You can have an endoscopy if your doctor suspects you may have ulcerative colitis (UC). The test can give a closer look at the inside of your gastrointestinal tract, specifically your colon and rectum.

Ulcerative colitis (UC) is a type of chronic inflammatory bowel disease (IBD). UC causes inflammation and sores to form in the inner lining of the large intestine (the rectum and colon).

To diagnose UC, a doctor may want to see inside the large intestine to check for sores or signs of other conditions. An endoscopy is an imaging test that can allow doctors this closer look at internal organs. Specifically, your doctor may do a colonoscopy, a type of endoscopy that’s used in the large intestine, to diagnose UC.

During the procedure, a thin, flexible tube with a light and camera at one end is inserted into the body and moved around for a better view of organs.

More than 1 million people in the United States and Europe have UC. For these people, endoscopies can help monitor the disease’s impacts on the large intestine. An endoscopy can also help check the progress of treatment.

This article will take a closer look at what an endoscopy is and why it’s used in people with ulcerative colitis.

If your doctor suspects you have UC, they’ll do a number of tests to rule out other possible issues first. These tests may include a stool culture, X-rays, and blood tests.

But if these tests don’t provide an answer, your doctor may want to get a closer look at the inside of some internal organs, specifically your colon and rectum. This is when one or more types of endoscopy may be used.

In addition to capturing images of the lining of the intestine, an endoscopy can be used to remove polyps or tissue samples for further testing. This is called a biopsy.

In fact, the American College of Gastroenterology (ACG) recommends a colonoscopy, a type of endoscopy, to help detect and diagnose UC. The ACG also recommends tissue biopsies to determine the full impact of the disease and to rule out other conditions, including Crohn’s disease and colorectal cancer.

Types of endoscopies

More than a dozen types of endoscopies are used to look at everything from the uterus to the inside of a nose. For UC or other diseases of the gastrointestinal tract, doctors may use these endoscopies:

  • Colonoscopy: A colonoscopy is a type of endoscope that enables doctors to get a detailed view of of your large intestine (all of the colon and the rectum).
  • Esophagogastroduodenoscopy (EGD): An esophagogastroduodenoscopyis a type of endoscopy that looks at the inside of your esophagus, stomach, and duodenum.
  • Enteroscopy: An enteroscopy lets your doctors view the inside of your small intestine.
  • Laparoscopy: A laparoscopy gives doctors the ability to see the inside of your abdominal or pelvic cavity.
  • Flexible sigmoidoscopy: A flexible sigmoidoscopy is a type of endoscopy that specifically looks at the last third of your descending colon.

People with UC can also have a capsule endoscopy. For this procedure, you’ll swallow a capsule-sized camera. This camera will send doctors detailed images of the inside of the digestive tract.

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An endoscopy is not a lengthy procedure. But it does require some preparation and recovery time. Here’s what you can expect:

Before an endoscopy

Your doctor will provide you with specific guidelines to follow before an endoscopy. These will likely include instructions to fast for 6 to 12 hours before surgery. If you’re having a colonoscopy, you may also need to take a laxative the day before to clear out your digestive system.

On the day of the procedure, you’ll arrive at a hospital or outpatient facility. Your doctor may conduct an exam before the procedure to make sure you’re ready for the test. You’ll then be given sedation, if needed, or a local anesthetic if you’ll remain awake during the procedure.

During an endoscopy

An endoscopy usually takes less than an hour. Your doctor will insert the endoscope (the lighted tube with camera) through an opening. This will likely be your mouth or anus. They’ll then carefully direct the tube through the digestive tract to the area of the body they want to see more clearly.

Once in the right area, they may take a series of photographs. They may also take tissue samples for a biopsy. When the test is complete, the endoscope will be removed, and you’ll be taken to a room for recovery.

After an endoscopy

This procedure doesn’t require an overnight stay. You’ll typically leave the facility within a few hours.

If you were sedated, you won’t be able to drive or return to work that day. However, recovery is typically quick, and you should be able to resume normal activities the following day.

An endoscopy is considered a safe, low risk procedure. More than 75 million endoscopies are performed every year. However, possible risks or side effects of the procedure may include:

  • feeling bloated after the procedure (for a short time)
  • mild cramping or stomach pain
  • infection
  • a sore throat if the endoscope was inserted through the mouth
  • minor blood loss after a biopsy

A rare but serious complication of an endoscopy is a perforation or tear in the lining of the stomach, intestine, or esophagus. This can cause internal bleeding and will need immediate treatment.

Contact your doctor if you have any of the following symptoms after your endoscopy:

  • bloody vomit
  • dark colored or bloody stool
  • shortness of breath
  • chest pain
  • severe abdominal pain

During an endoscopy, your doctor will take a series of measurements. These are meant to help them evaluate the severity of your UC and the disease activity in your colon and intestines.

The Ulcerative Colitis Endoscopic Index of Severity (UCEIS) and Mayo Endoscopic Score (Mayo ES) are used for these purposes.

If you need future endoscopies, scores will be taken again. These numbers can tell your care providers how well treatment is lasting and what your long-term outlook may look like.

Ulcerative colitis is a chronic condition that causes inflammation and sores in the lining of the large intestine. To see how much damage the condition is causing, doctors often want to get a close look at the inside of the colon. That’s when an endoscopy, specifically a colonoscopy, may be needed.

An endoscopy is a relatively safe, low risk procedure. It can be a useful tool in the management of UC, as it lets doctors see how well treatments are working and if the lining of the intestine is healing at all. However, if you have an endoscopy and experience any lingering issues or new symptoms, consult your doctor immediately.