An endoscopy is a procedure that allows a doctor to examine the inner compartments of the body. The endoscope is a long, thin tube-like instrument with a camera at the end. The doctor inserts this tube into the body and maneuvers it to see inside a specific body part. Endoscopies are considered minimally invasive and usually used as a diagnostic tool. In some cases, they serve a therapeutic purpose, as well.
Upper Gastrointestinal Endoscopy
An upper GI endoscopy examines the lining of the upper GI tract. The doctor inserts the endoscope through the mouth, then through the esophagus, stomach, and into the upper intestine. Upper GI endoscopies investigate many health problems, including bleeding, pain, persistent heartburn, unexplained weight loss, ulcers, blockages, and inflammation. The doctor may also collect a tissue sample for a biopsy or remove growths during this exam.
Sigmoidoscopy and Colonoscopy
Another GI endoscopy looks at the lower GI tract. A sigmoidoscopy examines the rectum and lower colon, and a colonoscopy checks the entire colon and rectum. These tests look for early signs of colon cancer and are routine for people over 50. Doctors also use them to look for causes of abdominal pain, rectal bleeding, unexplained weight loss, or unexplained changes in bowel habits.
Arthroscopy is an endoscopy of the joints. Doctors use them to diagnose and treat problems in the shoulder, elbow, wrist, hip, knee, and ankle when x-rays and other diagnostic images do not provide enough information for a diagnosis. This form of endoscopy can treat bone fragments, inflamed joints, torn cartilage, torn ligaments, and joint scarring.
An endoscopic survey of the airway and lungs is a bronchoscopy. In this procedure, the doctor inserts the endoscope into the nose or mouth. Then, they pass it into the trachea and bronchi, where the lungs branch off from the airway. Doctors use this procedure to detect signs of infections, tumors, and bleeding or assess blockages in the lungs.
Cystoscopy and Ureteroscopy
Urologists commonly perform two types of endoscopy: cystoscopy and ureteroscopy. Cystoscopy looks at the urethra and bladder, and ureteroscopy examines the ureters and kidneys. These exams diagnose urinary tract problems, including blood in the urine, urinary retention, and increased frequency and urgency. Doctors can also use them to remove stones from the bladder, kidney, or urethra, polyps, growths, or tumors.
A laparoscopy looks inside the abdomen. The doctor inserts the endoscope into an incision in the navel and introduces carbon dioxide into the abdomen to expand the area to get a better view. Laparoscopies are used in minimally invasive surgery and result in shorter hospital admissions, less pain, and faster recovery.
The factors that make an endoscopy unadvisable depend on the type of procedure. Generally, patients experiencing shock, heart attack, colitis, peritonitis, or abdominal perforation should not get an endoscopy. Nor should patients who are in a coma or uncooperative. The patient may need to stop taking anticoagulants and some other medications a few days before the procedure, especially if the surgeon also plans to obtain a biopsy.
What Happens During an Endoscopy
Preparation for an endoscopy depends on the body part that the doctor is going to examine. For example, for a colonoscopy, the patient will have to clear their bowels. Sometimes, the doctor prescribes antibiotics before the procedure to lower infection risk or stops some medications in the days before the exam. An endoscopy takes between 15 and 45 minutes and is an outpatient procedure in most cases.
Wireless Capsule Endoscopy
Wireless capsule endoscopy is a new technology that uses a small capsule containing a camera to look at the entire GI tract. The patient swallows the capsule, and it travels through the tract, capturing two images per second and transmitting them to a recording device worn by the patient.
Complications of endoscopy depend on the body part being examined, and the procedure should never replace a full workup to diagnose a problem. The most common complications relate to the effects of conscious sedation and include low heart rate, depressed breathing, and the need for supplemental oxygen.