Endoscopy - Frequently asked questions

1. What is endoscopy?

•  Endoscopy is a minimally invasive diagnostic medical procedure where an instrument called endoscope is passed into a specific organ like the bladder or intestine to examine the inner surface of that area. The endoscope contains a fiberoptic camera that magnifies the image of the particular area on the video screen to be viewed by the operator. Endoscope, unlike most other medical imaging device is directly pushed inside the organ. The most common type of endoscopy is upper gastrointestinal endoscopy (UGI), which is done to find out problems related to intestine. However, endoscopy is also often performed to examine if a particular region is affected by cancer. The biological name for this test is biopsy. In a biopsy, the endoscope retrieves the image of a small region, the tissues and muscles of which are then examined for detecting cancer.

2. Why is endoscopy done?

•  An endoscopy test is mainly done to find problems of the upper gastrointestinal (GI) tract.

•  The test determines if the tract is affected by inflammation of the stomach (also called gastritis) or inflammation of the oesophagus (also called esophagitis).  It also examines if there is any stricture or enlarged or swollen veins in the oesophagus. Besides, the test also detects diseases like Barrett’s oesophagus (a disease that may later develop into esophageal cancer), Ulcers, Hiatal Hernia etc.

•  Endoscopy also finds causes for hematemesis (or vomiting blood), dysphagia (or trouble swallowing), upper abdominal pain or bloating, unnecessary weight loss, or any type of infection.

• Post surgery, endoscopy is performed to examine the internal part of the stomach or duodenum (upper part of small intestine) and if there is any blockage in the gastric outlet (the opening between the stomach and small intestine).

• The endoscopy procedure is often carried out to detect an esophageal injury, gastrointestinal polyps or any foreign object including poison that has been deliberately or accidentally swallowed by the patient.

• It helps in treating oesophageal varices, a condition, where gastrointestinal bleeding occurs mainly due to enlarged and inflamed veins in the oesophagus.

•  It also collects tissue samples for biopsy.

3. What are the types of Endoscopy?

•  There are many types of Endoscopy.

•  Arthroscopy: The muscle joints are viewed by an Arthroscope, which is inserted through a small incision in the muscle.

•  Bronchoscopy: The trachea and bronchi (of lungs) are viewed by a Bronchoscope, which is inserted through the mouth.

• Colonoscopy: The entire colon and large intestine are viewed by a Colonoscope, which is inserted through the anus.

•  Colposcopy: The vagina and cervix are viewed by a Colposcope, which is positioned at the opening of the vagina while a speculum is inserted inside.

•  Cystoscopy: The internal part of the bladder is viewed by a Cystoscope, which is inserted through the urethra.

•  Esophagoscopy: The oesophagus is viewed by an Esophagoscope, which is inserted through the mouth.

•  Gastroscopy: The stomach and duodenum are viewed by a Gastroscope, which is inserted through the mouth.

•  Laparoscopy: The stomach, liver or female reproductive organs like uterus, ovaries, or fallopian tubes are viewed by a Laparoscope, which is inserted through an opening in the abdomen. The opening is done through a surgery.

•  Laryngoscopy: The larynx is viewed by a Laryngoscope, which is inserted through the mouth.

•  Neuroendoscopy: A specific area of brain is viewed by a Neuroendoscope, which is inserted through a small incision made in the skull area nearest to the region to be viewed.

•  Proctoscopy: The rectum and sigmoid colon are viewed by a Proctoscope, which is inserted through the anus.

•  Sigmoidoscopy: The bottom part of the colon, also called Sigmoid colon is viewed by a Sigmoidscope, which is inserted through the anus.

•  Thoracoscopy: The pleura (cover enveloping the lungs) or pericardium (cover enveloping the heart) is viewed by a Thoracoscope, which is inserted through a small surgical opening in chest.

4. If I have to go for an endoscopy, what preparations should I require before the procedure?

•  Before undergoing an endoscopy test, the endoscopy surgeon gives detailed instructions on how the patient should prepare for the test.

•  The patient should not eat or drink anything for a number of hours before the test.

•  Intake of any kind of blood thinning medicine is strictly prohibited by the doctor a few days before the procedure to eliminate the risk of bleeding.

•  In case of upper gastrointestinal endoscopy (endoscopy of the stomach, gallbladder, liver, colon, rectum, small intestine, oesophagus etc.) the patient is prescribed a laxative to clear stool from his/her bowels.

•  The patient needs to sign a consent letter that states that he/she is well aware of the benefits and risks of endoscopy.

5. Is the procedure painful?

•  The patient is given a sedative medication for he/she could relax during the procedure. The medication is given through a vein in the forearm. The doctor also sprays an anesthetic in some cases to numb the patient’s throat before inserting an endoscope. Thus, the patient does not feel any pain during the procedure. However, some mildly uncomfortable symptoms like gas formation, cramping or sore throat can be felt afterwards. Such symptoms are temporary and generally go within a few days.

6. Do I require admission for the procedure?

•  Depending on the region to be examined and the procedure to be followed, an endoscopy takes around 15 minutes to 1 hour. In some cases, it may take more than an hour depending on the region where it is done. It is usually performed on an outpatient basis and the patient is not required to stay in the hospital overnight.

7. How is an endoscopy done?

•  Most of the endoscopy procedures require local anesthesia. Only arthroscopy requires general anesthesia. Often the patient is also given a sedative to make him/her feel relaxed. The endoscope is carefully inserted into the part of the body that requires examination. In case of laparoscopy (also called keyhole surgery), the endoscope is inserted through a small incision made on the skin by the surgeon.

• There is another type of endoscopy, which is relatively new. The name of the procedure is Wireless capsule endoscopy. It involves a different kind of procedure. The patient needs to swallow a special type of capsule that can transmit images of the internal part of stomach and digestive system. It is a large pill that gets excreted from your body naturally through bowel. Sometimes it gets very hard to detect the cause of internal bleeding in the digestive system. Wireless capsule endoscopy helps to ascertain the result in these cases.

8. What precautions should I take after the procedure?

•  After the procedure, the patient should lie down quietly for 2 to 3 hours. He/she should be monitored clearly at that time.

•  The patient should strictly follow the diet chart suggested by the doctor.  First the patient should start with liquids like water, juice etc. and gradually shift to semisolid food that can be digested easily. Once he/she starts digesting these foods easily, he/she can make a lift to solid foods. The patient should not have junk, spicy and fatty food during the phase of recovery.

•  The patient is suggested not to take part in any kind of rigorous activity during the recovery phase. Pain is one sign that helps to determine if the person should actually indulge in a particular activity or not. If there is pain that means the patient is trying to get into his earlier routine too soon and he/she should resume it gradually.

•  If the patient faces any breathing problem or suffers from a severe pain, he should immediately call the doctor. Other complications that ask for an immediate consultation with the doctor include body temperature above 100 degrees, black stool, nausea, vomiting, decreased energy level or persistent diarrhea.

9. Should anyone accompany me for the procedure?

• If the patient is given any sedative, he/she must have someone, at least one family member or friend who would accompany him/her throughout the procedure and also help him/her reach home.

10. What are the side effects of the procedure?

• Every procedure has its side effects, risks and complications. In general endoscopy is a safe procedure and if there is any complication, that can be treated easily. The probable side effects of Endoscopy are:

•  An inflammation in the intestinal wall or the wall of the stomach

•  Excessive bleeding

•  Allergic reaction to the sedative

•  Pancreatitis (can occur due to surgical trauma)

•  Nausea, vomiting, diarrhea

•  Severe indigestion

•  Fever with temperature above 100 degrees

•  In wireless capsule endoscopy some patients might find difficulty in swallowing the large pill. Besides, the capsule can also cause blockage in the narrow area of bowel.

• Although sometimes patients face these side effects, they are easily treatable with antibiotics and other IV fluids.

11. Whom should I contact in case report is abnormal?

• If the report is abnormal, the patient needs to consult a gastroenterologist in most cases.

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