Gastro Procedures

After a thorough medical history and physical exam, Dr. Levy may order further laboratory tests and/or procedures, such as colonoscopy or upper endoscopy, in order to determine the best treatment plan for you. Whether your procedure is performed at our outpatient endoscopy center or a hospital affiliation, Dr. Levy will meet with you and your loved ones after your procedure to answer questions and discuss the next step.

Why Choose Dr. Levy for My Gastro Procedure?

When you choose Dr. Levy, you can be certain that you are in the best possible hands.  After medical school, Dr. Levy completed six years of intensive, high-caliber training, with a focus on heartburn/acid reflux evaluation and treatment and high quality colonoscopy/colon cancer screening. He has received recognition from the prestigious American College of Gastroenterology and was bestowed fellowship status (FACG) within the organization. Most importantly, Dr. Levy has worked with the utmost dedication and compassion to solve patients’ digestive problems and improve their quality of life. Dr. Levy’s unparalleled patient care has made him the “Doctor’s Doctor” with local physicians and their families choosing Dr. Levy for their care. He has also earned the trust of patients, their families, and referring physicians, both nationally and internationally.

Dr. Levy has a colonoscopy pre-cancer detection rate that far exceeds national guidelines. This means that when Dr. Levy performs a colonoscopy, he finds and removes more pre-cancerous colon polyps than is expected based on recommended guidelines, making him a great choice for patients who want a screening colonoscopy, have a history of cancer, or have a family history of colon cancer.

Dr. Levy’s expertise is so well-respected that physicians often refer him patients for second opinions for medical diagnosis and procedures as well as patients with difficult anatomies for “second-attempt” colonoscopies.

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Committed to Delivering Innovative Gastro Procedures to Middle Georgians

Dr. Levy has been at the forefront of delivering innovative advancements made in gastroenterology to the residents of Middle Georgia.

As a heartburn and acid reflux expert, Dr. Levy offers state-of-the-art technology to evaluate and treat patients suffering from chronic heartburn, including upper endoscopy, ambulatory pH monitoring, esophageal manometry and evaluation for LINX Reflux Management System. For patients diagnosed with Barrett’s Esophagus, a precancerous condition caused by chronic heartburn/acid reflux, Dr. Levy offers Barrx Radiofrequency Ablation (RFA) and the wide-area transepithelial sampling (WATS) biopsy for diagnosis and treatment.

He is the only private gastroenterologist in Macon trained in both balloon-assisted and spiral-assisted small bowel enteroscopy, a procedure used to diagnose small bowel problems such as tumors, gastrointestinal bleeding, inflammatory bowel disease, celiac disease, Crohn’s disease, and Irritable Bowel Syndrome. Dr. Levy uses advanced non-surgical techniques to remove large precancerous polyps during colonoscopy — allowing patients to avoid costly, painful surgeries.

Procedures We Offer

As a board-certified gastroenterologist, Dr. Levy diagnoses GI problems and treats them non-surgically using the following procedures:

Colonoscopy

A colonoscopy is an outpatient procedure performed under sedation lasting about 20 minutes. A thin, flexible tube with a light and camera (called an endoscope) is slowly inserted into the rectum allowing the doctor to inspect the colon (large intestine) and detect abnormal tissue. These abnormalities, known as colon polyps, are considered pre-cancerous growths, and are removed during the procedure to prevent them from progressing to colon cancer. Removed polyps are sent to the lab for microscopic evaluation by a trained GI pathologist to determine if they contain any abnormal cells. A colonoscopy can also detect bowel diseases that cause bleeding, diarrhea, constipation and abdominal pain. Learn about colonoscopies here.

Upper Endoscopy (EGD)

Upper endoscopy, also known as an EGD, is an outpatient procedure used to view the upper part of the gastrointestinal tract – the esophagus, stomach, and duodenum. During this procedure patients are sedated and a thin, flexible tube called an endoscope, equipped with a lens and light, is passed through the mouth and advanced to the beginning of the small intestine. If the doctor finds any abnormal tissue, biopsies are taken and sent to a pathologist for diagnostic purposes.

Upper endoscopy is a short and safe procedure, lasting between 10 to 15 minutes.

It is helpful in diagnosing and treating certain digestive diseases:

  • It can evaluate patients with chronic heartburn/acid reflux for signs of inflammation and/or precancerous changes to the tissue in the esophagus;
  • It can evaluate trouble swallowing, persistent upper abdominal pain, nausea and vomiting;
  • It is more accurate than X-ray films for detecting ulcers, tumors and inflammation of the esophagus, stomach and duodenum;
  • It is the test of choice for finding the cause of bleeding from the upper gastrointestinal tract;
  • It is used to treat bleeding and to dilate strictures (narrowed areas) in the upper gastrointestinal tract.
  • It can prevent esophagus and stomach cancers from developing.

EGD with Dilatation

Patients suffering from heartburn or acid reflux, cancerous tumors, motility disorders, scarring due to radiation and excess tissue in the esophagus (called “rings” or “webs”) may experience narrowing of the esophagus. This can make eating and swallowing difficult and painful. EGD with dilation is used to stretch a narrowed area of the esophagus so that swallowing goes back to normal. The esophageal dilation procedure is usually performed along with an upper endoscopy while the patient is sedated. The amount of narrowing can determine whether or not patients will need to undergo the procedure more than once. The esophagus is expanded in small increments so that complications are less likely to occur.

Barrx Radiofrequency Ablation (RFA)

Barrx Radiofrequency Ablation, also known as RFA, is an FDA-approved procedure that uses a thin, flexible tube called an endoscope to deliver heat energy to destroy precancerous tissue in the throat (esophagus) caused by Barrett’s Esophagus, a precancerous condition caused by chronic heartburn. The goal is to destroy these cells before they become cancerous so that healthy cells can grow again. This process takes between 25-35 minutes and is performed under sedation.  After undergoing RFA, normal tissue is restored in the esophagus within six to eight weeks.

Most patients require one to three RFA treatment sessions to remove all of the precancerous Barrett’s tissue. A follow-up endoscopy is performed after two to three months to assess healing and evaluate if further treatment is required. Patients are monitored with surveillance endoscopy on a regular basis starting every six months, increasing intervals if findings are normal.

Dr. Levy takes great pride in successfully lobbying Navicent Health (formerly known as the Medical Center of Central Georgia) to purchase the Barrx Radiofrequency Ablation system. In 2013, Dr. Levy was the first physician in Central Georgia to perform RFA for Barrett’s Esophagus.

Dr. Levy is the only private gastroenterologist in Macon to formally complete Covidian (Medtronic) certification in Barrx RFA, making him a great choice for patients with chronic heartburn/acid reflux and diagnosed Barrett’s Esophagus.

Bravo Esophageal pH Probe (Ambulatory pH Monitoring)

Ambulatory pH monitoring provides information about the frequency, duration and symptom correlation of acid in the esophagus caused by gastroesophageal reflux disease (GERD). This procedure is especially helpful in diagnosing GERD in patients with atypical symptoms including chest pain and chronic cough.

A Bravo esophageal pH probe uses a small capsule attached to your esophagus to measure the amount of acid reflux. The capsule works by transmitting information about the pH level of the esophagus to a small pager-sized device worn on the patient’s belt. Patients maintain their normal diet and activities and write down the times they experience heartburn or acid reflux symptoms. After 48 hours, you return your diary and Bravo Receiver to your doctor and the information is uploaded to a computer. This information helps the physician determine if the patient’s symptoms are due to gastroesophageal reflux disease (GERD) and determine treatment options. It is also used to assess response to medications in patients with known GERD.

The disposable pH capsule passes with a normal bowel movement usually within a few days after the test.

Esophageal Manometry

Esophageal manometry is a test to evaluate if your esophagus is able to move food to your stomach normally and how well the esophageal sphincter is working to prevent acid reflux. This test measures the function of the lower esophageal sphincter (the valve that prevents reflux of stomach acid into the esophagus) and the muscles of the esophagus.

The manometry test is commonly given to people who have:

  • Difficulty swallowing
  • Pain when swallowing
  • Heartburn
  • Chest pain

Capsule Endoscopy (PillCam)

Capsule endoscopy is a non-invasive procedure that allows the physician to see what is happening inside parts of your gastrointestinal (GI) tract. The GI tract is the tube which extends from the mouth to the anus in which the movement of muscles digests food. A swallowed vitamin-sized pill with a camera (a capsule) takes images of the inside of the esophagus, stomach and small intestine (small bowel).

The patient swallows the PillCam with a glass of water. As the capsule travels through the esophagus, stomach, and small intestine, it transmits images to a small recording device worn by the patient. You can continue with normal activity and return your device eight hours later. The physician downloads the information to a computer and reviews the images to identify abnormalities or sources of bleeding. The pill passes naturally with a bowel movement usually within 24 hours.

Capsule endoscopy can be used to diagnose and detect:

  • Crohn’s disease of the small intestine
  • Malabsorption disorders such as Celiac disease
  • Irritable bowel syndrome
  • Gastrointestinal bleeding of the small bowel
  • Angiodysplasias (collections of small blood vessels located just beneath the inner intestinal lining that can bleed intermittently and cause anemia)
  • Small intestinal tumors such as lymphoma and small intestinal cancer

Although the PillCam is purely diagnostic and cannot be used to take biopsies or apply therapy, it is frequently the test of choice to detect the source of bleeding in the small intestine if standard endoscopy has failed to do so.

Non-Surgical Internal Hemorrhoid Banding

This non-surgical procedure is used to eliminate hemorrhoids. The doctor will place a rubber band around the hemorrhoid, which cuts off the blood flow and eventually causes it to fall off.

Small Bowel Enteroscopy

Small bowel enteroscopy is an examination of the esophagus, stomach, and small intestine using a flexible tube with a camera. This procedure is used to diagnose various small bowel problems such as tumors, gastrointestinal bleeding, inflammatory bowel disease, celiac disease, Crohn’s disease, and Irritable Bowel Syndrome.

Dr. Levy is the only private physician in Macon trained in both balloon-assisted and spiral-assisted small bowel enteroscopy.

Flexible Sigmoidoscopy

Flexible sigmoidoscopy is a procedure in which the rectum and lower colon are examined to determine the source or cause of rectal pain or bleeding, irregular bowel habits, or abdominal pain. Prior to the exam, patients take fleet enema or laxatives to clear residual food in the bowel. Patients have the option to have sedation. A thin flexible tube is inserted into the anus and slowly advanced to the lower part of the colon (large intestine). Some patients experience bloating, cramping or a feeling of pressure during the procedure, however this usually resolves within minutes.

Similar to colonoscopy, you might feel bloating or some mild cramping because of the air that was passed into the colon during the examination. This will quickly resolve when you pass gas. You should be able to eat and resume your normal activities after leaving our office if you did not receive any sedative medication.

Polypectomy

A colon polypectomy is the removal of polyps from the colon during a colonoscopy procedure. Although most polyps are harmless, some are cancerous, making their removal very important. Some polyps can lead to uncomfortable symptoms, such as rectal bleeding, irregular bowel habits (diarrhea, constipation), anemia, or abdominal pain.

Wide-Area Transepithelial Sampling (WATS)

The WATS system allows physicians to quickly and easily detect precancerous tissue in the esophagus, providing a significant advance in preventing esophageal cancer — the fastest growing cancer in the U.S. This new diagnostic tool has proven to be more effective in the detection of Barrett’s Esophagus (precancerous tissue in the esophagus caused by chronic heartburn/acid reflux) than standard biopsy techniques alone.

WATS is a minimally invasive (non-surgical) technique performed during an upper endoscopy that uses a brush biopsy to obtain wide-area, full thickness samples of esophageal tissue. These samples are then analyzed by a specially trained GI pathologist using computer-assisted 3-dimentional analysis.

Dr. Levy is one of the few physicians in Middle Georgia who offers this innovative biopsy technique, making him a great choice for patients with chronic heartburn/acid reflux, diagnosed Barrett’s Esophagus, or a family history of esophageal cancer. Learn more about the WATS procedure at wats3d.com.

LINX Reflux Management System Evaluation

When patients with chronic heartburn/acid reflux, also known as gastroesophageal reflux disease (GERD), no longer have adequate symptom relief from medication, Dr. Levy evaluates and refers appropriate candidates for LINX placement.

The LINX Reflux Management System is an FDA-approved small implant device made of interlinked titanium beads with magnetic cores. The magnetic attraction between the beads augments the existing esophageal sphincter’s barrier function to prevent acid reflux. The device is implanted using a standard minimally invasive laparoscopic procedure and is an alternative to more invasive surgery for GERD, such as Nissen fundoplication.

LINX procedure is well-tolerated. After surgery, patients can resume a normal diet as quickly as tolerated. Patients usually go home the next day and can return to non-strenuous activity within a couple days. The device should not affect airport security. However, patients are given implant cards in the event that issues arise. It is compatible with MRI, however patients should discuss MRI scanning options prior to deciding on treatment with the LINX system.

The LINX Reflux Management System uses permanent magnets that are designed never to wear out. However, if needed, LINX can be removed during a laparoscopic procedure similar to the implant procedure. Removal of the device generally leaves the esophagus the same as before the implant.

Breath Tests

“Breath testing” refers to a variety of procedures that measure the gases produced by intestinal bacteria to diagnose the causes of symptoms including gas, bloating, diarrhea and abdominal pain. Breath tests are simple, non-invasive ways to identify the causes of gastrointestinal problems, and determine the best treatment. Most breath tests take less than 15 minutes, and immediately return results.

H. Pylori Breath Test

Helicobacter Pylori, more commonly known as H. Pylori , is an intestinal bacteria known to cause several gastrointestinal problems. H. pylori is the most common cause of peptic ulcer disease (PUD), and is associated with a higher risk of developing gastric cancer.

The most common ulcer symptom is a burning or gnawing pain in the abdominal area. This pain is often worse on an empty stomach. Other symptoms include nausea, vomiting and loss of appetite. Bleeding can also occur. However, many people infected with H. pylori never experience symptoms. If you have any symptoms or have a family history of H. pylori, you are at a higher risk for the bacteria, and should consider taking a breath test to determine if the bacteria is present.

The breath test is a simple procedure administered in the office that takes less than 15 minutes to complete and return results. If you test positive for H. pylori, Dr. Levy generally prescribes a course of antibiotics followed by a second breath test to confirm the bacteria has been eradicated.

Lactulose Breath Test (AKA Small Intestinal Bacterial Overgrowth (SIBO test)

The lactulose breath test is performed to detect small intestinal bacterial overgrowth (SIBO), a condition in which some bacteria that normally live in your lower intestine end up living in your small intestine. SIBO can cause many symptoms including bloating, nausea, diarrhea, gas, vomiting, joint pain, fatigue, malabsorption and other gastrointestinal symptoms.

During the three-hour test, lactulose, which is a non-absorbable sugar solution, is swallowed and hydrogen and methane gases are measured in the patient’s breath at regular intervals. Gas levels rise as the sugar solution passes through the intestine, resulting from fermentation of the sugar by bacteria. If the gas levels rise quickly and to an abnormal level, a diagnosis of small intestinal bacterial overgrowth can be made, and Dr. Levy will start a treatment plan.

Dr. Levy is a very knowledgeable and highly skilled physician.

Nikki R.

Dr. Levy improved my quality of life so much! He is friendly, down to earth and takes more time with me than other gastroenterologists that I have dealt with. The care I’ve gotten from him changed my life. Under his care, I went from not being able to eat solid foods for a year to being able to eat normal foods I enjoy. I can tell he cares and I'm not just another patient. I’m so grateful to Dr. Levy!

Susan A.

Dr. Levy is unbelievable! My cardiologist insisted that I see Dr. Levy for my colonoscopy and I’m glad I did. His knowledge gave me a lot of confidence in what I was facing since I have inflammatory bowel disease. His caring and compassionate ways make him different from other physicians I’ve seen. He is kind, gentle, caring, and not pushy. His staff is excellent, and the Endoscopy Center was more efficient and personal than having my procedure at the hospital. I would recommend Dr. Levy to any friend or doctor.

Jane W.

Dr. Levy goes above and beyond to provide excellent care. I was very sick and getting worse, and with his knowledge and persistence he diagnosed a rare vascular condition called median arcuate ligament syndrome (MALS). This allowed me to find a specialist and cure my condition. Dr. Levy actually listened to me, did a full work-up, and took the time to research my case. Since seeing Dr. Levy, I haven’t had any issues. I felt comfortable talking with him and I knew he would do whatever it took to help me. I highly recommend going to Dr. Levy!

Carissa G.