Endoscopy

Introduction

An endoscopy is a procedure where the inside of your body is examined internally using an endoscope.

Endoscope

An endoscope is a thin, long, flexible tube that has a light source and a video camera at one end. Images of the inside of your body are relayed to a television screen.

Endoscopes can be inserted into the body through a natural opening, such as through your throat or anus (the opening through which stools are passed out of the body).

Alternatively, it can be inserted through a small surgical cut made in the skin.

What happens during an endoscopy?

An endoscopy is usually carried out while a person is awake. It is not painful, but can be uncomfortable so a local anaesthetic or sedative (medication that has a calming effect) may be given to help you relax.

The endoscope is carefully inserted into your body. Exactly where it enters your body will depend on the part of the body being examined.

An endoscopy can take 15-60 minutes to carry out, depending on what it’s being used for. It will usually be performed on an outpatient basis, which means you will not have to stay in hospital overnight.

Risks

An endoscopy is usually safe and the risk of complications is low (less than 1 in 100).

Possible complications of an endoscopy include an infection in the part of the body that the endoscope is used to examine and excessive bleeding.

Types of endoscopes

Some of the most commonly used types of endoscopes include:

Arthroscopes, used to examine the joints
Hysteroscopes, used to examine the womb (uterus) in woman
Cystoscopes, used to examine the bladder

Other types of endoscope include:

Endoscopic retrograde cholangiopancreatography (ERCP) used to check for gallstones
Broncoscopes, used to examine your airways and lungs
Colonoscopes, used to examine your large intestine (colon)

An endoscopy can be used to investigate if symptoms suggest there might be a problem. It can also be used to help perform some types of keyhole surgery (laparoscopic surgery) such as removing the appendix or gallbladder.

Uses of an endoscopy

An endoscopy is used to investigate unusual symptoms and to help perform types of surgery.

Investigating symptoms

An endoscopy might be recommended to investigate the following symptoms:

Difficulties swallowing or pain when swallowing (dysphagia)
Persistent abdominal pain
Persistent nausea (feeling sick) and vomiting
Unexplained weight loss
Vomiting blood
Persistent diarrhoea

These types of symptoms are usually investigated with a gastroscopy (used to examine the upper section of the digestive system) or a colonoscopy (used to examine the bowel).

Other types of endoscopes used to investigate symptoms include:

Arthroscope – used to diagnosis symptoms such as unexplained joint pain and stiffness
Cystoscope – used to diagnosis bladder problems such as urinary incontinence (the involuntary passing of urine) and blood in your urine
Hysteroscope – used to diagnosis problems with the womb, such as unusual vaginal bleeding or repeated miscarriages

An endoscope can also be used to remove a small sample of tissue so it can be checked for cancer cells. This is known as a biopsy.

Surgery

Modified endoscopes that have surgical instruments attached to them or passed through them can be used to carry out certain surgical procedures. For example, they may be used to:

Remove gallstones, bladder stones and /or kidney stones
Repair a bleeding stomach ulcer
Tie and seal the fallopian tubes (a technique carried out when a woman wishes to be sterilised)
Remove small tumours from the lungs or digestive system
Remove fibroids – non-cancerous growths that can develop inside the womb

Laparoscopic surgery

A type of endoscope called a laparoscope is used by Dr. B C Shah as a visual aid when carrying out keyhole surgery (also known as laproscopic surgery). This means only small cuts are made so there is less post-operative pain and a faster recovery time compared to traditional open surgery.

Common types of keyhole surgery include:

Removal of an inflamed appendix in cases of appendicitis
Removing the gallbladder, which is often used to treat gallstones
Removing a section of the intestine, which is often used to treat digestive conditions, such as Crohn’s disease or diverticulitis, that do not respond to medication
Repairing hernias
Removing the womb (hysterectomy)
Removing some or all of an organ affected by cancer

How an endoscopy is performed

Most endoscopies are carried out at a local hospital.

Before having an endoscopy

Depending on what part of your body is being examined, you may be asked to avoid eating and drinking for several hours beforehand.

If you are having a colonoscopy or flexi-sigmoidoscopy you may also be given a laxative to help clear stools from your bowels.

In some cases, you may also require antibiotics to reduce risk of an infection.

If you are taking a medicine to thin your blood, such as warfarin, you may be asked to stop taking it for a few days before having your endoscopy. This is to prevent excessive bleeding during the procedure. However, do not stop taking any prescribed medicine unless Dr. B C Shah advises you to do so.

The endoscopy procedure

An endoscopy is not usually painful, although it may feel uncomfortable.

Endoscopies do not usually require general anaesthetic (with the exception of an arthroscopy). However, you may be given a local anaesthetic to numb a specific area of your body. This may be in the form of a spray or lozenge to numb your throat, for example.

You may also be offered a sedative which makes you feel more relaxed and less aware of what is going on around you.

The endoscope is carefully guided into your body. Exactly where it enters will depend on the part of your body being examined. This may include your:

Throat
Anus (the opening through which stools are passed out of the body)
Rethra (the tube that connects the bladder to the vulva or penis, through which urine passes)

In some cases, the endoscope will be inserted into a small cut Dr. B C Shah makes in your skin.

Depending on the exact nature of the procedure and its objectives, an endoscopy can take 15-60 minutes to carry out. It will usually be performed on an outpatient basis, which means you will not have to stay in hospital overnight.

After an endoscopy

After having an endoscopy, you will probably need to rest for about an hour until the effects of the local anaesthetic and/or the sedative have worn off. You should not drive immediately after the procedure, so you will need to arrange transport to take you home.

If your bladder is being examined (cystoscopy), you may notice some blood in your urine. This should pass within 24 hours of having the procedure. Contact Dr. B C Shah for advice if you still have blood in your urine after this time.

Risks of an endoscopy

An endoscopy is usually safe and the risk of complications is low (less than 1 in 100).

Possible complications include:

An infection in part of the body the endoscope is used to examine
Piercing or tearing (perforation) of an organ
Excessive bleeding
An allergic reaction to the anaesthetic

Contact Dr. B C Shah if you notice any signs of infection in the area of your body where the endoscope was inserted. Signs of infection include:

Redness
Pain
Swelling
A discharge of fluids or pus

Infections can usually be successfully treated with antibiotics.

Perforation of an organ or excessive bleeding may require surgery to repair damage to the tissues or organ.

Antihistamines are a type of medicine that can be used in the event of an allergic reaction.

A number of other signs could indicate a complication after having an endoscopy. These include:

Black or very dark coloured stools
Shortness of breath
Severe and persistent abdominal pain
Vomiting blood
Chest pain
A high temperature (fever) of 38C (100.4F) or above

ContactDr. B C Shah immediately if you notice any of these signs and symptoms.