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Endoscopy in Crohn Disease (cont.)

Is the endoscopy procedure painful?

While endoscopy is not usually painful, it can be uncomfortable, and many people feel apprehensive. If a patient is having an EGD, ERCP, or colonoscopy, they will probably be given a pain medication and a sedative to relax for the procedure. Patients should arrange for someone else to pick them up and drive them home after the test. Sigmoidoscopy is a limited test and does not usually require sedation.

What are other names for endoscopy in diagnosing Crohn's disease?

Doctors have different names for endoscopy depending on which part of the digestive tract they are examining.

  • Esophagogastroduodenoscopy (EGD): Also called upper endoscopy, this test examines the lining of the esophagus (the tube between the mouth and stomach), the stomach, and the duodenum (the upper part of the small intestine).
  • Colonoscopy: This test examines the lining of the colon, or large intestine, and sometimes the lower part of the ileum (the lowest part of the small intestine).
  • Sigmoidoscopy: This test examines the lining of the lowest third of the colon, which includes the rectum. The name of the test derives from a bend called the sigmoid in this part of the colon.
  • Endoscopic retrograde cholangiopancreatography (ERCP): This test combines endoscopy with X-rays to examine the ducts that open into the small intestine from the liver, gallbladder, and pancreas. In some people with Crohn's disease, these ducts become inflamed and close up.
  • Endoscopic ultrasound: This test combines endoscopy with ultrasound, a technology that uses sound waves to create images of organs deep within the body. (This is the same safe technology used to look at a fetus in its mother's womb.) This technique is widely used in the United States to evaluate fistulas, a common complication of inflammatory bowel disease.
  • Balloon endoscopy, or enteroscopy is an endoscopic procedure that allows the physician to visualize the entire small intestine and take tissue biopsies.
  • Capsule endoscopy (wireless endoscopy) is an endoscopic procedure in which a small video capsule is swallowed by the patient. The video capsule takes photographs of the inside of the esophagus, stomach, and small intestine. The drawbacks of capsule endoscopy include: 1) areas missed due to the rapid transit of the capsule, 2) battery failure, 3) inability to take tissue biopsies, 4) the capsule becoming stuck or lodged in strictures or tumors, and 5) the camera takes tens of thousands of photographs that becomes very time consuming for the health care professional to review.
  • Barium X-rays: These may include a barium swallow (upper GI series) or a barium enema (lower GI series).

Which of these tests your doctor chooses to do depends on the symptoms the patient has. Generally, the patient's symptoms suggest what part of the digestive tract is involved.

Medically Reviewed by a Doctor on 6/27/2016
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Crohn disease is an idiopathic, chronic, transmural inflammatory process of the bowel that often leads to fibrosis and obstructive symptoms, which can affect any part of the gastrointestinal (GI) tract from the mouth to the anus.

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