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Gastrointestinal Endoscopy Introduction

With the procedure known as gastrointestinal endoscopy, a doctor is able to see the inside lining of your digestive tract. This examination is performed using an endoscope-a flexible fiberoptic tube with a tiny TV camera at the end. The camera is connected to either an eyepiece for direct viewing or a video screen that displays the images on a color TV. The endoscope not only allows diagnosis of gastrointestinal (GI) disease but treatment as well.
  • Current endoscopes are derived from a primitive system created in 1806-a tiny tube with a mirror and a wax candle. Although crude, this early instrument allowed a first view into a living body.
  • The GI endoscopy procedure may be performed on either an outpatient or inpatient basis. Through the endoscope, a doctor can evaluate several problems, such as ulcers or muscle spasms. These concerns are not always seen on other imaging tests.
  • Endoscopy has several names, depending on which portion of your digestive tract your doctor seeks to inspect.
    • Colonoscopy: This procedure enables the doctor to see ulcers, inflamed mucous lining of your intestine, abnormal growths and bleeding in your colon, or large bowel.
    • Enteroscopy: Enteroscopy is a recent diagnostic tool that allows a doctor to see your small bowel. The procedure may be used in the following ways:
      • To diagnose and treat hidden GI bleeding
      • To detect the cause for malabsorption
      • To confirm problems of the small bowel seen on an x-ray
      • During surgery, to locate and remove sores with little damage to healthy tissue
  • Doctors do have other diagnostic tests besides GI endoscopy, including echography to study the upper abdomen and a barium enema and other x-ray exams that outline the digestive tract. Doctors can study the stomach juices, stools, and blood to learn about GI functions. But none of these tests offers a direct vision of the mucous lining of the digestive tube.

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Upper GI endoscopy (EGD): Although rare, bleeding and puncture of your esophagus or stomach walls are possible during EGD. Other complications include the following:
  • Severe irregular heartbeat
  • Pulmonary aspiration - When material, either particulate (food, foreign body) or fluid (gastric contents, blood, or saliva), enters from your throat into your windpipe
  • Infections and fever that come and go
  • Respiratory depression, a decrease in the rate or depth of breathing, in people with severe lung diseases or liver cirrhosis
  • Reaction of the vagus nerve system to the sedatives

Lower GI endoscopy (colonoscopy, sigmoidoscopy, enteroscopy): Although uncommon (less than 1.5% of cases), possible complications of colonoscopy and sigmoidoscopy include the following:
  • Local pain
  • Dehydration (due to excess of laxatives and enemas for bowel preparation)
  • Cardiac arrhythmias
  • Bleeding and infection
  • Hole in your colon
  • Explosion of combustible gases in your colon (certain gases are produced within the bowel) during removal of polyps
  • Respiratory depression usually due to oversedation in people with chronic lung disease

During the Procedure

Upper GI endoscopy
  • You will be placed on your left side and have a plastic mouthpiece placed between your teeth to keep your mouth open and make it easier to pass the tube.
  • The doctor lubricates the endoscope, passes it through the mouthpiece, then asks you to swallow it. The doctor guides the endoscope under direct visualization through your stomach into the small intestine.
  • Any saliva you have will be cleared using a small suction tube that is removed quickly and easily after the test.
  • The doctor inspects portions of the linings of your esophagus, stomach, and the upper portion of your small intestine and then reinspects them as the instrument is withdrawn.
  • If necessary, biopsies and removal of foreign bodies and polyps may be performed.
  • The procedure usually is completed within 10-15 minutes. Any surgical procedures will require several minutes, depending on the type.

Lower GI endoscopy
  • You will be placed on your left side with your hips back, flexed beyond your abdominal wall.
  • The doctor lubricates the endoscope and inserts it into your anus and advances it under direct vision.
  • You may be asked to change position during the procedure to assist moving the endoscope. The doctor will study your colon and rectum walls and reinspect them as the endoscope is withdrawn. If necessary, surgeries may be performed.
  • You may feel uneasiness and abdominal pain. The procedure usually takes 15-20 minutes. Any surgeries will require additional time, depending on the type.

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