Consult Services

We can help you with specific diseases and disorders of the stomach or digestive system, related to:


Lower GI Services

A colonoscopy may detect problems of the large intestine, including, but not limited to:

-Diverticula in the intestinal wall
-Cancerous growths
-Fistulae—abnormal openings in the intestinal wall
-Colitis – Ulcerative
-Crohn’s Disease

Upper GI Services

An upper gastrointestinal endoscopy may be done to find problems in the upper gastrointestinal (GI) tract. These problems can include, but are not limited to

-Inflammation of the esophagus (esophagitis) or the stomach (gastritis)
-Gastro esophageal reflux disease (GERD)
-Enlarged and swollen veins in the esophagus or stomach
-Barrett’s esophagus, a condition that increases the risk for developing esophageal cancer
-Halo procedure for Barrett’s esophagus
-Hiatal hernia

Selection Criteria

1. Is Your Doctor a Gastroenterologist?
Gastroenterologists are considered experts in performing endoscopic procedures (Endoscopy, Colonoscopy, and Flexible Sigmoidoscopy). Studies have shown that Gastroenterologists perform higher quality endoscopic examinations when compared to other physicians. This translates into the more accurate detection of polyps and fewer complications from procedures.
2. Where Did Your Doctor Complete His or Her Training?
Gastroenterologists must first complete a three-year residency in Internal Medicine and are then eligible for additional specialized training called a fellowship in Gastroenterology. This fellowship is generally 3 years long. During their training, fellows receive dedicated training in colonoscopy by expert instructors. This specialized training includes detailed and intensive study of how and when to perform colonoscopies, and optimal methods to complete endoscopic procedures safely and effectively.
Gastroenterologists also learn how to perform advanced endoscopic procedures such as polypectomy (removal of colon polyps), dilation (stretching of narrowed areas) and hemostasis (procedures to control bleeding). Additionally, Gastroenterologists learn how to properly interpret the findings and biopsy results of these studies in order to make appropriate recommendations to treat conditions and/or prevent cancer.
3. Is Your Doctor Board Certified?
Once fellows complete their training, they are then qualified to take the Gastroenterology Board Certification Test administered by the American Board of Internal Medicine. Once they have successfully completed this examination, they are considered “Board Certified.”
4. Is Your Doctor Affiliated with Any Hospitals?
Experienced and qualified physicians hold attending and admitting privileges at accredited, quality, hospitals and surgical centers.
5. Where Will My Procedure Be Performed?
Patients are usually offered a choice of where they can have their colonoscopy performed.
6. How Often Does Your Doctor Complete the Colonoscopy?
Quality evaluation of the colon during Colonosocpy consists of evaluating the entire colon and is defined as the passage of the colonoscope to the most proximal portion of the colon called the cecum. The term for this is called the “Cecal Intubation Rate.” Experienced Gastroenterologists should be able to intubate the cecum in >90% of all cases and in >95% of cases when the indication is “screening” in a healthy adult.
7. How Long Does Your Doctor Take to Examine Your Colon?
Studies have demonstrated increased detection of significant lesions within the colon in Colonoscopies where the withdrawal time (the time is takes a Gastroenterologist to withdraw the colonoscope while examining the inside lining of the colon) is 6 minutes or more.
8. How Often Are Polyps Found by Your Doctor?
Gastroenterologists may have variable skill levels for finding and removing precancerous growths of tissue called adenomas during a colonoscopy. Among healthy asymptomatic patients undergoing a screening colonoscopy, adenomas should be detected in >25% of men and >15% of women more than 50 years old.
9. How Many Perforations Has Your Doctor Had?
Perforation is the most serious complication in the short term during or after a colonoscopy. The rates of colonoscopic perforation vary widely in the medical literature. Considering all of the available data, perforation rates should be less than 1 in 500 cases overall, or less than 1 in 1000 in screening patients.

Seeking Referral

If you have specific gastrointestinal medical issues, the first step may be finding a gastroenterologist.

The physicians of Kane, Misawa, Spiess & Nguyen are all board-certified through the American College of Internal Medicine. Their education, training and fellowships have been focused exclusively in this specialty.

Gastroenterologist’s treat digestive symptoms of the stomach and intestines. They also treat disorders of the colon, esophagus, gallbladder, liver and pancreas.

In some cases, a referral to a gastroenterologist from your primary care physician will occur.