Gastroenterology

Gastroenterology (GI) is the branch of medicine focused on the digestive system and its disorders. The digestive system consists of the esophagus, stomach, pancreas, liver, gallbladder, small intestine, and colon. ​

 

Our mission is to provide high quality, compassionate, and cost-effective gastroenterology care to our patients. Our practice philosophy is based on the 3 A's of success: Availability.....Affability.....Ability.  

 

Our staff in the office and at the endoscopy facility appreciate the confidence you have placed in us and will work hard to ensure that you have a satisfying and informative experience.

Common GI conditions include, but are not limited to, the following:

 

  • Acid reflux

  • Dyspepsia

  • Esophagitis

  • Barrett's esophagus

  • Helicobacter pylori infection

  • Peptic ulcer disease

  • Celiac disease

  • Colon polyps

  • Diverticular disease

  • Irritable bowel syndrome

  • Inflammatory bowel disease

  • Diseases of the liver and bile ducts (fatty liver, hepatitis, cirrhosis, etc)

  • Diseases of the pancreas (pancreatitis, EPI, pancreatic cysts, etc)

Gastroenterology Team

  • Michael 
Demarkles, MD
    Michael
    Demarkles, MD

Sedation Information for Upper GI Endoscopy & Colonoscopy 

Please review your insurance coverage carefully and contact your insurance provider if you are concerned that MAC anesthesia would not be covered for you.

If MAC anesthesia is not covered, or if it is too costly, then you would need to be scheduled at a hospital based endoscopy center that offers conscious sedation.

Sedation for upper GI endoscopy and colonoscopy is divided into the following 3 categories:

 

1. Conscious Sedation

Narcotic (FENTANYL) + Benzodiazepine (VERSED)

Administration: Intravenous (IV) by endoscopist and/or nurse

Goal: Comfort but not unconsciousness.

 

Used for most endoscopies done in a surgical center or hospital endoscopy unit.

 

 

2. MAC Anesthesia with PROPOFOL 

 

Administration: Intravenous (IV) by anesthesiologist or anesthetist

Goal: Deeper sedation than conscious sedation but not general anesthesia.  Usually unconscious for the entire procedure.

 

Recommended anesthetic for the following situations:

  • > 70 years old (or < 18 yo)

  • History of MI, severe ASCAD, stroke, TIA

  • Pregnant (schedule at hospital endoscopy)

  • History of an adverse reaction to conscious sedation

  • Known resistance to conscious sedation

  • Substance abuse (daily alcohol, marijuana, etc)

  • Psychiatric medications (depression, etc) - SSRIs, etc.

  • COPD (emphysema)

  • Sleep apnea

  • Morbid obesity (BMI > 40)

  • Active hepatitis

  • Cirrhosis

  • Poorly controlled diabetes

  • Poorly controlled hypertension

  • End stage renal disease

  • Pacemaker

  • Implantable defibrillator

 

 

3. General Anesthesia (Operating Room)

 

Administration requires tracheal intubation in the OR by an anesthesiologist.

Rarely required for performing endoscopy

HOURS

Open 7 day/week

Monday–Thursday 7:30 AM to 7:30 PM

Friday:  7:30 AM to 5:30 PM

Saturday & Sunday 8:00AM to 12:00 PM

Evening hours are available Monday through Thursday

No Show Policy

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147 South Main Street Middleton, MA 01949

978-774-2555

978-774-8715

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