a scope that is passed through the mouth. EGD also allows the placement of esophageal or duodenal stents for malignant strictures, dilation of esophageal narrowing. Symptoms that may call for an EGD are nausea, vomiting, heartburn, difficulty swallowing and pain. Biopsies (taking small pieces of tissue) of any abnormality may also be done directly through the endoscope during the procedure, ulcers may be treated and any bleeding may be stopped. Feeding Tube Placement provides alternative nutrition for individuals who are unable to eat. Manometry measures pressures at different sites in the body for diagnostic purposes. Different types of manometry are anorectal, esophageal, and Sphincter of Oddi. pH Monitoring uses an endoscopically placed recording device to measure the level of pH in the esophagus, using either a 24-hour catheter or a 48-hour capsule. The patient wears a recording device and returns in 24 or 48 hours to have it removed and its images downloaded. pH monitoring is used to document abnormal esophageal acid exposure and monitor patients with GERD. Sigmoiodoscopy is a visualization of approximately eight inches of the colon. No sedation is required for this test. This screens for colorectal cancer and evaluates persistent diarrhea and bleeding from internal hemorrhoids. Small Bowel Enteroscopy with double balloon allows physicians to look directly at the small intestine using a lighted flexible tube with a tiny camera that transmits pictures of the small intestine to a video screen. The physician can examine the small intestine for ulcers, inflammation or disease. Biopsies may be taken during the procedure to test for infection, illness or early signs of cancer.