Endoscopy
What is Endoscopy?
There are many different endoscopy procedures, including but not limited to colonoscopy, sigmoidoscopy, endoscopic ultrasound (EUS), endoscopic retrograde cholangiopancreatography (ERCP) and upper endoscopy (EGD). Most involve inserting a flexible endoscope into the mouth or the anus, and guiding it through the gastrointestinal tract (GI tract) while a camera attached to the endoscope’s tip records pictures. An appropriate doctor can then examine the images for signs of health diseases, as they would have been able to do if during open surgery or another procedure more invasive than most endoscopies. Below is a list of endoscopy procedures that your gastroenterologist (GI doctor) may perform. Contact a GI doctor to find out which test is right for your medical condition.
What Are Some Endoscopy Procedures My GI Doctor Can Do?
- Colonoscopy—colonoscopy is considered to be the best way to screen the colon for colon cancer and related symptoms. It covers the rectum, the entire length of the large intestine, as well as the lowerpart of the small intestine (called the small bowel). Overall the test is minimally painful because patients are always sedated before the procedure starts.
- Sigmoidoscopy—flexible sigmoidoscopy is similar to colonoscopy, but is limited to the sigmoid colon and the rectal area of the body only. Sedation is optional during this test. Gastroenterologists usually do not recommend sigmoidoscopy as a substitute for colonoscopy, as polyps and inflammation located higher up the colon will surely be missed.
- Upper Endoscopy—also called an EGD or an esophagogastroduodenoscopy, an upper endoscopy covers the esophagus, stomach and duodenum (uppermost section of the small intestine). It is often performed to diagnose underlying conditions causing abdominal pain, vomiting and dysphagia (difficulty swallowing). Upper endoscopy is generally considered to be the most comprehensive examination of the upper GI tract. The procedures require medical sedation so that the patients’ gag reflex is suppressed, allowing for comfortable insertion of the endoscopy down the throat.
- Endoscopic Ultrasound (EUS)—endoscopic ultrasound is used to examine the upper or lower GI tract. The endoscope required to perform the procedure has an ultrasound device attached to its tip, which uses sound waves to allow for visuals of organs surrounding the GI tract, as opposed to only the lining of the GI tract. It is a great way to examine growths previously detected in the body, as the ultrasound technology will show how deep into the tissue the growth has spread and help doctors figure out the best form of treatment accordingly, whether it is biopsy or chemotherapy. EUS is often used to examine a patient’s gallbladder, bile duct and pancreas.
- Endoscopic Retrograde Cholangiopancreatography (ERCP)—ERCP is an endoscopic procedure of the liver and pancreas. It is sometimes used for examinations of the gallbladder, although that is less common. This relatively complex and long-lasting test requires deep medical sedation as an endoscope is inserted into a patient’s mouth, guided through the small intestine. Once situated, another device called a catheter is inserted and guided through a small opening called the papilla. After injecting a contrast solution into the duct, x-rays can be taken that will give doctors a view of these hard-to-reach areas of the body. Other procedures, such as stent placement and biopsy, can also be performed during ERCP. ERCP is often used to diagnose jaundice, cholangitis (bile duct inflammation), pancreatitis, gallstones and cancer.
Reviewed 12/29/2011 by David M. Nolan, M.D.
Diplomate of the American Board of Internal Medicine, 2011
Currently a Fellow of Gastroenterology, at UCI 2011-2014
