'first shot'

Endoscopic retrograde cholangiopancreatography, or ERCP, is a procedure to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. It combines X-ray and the use of an endoscope—a long, flexible, lighted tube. Your healthcare provider guides the scope through your mouth and throat, then down the esophagus, stomach, and the first part of the small intestine (duodenum). Your healthcare provider can view the inside of these organs and check for problems. Next, he or she will pass a tube through the scope and inject a dye. This highlights the organs on X-ray.

If you have an anal fissure that hasn’t healed with self-help measures and medical treatments, we may suggest you a procedure to treat it. An anal fissure is a small tear or ulcer (open sore) in your skin around the opening of your anus. There are several different types of procedures available, including injections with botulinum toxin, removal of the fissure (excision or fissurectomy) and sphincterotomy. We may suggest you have a procedure called a fissurectomy alongside Botox injections. This involves cutting away the damaged skin from around your anal fissure, along with any ‘sentinel’ skin tags (lumps of skin associated with the fissure).