The OBN has established standardized care paths based on current evidence and best practice that outline the minimal tests/assessments required pre-operatively for all bariatric patients in Ontario. Additional pre-operative assessments may vary from person to person, depending on the individual and their health care needs to optimize health prior to surgery.
This is a general list of tests that you may have before surgery. You may have some or all of these tests. Other tests may be needed as well.
You may need to prepare for some tests; your bariatric team will explain these to you and tell you how to prepare for them.
Abdominal Ultrasound
Other names for this are ultrasound imagining, scanning or sonography. Abdominal ultrasound involves using high-frequency sound waves to produce pictures of the inside of your body. The pictures show the structure and movement of your body’s internal organs as well as the blood flowing through blood vessels.
Upper Gastro-Intestinal Series (Upper G. I.)
This is an x-ray of the esophagus, pharynx, stomach, and first part of the small intestine called the duodenum. For this test, you swallow a special liquid dye called barium; as the barium moves through your body pictures are taken.
Cardiac Imaging
Cardiac imaging tests check your heart, heart valves, blood vessels and other structures of the heart. They pick up previous heart attacks, heart disease, blocks from plaque build-up or other problems that you may have with your heart, as well as provide measurements of the heart, chambers and function. There are many kinds of cardiac imaging tests such as a cardiac stress test, cardiac magnetic resonance imaging, cardiac MIBI, and cardiac perfusion scan.
Electrocardiogram (ECG or EKG)
This is a test that records the electro activity of your heart. It is used to diagnose some heart problems. This test is non-invasive and requires a few minutes of relaxation. While laying down sticky pads are placed on your chest, stomach, arms and legs; these are attached to a machine by thin wires. The machine is then turned on and records your heart activity during rest.
Sleep Apnea Studies
This is also called Polysomnography (PSG); it is a test that may require a few visits to complete. Sleep apnea tests help identify a variety of sleeping disorders such as sleep apnea (when you stop breathing several times when sleeping), narcolepsy (when you fall asleep any time, anywhere), restless leg syndrome and other sleep problems.
You will stay overnight for this sleep apnea testing. You are attached to a monitor and watched closely while you sleep. During the exam many body functions are monitored including, eye movement, brain waves, heart waves, muscle movement, snoring, breathing air flow and effort.
Cardiac Stress Test
A Cardiac Stress Test is also known as an Exercise Stress Test or a Treadmill Test. A Cardiac Stress Test helps the health care team find out how well your heart handles work. As your body works harder during the test, it needs more oxygen, so the heart pumps more blood.
This test shows if the blood supply is reduced in the arteries that supply the heart. It also helps the health care team know the kind and level of exercise appropriate for you. A medical professional is always present throughout the test. You start by walking slowly on a treadmill, then the speed of the treadmill is increased and the treadmill is tilted to produce the effect of walking up a small hill.
Gastroscopy
A gastroscopy is a test where a long flexible tube called a gastroscope is passed through your mouth, down your throat into the upper digestive tract. It allows the doctor to look at the lining of the esophagus, stomach and first part of the small intestine called the duodenum. A sample of tissue called a biopsy may be taken to check for H.Pylon.
Colonoscopy
A colonoscopy is a test that looks at the lower end of the intestine, colon and rectum. You need to prepare for this test the day before by emptying the bowel; This process will be explained to you beforehand.
On the day of the test, after you have medication to make you relaxed and sleepy, a small flexible tube scope is inserted into your rectum. The end of the scope has a light and is attached to a screen similar to a television, allowing the doctor see the inside of your lower bowel.
Blood Tests
Blood tests are also done to look your health and well being. Some of the common tests are: complete blood count (CBC), blood glucose (sugar), different vitamin and mineral levels such as iron, calcium, B vitamins and vitamin D.
Helicobacter Pylori (H. Pylori) Bacteria Test
- Pylori is the name of a common bacteria that can cause problems such as stomach ulcers and stomach cancer. If you have H. Pylori you must be treated with antibiotic medication to make sure the bacteria is gone before you have bariatric surgery. It is important to note that ulcers can also be caused by other diseases or from smoking, drinking alcohol and caffeine use after surgery.
Tests used to determine the presence of H. Pylori infection may include:
- Blood test : A blood sample may reveal signs of an H. pylori infection in your body
- Stomach Biopsy: A small sample of the stomach lining is removed by a scope passed from the mouth into the stomach. If bacteria are present, they can be seen when the sample is examined under a microscope.
- C-14/13 breath test: During this test, you drink a solution that contains radioactive carbon molecules. If you have an H. pylori infection, the radioactive carbon is released when the solution is broken down in your stomach. Your body absorbs the radioactive carbon and releases it when you exhale. You exhale into a bag and your doctor uses a special device to detect the radioactive carbon.
Pulmonary Function Tests
These are a group of tests that measure how well your lungs take in air, release air and move oxygen from the air into your body’s blood. These tests help diagnose lung diseases such as asthma, bronchitis, emphysema or find the cause of shortness of breath.
For some tests, you breathe normally and quietly. For other tests, you force air in or force air out during testing.
