An overview of endoscopy
An endoscopy test is a medical procedure that involves using a thin, flexible tube with a camera at the end to visually examine the upper digestive system, which includes the esophagus, stomach, and the beginning of the small intestine (duodenum). The procedure is usually performed by a specialist in digestive diseases called a gastroenterologist. It is done to diagnose and sometimes treat conditions affecting the upper digestive system. Endoscopies can help identify causes of symptoms like heartburn, difficulty swallowing, gastrointestinal bleeding, and can also detect diseases, collect tissue samples for testing, and perform treatments. Prior to the procedure, patients receive specific instructions on how to prepare, which may include fasting and avoiding certain medications.
What is endoscopy used for?
An endoscopy is a medical procedure used to visually examine the upper digestive system, including the esophagus, stomach, and beginning of the small intestine. It can be used for three main purposes: investigation, diagnosis, and treatment.
- Investigation: An endoscopy can help determine the cause of digestive symptoms such as heartburn, nausea, vomiting, abdominal pain, difficulty swallowing, and gastrointestinal bleeding.
- Diagnosis: During an endoscopy, a healthcare provider can collect tissue samples (biopsy) for testing to diagnose diseases, conditions, or cancers affecting the upper digestive system.
- Treatment: Special tools can be passed through the endoscope to treat problems in the digestive system, such as burning a bleeding vessel, widening a narrow esophagus, clipping off a polyp, or removing a foreign object. An upper endoscopy is performed using a flexible tube with a camera attached, and it may be combined with other procedures like ultrasound or endoscopic ultrasound for better imaging and detection. While generally a safe procedure, it may have rare complications such as bleeding or reactions to sedation or anesthesia. It is important to follow your healthcare provider's instructions for preparation, and seek immediate medical attention if you experience post-procedure symptoms such as fever, chest pain, difficulty swallowing, severe or persistent abdominal pain, or bloody or dark-colored stool.
How to prepare for endoscopy?
Before an endoscopy test, patients are typically instructed to:
- Fast: Stop eating solid food for eight hours and stop drinking liquids for four hours before the procedure to ensure an empty stomach.
- Medications: Stop taking certain blood-thinning medications in the days before the endoscopy, if possible. Consult your healthcare provider about ongoing medications, such as diabetes, heart disease, or high blood pressure medications.
- Inform the provider: Mention all medications and supplements you are taking to your healthcare provider.
Patients should also plan ahead for their recovery, arranging transportation and taking the day off from work, as they may feel mentally alert but with impaired memory, reaction times, and judgment due to the sedative.
How is endoscopy conducted?
An endoscopy test, specifically an upper endoscopy, is conducted by using a thin, flexible tube with a camera at the end. The specialist inserts the tube into the patient's mouth, guiding it down the esophagus to examine the upper digestive system, which includes the esophagus, stomach, and duodenum. During the procedure, images are transmitted to a video monitor for the provider to examine, and special tools can be used to collect tissue samples or treat certain conditions. The test is typically performed with sedation or anesthesia and requires specific preparation instructions from a healthcare provider. If you experience any complications after the endoscopy, such as fever, chest pain, or difficulty swallowing, you should contact your provider immediately or seek emergency care.
How are endoscopy results reported?
Endoscopy results are typically reported by your healthcare provider after the procedure. The time it takes to receive the results depends on the reason for the endoscopy and whether a tissue sample (biopsy) was collected. If the endoscopy was performed to look for an ulcer, you may learn the findings right after your procedure. However, if a tissue sample was collected, you may need to wait a few days to get results from the testing laboratory. It's essential to ask your healthcare provider when you can expect the results of your endoscopy.
Understanding the report
Endoscopy results are typically interpreted by a healthcare provider, such as a gastroenterologist. The provider will examine the findings from the endoscopy, which may include images of the upper digestive system, tissue samples (biopsy), or any abnormalities observed during the procedure.
The interpretation of endoscopy results depends on the reason for the procedure. If the endoscopy was performed to investigate symptoms, the provider will analyze the findings to determine the cause of the symptoms. If a tissue sample was collected for testing, the results from the laboratory will help diagnose any diseases or conditions present.
In some cases, further testing or additional procedures may be necessary to confirm a diagnosis or treatment plan. Your healthcare provider will discuss the results with you and explain any necessary follow-up actions.
It's important to follow your healthcare provider's instructions for preparing for and following an endoscopy, and to seek medical attention if you experience any complications or have concerns about the procedure's aftermath.
Limitations and Considerations
Limitations of the Endoscopy Test
While endoscopy is a valuable diagnostic and therapeutic tool, it does have some limitations:
- Incomplete visualization: The scope can only reach a limited area, and some parts of the digestive system may not be accessible. This may lead to missing other potential issues that are not within the scope's view.
- Missed diagnoses: Despite its accuracy in detecting certain conditions, there can still be instances where an endoscopy fails to diagnose a condition or disease. In some cases, further testing or a different diagnostic procedure may be required.
- Dependent on experience and expertise: The quality of the procedure and interpretation of findings can be influenced by the experience and skill of the healthcare provider performing the examination.
- Limited tissue sampling: Biopsy samples collected during an endoscopy may not always be representative of the entire affected area, leading to potentially incomplete or inaccurate diagnoses.
- Inability to diagnose certain conditions: For certain conditions, such as some cancers or infections deeper within the digestive tract, an endoscopy may not provide sufficient information for a definitive diagnosis.
- Preparation challenges: Patient compliance with preparation instructions, such as fasting and medication adherence, can affect the quality and accuracy of the examination.
- Sedation risks: Although rare, there is a risk of complications from sedation or anesthesia used during the procedure.
It is essential to discuss any concerns and questions with your healthcare provider before the endoscopy, as they can provide guidance and address any specific limitations based on your individual case.