Endoscopy is a nonsurgical procedure used to examine a person’s digestive tract. Using an endoscope, a flexible tube with a light and camera attached to it, your doctor can view pictures of your digestive tract on a color TV monitor.
Endoscopy is a medical procedure that allows a doctor to observe the inside of the body without performing major surgery. An endoscope (fibrescope) is a long flexible tube with a lens at one end and a video camera at the other.
The end with the lens is inserted into the patient. Light passes down the tube (via bundles of optical fibres) to illuminate the relevant area, and the video camera magnifies the area and projects it onto a television screen so the doctor can see what is there. Usually, an endoscope is inserted through one of the body’s natural openings, such as the mouth, urethra, or anus.Specially designed endoscopes are used to perform simple surgical procedures, such as:
- Locating, sampling or removing tumours from the lungs and digestive tract.
- Locating and removing foreign objects from the lungs and digestive tract.
- Taking small samples of tissue for diagnostic purposes (biopsy).
- Removing stones from the bile duct.
- Placing tubes (stents) through blockages in the bile duct, oesophagus, duodenum, or colon.
What Is an Endoscopy?
An endoscopy is a procedure in which your doctor uses specialized instruments to view and operate on the internal organs and vessels of your body. It allows surgeons to see problems within your body without making large incisions.
A surgeon inserts an endoscope through a small cut or an opening in the body such as the mouth. An endoscope is a flexible tube with an attached camera that allows your doctor to see. Your doctor can use forceps and scissors on the endoscope to operate or remove tissue for biopsy.
Types
Endoscopy is useful for investigating many systems within the human body; these areas include:
- Gastrointestinal tract: esophagus, stomach, and duodenum (esophagogastroduodenoscopy), small intestine (enteroscopy), large intestine/colon (colonoscopy, sigmoidoscopy), bile duct, rectum (rectoscopy), and anus (anoscopy).
- Respiratory tract: Nose (rhinoscopy), lower respiratory tract (bronchoscopy).
- Ear: Otoscopy
- Urinary tract: Cystoscopy
- Female reproductive tract (gynoscopy): Cervix (colposcopy), uterus (hysteroscopy), fallopian tubes (falloposcopy).
- Through a small incision: Abdominal or pelvic cavity (laparoscopy), interior of a joint (arthroscopy), organs of the chest (thoracoscopy and mediastinoscopy).
Why Do I Need an Endoscopy?
Doctors will often recommend endoscopy to evaluate:
- Stomach pain
- Ulcers, gastritis, or difficulty swallowing
- Digestive tract bleeding
- Changes in bowel habits (chronic constipation or diarrhea)
- Polyps or growths in the colon
In addition, your doctor may use an endoscope to take a biopsy (removal of tissue) to look for the presence of disease.
Endoscopy may also be used to treat a digestive tract problem. For example, the endoscope might not only detect active bleeding from an ulcer, but devices can be passed through the endoscope that can stop the bleeding. In the colon, polyps can be removed through the scope to prevent the development of colon cancer.
Also, using ERCP, gallstones that have passed outside the gallbladder and into the bile duct can often be removed.
How Do I Prepare for an Endoscopy?
Your doctor will give you complete instructions on how to prepare. Most types of endoscopy require you to stop eating solid foods for up to 12 hours before the procedure. Some types of clear liquids, such as water or juice, might be allowed for up to two hours before the procedure. Your doctor will clarify this with you.
Your doctor may give you laxatives or enemas to use the night before the procedure to clear your system. This is common in procedures involving the gastrointestinal (GI) tract and the anus.
Prior to the endoscopy, your doctor will do a physical examination and go over your complete medical history, including any prior surgeries.
Be sure to tell your doctor about any medications you’re taking, including over-the-counter drugs and nutritional supplements. Also alert your doctor about any allergies you might have. You may need to stop taking certain medications if they might affect bleeding, especially anticoagulant or antiplatelet drugs.
You may want to plan for someone else to drive you home after the procedure because you might not feel well from the anesthesia.
How You Prepare
Your doctor will give you specific instructions to prepare for your endoscopy. In some cases your doctor may ask that you:
- Fast before the endoscopy. You will need to stop drinking and eating four to eight hours before your endoscopy to ensure your stomach is empty for the procedure.
- Stop taking certain medications. You will need to stop taking certain blood-thinning medications in the days before your endoscopy. Blood thinners may increase your risk of bleeding if certain procedures are performed during the endoscopy. If you have chronic conditions, such as diabetes, heart disease or high blood pressure, your doctor will give you specific instructions regarding your medications.
Tell your doctor about all the medications and supplements you’re taking before your endoscopy.
Procedure
The procedure will depend to some extent on the reason for the endoscopy.
There are three main reasons for carrying out an endoscopy:
- Investigation: If an individual is experiencing vomiting, abdominal pain, breathing disorders, stomach ulcers, difficulty swallowing, or gastrointestinal bleeding, for example an endoscope can be used to search for a cause.
- Confirmation of a diagnosis: Endoscopy can be used to carry out a biopsy to confirm a diagnosis of cancer or other diseases.
- Treatment: an endoscope can be used to treat an illness directly; for instance, endoscopy can be used to cauterize (seal using heat) a bleeding vessel or remove a polyp.
Sometimes, endoscopy will be combined with another procedure such as an ultrasound scan. It can be used to place the ultrasound probe close to organs that can be difficult to image, such as the pancreas.
Modern endoscopes are sometimes fitted with sensitive lights that use narrow band imaging. This type of imaging uses specific blue and green wavelengths that allow the doctor to spot precancerous conditions more easily.
An endoscopy is typically performed while the patient is conscious, although sometimes the patient will receive local anesthetic (commonly an anesthetic spray to the back of the throat); often, the patient is sedated.
What Happens After An Endoscopy?
Most endoscopies are outpatient procedures. This means you can go home the same day.
Your doctor will close incision wounds with stitches and properly bandage them immediately after the procedure. Your doctor will give you instructions on how to care for this wound on your own.
Afterward, you’ll likely have to wait for one to two hours in the hospital for the effects of the sedation to wear off. A friend or family member will drive you home. Once you’re home, you should plan to spend the remainder of the day resting.
Some procedures may leave you slightly uncomfortable. It may require some time to feel well enough to go about your daily business. For example, following an upper GI endoscopy, you may have a sore throat and need to eat soft foods for a couple days. You may have blood in your urine after a cystoscopy to examine your bladder. This should pass within 24 hours, but you should contact your doctor if it persists.
If your doctor suspects a cancerous growth, they’ll perform a biopsy during your endoscopy. The results will take a few days. Your doctor will discuss the results with you after they get them back from the laboratory.
Read more How to Prepare Eating for an Endoscopy
