What Is Endoscopy?

Gastrointestinal endoscopy involves the use of endoscopes. The endoscope is a thin, flexible tube fitted with a camera head and light guides. Designed with patient comfort in mind, this gentle device moves smoothly through your gastrointestinal tract to provide a clear picture of the insides of your oesophagus, stomach, duodenum and colon.

• A Gastroscope examines your oesophagus, stomach and duodenum. The examination is called Gastroscopy.
• A Colonoscope examines your large intestine or colon and can enter the last part of the small intestine (the ileum) that connects with the colon. If only a short examination is performed, it is called Sigmoidoscopy. If a complete examination is done it is called Colonoscopy.
• A special kind of endoscope (ERCP side-viewing Duodenoscope) allows visualisation and therapy of the bile ducts and pancreatic duct.
• The small bowel can be visualised by modern methods such as Capsule Endoscopy or Balloon Enteroscopy. Capsule Endoscopy uses a high-tech capsule the size of a large vitamin pill, which contains camera, lights, lenses and a radio transmitting device. It is swallowed and as it moves through the small intestines, pictures are taken at a rate of two per second. The Capsule transmits images to a recorder worn during the duration of the test and these thousands of images can be downloaded to a computer to be studied in detail. The capsule then passes harmlessly in the stools.
• A Balloon Enteroscope is a modern endoscope that is fitted with a sheath with an inflatable balloon. By means of alternating inflation and deflation during advancement, the enteroscope can be advanced deeply into the small bowel, either through the upper or the lower digestive tract.
• Endoscopic Ultrasound (EUS) is performed by an endoscope with an ultrasound wave device at the head. This is used to examine the layers of the walls of the digestive tract and lesions in the wall, outside the wall or in organs adjacent to the digestive tract. For example, it is possible to examine cysts or tumours in the pancreas by doing EUS via the stomach wall.

As the endoscope is gently inserted into your body, true-to-colour high definition images are relayed electronically and displayed in real time on a monitor. Modern endoscopes have a “Narrow Beam Imaging” (NBI) function which changes the wavelength of the light used to examine the lining of the digestive tract and highlights abnormal features more clearly so that subtle abnormalities such as flat polyps can be detected. Other Chromoendoscopy methods include dye sprays of the lining of the digestive tract to accentuate abnormalities.

Photographs and DVD recordings can be made for record purposes and given to the patient for future reference. Results of endoscopy are known immediately and in many cases patients be offered initial treatment at once. If biopsies are taken, these results will be available after another one or two days.

Endoscopy is one of the most reliable methods of detection of gastroenterological diseases. Physical examinations, x-ray or other imaging techniques and laboratory tests can offer clues to health problems. But endoscopy actually shows how your internal intestinal tissue looks, without surgery and with minimal risks.

A great advantage of endoscopy is that tiny surgical instruments can be passed through the endoscope to take biopsies, remove growths such as polyps, stop bleeding from lesions, insert stents (devices that hold open blocked tubes) and remove gallstones from the bile ducts. A Nd-YAG laser or Argon Plasma fibre can also be passed down the endoscope to burn away cancers where appropriate or to coagulate bleeding blood vessels. In other imaging methods, including Capsule Endoscopy, the doctor can only see abnormalities but can do nothing to confirm diagnosis nor treat anything.