An endoscopy is a procedure that evaluates any hollow organ within the body. The term endoscopy is broad and encompasses a number of procedures. Examples include upper endoscopy (visualizes esophagus, stomach and some of the small bowel), lower endoscopy (colonoscopy, to view the colon & rectum), bronchoscopy (to view the lungs), and cystoscopy (view the bladder). For the purpose of this discussion, we will focus on upper endoscopy, or evaluation of the upper gastrointestinal tract.
Your GI tract is a long tube and the endoscope (or "scope") can easily pass through it. Upper endoscopy allows the physician to see inside the esophagus, stomach and part of the small intestine to assess the health of these organs. Reason for upper GI endoscope include pain, persistent nausea and vomiting, bleeding, anemia, difficulty swallowing, history of polyps or Barrett's esophagus, infection, and unexplained weight loss.
Because the GI tract is hollow, it can be very easily evaluated with an endoscope.
Most endoscopies occur as an outpatient procedure. The procedure is minimally invasive, well tolerated, and widely available throughout the U.S. and in most developed countries.
How is this test performed?
An endoscopy is performed by inserting a camera attached to a long tube into the mouth, down the esophagus (swallowing tube), and into the stomach and the first portion of the small intestine (known as the duodenum).
Prior to the procedure, the patient will be given a sedative (to relax) and possibly a pain medication (to prevent pain). Vital signs are monitored to ensure that the patient's heart rate and blood pressure remain within the normal range. The patient typically will not remember the procedure once it is complete.
The patient will lie on a table on his/her side, the sedatives will be given, and then the doctor will insert the scope gently into the esophagus. The scope has a camera and light attached to the end. The scope has a camera and light attached to the end and can inflate the GI tract with air to help the physician visualize the lining of the tract.
The scope has a number of tools, including a needle for biopsy if needed, a cauterizing device to stop bleeding, and a blade if a growth needs to be removed.
The actual procedure generally takes 30-60 minutes if no unexpected findings occur. However, because patients must be sedated, woken up, and monitored, the patient may be at the facility for several hours.
The most important risk associated with endoscopy is an abnormal reaction to sedation. Generally, there is very little bleeding associated with the procedure, although some can occur if a biopsy is taken. There is also a risk of puncturing the GI track, particularly if a biopsy is taken.
Following the procedure, there can be slight discomfort that should resolve over the next few days. If there is severe pain following the procedure, you should contact your doctor immediately.
How do I prepare for an endoscopy?
The preparation for an endoscopy is very important.
Every medical practice has a bowel preparation it prefers, thus it is best to follow the instructions you are given.
You will need to fast (no food or drink) for at least 8 hours prior to the procedure. Frequently, only clear liquids can be consumed for 12 hours prior to that. This is to maximize the ability of the doctor to see the lining of the stomach and intestine.
Be sure to discuss any allergies or heart and lung problems you have with the doctor, as this can impact the types of medications that can be used for sedation.
If you are on blood thinners, your doctor will likely have you stop them several days in advance. This should be discussed when the biopsy is scheduled.
You will not be able to drive following sedation, so arrangements for a ride home will be needed. Patients should not drive for the remainder of the day.
How do I interpret the results of an endoscopy report?
Following the procedure, the physician will usually discuss their findings with you before you are sent home. It may be helpful to have a friend or family member with you since you may have some difficulty remembering what is said after sedation.
If any biopsies were taken, they will be sent to pathology to determine what was found. It can take 7-10 days for your doctor to receive these results.
Your doctor will create a report that is sent to the ordering doctor (often your primary care physician).
The first paragraph typically reports the final diagnosis. This is a summary of the findings, often generated to answer the question posed by the ordering physician.
The remaining paragraphs generally include the specific technical information that occurred during the procedure. This can include the type of sedation, the details of the findings, biopsies and any complications that occurred.