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Endoscopy Procedure

by | Nov 30, 2022 | Info | 0 comments

Endoscopy Procedure Overview

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, a doctor can view pictures of a person’s digestive tract on a monitor.

During an upper endoscopy, an endoscope is passed through the mouth and throat and into the esophagus, allowing the doctor to view the esophagus, stomach, and upper part of the small intestine.

Similarly, endoscopes can also be passed into the large intestine (colon) through the rectum to examine this area of the intestine. This procedure is called colonoscopy or sigmoidoscopy depending on how far up the colon is examined.

Endoscopies are minimally invasive and involve openings of the body such as the mouth or anus.

Alternatively, they can be inserted into small incisions, for instance, in the knee or abdomen. Surgery completed through a small incision and assisted with special instruments, such as the endoscope, is called keyhole surgery.

Because modern endoscopy has relatively few risks, delivers detailed images, and is quick to carry out, it has proven incredibly useful in many areas of medicine. These days, an estimated 75 million endoscopies are carried out each year in the United States.

Key Points of Endoscopy Procedure

Following are some key points about endoscopy procedure:

  • The first endoscope was designed in 1806
  • Endoscopies are quick and relatively safe procedures
  • The main reasons for endoscopy are investigation, confirmation, and treatment
  • Endoscopy can be used to remove tumors or polyps from the digestive tract


Reasons for Endoscopy Procedure

Usually, doctors recommend endoscopy to evaluate the following conditions:

  • Chronic constipation or diarrhea
  • Changes in bowel movements
  • Difficulty swallowing food
  • Digestive tract bleeding
  • Gastritis
  • Polyps or growths in the colon
  • Stomach pain
  • Ulcers

In addition, your doctor may use an endoscope to take a biopsy (removal of a tissue from the affected areas) 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.

Complications of Endoscopy Procedure

Overall, endoscopy is very safe; however, the procedure does have a few potential complications, which may include:

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


Types of Endoscopy Procedure

Endoscopies are useful for investigating many systems within the human body; these areas include:

  • Ear: otoscopy
  • Female reproductive tract (gynoscopy): Cervix (colposcopy), uterus (hysteroscopy), fallopian tubes (falloposcopy)
  • 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)
  • Through a small incision: abdominal or pelvic cavity (laparoscopy), interior of a joint (arthroscopy), organs of the chest (thoracoscopy and mediastinoscopy)
  • Urinary tract: cystoscopy


Preparation for Endoscopy Procedure

An endoscopy does not require an overnight stay in the hospital and usually only takes around 1 hour to complete. The doctor will provide instructions about the preparation for the procedure.

For many types of endoscopies, the patient needs to fast for around 12 hours, though this varies based on the type.

For procedures investigating the gut, laxatives may be taken the night before to clear the system.

A doctor will conduct an examination before the endoscopy. It is important to mention all current medications (including supplements) and any previous procedures.

Gut Preparation. Examining the upper digestive tract (upper endoscopy or ERCP) requires nothing more than fasting for 6-8 hours prior to the procedure. To examine the colon, it must be cleared of stool. Therefore, a laxative or group of laxatives is given on the day before the procedure.

Sedation. For most examinations with an endoscope, a sedative is provided. This increases the comfort of the individual undergoing the examination. The sedative, which is administered via an injection into the vein, produces relaxation and light sleep.

There are usually few if any recollections of the procedure. Patients wake up within an hour, but the effects of the medicines are more prolonged, so it is not safe to drive until the next day.

General anesthesia (puts you totally asleep for a period of time) is given in only very special circumstances (in young children, and when very complex procedures are planned).


During an Endoscopy Procedure

During an endoscopy procedure, the patient will be asked to lie down on a table on your back or on your side. As the procedure gets underway:

  • Monitors are attached to your body: This allows your health care team to monitor your breathing, blood pressure and heart rate.
  • You may receive a sedative medication: This medication, given through a vein in your forearm, helps you relax during the endoscopy.
  • An anesthetic may be used in your mouth: An anesthetic spray numbs your throat in preparation for insertion of the long, flexible tube (endoscope). You may be asked to wear a plastic mouth guard to hold your mouth open.
  • Then the endoscope is inserted in your mouth: Your provider may ask you to swallow as the scope passes down your throat. You may feel some pressure in your throat, but you shouldn’t feel pain.

The patients can’t talk after the endoscope passes down their throat, though they can make noises. The endoscope doesn’t interfere with your breathing.

As the endoscope travels down your esophagus:

  • A tiny camera at the tip transmits images to a video monitor in the exam room. Your doctor watches this monitor to look for anything out of the ordinary in your upper digestive tract. If something unusual is found in your digestive tract, images can be taken for later examination.
  • Gentle air pressure may be fed into your esophagus to inflate your digestive tract. This allows the endoscope to move freely. And it allows the folds of your digestive tract to be examined more easily. You may feel pressure or fullness from the added air.
  • Your provider will pass special surgical tools through the endoscope to collect a tissue sample or remove a polyp. This is done with the help from a video monitor to guide the tools.

When the exam is finished, the endoscope is slowly retracted through your mouth. An endoscopy typically takes 15 to 30 minutes.

After the Endoscopy Procedure

The patient will be taken to a recovery area to sit or lie quietly after the endoscopy procedure. The individual may stay for an hour or so. During this time, the health care team can monitor the patient as the sedative begins to wear off.

Once the patients are at home, they may experience some mildly uncomfortable symptoms after endoscopy, such as:

  • Bloating and gas
  • Cramping
  • Sore throat

However, these signs and symptoms will improve with time. If you’re concerned or quite uncomfortable, call your health care provider.

Take it easy for the rest of the day after your endoscopy. After receiving a sedative, you may feel alert, but your reaction times are affected, and judgment is delayed.


Side Effects of Endoscopy Procedure

There are certain risks involved in endoscopy procedure. Risks depend on the area that is being examined.

Risks of endoscopy may include the following:

  • A numb throat for a few hours due to the use of local anesthetic
  • Complications related to preexisting conditions
  • Feeling bloated for a short time after the procedure
  • internal bleeding, usually minor and sometimes treatable by endoscopic cauterization
  • Infection of the area of investigation, which most commonly occurs when additional procedures are carried out at the same time (the infections are normally minor and treatable with antibiotics) 
  • Mild cramping
  • Over-sedation, although sedation is not always necessary
  • Persistent pain in the area of the endoscopy
  • Perforation or tear of the lining of the stomach or esophagus, a rare but serious complication

Any of the following symptoms should be reported to a doctor:


Recovering from an Endoscopy Procedure

Recovery will depend on the type of procedure. For an upper endoscopy, which lets a doctor examine the upper gastrointestinal tract, the patient will undergo observation after the procedure. This usually lasts around one hour while any sedative medication wears off.

The patient should not usually work or drive for the rest of the day because of the sedative effect of the medication used to prevent the pain. Any cognitive effects should be reported to a doctor prior to leaving the procedure area or after.

There may be some soreness. With this type of endoscopy, there may be bloating and a sore throat. However, these usually resolve quickly.

Summary

Endoscopic procedures are typically minimally invasive and can be done through the mouth, anus, or in small incisions. These procedures may be used to investigate, diagnose, or treat various conditions.

These procedures have low complication rates, and a person is typically discharged within a few hours. Some side effects may occur, such as a sore throat or bloating. However, they will typically resolve quickly. A patient should speak with their doctor if lingering effects occur.

 

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