Endoscopy Procedure
What Is Endoscopy?
Endoscopy is a medical procedure that lets doctors look inside the body using a thin, flexible tube with a light and camera at the tip. It helps examine areas like the esophagus, stomach, intestines, and sometimes the respiratory or urinary tract—without surgery. Doctors use this tool to uncover causes of symptoms such as pain, bleeding, or trouble swallowing and may also treat certain conditions during the same procedure.
Endoscopy can also be used to collect tissue samples (biopsies), remove growths such as polyps, or stop bleeding. It is generally considered a safe and quick procedure that can provide answers and relief with minimal recovery time.
How Endoscopy Works
Doctors gently guide the endoscope through the mouth, nose, or a small cut in the skin, depending on the area being examined. The camera at the tip sends real-time images to a screen, allowing doctors to closely observe internal tissues and organs. Common actions during endoscopy include:
- Taking pictures or videos for review.
- Performing a biopsy involves collecting small tissue samples.
- Removing polyps or foreign objects using tools inserted through the endoscope.
- Cauterization, which means stopping bleeding by applying heat.
The following table summarizes common uses of an endoscope:
| Use | Description |
|---|---|
| Observation | Looking for abnormalities. |
| Biopsies | Removing small pieces of tissue. |
| Cauterization | Sealing blood vessels to stop bleeding. |
| Treatment | Removing growths or blockages. |
Doctors may perform different procedures using an endoscope, such as a colonoscopy for examining the colon or a gastroscopy for the stomach. The ability to reach internal organs without open surgery makes endoscopy a valuable tool. Any samples collected are typically sent to a lab for further testing, and additional treatments can often be done during the same procedure.
Brief History of Endoscopy
Endoscopy began over a century ago. Early versions were simple tubes with basic lights. In the 19th century, doctors tried using mirrors and candles to look inside the body. These early tools could only examine areas close to body openings. Modern endoscopes emerged in the mid-20th century with better optics and flexible designs.
The addition of fiber optics and video cameras allowed doctors to see clear images inside the body on a screen. Today’s endoscopes provide high-quality images and allow doctors to treat certain problems during the same procedure. The technique is now a critical tool in diagnosing issues throughout the digestive, urinary, and respiratory systems.
Types of Endoscopy
Upper GI Endoscopy
Upper GI endoscopy, also called esophagogastroduodenoscopy (EGD) or gastroscopy, allows doctors to see the throat, esophagus, stomach, and the beginning of the small intestine. They gently pass a flexible tube with a camera through the mouth and down the throat.
Doctors use this test to check for problems like ulcers, bleeding, tumors, and inflammation. It can help find the causes of symptoms like heartburn, nausea, swallowing problems, or unexplained pain. During the procedure, doctors may take samples (biopsies) for testing.
Sometimes, they can also treat problems during the endoscopy, such as stopping minor bleeding or removing small growths. Sedation is often used to help with comfort. Upper GI endoscopy differs from other types like enteroscopy or ERCP, which look further along the digestive tract or at specific ducts.
Colonoscopy
Colonoscopy allows doctors to look at the inner lining of the colon and rectum. They place a long, flexible tube with a camera through the anus and guide it up through the large intestine. This procedure is most often used to screen for colon cancer, investigate changes in bowel habits, and check for polyps, bleeding, or inflammation. Doctors can often remove polyps during the test.
People usually get a colonoscopy if they are at higher risk for colon cancer or have persistent symptoms like blood in the stool or unexplained weight loss. Sedation is usually given for comfort. Colonoscopy can examine the full length of the colon. Doctors sometimes compare it with other procedures like sigmoidoscopy or anoscopy, which look at only part of the colon or rectum.
Sigmoidoscopy
Sigmoidoscopy lets doctors check the lower part of the colon, called the sigmoid colon, and the rectum. They insert a short, flexible scope through the anus. Unlike colonoscopy, sigmoidoscopy only checks about the last one-third of the colon. Doctors use it to find the causes of symptoms like bleeding, pain, or bowel changes.
Doctors can also use it to find and sometimes remove small polyps or take biopsies if needed. Sigmoidoscopy usually does not require full sedation, and the preparation is a bit easier than for a full colonoscopy. This test is quicker than colonoscopy and is often used for screening or to help diagnose inflammation or other problems in the lower bowel.
Capsule Endoscopy
Capsule endoscopy uses a small, swallowable capsule with a tiny camera inside. As the capsule travels through the digestive tract, it takes thousands of pictures. The main use of capsule endoscopy is to examine the small intestine, which is hard to see with standard scopes. It can help find bleeding, tumors, or Crohn’s disease.
After the patient swallows the capsule, they can go about their day. A recorder worn on the belt collects the images. The capsule passes out of the body naturally in a day or two. Capsule endoscopy does not allow for biopsies or treatment, but it is very useful for seeing parts of the intestine that regular endoscopy cannot reach. Doctors do not use this technique for the colon or stomach.
Specialized Endoscopy Procedures
Doctors perform several specialized endoscopy procedures. Each one examines a certain area or system in the body.
| Procedure | Area Examined |
|---|---|
| Bronchoscopy | Lungs, airways |
| Cystoscopy | Bladder, urethra |
| Hysteroscopy | Uterus |
| Colposcopy | Cervix, vagina, vulva |
| Arthroscopy | Joints |
| Laparoscopy | Abdomen, pelvis |
| Thoracoscopy | Chest cavity |
| Mediastinoscopy | Chest (mediastinum) |
| Rhinoscopy | Nose, sinuses |
| Gynoscopy | Female genital tract |
| Falloposcopy | Fallopian tubes |
- Bronchoscopy lets doctors look inside the large airways and lungs. They use it to find causes of cough, infection, or lung problems.
- Cystoscopy lets doctors examine the bladder and the urethra. It helps them spot issues like bladder stones or tumors.
- Hysteroscopy allows doctors to check the inside of the uterus in women. They can help explain abnormal bleeding.
- Colposcopy focuses on the cervix, vagina, and vulva. Doctors use it to investigate abnormal Pap test results.
- Arthroscopy allows a doctor to see inside a joint, such as a knee or shoulder. They use it to find issues like torn cartilage or swelling.
- Laparoscopy involves making a small cut in the abdomen. Doctors get a clear view of organs like the ovaries, appendix, or liver.
- Thoracoscopy and mediastinoscopy help doctors check the chest and the area between the lungs. They use these procedures to find lung or lymph node problems.
- Rhinoscopy lets doctors look inside the nose and sinus passages. It is useful for testing causes of congestion or nosebleeds.
- Gynoscopy and falloposcopy allow doctors to inspect the female reproductive organs. They can help diagnose reasons for infertility.
These specialized procedures help doctors make accurate diagnoses and plan the best treatments. Each uses a scope built for the specific area being studied.
Indications for Endoscopy
Doctors often recommend endoscopy to find the cause of certain digestive symptoms. Common reasons include abdominal pain, difficulty swallowing, nausea, or vomiting. If someone has bloating or ongoing indigestion, doctors can use endoscopy to help determine the cause.
Doctors also perform endoscopy if they suspect bleeding in the digestive tract. This can show up as vomiting blood or blood in the stool. Doctors need to address gastrointestinal bleeding quickly to find the cause and start treatment.
Doctors use endoscopy for long-term heartburn or symptoms of gastroesophageal reflux disease (GERD). They may also use endoscopy for people with Barrett’s esophagus to check for changes in the tissue lining the esophagus. Doctors use endoscopy to find out if there are conditions such as:
- Esophageal varices
- Peptic ulcer
- Gastritis
- Esophageal cancer
- Stomach cancer
- Pancreatitis
Sometimes, doctors use endoscopy as part of treatment. For example, they can use it to stop bleeding, remove growths, or open narrowed areas in the digestive tract. Below is a table of some common indications:
| Symptom/Condition | Why Endoscopy is Used |
|---|---|
| Abdominal pain | To find the cause. |
| Difficulty swallowing | Check for blockages. |
| Bleeding | Locate and possibly treat. |
| Nausea and vomiting | Diagnose source. |
| Heartburn or GERD | Evaluate damage or changes. |
| Cancer concern | Take a biopsy for diagnosis. |
Endoscopy Procedure: Step-by-Step
Preparation and Fasting
Patients usually meet with their doctor days before the endoscopy to review their medical history, current medications, and any allergies. Patients should tell the doctor about all medicines and supplements—including blood thinners, aspirin, and anti-inflammatory drugs. Doctors may ask patients to stop or change some medications to reduce risks, especially if bleeding is a concern.
Most endoscopy procedures require fasting. Doctors usually instruct patients not to eat or drink for at least six to eight hours beforehand. This lowers the risk of vomiting and helps doctors see more clearly during the exam. For some procedures, doctors may require a laxative to empty the stomach or intestines.
Water is sometimes allowed up to a few hours before, depending on the doctor’s instructions. In the final hours before the procedure, patients should avoid chewing gum, smoking, or using mints, as these can affect results. Following all preparation steps increases safety and improves the quality of the exam.
Sedation and Anesthesia
Most endoscopy procedures involve sedation to keep the patient comfortable and calm. Medical staff may give sedative medications through an IV, by mouth, or as a spray to numb the throat. These medications make the patient feel drowsy but relaxed, while still able to respond to instructions. In rare cases, doctors use strong anesthetics or general anesthesia, especially in children or for longer procedures.
The doctor decides which method fits best based on the patient’s health, medical history, and the type of endoscopy planned. Medical staff carefully monitor patients during the process. They check vital signs such as breathing, pulse, and blood pressure often. Most patients do not remember much of the test after sedation.
Performing the Examination
The patient lies on their side, and medical staff may use a mouth guard or bite block to protect teeth and the camera. The doctor gently guides the endoscope—a thin, flexible tube—through the mouth and down the throat. The camera sends real-time images to a monitor, allowing the doctor to inspect the esophagus, stomach, and small intestine.
If needed, the doctor can use small tools passed through the endoscope to take tissue samples (biopsies), remove polyps, or stop bleeding. The exam usually takes 15 to 30 minutes, depending on the purpose and findings. Most patients feel only mild discomfort, such as bloating or a sore throat.
After the procedure, medical staff move the patient to a recovery area until the sedative wears off. Patients should have someone drive them home, as the medicine can cause drowsiness for several hours.
Recovery and Post-Endoscopy Care
After an endoscopy, most people rest in a recovery area for 1 to 2 hours until the effects of sedation wear off. Patients should not drive, drink alcohol, or use heavy machinery for at least 24 hours, as drowsiness may continue. Mild side effects are common during recovery. These can include:
- Sore throat
- Bloating
- Cramps
- Mild nausea
These symptoms usually go away within a few hours. Patients should drink water and eat light foods once they feel comfortable. To help with soreness or bloating, patients can:
- Suck on ice chips or drink cool liquids for a sore throat.
- Walk slowly and rest as needed for cramps or bloating.
If patients have vomiting, fever, severe pain, or trouble breathing, they should contact a doctor right away, as these can be signs of a problem. A typical recovery timeline is shown below:
| Symptom | Usual Duration | When to Call a Doctor |
|---|---|---|
| Sore throat | A few hours | Lasts more than 2 days |
| Bloating/cramps | A few hours | Severe or ongoing pain |
| Vomiting | Rare/short-term | Can’t keep fluids down |
Risks, Complications, and Side Effects
Endoscopy is generally safe, but like any medical procedure, it does carry some risks and possible side effects. Problems are rare, but they can happen. Serious complications are less common but can include:
- Infection
- Bleeding or internal bleeding
- Perforation (a tear or hole in the digestive tract)
- Oversedation (too much sedation causing slow breathing or low blood pressure)
- Allergic reactions to medications
Perforation is a rare but severe complication. The risk increases in the esophagus and may require surgery. The chance of death from an esophageal perforation ranges from 2% to 36%, depending on the person’s health and how quickly doctors treat it.
Mild bleeding can occur, especially if the doctor takes a biopsy or removes a polyp. This bleeding usually stops on its own, but severe cases can require more treatment. A table of possible risks:
| Risk/Complication | Likelihood | Notes |
|---|---|---|
| Sore throat | Common | Lasts 1-2 days |
| Bloating | Common | Mild, temporary |
| Infection | Rare | Needs medical attention |
| Internal bleeding | Rare | Often minor, sometimes more serious |
| Perforation | Very rare | May require surgery |
| Over-sedation | Rare | More likely in some patients |
Contact your healthcare provider if you notice severe pain, fever, vomiting, or heavy bleeding after the procedure.
