What are the main risks with gastrointestinal endoscopy?

Dr. Tan Chi Chiu discusses the common concerns patients have before undertaking an endoscopic procedure of the digestive system


Many patients have anxieties about undergoing endoscopy, says Dr. Tan. The thought that a flexible instrument is going to enter the mouth and into the oesophagus, stomach and into the intestines or up the other end into the colon, fills patients with dreadful pictures. In gastroscopy patients worry about gagging on a scope that may pass the pharynx, which is quite sensitive, on its way into the oesophagus and stomach. At the other end patients worry about pain when the colonoscope enters the large intestine and has to navigate its way through the loops of bowel. These are all very reasonable worries.

Nowadays endoscopy is done very comfortably using sedative techniques. When we sedate patients for endoscopy we use medicines that will bring about a state of relaxation and perhaps put the patient into a dream like state. Under sedation patients do not experience the endoscopy at all. When they wake up they have no memory of it and no experience of it.

When patients have to undergo a colonoscopy some bowel preparation is necessary. Patients have to drink some laxative liquids in order to purge out all the faeces so that they are very clean. Patients sometimes worry that this may feel like having food poisoning or diarrhoea. But in fact it is a relatively easy procedure where the patient merely experiences the need to go to the toilet as if it were normal and then passes the motion. As the motion becomes more and more liquid the patient can see that the colon is being cleaned out. At the end, the patient may pass what may look like water or thinly stained water. Then we know that the patient is clean enough in the colon for us to do a colonoscopy and see everything.

We also inform patients of the risks of endoscopy. Sedation is at the very safe end of the spectrum of anaesthesia and the vast majority of patients do not have any ill experie