Scott H Plantz, MD, FAAEM
Francisco Talavera, PharmD, PhD
Gastrointestinal Endoscopy Introduction
With the procedure known as gastrointestinal endoscopy, a doctor is able to see the inside lining of your digestive tract. This examination is performed using an endoscope-a flexible fiberoptic tube with a tiny TV camera at the end. The camera is connected to either an eyepiece for direct viewing or a video screen that displays the images on a color TV. The endoscope not only allows diagnosis of gastrointestinal (GI) disease but treatment as well.
- Current endoscopes are derived from a primitive system created in 1806-a tiny tube with a mirror and a wax candle. Although crude, this early instrument allowed a first view into a living body.
- The GI endoscopy procedure may be performed on either an outpatient or inpatient basis. Through the endoscope, a doctor can evaluate several problems, such as ulcers or muscle spasms. These concerns are not always seen on other imaging tests.
- Endoscopy has several names, depending on which portion of your digestive tract your doctor seeks to inspect.
- Colonoscopy: This
procedure enables the doctor to see ulcers, inflamed mucous lining of your intestine, abnormal growths and bleeding in your colon, or large bowel.
- Enteroscopy: Enteroscopy is a recent diagnostic tool that allows a doctor to see your small bowel. The procedure may be used in the following ways:
- To diagnose and treat hidden GI bleeding
- To detect the cause for malabsorption
- To confirm problems of the small bowel seen on an x-ray
- During surgery, to locate and remove sores with little damage to healthy tissue
- Doctors do have other diagnostic tests besides GI endoscopy, including echography to study the upper abdomen and a barium enema and other x-ray exams that outline the digestive tract. Doctors can study the stomach juices, stools, and blood to learn about GI functions. But none of these tests offers a direct vision of the mucous lining of the digestive tube.
- Endoscopy has little value for people with the following conditions:
- Severe coronary artery disease and acute or recent heart attack
- Uncontrolled high or low blood pressure
- Massive upper GI bleeding
- Acute peritonitis (inflammation of certain tissues in your abdomen)
- Injuries of the cervical spine
- Perforation of organs of the upper GI tract
- A history of respiratory distress
- Severe coagulopathy, a disease in which you continue bleeding because of inadequate clotting in your blood
- Recent upper GI tract surgery
- Long-standing and stable inflammatory bowel diseases (except for watching cancers)
- Chronic irritable bowel syndrome
- Acute and self-limiting diarrhea
- Bloody or tarry stools with a clear source of the bleeding
- Pregnancy in
second or third trimester
- History of severe chronic obstructive pulmonary disease
- Recent colon surgery or past surgery of your abdomen or pelvis resulting in internal adhesions
- Acute diverticulitis
- Tear in a blood vessel in your abdomen
- Sudden colon inflammation
- Acute inflammation of the sac that lines your abdomen
- Noncorrectable coagulopathy, a disease in which you continue bleeding due to inadequate clotting factors in your blood
- Massive gastrointestinal bleeding
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