Why would an endoscopy be needed?
An endoscope is a thin tube-like instrument with a camera at the end, used to diagnose and treat conditions in the oesophagus, stomach, duodenum and colon. Digestive tract problems, tumours, ulcers, abnormal growths and inflammation can all be diagnosed and treated during a gastroscopy or colonoscopy.
How is an endoscopy done?
Depending on your symptoms, Dr Aikman may suggest either a gastroscopy or a colonoscopy to get a better view of the internal state of the gastrointestinal tract. Both of these procedures can be done for diagnostic reasons or as a treatment for the condition that is found. The symptoms of gastro-intestinal tract pathology can be subtle, and the following symptoms can indicate an underlying problem:
- Vomiting blood or passing blood per rectum
- Difficulty swallowing
- Change of bowel habits, including sudden onset of constipation or diarrhoea
- Unplanned weight loss
- Palpable abdominal masses, which might be painful but may also be asymptomatic.
A gastroscopy is done to investigate the upper gastro-intestinal tract from the mouth to the first part of the small bowel. The most commonly diagnosed condition during a gastroscopy is known as peptic ulcer disease. Other pathology which could be found include oesophageal strictures (benign or cancerous), gastro-oesophageal reflux, ulceration of the oesophagus, stomach or small bowel and masses. Biopsies can be taken, or the lesions can be completely removed by endoscopy.
A colonoscopy is done to investigate pathology affecting the large intestine. Most common pathology include colonic diverticula (abnormal outpouching of part of the wall of the colon), polyps and other masses. The extent of inflammation of the colon in inflammatory conditions can also be done. Biopsies can be taken, or the lesion can be completely removed.
Prior to the procedure, your stomach and bowels will need to empty. Your general surgeon will instruct you to stop eating either 8 hours (for a gastroscopy) or 24 hours prior (for a colonoscopy) to the procedure. You may also be prescribed a laxative to flush out the colon before a colonoscopy.
A gastroscopy can be done as an outpatient procedure, which means you won't need to go into hospital. If there are other risks present, like heart, lung or kidney disease, it may be safer to do the procedure in hospital. Dr Aikman will decide which of the two will be the safest for you.
Dr Aikman does all gastroscopies under deep sedation and an anaesthetist will be present for the sedation. An intravenous cannula will be placed prior to the procedure. Ideally you will not experience any discomfort during this procedure.
The endoscope is fitted with a camera that will give your general surgeon a view of the internal oesophagus, stomach and small intestine on a video screen. From here he can make a diagnosis. If narrowed areas are found, these may be treated by stretching up with a dilator passed down the endoscope. Bleeding ulcers can be treated, and biopsies of polyps and small cancerous tumours can be taken during this procedure.
A colonoscopy is done as an inpatient procedure in theatre. After you have been given a sedative to relax, your general surgeon will put the tube-like endoscope into your rectum. The endoscope, otherwise known as a colonoscope, is also fitted with a camera to provide a view of the internal lining of the colon and rectum. The colonoscope is also fitted with a tube that allows your general surgeon to pump in the air and inflate your colon. This helps to get a better view of the lining and make a more accurate diagnosis. In the same procedure, abnormal growths like polyps can be removed. Other abnormal-looking tissues can be sampled, and a biopsy may be done to test for cancerous cells.
What will recovery entail?
You can go home immediately after completely recovering from the sedation. You will however need someone to drive you home after the procedure. Mild stomach cramps and gas are normal after an endoscopy. If you experience any fever, chills, extreme pain in the abdomen or bleeding in the stool, be sure to contact your doctor as this may be cause for concern.