Everything You Need To Know About Endoscopy | Gastroenterology


Overview of Endoscopy

Endoscopy is the insertion of a long, thin tube directly into the body to examine the internal organ or tissue in detail. It can also be used to perform other tasks, including imaging and minor surgery.

Endoscopes are minimal and can be inserted into openings in the body, such as the mouth or anus.

Types of endoscopy

Endoscopy is useful for investigating many systems in the human body, these areas include:

Gastrointestinal tract: Esophagus, stomach, and duodenum (esophagus)

Respiratory tract: Nose (rhino), lower respiratory tract (bronchoscopy)

Ear: Otoscopy

Urinary tract: Cystoscopy

Female reproductive tract (gynechoscopy): Cervix (colposcopy), uterus (hysteroscopy), fallopian tubes (phalloscopy)

Through small incisions: Abdominal or pelvic cavity (laparoscopy), internal joint (arthroscopy), organs of the thorax (thoracoscopy and mediastinoscopy).

Why do I need an endoscopy?

Doctors often recommend endoscopy to evaluate:

  • Abdominal pain
  • Ulcers, gastritis, or difficulty swallowing
  • Gastrointestinal bleeding
  • Changes in bowel habits (chronic constipation or diarrhea)
  • Polyps or enlargement in the colon
  • Also, your doctor may use an endoscope to take a biopsy (removal of tissue) to look for the presence of disease

Endoscopy can also be used to treat a digestive problem. For example, an endoscope can not only detect active bleeding from an ulcer, but it can also send devices that can stop bleeding through the endoscope. In the colon, polyps can be removed with an endoscope to prevent the development of colon cancer.

Also, with ERCP, gallstones that have flowed out of the gallbladder into the bile duct can often be removed.

Is endoscopy safe?

In general, endoscopy is very safe. However, there are some potential problems with this approach, which may include:

  • Perforation (tear in the intestinal wall)
  • Reaction to poisoning
  • Infection
  • Bleeding
  • Pancreatitis as a result of ERCP

Preparation for the endoscopy

Your doctor will give you complete instructions on how to prepare it. For most types of endoscopy, you should avoid eating solid foods for up to 12 hours before the procedure. Some clear liquids, such as water or juice, may be allowed up to two hours before the procedure. Your doctor will clarify this for you.

Your doctor may give you laxatives or enemas to use the night before the procedure to cleanse your system. It is most common in the gastrointestinal (GI) tract and rectum.

Before the endoscopy, your doctor will perform a physical exam and obtain your complete medical history, including any previous surgeries.

Over-the-counter medications Tell your doctor about any medications you are taking, including medications and nutrients. If you have any allergies inform the doctor. Bleeding, especially anticoagulant or antiplatelet. If medications can affect you, you can stop taking certain medications.

You may feel like someone else will drive you home after this procedure because you are not in good health due to the anesthesia.

During the endoscopy

During the upper endoscopy procedure, you are asked to lie on a table behind you or on your side. During the process:

  • Monitors are usually attached to your body to monitor your breathing, blood pressure, and heart rate.
  • You can get pills. This medicine, given through a vein in your forearm, can help you relax during the endoscopy.
  • Your doctor may spray narcotics into your mouth. These medicines numb your throat to insert a long, flexible tube (endoscope). You may be asked to wear a plastic mouth guard to keep your mouth open.
  • Then the endoscope is inserted into your mouth. Your doctor may ask you to swallow when the scope passes through your throat. No pain is felt, but you may experience pressure in the throat.
  • You cannot speak after the scope has passed through your throat, although you can still make noises. The endoscope does not interfere with your breathing.

As your doctor inserts the endoscope into your esophagus:

  • A small camera on the tip transmits images to a video monitor in the exam room. Your doctor will watch this monitor see if there are any abnormalities in your upper digestive system. If abnormalities are found in your digestive system, your doctor can record images for further testing.
  • Gentle air pressure is delivered into your esophagus to stimulate your digestive system. This allows the endoscope to move freely. And it makes it easier for your doctor to examine the folds of your digestive system. You may feel stressed or full from the extra air.
  • Your doctor will pass special surgical instruments through an endoscope to collect a tissue sample or remove the polyp. Your doctor will see a video monitor to guide you through the tools.
  • When your doctor completes the test, the endoscope is slowly withdrawn through your mouth. Endoscopy generally takes 15 to 30 minutes depending on your condition.

After the endoscopy

Most endoscopies are ati procedures for patients. That means you can go home the same day. Your doctor will close the incisions with stitches and tie them properly as soon as the procedure is finished. Your doctor will give you instructions on how to care for this injury on your own.

Then you will have to wait an hour or two in the hospital for the effects of the narcotics. A friend or family member will take you home. Once you get home, you should plan to spend the rest of the day relaxing.

Some procedures can make you feel a bit uncomfortable. You need some time to learn about your daily activities. For example, if you have an upper endoscopy, you may have a sore throat and need a soft diet for two days. There may be blood in your urine after the cystoscopy to examine your bladder. It should pass within 24 hours, but you should see your doctor if it persists.

If your doctor suspects an increase in cancer, he will perform a biopsy during your endoscopy. Results take a few days. Your doctor will talk with you after getting the lab results.

Risks of endoscopy

Endoscopy is a very safe procedure.

  • Bleeding: The risk of bleeding after endoscopy increases if the test (biopsy) involves removing a piece of tissue or treating a gastrointestinal problem. In rare cases, such bleeding may require a blood transfusion.
  • Infection. Most endoscopies involve an exam and biopsy, and the risk of infection is low. When additional procedures are done, the risk of infection increases. Most infections are mild and can be treated with antibiotics. If you are at high risk of infection, your doctor may prescribe preventive antibiotics before your procedure.
  • Rupture of the gastrointestinal tract. You may need to be hospitalized in your esophagus or another part of your upper digestive tract, and sometimes you will need surgery to repair it. The risk of this problem is very low: it occurs in 1 in 2,500 to 11,000 high diagnostic endoscopies. The risk increases if you perform additional procedures such as dilation to dilate your esophagus.
  • You can reduce your risk of complications by carefully following your doctor’s instructions for preparing for your endoscopy, such as fasting and stopping certain medications.

Other tools used during endoscopy

The endoscope usually has a channel through which the doctor can insert tools. These tools collect tissue or provide treatment.

Types of tools:

Flexible forceps: These tongue-shaped devices take a tissue sample.

Biopsy forceps: These remove the suspicious tissue pattern or growth

Cytology brushes: They take cell samples. 

Suture removal forceps: These eliminate the piercings inside the body

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