Endoscopy

EndoscopyWhat is an endoscopy?

An endoscopy is a test that examines the lining of digestive system. It is performed using an endoscope, a thin (thickness of a small finger) flexible tube, with a camera and light source, which transmits an image to a video monitor).

You may need an endoscopy to inspect the lining of the oesophagus (swallowing tube), stomach, duodenum (first part of the small bowel that attaches to the stomach), or the colon (large bowel).


Upper GI Endoscopy

1. What is an upper GI endoscopy?
An upper GI endoscopy is when the lining of the oesophagus, stomach and duodenum is inspected and sometimes called oesophago – gastro -duodenoscopy (OGD) or gastroscopy.By comparison, a lower gastrointestinal endoscopy is when the lining of colon (large bowel) is inspected. It is called a colonoscopy when the whole of the colon is inspected and a sigmoidoscopy when the sigmoid part of the colon is inspected.
2. Why is an upper endoscopy performed?
Upper GI endoscopy evaluates the following:

  • Bleeding from the upper GI tract
  • Unexplained weight loss
  • Swallowing difficulties
  • Upper Abdominal pain
  • Ethnicity: Scandinavians
  • Gastric reflux
  • Vomiting
  • Anaemia
  • Nausea

Upper endoscopy is more accurate than X-ray for detecting inflammation or smaller abnormalities such as ulcers or tumours. It is able to take biopsies (obtain small pieces of tissue) or cytology (obtain some cells with a fine brush) for microscopic examination to determine the nature of the abnormality, benign or malignant (cancerous).

3. What might an upper endoscopy detect?
Upper GI endoscopy might detect:

  • Precancerous Conditions
  • Abnormal Growths
  • Inflammation
  • Hiatal Hernia
  • Ulcers
4. How do I prepare for the endoscopy?
To accomplish a safe and complete examination, the stomach should be empty. The patient will be asked to have nothing to eat or drink for eight hours prior to the procedure. Smoking and chewing gum are also prohibited during this time. You will receive written instructions about this beforehand, or they may arrive with the appointment letter.Prior to scheduling the procedure, the patient should inform his or her physician of any medications they are currently taking, any allergies, and all of their health problems. This information will remind the doctor whether the patient may need antibiotics prior to the procedure, what potential medications should not be used during the exam because of the patient’s allergies, and will provide the individual scheduling the procedure an opportunity to instruct the patient whether any of the medications they are taking should be held or adjusted prior to the endoscopy. Knowledge whether the patient has any major health problems, such as heart or lung diseases, will alert the examiner of possible need for special attention during the procedure.Driving or handling machinery is not permitted for 12 to 24 hours after upper GI endoscopy to allow sedatives time to completely wear off. Before the appointment, patients should make plans for a ride home.

5. Where and how is it performed?
Upper GI endoscopy is conducted at a hospital or on outpatient basis. The doctor will discuss why the procedure is being done, whether there are alternative procedures or tests, and what possible complications may result from the endoscopy.
Upper Endoscopy
Most patients have a choice between having the test while awake under local, “anaesthetic sprayed on the back of the throat” or after having a medicine to make them drowsy (a sedative). The anaesthetic numbs the throat and calms the gag reflex. An intravenous (IV) needle is placed in a vein in the arm if a sedative will be given. Sedatives help patients stay relaxed and comfortable. While patients are sedated, the doctor and medical staff monitor vital signs.The hospital may not be happy for you to have a sedative if you live alone and have no one to look after you when you go home. If you live alone but really want sedation, your hospital may allow you to stay overnight.During the procedure, patients lie on their back or side on an examination table. Once the sedative or throat spray has worked, an endoscope is carefully fed down the oesophagus and into the stomach and duodenum. You will be asked to swallow as the tube goes down, but if you’ve had a sedative, you won’t remember that afterwards. This procedure will NOT interfere with your breathing.

A small camera mounted on the endoscope transmits a video image to a video monitor, allowing close examination of the intestinal lining. Air is pumped through the endoscope to inflate the stomach and duodenum, making them easier to see. Special tools that slide through the endoscope allow the doctor to perform biopsies, stop bleeding, and remove abnormal growths.

6. Recovery
After the upper GI endoscopy, patients are moved to a recovery room where they wait about an hour for the sedative to wear off. During this time, patients may feel bloated or nauseated. They may also have a sore throat, which can stay for a day or two.Patients will likely feel tired and should plan to rest for the remainder of the day. Unless otherwise directed, patients may immediately resume their normal diet and medications.
7. Risks
Endoscopy is a safe procedure when performed by a specialist. Major complications are rare and usually requires surgical repair.Risks include:

  • Bleeding from biopsy
  • Abnormal reaction to sedatives
  • Accidental puncture of the upper GI tract
  • Vomiting
  • Fever

Patients who experience any of the following symptoms after upper GI endoscopy should contact their doctor immediately.
Symptoms may include:

  • Worsening throat, chest, and abdominal pain
  • Bloody or very dark stool
  • Swallowing difficulties
  • Vomiting
  • Fever
8. Results
The endoscopist (doctor who carries out the endoscopy) types a report straight away. The endoscopist will inform the patient of the test results or the probable findings prior to discharge from the recovery area. The results of biopsies or cytology usually take 72-96 hours and the doctor may only give the patient a presumptive diagnosis pending the definitive one, after the microscopic examination.A copy of the report will be sent to the referring doctor and/or your GP. Biopsies are taken for many reasons and do not necessarily mean that cancer is suspected. Routine biopsy results may take up to 10 days.