Argon plasma coagulation (APC) is a relatively new procedure that effectively treats multiple conditions affecting the gastrointestinal tract, including:
- Angiodysplasia, which can cause unexplained GI bleeding as well as anemia.
- Gastric antral vascular ectasia (GAVE) or watermelon stomach, a less common cause of GI bleeding and/or anemia.
- Colonic polyps.
- Radiation colitis, severe inflammation or damage to the colon after radiation treatment
- Esophageal cancer.
APC is an encouraging alternative to existing treatments for these conditions, such as contact thermal coagulation (heater probe and bipolar cautery) and laser treatments. In addition to its more straightforward application, APC is also more effective at treating multiple lesions during the same procedure, requires lesser depth of penetration (increasing safety), is associated with faster recovery times. It is also more cost-effective than other alternatives.
What is Argon Plasma Coagulation (APC)?
Many people mistakenly believe that APC is another type of laser treatment. It is not. Instead, APC uses the combination of argon gas and a high-voltage spark. Like lightening, this activated gas spark wants to find a ground in the nearest tissue. Thus, we use a very targeted probe to deliver the spark to the adjacent lesion or area of concern.
The spark penetrates the affected tissue to between two- to three-millimeters (2mm to 3mm) deep. This technology makes it possible for us to treat lesions that occur in a fold of the GI tract or that are located in positions that are inaccessible to the tip of the endoscope.
What Can I Expect During the Procedure?
In many ways, your APC isn’t all that different from the patient perspective than a typical endoscopic procedure. If it is the upper-GI area being treated, you may only need to fast and refrain from drinking liquids after midnight the evening before the procedure. If the lower GI will be treated, you will probably need to fast and cleanse as per your doctor’s instructions. If you have diabetes, we will work with you to keep your blood sugar in check throughout the fasting, procedure and post-op period.
We will require a list of both prescription and over-the-counter medications – including acid reflux meds and anticoagulants – so we can discuss whether or not you’ll need to abstain or adjust the dosage for the weeks or days leading up the procedure.
The procedure will involve a local anesthetic to reduce discomfort and the gag reflex. You will also be sedated, which means someone needs to be available to drive you home after the procedure.
In most cases, the APC treatment will be completed in under an hour, but there are exceptions – depending on the number and severity of the lesions. Once the APC is complete, the doctor will report on how things went and send you home with instructions for the next week.
Most patients experience only mild, if any, discomfort, manageable with mild pain medications. For the first 24 to 48 hours, you should adhere to a liquid diet, and you may also be instructed to observe a soft diet for the following week. This aids the healing process and minimizes the chance of infection or complications at the treatment sites.
Are you interested in learning more about argon plasma coagulation and its potential for treating your GI issue? Contact the office of Dr. Samuel Marcus to schedule a consultation.