How Endoscopy Test Helps Diagnose Digestive Issues

Many upper digestive tract problems cannot be diagnosed through X-rays. This is what makes the endoscopy procedure an essential means for diagnosing and treating various gastrointestinal diseases. Endoscopy can also be used to detect stomach and duodenal ulcers, especially when there is bleeding or scarring from a previous ulcer.

The examination is also used to detect early forms of cancer that are too small to be seen on X-rays. The endoscope is not only used for diagnosis but also for treatment, such as dilating narrow areas of the esophagus, removing polyps, or retrieving swallowed objects.

Given the importance of this examination, we will discuss in detail:

• What is an endoscopy?
• What is endoscopy used for?
• What precautions should be taken before undergoing this procedure?
• What are the steps of an endoscopy?

• What should you do after the examination?

What Is An Endoscopy Test?

An endoscopy is a visual examination of the lining of the upper digestive tract, including the esophagus, stomach, and duodenum. The endoscope is passed through your mouth and down into the digestive system. The images from the camera are displayed on a video screen, and pictures can be taken. The endoscope will not interfere with your breathing.

During the examination, the doctor can look for any abnormalities, and if it is necessary, take a small tissue sample using a tiny (biopsy) forceps (a painless procedure), after which the tissue sample is sent to a laboratory for microscopic examination.

What Is Endoscopy Used For?

Endoscopy is a very safe, accurate, and well-tolerated procedure. It can be used, as mentioned, for diagnosis or treatment in the following important cases:

• Indigestion, heartburn, and gastroesophageal reflux disease (GERD)
• Locating the source of bleeding if it occurs
• Digestive disorders (such as damage to the small intestine lining due to gluten intolerance)
• Esophageal varices (swollen veins in the esophageal lining due to liver cirrhosis)
• Esophagitis (inflammation or swelling of the esophageal lining)
• Gastritis (inflammation or swelling of the stomach and duodenal lining)
• Gastroesophageal reflux disease (GERD) (a condition where food or liquid from the stomach flows back into the esophagus)
• Hiatal hernia (a condition where part of the stomach protrudes through an opening in the diaphragm into the chest)
• Mallory-Weiss syndrome (a tear in the esophagus)
• Strictures in the esophagus
• Tumors or cancer in the esophagus, stomach, or duodenum
• Stomach or duodenal ulcers
• Peptic ulcer disease or gastritis
• Removal of benign tumors
• Complementing other tests: Endoscopy allows for confirming suspected abnormalities seen on X-rays and can also reveal abnormalities not visible on X-rays.
• Diagnosing tumors: If a suspicious area is found, your doctor can pass an instrument through the endoscope and remove a small tissue sample, a procedure known as a biopsy. Keep in mind that biopsies are taken for many reasons and do not necessarily indicate cancer.

Preparation for Endoscopy

First: Days before the endoscopy

Endoscopy requires special preparation and preliminary steps that the doctor will inform the patient about:

1. It is essential to bring results of any previous procedures, if any, X-ray images, test results, and any data related to previous tests of the stomach and duodenum.
2. If time permits, the patient should avoid chocolate, nuts, seeds, and spicy foods from their diet two days before the procedure.
3. The patient must fast for 8 hours before the examination, avoiding food and 2-4 hours avoiding liquids on the day before the procedure.
4. Before the procedure, it is recommended to avoid coarse foods, heavy salads, mayonnaise, whole-wheat bread, fatty meat, fish, and cheese.
5. If you are taking any medications, consult your doctor. You may be asked to stop taking medications that can increase the risk of bleeding for a few days before the test, including blood thinners such as aspirin and non-steroidal anti-inflammatory drugs.

Second: Preparation on the day of the endoscopy

• On the day of the examination, you should refrain from eating or drinking anything. A small amount of water can be consumed up to 2-4 hours before the procedure.
• If the patient is taking any long-term medication in capsule or tablet form, they should stop taking it.
• It is essential to inform the doctor of any existing allergies, especially if they are related to medications.

The Endoscopy Procedure in Detail

Tools used:

• Endoscope: The endoscope is a thin, flexible tube with a camera and light at the end. It is inserted through the mouth and into the esophagus, stomach, and duodenum.
  • The light source illuminates the tip of the endoscope, allowing the gastroenterologist to see the inside of the upper digestive tract (esophagus, stomach, and upper small intestine).
  • The video processor allows the image to be displayed on a monitor screen.
• Your doctor will pump air through the endoscope to dilate the tissues, allowing for better visualization and examination.

Anesthesia:

• Before starting, the doctor will numb the back of your throat with a topical anesthetic spray or mouthwash solution.
• This helps relax the throat muscles and reduce pharyngeal constriction, facilitating smoother passage of the endoscope through the esophagus

Endoscopy Test Steps:

• The doctor will ask you to lie on your side, usually the right side.
• A specialized mouth guard will be placed in your mouth to protect your teeth from any damage caused by the endoscope and to protect the endoscope from biting.
• The endoscope will then be inserted into your mouth, gently pressing on the tongue as it moves gradually.
• You will be asked to swallow to allow the endoscope to pass into the esophagus, as the diameter of the endoscope is much smaller than that of a food bolus, so you should not experience any difficulty in swallowing or breathing.
• You will be instructed to avoid swallowing unnecessarily during the procedure. If there is excess saliva in the mouth, it will be suctioned out with special medical instruments.
• The doctor will gradually move the endoscope down the digestive tract while observing the video screen to assess the condition of the esophageal, stomach, and duodenal walls.
• If there are any issues in examining the organ walls, the doctor will introduce some air or water through a special channel in the endoscope into the stomach cavity to flush the walls, clean the area being examined, or clean the endoscope lens. The fluid and air are then removed using suction instruments.
• The endoscope’s camera facilitates continuous video capture during the procedure, enabling thorough subsequent evaluation of any identified abnormalities.
• Through a special channel in the endoscope, the doctor can introduce small endoscopic instruments (forceps, snares, or clips) to perform a biopsy or remove any abnormal growth in the mucosal lining.
• The endoscopy typically takes 10 to 20 minutes.

What To Do And How Will You Feel After Endoscopy?

After the examination, you may experience the following:

• You may feel pain in your throat due to the insertion of the endoscope, and you may feel temporary bloating in the intestines due to the carbon dioxide or air used to provide the doctor with a better view of the stomach.
• You may feel unsteady for approximately 30 minutes after the procedure, but this feeling should start to dissipate within an hour.
• You may feel hungry or thirsty, but do not eat or drink anything until you can swallow comfortably.
• If your throat was sprayed with numbing medications, do not eat anything for at least an hour after the procedure to avoid swallowing and choking issues. When you feel the numbing effect has worn off, start slowly with water or other cold liquids.
• For the next 24 to 48 hours, consume small meals consisting of soft, easily digestible foods such as soups, eggs, juices, puddings, applesauce, and so on.

When Should You Contact Your Doctor After An Endoscopy?

If you experience any of the following symptoms after undergoing an endoscopy, you should contact your doctor:

• Severe or persistent abdominal pain
• Severe or persistent nausea or vomiting
• Fever
• Rectal bleeding
• Black stools
• Difficulty urinating
• Shortness of breath

How To Understand The Results Of An Endoscopy?

If any biopsies were performed and tissue samples were taken, you can receive the results within two weeks of the examination. We discussed potential diagnoses from the examination at the beginning of the article, which you can refer back to. Your doctor will schedule a follow-up appointment to discuss the results of the procedure and any other treatment options. It is important to attend all follow-up appointments to ensure that your condition is properly monitored and treated.

Answering Common Questions

What is the difference between a colonoscopy and an endoscopy?

An endoscopy is a procedure in which the inside of the esophagus, stomach, and duodenum is examined. The endoscope is inserted through the mouth and passes through the back of the throat. A colonoscopy, on the other hand, is a procedure in which the inside of the colon (large intestine) is examined. The colonoscope is inserted through the anus, and some air is inflated into the colon to obtain a clear view.

Related:

• Irritable Bowel Syndrome (IBS) in Women and Men
• Irritable Bowel Syndrome Diet

Does an endoscopy require general anesthesia?

No, you will not receive general anesthesia before the procedure. A mild sedative is usually given, and the patient remains awake with a mild local anesthetic in the throat. Most people tolerate this procedure well without anesthesia as modern endoscopes are thin and easy to swallow.

How long does throat pain last after an endoscopy?

You may experience throat irritation for a day or two after the test.

Can a CT scan replace an endoscopy?

An endoscopy provides better detail than a CT scan, as the endoscope examines an area that may not be as clearly visible on a CT scan.