Dr. Stephen G. Kimmel, MD

Patients may be asked to drink only liquids in the days before a colonoscopy, or they may be given an enema to remove residual fecal matter. Before the exam, patients are given medication to help them relax, and then lay on their side on a table. The scope is inserted into the anus and gently moved all the way through the large intestine. Air may be pumped into the intestine to improve the view for the physician. Any polyps that are found will be removed. Then the colonoscope will be withdrawn. A colonoscopy is not usually painful, but patients may feel some bloating or have some cramps right afterward. If patients have polyps removed, they might experience a small amount of bleeding. Any side effects should go away within a few hours.

Today, most gallbladder surgeries are done laparoscopically. Four tiny incisions are made in the abdomen, and small tools are inserted through these tiny incisions to perform the surgery. Because the incisions are much smaller, recovery time is much faster with this type of surgery. Patients are usually discharged from the hospital the same day. Sometimes, open surgery is used to remove a gallbladder. In this type of surgery, a cut about six inches long is made in the upper right abdomen. After the gallbladder is removed, it is sutured or stapled closed. With open surgery, patients usually stay in the hospital for two to three days to recover before they are discharged.

Gallbladder removal, like any surgery, carries some risks, such as bleeding, infection, or the development of blood clots. Doctors will tell patients how to minimize their risk for complications. After surgery, patients are advised to avoid strenuous activity for several days. They should not soak in a bath until their sutures or staples have been removed. Patients should wash hands before touching the area around the incision. It will take a couple of days until patients feel like themselves again and a few weeks until their scar has healed and faded.

Both hypothyroidism and goiters are caused by an autoimmune reaction where the body produces antibodies that attack the thyroid cells for unknown reasons. The thyroid reacts by releasing too little or too much T3 and T4 thyroid hormones, impairing thyroid function and causing irregular metabolism. Goiters develop from the autoimmune reaction causing continued antibody damage to the thyroid over time. Thyroid goiters are large, swollen lumps that can be felt near the base of the neck. Obstructive goiters can cause pain, coughing, and abnormal breathing. Hypothyroidism may also be caused by iodine deficiency, as iodine is needed to produce thyroid hormones.

The exact cause of thyroid cancer and thyroid nodules or cysts is unknown. While thyroid cancer and thyroid nodules or cysts can occur in individuals with thyroid disorders, they are not associated with a malfunctioning thyroid.

Physicians may prescribe thyroid surgery if blood tests reveal patients' thyroid stimulating hormones (TSA) are outside of the acceptable range, indicating a malfunctioning thyroid. Thyroid biopsies (tissue samples) and tests for thyroid-attacking antibodies are also criteria for surgery.

An ENT or general surgeon performs thyroid surgery. While a patient is placed under anesthesia, the surgeon makes an incision at the center of the neck and removes the thyroid gland. Two alternative methods of thyroid surgery are transoral (incision through the mouth) and endoscopic, where a surgeon operates a video camera for live footage to help guide the removal process.

Thyroid surgery requires minimal aftercare. Most patients recover quickly and resume normal activities within a few days of surgery. However, thyroid surgery patients must take daily synthetic thyroid medication (levothyroxine) for life to replace their removed thyroid.