Definition and Overview
An endoscopy is a non-surgical procedure used to examine the digestive tract of a patient and, in some cases, apply treatment, if it is already possible. It involves the use of an endoscope, a flexible tube with a camera attached to its end. The camera takes images of the inside of the digestive tract, allowing the diagnosing doctor to view the images on a TV monitor connected to the endoscope.
Different types of Endoscopy
There are many ways that an endoscopy is performed. These include:
- Upper Endoscopy – An upper endoscopy is performed by passing the endoscope through the mouth, throat, and down into the esophagus. This is used when the doctor needs to examine the esophagus, stomach, and the small intestine, particularly its upper portion.
- Sigmoidoscopy or Colonoscopy – These are two similar procedures that pass the endoscope through the rectum into the large intestine or colon. This is performed when a problem with the colon is suspected.
- Endoscopic Retrograde Cholangiopancreatography (ERCP) – This is a special type of endoscopy that examines the gallbladder and the pancreas. It is also used to examine the body parts that are in the same vicinity. An ERCP is also sometimes used to remove gallstones that have made their way into the bile duct.
- Endoscopic Ultrasound (EUS) – This procedure combines endoscopy with ultrasound technology to get more helpful information on the state and health of the digestive tract.
- Biopsy – Your doctor may also use an endoscope during an endoscopy procedure to take a biopsy sample of the digestive tract. A special tool will be used to remove some tissue from the affected area. This sample is then analyzed to determine whether a disease is present.
- Treatment – During an endoscopy, if your doctor detects certain problems, it is also possible to use the procedure to apply treatment. For example, if the procedure shows active bleeding in the digestive tract, your doctor can pass other devices through the endoscope in order to stop the bleeding. Likewise, if polyps and other growths are found, the endoscope may also be used to remove them.
When is it used
An endoscopy is primarily used in the diagnosis and treatment of gastrointestinal disorders. Diseases that affect the gastrointestinal tract affect several different organs, starting from the mouth down to the anus.
An endoscopy is often necessary to diagnose or confirm the diagnosis of gastrointestinal diseases, which include:
- Bowel obstruction
- Barrett's esophagus
- Crohn's disease
- Lactose intolerance
- Peptic ulcer disease
- Ulcerative colitis
- Irritable bowel syndrome
- Celiac disease
- Cancers of the digestive system, i.e. colon cancer, gallbladder cancer, stomach cancer
An endoscopy is used to look for signs or the presence of:
- Gastrointestinal bleeding
- Inflammation in the digestive tract/intestines
- Polyps and other abnormal growths in the colon
Aside from its uses in gastrointestinal medicine, an endoscopy is also used as an additional tool to diagnose or confirm a diagnosis pertaining to several other health problems involving different body systems. Here are some examples of the secondary uses of endoscopy.
- Rhinoscopy - examination of the nose
- Bronchoscopy – examination of the lower respiratory tract
- Otoscopy – examination of the ear
- Gynoscopy – examination of the female reproductive system, including the cervix, uterus, and fallopian tubes
- During pregnancy – to examine the amnion or the fetus
- Orthopedic surgery – involves endoscopic carpal tunnel release for the hands and anterior cruciate ligament reconstruction for the knee
Doctors usually prescribe an endoscopy when the patient is experiencing the following key symptoms:
- Stomach pain
- Difficulty swallowing
- Changes in bowel movement
- Chronic constipation
- Chronic diarrhea
- Fecal incontinence
An endoscopy is a safe and commonly used diagnostic and treatment procedure with a high success rate and very few risks and possible complications. These include:
- Perforation of the gut wall
- Negative effects caused by sedation
Your doctor will discuss the procedure in detail with you to keep you informed and at ease prior to undergoing an endoscopy.
Who to see
If you are experiencing some symptoms involving your stomach, abdomen, or your bowel movement, you can go to your family doctor or internist for a checkup. If other possible causes are ruled out, your doctor will prescribe an endoscopy or sigmoidoscopy, whichever is needed.
However, if you need an ERCP or EUS, or if your family doctor suspects a more serious or chronic problem, he or she may refer you to a gastroenterologist or a gastrointestinal surgeon. These are medical doctors who specialize in the diagnosis and treatment of gastrointestinal diseases or diseases of the digestive system. Gastroenterologists are required to take special training focused only on endoscopy, since this is a significant tool used in their specialization.
Preparation and recovery
If you are scheduled for an endoscopy, you will have to take certain steps to prepare for the procedure. These include:
- Dietary restrictions – You will not be allowed to eat 6-8 hours prior to the procedure. This is because for the successful examination of the colon, all stool should be cleared hours before the procedure. To do so, you will be given a laxative on the day before your scheduled endoscopy.
- Sedation – You will be under a sedative to keep you comfortable during the procedure. This will put you in a relaxed state and you will fall into a light sleep. The sedative will keep you in this state for an hour, which is enough time for the procedure to be completed. Upon waking up, you will have very little to no recollection of the endoscopy.
- General anesthesia – An endoscopy is sometimes performed under general anesthesia. Some examples of such instances are when the patient is a very young child and when the treatment plan involves other complex procedures.
After the endoscopy, the effects of the anesthesia or sedative will gradually wear off. You will be asked to stay in the hospital for further observation and monitoring until this occurs. Any lingering discomfort such as distention or a mild sore throat are very mild and will go away on its own during the first few days following the procedure. Within a few hours, you will be allowed to eat and drink, and may be discharged from the hospital with advice to rest. However, you will not be allowed to drive on the same day due to the effects of the sedation or anesthesia. Arrangements for driving home should be made prior to the procedure.
- Gastrointestinal Endoscopy: http://www.giejournal.org
- World Journal of Gastrointestinal Endoscopy
- Surgical Endoscopy, Official Journal of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) and European Association for Endoscopic Surgery (EAES)
- Endoscopy, Journees Francophones d’Hepato-Gastroenterologie et d’Oncologie Digestive (JFHOD)