To our valued patients:
We want you to know that your health and safety is our utmost priority. In light of the pandemic and in an effort to protect the health and safety of our patients, we are pleased to announce that Dr. Bal and staff at Arizona Gastroenterology Clinic LLC will be offering telemedicine services to our patients. Having a “virtual” visit by telephone or video conference will allow you to access your physician from the comfort and safety of your home or workplace. Please contact our office and the staff will schedule a telemedicine visit and provide you with the detailed instructions to conduct your appointment. Our location information is available on our website at azgastroliver.com

Very best regards from Dr. Bal and the staff at Arizona Gastroenterology Clinic LLC

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  • Career Opportunities

    Posted May 2013:
    We are actively looking for Gastroenterology physicians to join our practice. Also, we are looking for medical assistants and front office staff. Please email kbal@cox.net with your CV.

     

  • Book An Appointment

    Arizona Gastroenterology & Liver Clinic, P.C.
    14155 N. 83rd Ave, Suite 122
    Peoria, AZ 85381
    Phone: (623) 773-1161
    Fax: (623) 773-1181

  • Endoscopic Ultrasonography

    What is EUS?

    Endoscopic ultrasonography (EUS) allows your doctor to examine your esophageal and stomach linings as well as the walls of your upper and lower gastrointestinal tract. The upper tract consists of the esophagus, stomach and duodenum; the lower tract includes your colon and rectum. EUS is also used to study other organs that are near the gastrointestinal tract, including the lungs, liver, gall bladder and pancreas.

    Endoscopists are highly trained specialists who welcome your questions regarding their credentials, training and experience. Your endoscopist will use a thin, flexible tube called an endoscope that has a built-in miniature ultrasound probe. Your doctor will pass the endoscope through your mouth or anus to the area to be examined. Your doctor then will use the ultrasound to use sound waves to create visual images of the digestive tract.

    Why is EUS done?

    EUS provides your doctor with more information than other imaging tests by providing detailed images of your digestive tract. Your doctor can use EUS to diagnose certain conditions that may cause abdominal pain or abnormal weight loss.

    EUS is also used to evaluate known abnormalities, including lumps or lesions, which were detected at a prior endoscopy or were seen on x-ray tests, such as a computed tomography (CT) scan. EUS provides a detailed image of the lump or lesion, which can help your doctor determine its origin and help treatment decisions. EUS can be used to diagnose diseases of the pancreas, bile duct and gallbladder when other tests are inconclusive or conflicting.

    Why is EUS used for patients with cancer?

    EUS helps your doctor determine the extent of spread of certain cancers of the digestive and respiratory systems. EUS allows your doctor to accurately assess the cancer’s depth and whether it has spread to adjacent lymph glands or nearby vital structures, such as major blood vessels. In some patients, EUS can be used to obtain a needle biopsy of a lump or lesion to help your doctor determine the proper treatment.

    How should I prepare for EUS?

    For EUS of the upper gastrointestinal tract, you should have nothing to eat or drink, usually for six hours before the examination. Your doctor will tell you when to start this fasting and whether it is advisable to take your regular prescription medications.

    For EUS of the rectum or colon, your doctor will instruct you to either consume a colonic cleansing solution or to follow a clear liquid diet combined with laxatives or enemas prior to the examination. The procedure might have to be rescheduled if you don’t follow your doctor’s instructions carefully.

    What about my current medications or allergies?

    You can take most medications as usual until the day of the EUS examination. Tell your doctor about all medications that you’re taking and about any allergies you have. Anticoagulant medications (blood thinners such as warfarin or heparin) and clopidogrel may need to be adjusted before the procedure. Insulin also needs to be adjusted on the day of EUS. In general, you can safely take aspirin and non-steroidal anti-inflammatory medications (ibuprofen, naproxen, etc.) before an EUS examination. Check with your doctor in advance regarding these recommendations.

    Check with your doctor about which medications you should take the morning of the EUS examination, and take only essential medications with a small sip of water.

    If you have an allergy to latex, you should inform your doctor prior to your test. Patients with latex allergies often require special equipment and may not be able to have a complete EUS examination.

    Do I need to take antibiotics?

    Antibiotics are not generally required before or after EUS examinations. However, your doctor might prescribe antibiotics if you are having specialized EUS procedures, such as to drain a fluid collection or a cyst using EUS guidance.

    Should I arrange for help after the examination?

    If you received sedatives, you will not be allowed to drive after the procedure, even if you do not feel tired. You should arrange a ride home in advance. You should also plan to have someone stay with you at home after the examination, because the sedatives could affect your judgment and reflexes for the rest of the day.

    What can I expect during EUS?

    Practices vary among doctors, but for an EUS examination of the upper gastrointestinal tract, some endoscopists spray your throat with a local anesthetic before the test begins. Most often you will receive sedatives intravenously to help you relax. You will most likely begin by lying on your left side. After you receive sedatives, your endoscopist will pass the ultrasound endoscope through your mouth, esophagus and stomach into the duodenum. The instrument does not interfere with your ability to breathe. The actual examination generally takes less than 60 minutes. Many do not recall the procedure. Most patients consider it only slightly uncomfortable, and many fall asleep during it.

    An EUS examination of the lower gastrointestinal tract can often be performed safely and comfortably without medications, but you’ll receive a sedative if the examination will be prolonged or if the doctor will examine a significant distance into the colon. You will start by lying on your left side with your back toward the doctor. Most EUS examinations of the rectum generally take less than 45 minutes. You should know that if a needle biopsy of a lesion or drainage of a cyst is performed during the EUS, then the procedure will be longer and may take up to two hours.

    What happens after EUS?

    If you received sedatives, you will be monitored in the recovery area until most of the sedative medication’s effects have worn off. If you had an upper EUS, your throat might be a little sore. You might feel bloated because of the air and water that were introduced during the examination.

    You’ll be able to eat after you leave the procedure area, unless you’re instructed otherwise.

    Your doctor generally can inform you of the preliminary results of the procedure that day, but the results of some tests, including biopsies, may take several days.

    What are the possible complications of EUS?

    Although complications can occur, they are rare when doctors with specialized training and experience perform the EUS examination. Bleeding might occur at a biopsy site, but it’s usually minimal and rarely requires follow-up. You might have a slight sore throat for a day or so. Nonprescription anesthetic-type throat lozenges help soothe a sore throat.

    Other potential but uncommon risks of EUS include a reaction to the sedatives used, aspiration of stomach contents into your lungs, infection, and complications from heart or lung diseases. One major but very uncommon complication of EUS is perforation. This is a tear through the esophagus, stomach or lining of the intestine that might require surgery to repair.

    The possibility of complications increases slightly if a needle biopsy is performed during the EUS examination, including an increased risk of pancreatitis or infection. These risks must be balanced against the potential benefits of the procedure and the risks of alternative approaches to the condition.

  • Capsule Endoscopy

    What is Capsule Endoscopy?

    Capsule Endoscopy lets your doctor examine the lining of the middle part of your gastrointestinal tract, which includes the three portions of the small intestine (duodenum, jejunum, ileum).

    Your doctor will give you a pill-sized video camera for you to swallow. This camera has its own light source and takes pictures of your small intestine as it passes through. These pictures are sent to a small recording device you wear on your body.

    Your doctor will be able to view these pictures at a later time and might be able to provide you with useful information regarding your small intestine.

    Why is Capsule Endoscopy Done?

    Capsule endoscopy helps your doctor evaluate the small intestine. This part of the bowel cannot be reached by traditional upper endoscopy or by colonoscopy. The most common reason for doing capsule endoscopy is to search for a cause of bleeding from the small intestine. It may also be useful for detecting polyps, inflammatory bowel disease (Crohn’s disease), ulcers, and tumors of the small intestine.

    As is the case with most new diagnostic procedures, not all insurance companies are currently reimbursing for this procedure. You may need to check with your own insurance company to ensure that this is a covered benefit.

    How Should I Prepare for the Procedure?

    An empty stomach allows for the best and safest examination, so you should have nothing to eat or drink, including water, for approximately twelve hours before the examination. Your doctor will tell you when to start fasting.

    Tell your doctor in advance about any medications you take including iron, aspirin, bismuth subsalicylate products and other over-the-counter medications. You might need to adjust your usual dose prior to the examination. Discuss any allergies to medications as well as medical conditions, such as swallowing disorders and heart or lung disease. Tell your doctor of the presence of a pacemaker or defibrillator, previous abdominal surgery, or previous history of bowel obstructions, inflammatory bowel disease or adhesions.

    Your doctor may ask you to do a bowel prep/cleansing prior to the examination.

    What Can I Expect During Capsule Endoscopy?

    Your doctor will prepare you for the examination by applying a sensor device to your abdomen with adhesive sleeves (similar to tape). The pill-sized capsule endoscope is swallowed and passes naturally through your digestive tract while transmitting video images to a data recorder worn on your belt for approximately eight hours. At the end of the procedure you will return to the office and the data recorder is removed so that images of your small bowel can be put on a computer screen for physician review.

    Most patients consider the test comfortable. The capsule endoscope is about the size of a large pill. After ingesting the capsule and until it is excreted you should not be near an MRI device or schedule an MRI examination.

    What Happens After Capsule Endoscopy?

    You will be able to drink clear liquids after two hours and eat a light meal after four hours following the capsule ingestion, unless your doctor instructs you otherwise. You will have to avoid vigorous physical activity such as running or jumping during the study.

    Your doctor generally can tell you the test results within the week following the procedure; however, the results of some tests might take longer.

    What are the Possible Complications of Capsule Endoscopy?

    Although complications can occur, they are rare when doctors who are specially trained and experienced in this procedure perform the test. There is potential for the capsule to be stuck at a narrowed spot in the digestive tract resulting in bowel obstruction. This usually relates to a stricture (narrowing) of the digestive tract from inflammation, prior surgery, or tumor. It’s important to recognize obstruction early. Signs of obstruction include unusual bloating, abdominal pain, nausea or vomiting. You should call your doctor immediately for any such concerns. Also, if you develop a fever after the test, have trouble swallowing or experience chest pain, tell your doctor immediately. Be careful not to prematurely disconnect the system as this may result in loss of pictures being sent to your recording device.

  • Phoenix Office Location

    Phoenix Office

    Arizona Gastroenterology Clinic
    2040 W. Bethany Home Road
    Phoenix, AZ 85015
    Phone: (623) 773-1161
    Fax: (623) 773-1181


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  • Peoria Office Location

    Peoria Office

    Arizona Gastroenterology Clinic, P.C.
    14155 N. 83rd Ave, Suite 122
    Peoria, AZ 85381
    Phone: (623) 773-1161
    Fax: (623) 773-1181


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  • Surprise Office Location

    Surprise Office

    Arizona Gastroenterology Clinic LLC
    12301 W Bell Rd, Suite A105
    Surprise, AZ 85378
    Phone: (623) 773-1161
    Fax: (623) 773-1181

  • Surprise Office Location

    Surprise Office

    Arizona Gastroenterology Clinic LLC
    12361 W. Bola Drive, Suite 107
    Surprise, AZ 85374-9021
    Phone: (623) 773-1161
    Fax: (623) 773-1181


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  • Peoria Office

    Peoria Office

    Arizona Gastroenterology & Liver Clinic, P.C.
    14155 N. 83rd Ave, Suite 122
    Peoria, AZ 85381
    Phone: (623) 773-1161
    Fax: (623) 773-1181


    View Larger Map