Everything about digestive endoscopy: types, procedure and care
What is a digestive endoscopy?
Endoscopy is a term derived from Latin and Greek, from the words “endo,” meaning inside, and “scopia,” meaning to look. Therefore, endoscopy refers to looking inside any body orifice. For example, Otoscopy is a clinical procedure used to examine structures of the ear, Bronchoscopy is a test to view the airways and diagnose lung disease, and in the case of digestive endoscopy, it involves looking inside the digestive system.
What is an upper digestive endoscopy?
An upper digestive endoscopy examines the upper digestive tract, starting from the esophagus, which is the first part after the mouth and pharynx where food enters, continuing through the stomach, where digestion occurs, and the duodenum, the first part of the small intestine. All these parts are examined during an upper digestive endoscopy, which is why it is also called esophagogastroscopy, because it examines the esophagus and stomach, or esophagogastroduodenoscopy, because it examines the esophagus, stomach, and duodenum. The test can be named based on the area explored, in this case, the “upper” part of the organs inspected.
What is a lower digestive endoscopy?
A lower digestive endoscopy explores the lower gastrointestinal tract, meaning the organs that include the rectum, which is the first part after the anus, followed by the colon, also known as the large intestine, and sometimes the ileum, the last part of the small intestine. Therefore, the lower digestive endoscopy can also be referred to as a rectocolonoscopy or rectocolonoscopy with ileoscopy, depending on the organs examined.
How is a digestive endoscopy performed?
A digestive endoscopy is performed by inserting the endoscope, a flexible tube with a digital camera at one end, allowing visualization of the digestive tract. This process lets endoscopists see the organs being examined in real-time on an enlarged screen, enabling the detection of any lesions such as polyps, cancers, ulcers, signs of inflammation, or mucosal alterations like gastritis or colitis, allowing for a diagnosis. A common question is, “Why is a biopsy done during an endoscopy?” The answer lies in the procedure’s ability to take tissue samples for analysis, which helps detect conditions like infections, inflammation, or precancerous changes.
Endoscopy can also be used for treatments, as the endoscope has an accessory channel through which instruments can be inserted. These might include forceps to take biopsies for tissue analysis, needles for injecting substances, loops for removing lesions, small scalpels, and foreign body forceps to extract accidentally ingested objects (for example, in children, coins or batteries are often removed). Therefore, endoscopy has many applications, not just for diagnosis but also for treatment during the same procedure.
Anesthesia in lower digestive endoscopy
Endoscopy involves inserting a tube through the mouth to the small intestine or through the anus to the end of the colon or even the last part of the small intestine, which can be very uncomfortable for the patient. Therefore, these tests are performed under anesthesia, with deep sedation, usually with propofol, so that patients feel as if they are taking a pleasant nap while the endoscopist is working and examining the digestive tract’s mucosa, whether upper or lower.
For a lower digestive endoscopy, it’s important to note that the usual content of the colon and rectum is stool, so patients need to take a special preparation prescribed by the doctor that has a purgative effect to empty the intestines of stool. Additionally, a fiber-free diet is necessary in the days leading up to the procedure to avoid undigested vegetable matter or seeds in the intestines that could interfere with the proper visualization of the mucosa.
Fasting and preparation for upper digestive endoscopy
For an upper digestive endoscopy, the patient must be fasting for two reasons. First, if the stomach or small intestine is to be examined, they should not be full of food, as remnants would obstruct the specialist’s view of the mucosa. The second reason is patient safety. If the patient is sedated and the endoscope encounters a stomach full of liquid or food, those contents could migrate to the airway, causing a complication known as aspiration.
Complete fasting means no intake of solids or liquids, typically for 8 hours before the procedure.
Duration of a digestive endoscopy
An upper digestive endoscopy typically lasts between 15 and 20 minutes, while a lower digestive endoscopy lasts around 30 minutes. These times are approximate, as medical professionals cannot predict what they will find until the area is examined. If therapeutic intervention is necessary, the duration may increase depending on the pathology and required treatment.
What is the purpose of a digestive endoscopy?
A digestive endoscopy has several functions (diagnostic, therapeutic urgent or non-urgent, and preventive). The diagnostic function determines the cause of any digestive symptoms that prompted the endoscopy, such as chronic diarrhea, repeated vomiting, difficulty swallowing, digestive bleeding (evidenced by anemia, vomiting blood, black tar-like stools, or anal bleeding), among other symptoms.
It is also a useful technique for monitoring established diseases such as celiac disease, inflammatory bowel disease, cancer, Barrett’s esophagus, ulcers, etc.
Additionally, endoscopy allows for treatment, either scheduled (e.g., polyp removal) or urgent (e.g., treating a life-threatening digestive hemorrhage or extracting objects introduced through the anus or accidentally swallowed).
Moreover, endoscopy serves an important preventive role by detecting and removing precancerous lesions before they turn into cancer, such as colon polyps.
Risks associated with digestive endoscopy
The risks of endoscopy are relatively low. A distinction must be made between diagnostic endoscopy, whether oral or rectal, which only observes the mucosa. In these cases, the examination is conducted by inflating the digestive tract with CO2 to distend the folds and clean any residue with water to obtain a clear view of the mucosa. In these cases, the risk is extremely low since no intervention beyond simple observation is performed.
When treatment is involved, the risk of complications increases depending on the intervention. For example, removing a 3mm lesion is not the same as removing a 3cm lesion.
One of the main risks of therapeutic endoscopy is bleeding, which can occur immediately and be treated on the spot or delayed, where no bleeding occurs during the endoscopy but may happen days later.
Another risk is perforation, which is a tear or hole in the mucosa. Often, this can be resolved with endoscopy using clips (“small staples”), but if the tear is large, surgical repair may be necessary.
Who performs a digestive endoscopy?
Digestive endoscopies should be performed by qualified medical professionals specializing in these procedures. It’s important to seek doctors with qualified experience in endoscopy, such as those at the Guadalentín Hospital, for both diagnostic and therapeutic procedures.
For patients, this is crucial because if lesions are present, a skilled professional is needed to detect them, as undetected lesions could lead to complications if left untreated.
The medical professionals at Guadalentín Hospital have extensive experience in this field and can successfully implement therapeutic solutions following a diagnostic endoscopy, such as removing polyps and avoiding unnecessary repeat procedures.
Is It Normal for the Stomach to Hurt After an Endoscopy?
Patients who undergo an endoscopy should avoid activities such as work, driving, or tasks requiring responsibility for the next eight hours following the procedure, as reflexes are diminished and do not fully recover until eight hours later.
Upper endoscopy or gastroscopy typically does not cause discomfort, while a colonoscopy or lower digestive endoscopy may cause discomfort such as gas, as water is introduced to wash away any residue, and a small amount of CO2 is used to distend the folds for better mucosal visualization.
At what age is it recommended to have an endoscopy?
Endoscopy has a preventive role, either because a family member has had digestive cancer, the individual has had digestive cancer requiring follow-up, or because they have reached an age where a colon cancer screening endoscopy is recommended, typically starting at age 50 for healthy individuals.
How much does a digestive endoscopy cost in Murcia?
In Murcia, the cost of an endoscopy can vary depending on the specific procedure and the clinic chosen. For example, a gastroscopy, which is a type of upper digestive endoscopy, costs between 300 and 400 euros. A colonoscopy, which examines the colon, typically costs between 320 and 420 euros.
At Guadalentín Hospital, endoscopies start at 250 euros, depending on the area explored and the type of tests required, whether diagnostic or therapeutic. For more information on protocols and procedures, visit Hospital del Guadalentín Endoscopy or call the hospital directly at 868 682 900.
