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.
Endoscopy allows your doctor to visually examine an organ without having to make a large incision. A screen in the operating room lets the doctor see exactly what the endoscope sees.
Endoscopy is typically used to:
- help your doctor determine the cause of any abnormal symptoms you’re having
- remove a small sample of tissue, which can then be sent to a lab for further testing; this is called an endoscopic biopsy
- help your doctor see inside the body during a surgical procedure, such as repairing a stomach ulcer, or removing gallstones or tumors
Your doctor may order an endoscopy if you’re having symptoms of any of the following conditions:
- inflammatory bowel diseases (IBD), such as ulcerative colitis (UC) and Crohn’s disease
- stomach ulcer
- chronic constipation
- unexplained bleeding in the digestive tract
- blockage of the esophagus
- gastroesophageal reflux disease (GERD)
- hiatal hernia
- unusual vaginal bleeding
- blood in your urine
- other digestive tract issues
Your doctor will review your symptoms, perform a physical examination, and possibly order some blood tests prior to an endoscopy. These tests will help your doctor gain a more accurate understanding of the possible cause of your symptoms. These tests may also help them determine if the problems can be treated without endoscopy or surgery.
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.
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.
Endoscopies fall into categories, based on the area of the body that they investigate. The American Cancer Society (ACS) lists the following types of endoscopies:
|Type||Area examined||Where scope is inserted||Doctors who typically perform the surgery|
|arthroscopy||joints||through a small incision near the examined joint||orthopedic surgeon|
|bronchoscopy||lungs||into the nose or mouth||pulmonologist or thoracic surgeon|
|colonoscopy||colon||through the anus||gastroenterologist or proctologist|
|cystoscopy||bladder||through the urethra||urologist|
|enteroscopy||small intestine||through the mouth or anus||gastroenterologist|
|hysteroscopy||inside of the uterus||through the vagina||gynecologists or gynecological surgeons|
|laparoscopy||abdominal or pelvic area||through a small incision near the examined area||various types of surgeons|
|laryngoscopy||larynx||through the mouth or nostril||otolaryngologist, also known as an ear, nose, and throat (ENT) doctor|
|mediastinoscopy||mediastinum, the area between the lungs||through an incision above the breastbone||thoracic surgeon|
|sigmoidoscopy||rectum and the lower part of the large intestine, known as the sigmoid colon||into the anus||gastroenterologist or proctologist|
|thoracoscopy, also known as a pleuroscopy||area between the lungs and the chest wall||through a small incision in the chest||pulmonologist or thoracic surgeon|
|upper gastrointestinal endoscopy, also known as an esophagogastroduodenoscopy||esophagus and upper intestinal tract||through the mouth||gastroenterologist|
|ureteroscopy||ureter||through the urethra||urologist|
Like most technologies, endoscopy is constantly advancing. Newer generations of endoscopes use high-definition imaging to create images in incredible detail. Innovative techniques also combine endoscopy with imaging technology or surgical procedures.
Here are some examples of the latest endoscopy technologies.
A revolutionary procedure known as a capsule endoscopy may be used when other tests aren’t conclusive. During a capsule endoscopy, you swallow a small pill with a tiny camera inside. The capsule passes through your digestive tract, without any discomfort to you, and creates thousands of images of the intestines as it moves through.
Endoscopic retrograde cholangiopancreatography (ERCP)
Chromoendoscopy is a technique that uses a specialized stain or dye on the lining of the intestine during an endoscopy procedure. The dye helps the doctor better visualize if there’s anything abnormal on the intestinal lining.
Endoscopic ultrasound (EUS)
EUS uses an ultrasound in conjunction with an endoscopy. This allows doctors to see organs and other structures that aren’t usually visible during a regular endoscopy. A thin needle can then be inserted into the organ or structure to retrieve some tissue for viewing under a microscope. This procedure is called fine needle aspiration.
Endoscopic mucosal resection (EMR)
EMR is a technique used to help doctors remove cancerous tissue in the digestive tract. In EMR, a needle is passed through the endoscope to inject a liquid underneath the abnormal tissue. This helps separate the cancerous tissue from the other layers so it can be more easily removed.
Narrow band imaging (NBI)
NBI uses a special filter to help create more contrast between vessels and the mucosa. The mucosa is the inner lining of the digestive tract.
Endoscopy has a much lower risk of bleeding and infection than open surgery. Still, endoscopy is a medical procedure, so it has some risk of bleeding, infection, and other rare complications such as:
- chest pain
- damage to your organs, including possible perforation
- persistent pain in the area of the endoscopy
- redness and swelling at the incision site
The risks for each type depend on the location of the procedure and your own condition.
For example, dark-colored stools, vomiting, and difficulty swallowing after a colonoscopy could indicate that something is wrong. A hysteroscopy carries a small risk of uterine perforation, uterine bleeding, or cervical trauma. If you have a capsule endoscopy, there’s a small risk that the capsule can get stuck somewhere in the digestive tract. The risk is higher for people with a condition that causes narrowing of the digestive tract, like a tumor. The capsule may then need to be surgically removed.
Ask your doctors about symptoms to look out for following your 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.