Endoscopy

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Introduction

When An Endoscopy Is Used

When an endoscopy is used

An endoscopy can be used to:

investigate unusual symptoms
help perform certain types of surgery

An endoscope can also be used to remove a small sample of tissue for further analysis. This is known as a biopsy.

Investigating symptoms

An endoscopy might be recommended to investigate the following symptoms:

difficulty swallowing (dysphagia)
persistent abdominal pain
chest pain that isn't caused by heart-related conditions
persistent nausea and vomiting
unexplained weight loss
vomiting blood
persistent diarrhoea
blood in your stools

If the gullet (oesophagus), stomach or first part of the small intestine needs to be examined, it's known as a gastroscopy.

If the bowel needs to be examined, it's known as a colonoscopy. Watch a video about what happens during a colonoscopy.

Other types of endoscopies used to investigate symptoms include:

bronchoscopy – used to examine the airways if you have a persistent cough or you're coughing up blood
hysteroscopy – used to examine the inside of the womb (uterus) if there are problems such as unusual vaginal bleeding or repeated miscarriages
cystoscopy – used to examine the inside of the bladder if there are problems such as urinary incontinence or blood in your urine
endoscopic ultrasound – used to create images of internal organs, such as the pancreas, and take tissue samples

Therapeutic endoscopy

Modified endoscopes with surgical instruments attached to them or passed through them can be used to carry out certain types of surgery.

For example, they may be used to:

remove gallstones, bladder stones or kidney stones – the procedure used to remove gallstones is known as an endoscopic retrograde cholangiopancreatography
repair damage inside joints (arthroscopy)
repair a bleeding stomach ulcer
place a stent across an area that has become narrowed or blocked
tie and seal the fallopian tubes – a technique carried out during female sterilisation
remove small tumours from the lungs or digestive system
remove fibroids, non-cancerous growths that can develop inside the womb

Laparoscopic surgery

A laparoscope is a type of endoscope used by surgeons as a visual aid when carrying out keyhole surgery (laparoscopic surgery).

Only small incisions are made during laparoscopic surgery, which means it's less painful afterwards and you'll recover more quickly.

Common types of keyhole surgery include:

removing an inflamed appendix in cases of appendicitis
removing the gallbladder, which is often used to treat gallstones
removing a section of the intestine, which is often used to treat digestive conditions, such as Crohn's disease or diverticulitis, that don't respond to medication
repairing hernias
removal of the womb (hysterectomy)
removing some or all of an organ affected by cancer

Laparoscopies are also often used to investigate certain symptoms and help diagnose many different conditions.

What Happens During An Endoscopy

What happens during an endoscopy

Endoscopies are usually carried out at local hospitals, although some larger GP surgeries may also offer the procedure.

Before having an endoscopy

Depending on what part of your body is being examined, you may be asked to avoid eating and drinking for several hours beforehand.

You may be given a laxative to help clear stools from your bowels if you're having a colonoscopy to examine the large intestine or a sigmoidoscopy to examine the rectum and lower part of the bowel.

In some cases, you may also need antibiotics to reduce the risk of an infection.

If you're taking a medicine to thin your blood, such as warfarin or clopidogrel, you may need to stop taking it for a few days before having an endoscopy. This is to prevent excessive bleeding during the procedure.

However, don't stop taking any prescribed medicine unless your GP or specialist advises you to do so.

The endoscopy procedure

An endoscopy isn't usually painful, and most people only experience some mild discomfort, similar to indigestion or a sore throat.

The procedure is usually carried out while you're conscious. You may be given a local anaesthetic to numb a specific area of your body. This may be in the form of a spray or lozenge to numb your throat, for example.

You may also be offered a sedative to help you relax and make you less aware of what's going on around you.

The endoscope will be carefully inserted into your body. Exactly where it's inserted will depend on the part of your body being examined.

For example, it may be inserted into your:

throat
anus – the opening stools are passed out of the body through
urethra – the tube urine passes through out of the body

If you're having keyhole surgery (laparoscopy), the endoscope will be inserted into a small incision your surgeon makes in your skin.

An endoscopy usually takes between 15 and 60 minutes, depending on what it's being used for. It will usually be carried out on an outpatient basis, which means you won't have to stay in hospital overnight.

Wireless capsule endoscopy

A wireless capsule endoscopy is a relatively new type of endoscopy. It involves swallowing a capsule that's able to wirelessly transmit images of the inside of your stomach and digestive system.

The capsule is the size of a large pill and leaves your body naturally when you go to the toilet.

It's often used to investigate internal bleeding in the digestive system when there's no obvious cause.

There are some complications associated with wireless capsule endoscopy. Swallowing the capsule can be difficult, as can passing it naturally. The capsule can also get caught in the narrow areas of your bowel, causing a blockage.

After an endoscopy

After having an endoscopy, you'll probably need to rest for about an hour until the effects of the local anaesthetic or sedative have worn off.

If you decide to have a sedative, a friend or relative will need to take you home after the procedure.

If you've had a cystoscopy to examine your bladder, you may have blood in your urine for 24 hours afterwards. This should settle, but contact your GP if you still notice it after 24 hours.