An endoscope is a long flexible tube that is thinner than most food you swallow. It is passed through the mouth and back of the throat into the upper digestive tract and allows the physician to examine the lining of the esophagus, stomach, and duodenum (the first portion of the small intestine). Abnormalities suspected by X-ray can be confirmed and abnormalities may be detected which are too small to be seen on X-ray. If the doctor sees a suspicious area, he can take a small piece of tissue (a biopsy) for examination in the laboratory. Biopsies are taken for many reasons and do not necessarily imply cancer. Other instruments can also be passed through the endoscope without causing discomfort. A small brush to wipe cells from a suspicious area for examination in the laboratory (a form of Pap test or “cytology”) and a wire loop or snare to remove polyps (abnormal, usually benign, growths of tissue.)
Your throat will be sprayed with local anesthetic and you may receive a medication to help you relax. While you are in a comfortable position, the endoscope is inserted through the mouth, and each part of the esophagus, stomach, and duodenum is examined. The procedure is extremely well tolerated with little or no discomfort. The tube will not interfere with your breathing. Gagging is usually prevented or reduced by the spray medication. The procedure usually takes couple of minutes. Major effects of the sedation wear off in about one hour.
If you receive a sedative, you will be kept in the recovery area until most of the effects of the medication have worn off. Your throat may be a little numb for a couple of hours and you may feel bloated for a few minutes right after the procedure because of the air that was introduced to examine your stomach. You will be able to resume your normal diet one-hour after the Endoscopy unless you are instructed otherwise.
Endoscopy is safe and is associated with very low risk when performed by physicians who have been trained and are experienced in this procedure. Complications can occur but are rare. Local irritation of the throat may occasionally persist for a few days. Bleeding may occur from the site of biopsy or polyp removal. It is usually minimal but rarely may require transfusions or surgery.
Many problems of the upper digestive tract cannot be diagnosed by X-ray. Endoscopy may be helpful in the detection of lesions or of inflammation of the esophagus, stomach, and duodenum (esophagitis, gastritis, and duodenitis), and to identify the site of upper gastrointestinal bleeding.
Endoscopy is more accurate than X-ray in detecting gastric (stomach) and duodenal ulcers. Endoscopy may detect early cancers too small to be seen by X-ray and can confirm the diagnosis by biopsies and brushings. Endoscopy may also be needed for treatment such as for stretching narrowed areas of the esophagus or for removal of polyps or swallowed objects.
Control of active upper gastrointestinal bleeding through the endoscope can frequently be achieved. Safe and effective endoscopic control of bleeding drastically reduces the need for transfusions and surgery in these patients.
Endoscopy is an extremely worthwhile and safe procedure that is very well tolerated, and is invaluable in the diagnosis and proper management of disorders of the upper digestive tract.
Endoscopy is usually done with sedation and a local anesthetic spray to freeze the back of your throat. Your pulse, respiration and blood pressure will be checked. If you receive a sedative, you will be kept in the office until most of the effects of the medication have worn off. You will be able to resume your normal diet one hour after the endoscopy unless you are instructed otherwise. If you have had sedation, you will not be able to drive for the rest of the day and will require someone to take you home or to take taxi.
(Driving after you have received a sedative is illegal, and if you are in an accident your auto insurance may not cover it.) Even though you may not feel tired, your judgment and reflexes may not be normal. Do not plan to go back to work after having sedation.