What Is an Endoscopy?
FG Trade / Getty Images
Medically reviewed by Robert Burakoff, MD
Endoscopy is a procedure that uses a thin, flexible, lighted tube with a camera (endoscope) to examine the inside of the body.
Different types of endoscopies examine and treat particular body regions like the gut, chest, lungs, and joints.
The procedure is relatively safe but may cause some pain and discomfort.
Endoscopy is a common procedure in which a medical doctor or surgeon inserts a thin, flexible, lighted tube with a camera, or endoscope, to examine the inside of the body.
Many types of healthcare providers, including gastroenterologists (specialists who focus on diagnosing and treating conditions affecting the gastrointestinal, or GI, tract) and surgeons, use endoscopy to examine, diagnose, and treat diseases. Different types of endoscopy are specialized for particular body regions. In the United States, about 6.1 million upper endoscopies are performed each year.
Purpose
Endoscopy is used to investigate, confirm, and treat a wide variety of symptoms and conditions, including:
Gastrointestinal (digestive) conditions like irritable bowel syndrome (IBS), a chronic condition that affects the gastrointestinal tract
Pelvic conditions like urinary tract infections (UTIs), infections in any part of the urinary system (including the kidneys or bladder)
Abdominal conditions like appendicitis (inflammation of the appendix) and ovarian cysts (fluid-filled sacs that grow on or inside the ovaries)
Respiratory conditions like shortness of breath and lung tissue scarring
Other instruments might be inserted through the endoscope to:
Take a closer look at abnormal tissue
Take a biopsy (tissue sample) for further examination
Remove polyps (small growths of tissue) or tumors
Stop internal bleeding
Remove obstructions like food or scar tissue
Types
An upper endoscopy is an examination of the upper gut. It's often referred to as an endoscopy. However, this is only one of many endoscopy types performed by different healthcare providers.
Other types include:
Anoscopy: A family physician often uses this procedure to check the anus and lowest part of the large intestine (rectum). It helps diagnose:
Hemorrhoids: Swollen, inflamed veins near the anus and lower rectum
Fissures: Small anal tears
Polyps: Abnormal growths on the anal lining
Colorectal cancer: Cancer of the large, muscular tube known as the colon, or cancer of the rectum, which sits at the end of the digestive tract
A healthcare provider might recommend an anoscopy for symptoms like blood in your stool, itching or painful lumps around your anus, or painful bowel movements.
Arthroscopy: Orthopaedic surgeons are surgeons who specialize in bones, joints, ligaments, tendons, and muscles. They perform arthroscopies to examine inflammation and treat acute or chronic (long-term) injuries, including tendon or ligament tears and carpal tunnel syndrome (a group of conditions caused by nerve compression in the wrist).
Bronchoscopy: Thoracic surgeons, surgeons who specialize in chest organs like the lungs and heart, use this procedure to examine the airways and lungs. It is an important procedure for managing and diagnosing lung diseases and respiratory disorders.
Capsule endoscopy: This procedure is also used to examine the small intestine. Your healthcare provider will give you a capsule that has a small camera inside it. The capsule takes images of your gut lining as it passes through your gut over 1-2 days. Capsule endoscopy is most often used to examine gastrointestinal bleeding.
Colonoscopy: Gastroenterologists use this procedure to examine the lining of the colon and rectum. It is a common test that screens for colorectal cancer in people over the age of 45. It can also stop bleeding or diagnose conditions like IBS.
Cytoscopy: Urologic surgeons, surgeons who specialize in urinary tract organs, use this test to look at the urethra, bladder, prostate, and other nearby structures. It might be used for conditions like:
Chronic pelvic pain syndrome: Pain in the pelvic area for at least six months
Urinary incontinence: Loss of bladder control
Frequent urinary tract infections (UTIs): Infections in parts of the urinary system like the bladder, kidneys, or urethra
Enteroscopy: A gastroenterologist performs this procedure to examine the entire small intestine. In contrast, an upper endoscopy only looks at the upper portion. An enteroscopy is commonly used to diagnose small intestine conditions—for example, if you have abnormal x-ray results or tumors, or unexplained diarrhea or gastrointestinal bleeding.
Laparoscopy: Many types of medical specialists including general surgeons and gynecologists (medical doctors who specialize in female reproductive health) use laparoscopy to view the inside of your body and take biopsies without a large incision. It's usually used to diagnose the cause of symptoms in the abdomen or pelvis (area between your hips), including pain and difficulty getting pregnant.
Mediastinoscopy: Thoracic surgeons use this procedure to examine the space between the lungs and breastbone, called the mediastinum. It's most commonly used to diagnose lung cancer.
Thoracoscopy: Thoracoscopy includes pleuroscopy, which views the chest cavity, and surgical thoracoscopy, also known as video-assisted thoracoscopic surgery (VATS). VATS is performed by a thoracic surgeon. Thoracoscopy is used to manage and treat heart and lung conditions.
Upper endoscopy: This is also known as esophagogastroduodenoscopy, EGD, or endoscopy. Gastroenterologists use this test to look at the lining of the upper gut for bleeding, tumors, or other signs of disease. The upper gut includes the esophagus, stomach, and upper part of the small intestine (duodenum).
Endoscopy Procedure
All endoscopy procedures involve inserting a thin, flexible tube into the body through either a small cut or a natural opening like your mouth or anus. The tube has a light and camera on one end.
Talk to your healthcare provider before your procedure for more information on what to expect for your particular procedure.
Before the Test
You'll complete a questionnaire and waiver before the endoscopy test. The pre-questionnaire helps identify any potential risks that would prevent you from having the procedure.
You might need to change into a medical gown for the procedure. The medical staff may check your blood pressure, oxygen levels, and pulse before the endoscopy. You will likely receive pain medication and a sedative or anesthesia, depending on the procedure.
A sedative is a medication that causes sleepiness and helps you relax. Conscious sedation causes drowsiness and forgetfulness, and deep sedation puts you into a deeper sleep mode. Most people are given a sedative unless they're considered a very high-risk patient or are pregnant. Talk to your healthcare provider and the procedural team about what might be the best option for you.
If you receive anesthesia, the anesthesiologist will ask you about any medical conditions. This information can help determine which type of anesthesia and how much to use.
An endoscopy procedure usually takes about 15-30 minutes, plus prep time. The procedure can be as brief as 5-10 minutes.
Related: What I Wish I Knew About Choosing Sedation
During the Test
You'll likely lie on an examination table during the procedure. The medical staff may instruct you on how to position yourself. For example, you will likely lie on your left side during an upper endoscopy.
The anesthesiologist (a medical doctor who specializes in drugs used for pain management and sedation) will administer the anesthesia via an intravenous (IV) line in a vein, likely in your arm.
The medical doctor or surgeon will insert the endoscope into your body—for example, into your esophagus or anus. For procedures like thoracoscopy or laparoscopy, the surgeon will make a small incision to insert the endoscope.
They may insert other instruments through the endoscope during the procedure. These tools deliver medications, treat bleeding, remove polyps or tumors, and collect tissue for biopsy. You may experience some pain or discomfort during the procedure, especially if you don't have anesthesia or deep sedation.
After the Test
You may feel pain or discomfort after the procedure. For example, you might experience a sore throat, bloating, or nausea. The staff will likely monitor you for about 1-2 hours as the sedative or anesthesia wears off.
Most endoscopies do not require an overnight hospital stay. You will need to pre-arrange a ride home if you had a sedative or anesthesia. The medical staff may also provide instructions for post-endoscopy care. You will likely be advised to rest at home that day.
Other post-procedure instructions will vary depending on the endoscopy type. For example, you'll need to wear a chest tube for 1-2 days after a thoracoscopy.
Risks and Precautions
Endoscopies are relatively safe procedures, but there are some potential risks and side effects. The risks depend on the type of endoscopy.
Possible risks include:
Bleeding and perforation: Bleeding occurs as a result of perforation, after a biopsy, or after a polyp removal. Perforations occur when the endoscope tears the tissue lining or blood vessels. This is treated during the procedure via cauterization (sealing blood vessels with heat) or medication.
Side effects of anesthesia or sedatives: Some medications can cause changes in blood pressure or breathing problems, or allergic reactions.
Pain, numbness, or soreness: These symptoms can occur at the site of the endoscopy, especially as sedatives or painkillers begin to wear off.
Infection: In rare cases, you can acquire an infection during the endoscopy procedure. This is treated with antibiotics, a class of medications used for bacterial infections.
When To Seek Immediate Help
Some symptoms following endoscopy require immediate medical attention. These symptoms include:
Dark-colored or bloody stool
Shortness of breath
Severe and persistent abdominal or chest pain
Nausea or vomiting blood
Endoscopy Prep
Preparation depends on the type of endoscopy. For example, an anoscopy doesn't require any preparation. A colonoscopy requires a particular diet and laxatives. Speak with your healthcare provider about how to prepare for your procedure and follow their instructions.
You will need to consider the following:
Location: Most endoscopy procedures are performed in a hospital or outpatient setting.
Clothing: You may need to change into a hospital gown for the procedure.
Medications: Tell the medical doctor or surgeon about any health conditions, medications, and supplements you take. Some medications and supplements can cause bleeding or interact with medications during the procedure.
Food and drink: Many endoscopies require fasting or eating a liquid diet before the procedure. Endoscopy of the gut will require a bowel cleanse to make it easier for the clinician to examine your gut lining. This may involve fasting for 12 hours beforehand, switching to a clear liquid diet, or using laxatives. You'll also need to refrain from eating eight hours before your procedure and refrain from drinking two hours before if you receive sedation.
What to bring: Bring your identification card (such as a driver's license) and insurance card to the procedure.
Pre-arrange a ride home: You will not be able to drive for 24 hours after an endoscopy involving anesthetics or sedatives.
Check with your insurance provider to see whether the endoscopy is covered. Some procedures, like a colonoscopy, may only be covered if they are used to screen for cancer.
Related: How Much Does a Colonoscopy Cost?
Results
You may receive results immediately after the procedure. A pathologist (a medical doctor who specializes in examining body tissues and fluids) will review any samples taken. It might take several days to get the results of a biopsy.
You may receive your results via in-office appointment, mobile app, or over the phone, depending on the reasons for the endoscopy and the results.
Interpreting your Results
The doctor or surgeon will tell you if they find abnormalities after the procedure.
Endoscopy results might be:
Positive: The doctor or surgeon found polyps, growths, or other abnormalities in the body region being examined. A biopsy will be sent to a pathologist to confirm a diagnosis.
Negative: The doctor or surgeon did not detect any polyps or other abnormalities.
Inconclusive: The doctor or surgeon could not complete the procedure or the procedure didn't lead to a firm conclusion.
A Quick Review
Endoscopy is a procedure that uses a thin, flexible tube with a camera and light on the end (endoscope) to view the inside of the body. Endoscopy allows medical doctors and surgeons to investigate unexplained symptoms, diagnose, and treat a wide variety of conditions.
Procedures and possible risks vary depending on the type of endoscopy. Speak to your healthcare provider before the procedure to make sure you understand the process, risks, and any other important information.
For more Health news, make sure to sign up for our newsletter!
Read the original article on Health.
