Procedures and Treatment

Our physicians offer a variety of procedures and services to diagnose, treat, and prevent gastrointestinal and liver diseases. Patients who are suffering from GI problems can be treated at our convenient location in Smithfield, with easy access to a variety of other services at Johnston Health – Smithfield.

The main procedures that we offer include:


Early detection is so important for the diagnosis and treatment of cancer.  It is recommended for everyone over the age of 50 to have a colonoscopy.  During a colonoscopy, the physician is able to examine the lining of the rectum and colon using a long, flexible tube. This allows the physician to look for abnormalities such as inflamed tissue, ulcers, bleeding, or growths.  They are also able to screen for polyps, which could be a precursor to colon cancer.  During this procedure, the physician can remove any abnormal growths or tissue that needs to be tested.

To prepare for a colonoscopy, the bowel must be completely emptied.  Preparation can take 1-2 days, and can often be harder on patients than the actual procedure.  There are a variety of preparation methods available today, and our physicians will work with you to find the one that’s right for you. Our goal is to make this procedure as quick and as comfortable for you as possible.

Learn more about screenings and early detection for colon cancer.


ERCP (endoscopic retrograde cholangiopancreatography) is used to diagnose and treat conditions in the liver, gallbladder, bile ducts, or pancreas. Conditions of the bile ducts can include gallstones, inflammatory strictures (scars), leaks, and cancer.  ERCP can be used when it is suspected a person’s bile or pancreatic ducts may be narrowed or blocked due to:

  • Tumors
  • Gallstones that form in the gallbladder and become stuck in the ducts
  • Inflammation due to trauma or illness (such as pancreatitis)
  • Infection
  • Improperly opening valves in the ducts
  • Scarring of the ducts
  • Pseudocysts (accumulations of fluid and tissue debris)

The procedure combines the use of X-rays and an endoscope to allow the physician to see the inside of the stomach.  A dye is injected into the ducts of the biliary tree and pancreas so they will be visible on an X-ray.  Tissue samples are sometimes taken during this procedure, and the physician can remove obstructions from the bile ducts.

Pill Cam

PillCam®, a pill with a camera, is used to monitor and diagnose disorders of the gastrointestinal tract without sedation or invasive endoscopic procedures. It allows visualization of the small bowel, esophagus, and colon with a small, disposable capsule.

Pill Cam Colon is also used for patients who have higher risk for complications from a colonoscopy including patients with bleeding, sedation risks, previous incomplete colonoscopy, or for patients with inflammatory bowel disease.

Other versions of the PillCam® are used to study the esophagus and monitor abnormalities, including esophageal cancers. It can also be used study the small bowel and allow physicians to detect the source of bleeding, Crohn’s disease, and iron deficiency anemia.

Upper GI Endoscopy

Upper endoscopy is a procedure used to examine the inside if the upper GI tract.  It is often used if a patient is experiencing abdominal pain, nausea, vomiting, swallowing difficulties, gastric reflux, unexplained weight loss, anemia, or bleeding in the upper GI tract.  These symptoms can be caused by a number of conditions that the physician can detect during this procedure, including:

  • Ulcers
  • Abnormal growths
  • Precancerous conditions
  • Bowel obstructions
  • Inflammation
  • Hiatal hernia

An upper GI endoscopy can also be used to remove stuck objects (including food) as well as for biopsy of tissue in the upper GI tract. Bleeding ulcers may be treated through this procedure.

During an upper GI endoscopy, the physician will use a lighted, flexible endoscope to see inside the upper GI tract, including the esophagus, stomach, and duodenum—the first part of the small intestine.

Hemorrhoid Banding

Hemorrhoid banding is one of the leading medical treatment options for hemorrhoids.  Hemorrhoids are a painful condition caused by arteries, nerves, tissues, and veins in the anal wall that can enlarge and prolapsed over time.  Hemorrhoids can cause bleeding, irritated or itchy skin, rectal pain, and general discomfort.

If hemorrhoids start to cause severe discomfort and pain, hemorrhoid banding is often the best treatment option. This procedure uses rubber bands to tie the hemorrhoid at its base and cut off the flow of blood.  This will cause the hemorrhoid to shrink, and after several days, fall off. This treatment is especially effective because it leaves a small scar that will deter future hemorrhoids from forming in the same spot.

Our physicians will work with you to make this procedure as comfortable as possible.  If the banding causes severe discomfort, the area can be numbed to relieve the pain.