What are the Risks of Endoscopy?

As with crossing any road, the chance of accident and injury is very small when all sensible precautions are taken. But the chance of accident and injury is never zero. At random, one could still have an accident despite the best precautions. So it is with endoscopy. Every precaution is taken to prevent the complications the might happen. Yet, despite the best of efforts, the risk of injury is not zero, although extremely small. What are the known risks?

• Perforation (tear in the gut wall) – Injury to the walls of the digestive tract is possible, with the worst case being a perforation that might require (usually laparoscopic or key-hole) surgery to repair. The risk is very small and even smaller for a relatively healthy digestive tract and an experienced endoscopist.
• Risks of sedation - Medications to obtain conscious sedation may be given in the vein to help you relax and be comfortable during the procedure and may cause vein irritation (phlebitis) or pain, allergic reaction, or heart/breathing complications.
• Bleeding – Bleeding may be a complication of biopsy, polypectomy, or dilatation and may rarely require blood transfusions or possibly a surgical operation. In diagnostic procedures, the risk of bleeding is virtually zero. The risk is higher the larger the polyp removed or the more complex the therapeutic procedure.
• Damage to teeth - Capped, loose, or false teeth or teeth in poor condition may be damaged during an endoscopy. Even normal teeth may rarely be affected during safety or protective procedures relate to sedation. Although we make every effort to protect teeth, such damage is a recognized and accepted hazard of endoscopy.
• Pancreatitis – This may be a result of ERCP, Balloon Enteroscopy or Endoscopic Ultrasound with fine needle biopsy of a lesion or tumour of the pancreas.
• Infection - Rarely, passage of the endoscope and manipulations may cause infection elsewhere in the body. Transmission of infections from one patient to another is virtually impossible due to the high world-class standard of sterilisation of the instruments employed.
• Mild discomfort – There may be sore throat, rectal irritation or abdominal bloating discomfort after endoscopy. Air is often put into the stomach or colon to open it up for visualisation. As much of this air as possible is removed at the end of the procedure, but there may still be some left behind. The air is usually easily passed and any discomfort will be eased.
• Inaccurate diagnosis - Endoscopy is an extremely effective means of examining the gastrointestinal tract, but it is not 100% accurate in diagnosis. Rarely, a failure of diagnosis or misdiagnosis may result, particularly with colonoscopy due to the numerous turns and folds in the colon. Although endoscopic ultrasonography is a valuable tool for the diagnosis of gastrointestinal, pancreatic and biliary conditions, a missed lesion such as cancer, can occur even in expert hands.