Endoscopy

Overview

Endoscopy or endoscopic ultrasound is a diagnosis test used to determine the abnormalities present in the digestive tract and the surrounding organs. The instrument used for this procedure is an endoscope. It is a tubular and flexible instrument and contains and attached camera. The endoscope is inserted either through the upper digestive tract (mouth) or the lower digestive tract (rectum) and the camera in it helps the doctor to clearly see the internal organs of the patient. In some cases, a sample tissue may be collected from the organs for biopsy. The patient is given sedatives before the test as it takes around 30- 90 for the procedure. The procedure provides an accurate and clear examination of the organs.

Surgical Endoscopy

Endoscopy is also employed during surgery. It is one of the important tools that allows the surgeon to look inside your body and locate the source of your illness. Small incisions are made in your abdomen and the abnormal tissue or clumps are removed with the help of endoscope. The wounds are then cleared and stitched or patched.

Why is an endoscopic ultrasound required?

Often, for disorders relating to the digestive system, the cause cannot be accurately determined superficially and thus endoscopic ultrasound is recommended by the doctors to be exactly sure about the underlying cause.

The symptoms that may call for an endoscopy are:

  • persistent abdominal pain
  • diarrhoea that doesn't respond to medicines
  • blood in stool
  • blood while vomiting
  • nausea and weight loss
Some common situations during which endoscopy is performed are:
  • To check for abnormalities in gallbladder or liver
  • To determine diseases like pancreatitis
  • To evaluate the stages of cancer
  • To study the intestinal wall
  • During surgery

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Preparing for an endoscopy test

Prior to an endoscopy, blood tests and stool tests are done 2 or 3 days earlier. You need to inform your doctor about any medications that your are taking or any other illness that you have such as diabetes, kidney or heart problems etc. 6 – 8 hours before the endoscopy test you are disallowed to consume any food; though you may be allowed to drink sips of water up to 2 hours before the endoscopic ultrasound procedure. After the endoscopy procedure, a patient is kept in the recovery room so that the sedation wears off and the reflexes return in order to avoid any complications.   

Endoscopy risks

Endoscopy is a safe test but it comes with a little complications or after effects which can cause discomfort.

  • The most usual discomfort is bloating or feeling gassy after the procedure. This is quite normal and goes away on it's own or by the intake of the drugs provided by the doctor.
  • Sore throat. If local anesthesia has been given by mouth, you may have experience a sore throat in the next 24 hours. If accompanied by chest pain or abdominal pain, consult your doctor.
  • Difficulty in breathing. This can be caused due to allergies to the sedatives or because of your illness (if any). Consult your doctor for the same and it will be taken care of.

Types of endoscopy

Depending upon which organ needs to be examined, endoscopy can be classified as following:

  • Gastroscopy
Stomach or upper part of small intestine is examined.
  • Colonoscopy
The bowel needs to be examined and so the rectum will be examined.
  • Bronchoscopy
This procedure is employed of you cough or vomit blood. It examines the airways.
  • Hysteroscopy
If a woman experiences frequent miscarriages or vaginal bleeding, the uterus is examined during hysteroscopy to discover the abnormalities.
  • Cystoscopy
In case you complain of blood in urine or other problems related to the urinary tract, cystoscopy is employed to evaluate the urinary bladder.

Major common types of Endoscopy

  • Esophagogastroduodenoscopy (EGD

Esophago- gastro-duodenoscopy EGD as the name suggests is an examination of the inner lining of the esophagus, stomach or the upper part of the small intestine i.e the duodenum using an endoscope. The endoscope is inserted through the mouth. A mouth guard is used to protect the teeth (dentures) need to be removed. Local anesthesia is sprayed in the mouth so as to prevent coughing and gagging which might meddle with the examination. The procedure can last for a maximum of 20 or 30 minutes. The patient is prohibited from eating anything till their gag reflex comes back.

  • Upper gastrointestinal endoscopy (UGI endoscopy)/ Upper endoscopy
The procedure is the same as that of EGD, the only difference being that in this case the mouth is also well examined in addition to the esophagus, stomach snuff duodenum. Many times, both the names are used synonymously. If the patient complains of the following symptoms, UGI may be carried out :
  • Heartburn
  • Trouble swallowing
  • Nausea and vomiting
  • Unexplained weight loss
Upper GI endoscopy is used to detect diseases like :
  • Inflammatory disorders
  • Ulcers
  • Celiac disease
  • Pancreatitis
  • Cancers

The endoscopy of the stomach is very useful as it may detect stomach cancer at an early stage. Any kind if cancer if detected early can save many lives.

Apart from examination, if there is a bleeding issue (like bleeding ulcers) , it can be treated during endoscopy.

The patient is required to stay in the hospital for an hour or more until the sedatives wear off.

  • Lower GI endoscopy/ Lower endoscopy

Lower gastrointestinal (GI) endoscopy is used to examine the lower digestive tract which includes the large intestine and the anal canal. When the colon and rectum is examined, the lower endoscopy procedure is called colonoscopy and when only the sigmoid colon is examined, it is referred to as sigmoidoscopy. 

The test for lower GI tract is performed when you have pain during bowel movements or blood in your stools. The pre preparation for lower endoscopy varies slightly as compared to upper endoscopy: In upper endoscopy there were no restrictions on eating solid food two or three days prior to the test but in order to prepare for a colonoscopy, you need to ensure that your lower gastrointestinal tract is kept clean and empty for the accurate examination. The doctor usually puts you on a liquid diet or soft solid diet few days earlier. You may be required to take laxatives or enema solution to empty your bowels. 
Rest of the process is similar to that of stomach endoscopy.

Endoscopy biopsy

Biopsy means collecting sample tissue for further examination in the lab to find out what agents are actually responsible for the abnormalities and if they pose greater threats such as cancer or not. A small tissue is cut from the organ ( the stomach, small intestine, colon or rectum) for examination. There might be a little bleeding after the cut which the doctor cares and treats during the endoscopy. In case, there is heavy bleeding after the procedure, it invites serious attention and prompt medical treatment is mandatory.

Cost of endoscopy in India

The endoscopy cost varies according to locations and the operating healthcare practitioners. The health condition of the person, the type of endoscopy performed, the anesthesia given and the urgency of the procedure are other factors that affect on endoscopy cost. When endoscopy procedure doesn’t involve surgery or biopsy, the cost is usually lies low , while their inclusion flares up the cost. The endoscopy cost can range from Rs 1500- 35000 based on these factors. 

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