Medical conditions that affect the gastrointestinal tract can be..unpleasant..to say the least. From constipation and diarrhea to colitis and a whole series of ailments most commonly known by their acronyms (IBS, IBD, and GERD for example), the digestive system can be quite the problem child.
What complicates the discovery and diagnosis of many of these conditions is that they often share very similar symptoms, and in some cases, the set of symptoms for a person with one condition may be virtually indistinguishable from the symptoms of another person’s condition.
Fortunately for us, gastroenterologists now have a variety of imaging test technologies at their disposal to investigate the causes of the symptoms that might be causing a ruckus in our digestive tracts. Some of the most common procedures that doctors can utilize—such as the colonoscopy, cystoscopy, or sigmoidoscopy—all utilize an endoscope.
There are many different types of endoscopes, and there are of course a number of them that are used outside the digestive system and are designated by the area of the body where they are used: bronchoscopy for lungs and arthroscopy & laparoscopy for minimally invasive surgeries, etc. For the majority of these procedures, the endoscope is similar in that it has a long, flexible tube and a tiny camera with very small lights. The doctor can see inside the body and get the kind of visual data that was never possible before with older technology like an x-ray.
What is an Upper Endoscopy? Are There Other Types of Endoscopy?
For gastroenterologists, seeing inside the gastrointestinal tract is extremely valuable; they can often quickly identify the problem just by getting a visual. One of the most common procedures they use is an upper endoscopy.
Known by its official medical term as an esophagogastroduodenoscopy, the goal of this procedure is to get a real-time visual examination of the upper part of the gastrointestinal tract. Whereas a colonoscopy involves the camera entering the rectum, an upper endoscopic tube and camera are fed down the esophagus, through the stomach, and into the duodenum, which is the first part of the small intestine.
A recently developed (the first used was in 1997) alternative to a traditional tube-and-camera endoscopy is the capsule endoscopy. As the name implies, this procedure uses a capsule with a similar tiny camera embedded in it. The capsule is then swallowed in the same manner as medication. Once swallowed, the capsule travels through the digestive tract, transmitting visual data to a recording device worn around the patient’s waist.
In some situations, an endoscopy can also be combined with ultrasound for more specialized images of the inner linings of the organs in the digestive tract. Similarly, for the organs of the digestive system (like the pancreas or liver) that are more difficult to access, endoscopic retrograde cholangiopancreatography (ERCP) is an option that uses an endoscope that can inject a contrast medium into the organ so that it is visible on radiographs.
Why has my Doctor Ordered an Endoscopy?
Whichever method the doctor has employed to perform the upper endoscopy, the purpose is the same: investigate the digestive tract and diagnose evidence of a possible medical condition. Additionally, the doctor may even be able to treat the problem he or she discovers; the endoscope can also carry special tools that can be used for tasks like cauterizing gastrointestinal bleeding or removing a foreign object.
Usually a gastroenterologist will only move forward with an endoscopy after the patient has been to the office and been evaluated with a more traditional medical exam. Depending on their severity, the doctor may order the procedure to investigate some of the following symptoms:
- Polyps (or any other kind of abnormal growth)
- Bleeding along the digestive tract
- Abdominal pain
- Chronic diarrhea or constipation
What Can I Expect Before and During the Procedure? Will I be Awake?
A traditional upper endoscopy is the most common type that a doctor will prescribe; though it is a relatively simple procedure, there are some important preparations that patients will have to make before they even get to the office. The first is to stop eating and drinking at least 8 hours before the procedure.
Depending on the regular medications you take, the doctor may instruct you to stop taking them until the procedure is over. For those with chronic medical conditions like high blood pressure, diabetes, or heart disease, the doctor will also likely have additional instructions specific to your condition. This is why it’s important to discuss openly with the doctor during the medical history portion of the initial exam.
Right before the doctor begins the endoscopy, you will be asked to lie down while a sedative is administered. The purpose of the sedative is to help keep you relaxed during the procedure; you may even fall asleep. The doctor may also spray a numbing agent in the back of the throat to help ease the passage of the long endoscopic tube.
When the tube is inserted, the doctor will ask you to swallow while the tube is moving down the esophagus. While the experience will undoubtedly feel odd, it shouldn’t result in any pain—in part because of the sedative and numbing agent. The patient will also be able to breathe normally while the tube is in the esophagus.
The entire procedure typically takes between 15-30 minutes for the doctor to complete the examination. It could potentially take longer, depending on a patient’s particular circumstances or whether or not the doctor may also be using endoscopic tools for treatment purposes.
What Happens After the Procedure? Can I Drive?
When the doctor has completed the examination, he or she will carefully retract the tube. The patient will then be brought to a recovery room to be monitored until the sedative wears off enough for the patient to be discharged. The doctor will recommend not driving or resuming normal activities for the rest of the day.
Since the procedure is mildly invasive, it is possible for a patient to feel some side effects from the presence of the endoscopic tube in the digestive tract. The possible post-endoscopy symptoms can include gas, cramping, bloating, or a sore throat. These are temporary, however, and should dissipate by the next day.
What are the Risks of an Endoscopy?
Even though an endoscopy is very safe for the vast majority of people, there are some minor risks and complications that can arise after the procedure. Here are some issues to be watchful for:
- Over-sedation: as with any time sedation is used, there is a risk of cardiovascular, respiratory, or allergy-related problems that can develop.
- Perforation: the camera and tube itself could cause a tear in the lining of the gastrointestinal tract.
- Infection: any time a foreign object is inserted into the body, an infection is possible.
Signs of Possible Complications
- Difficulty swallowing
- Bloody or dark stool
- Chest or abdominal pain
- Shortness of breath
If you’ve already had an endoscopy and have been experiencing any of the above symptoms, you should call a doctor or go to an emergency room; while rare, these complications could potentially be life-threatening.
If you have been having other symptoms of gastrointestinal distress, particularly if it has become chronic or ongoing, it might be a perfect time to visit a healthcare provider for an examination. The office of Carolina Digestive Health Associates has 14 accredited gastroenterologists who are dedicated to providing excellent care for all manner of digestive health concerns.