Introduction
Endoscopy simply refers to any procedure whereby a flexible telescope is inserted inside your body in order to examine the organ of interest.
There are many types of endoscopy procedures, such as:
- Gastroscopy
- Colonoscopy
- Endoscopic Ultrasound (EUS)
- Endoscopic retrograde cholangiopancreatography (ERCP)
- Capsule endoscopy
Gastroscopy and colonoscopy are the procedures most patients will undergo, whilst EUS, ERCP, and capsule endoscopy are usually done in very specific circumstances and are not needed as often. This page will allow you to learn about the different endoscopy procedures listed above.
Gastroscopy
What is it?
A gastroscopy is a test which allows the doctor to examine your oesophagus (swallowing tube), stomach and duodenum (the first part of your small intestine).
The doctor will insert a thin flexible camera, through the mouth, and he will be able to examine the inner lining of the oesophagus, stomach and duodenum and detect any abnormalities.
Who should undergo a gastroscopy?
If somebody experiences heartburn, regurgitation, abdominal pain, difficulty swallowing, persistent vomiting, vomiting out blood and persistent bloatedness, then a gastroscopy will be able to give further information.
Conditions that can be detected via gastroscopy include GERD, stomach ulcer, gastritis (inflammation of the stomach lining), and stomach cancer.
In general
A gastroscopy is:
- A very simple and straightforward procedure
- Not painful
- Takes only about 10 minutes
- Done under Daycare (patient does not need to stay overnight in hospital)
- You will be given sedation, so you will be asleep during the procedure.
To prepare for a gastroscopy, all you need to do is fast for 6 hours before the procedure.
Risks
Gastroscopy is a very safe procedure, but some of the risks you should be aware of include:
- Infection
- Injury or tear to the lining of the stomach
- Side effects of sedation such as low oxygen levels and low blood pressure
Colonoscopy
What is it?
A colonoscopy is a test which allows the doctor to examine your colon (large intestine).
The doctor will insert a thin flexible camera, through the anus, and he will be able to examine the inner lining of the colon and detect any abnormalties.
Who should undergo a colonoscopy?
If somebody experiences abdominal pain, persistent bloatedness, blood in their stools, change in bowel habit, loss of appetite, and unintentional weight loss, then a colonoscopy will be important to find the cause.
Conditions that can be detected via colonoscopy include colon cancer, inflammatory bowel disease, and irritable bowel syndrome.
Colonoscopy is also essential for those with a family history of colon cancer. It will be used to detect polyps, and these polyps can be removed on the spot during the colonoscopy.
In general
A colonoscopy is:
- A very simple and straightforward procedure
- Not painful
- Takes only about 20 minutes
- Done under Daycare (patient does not need to stay overnight in hospital)
- You will be given sedation, so you will be asleep during the procedure.
To prepare for a colonoscopy, you will need to do bowel preparation (please see different section).
Risks
Colonoscopy is a very safe procedure, but some of the risks you should be aware of include:
- Infection
- Injury or tear to the lining of the colon
- Bleeding, especially if polyps are removed during the procedure
- Side effects of sedation such as low oxygen levels and low blood pressure
Endoscopic Ultrasound (EUS)
What is it?
Endoscopic Ultrasound (EUS) is a test which allows the doctor to examine your pancreas, bile ducts, gallbladder and nearby tissues.
It combines endoscopy and ultrasound technology, and is able to give highly detailed images of organs which are normally difficult to access such as the pancreas.
Who should undergo EUS?
Patients who have conditions affecting their pancreas and bile ducts will usually need to undergo an EUS. They may have experienced abdominal pain, jaundice, fever, and weight loss.
Frequently, patients would have had a CT or MRI scan prior to being referred for an EUS. CT or MRI scan may have already shown an abnormality such as a tumour, cyst, or enlarged lymph nodes, and the patient then requires further assessment or evaluation via EUS.
During EUS, more detailed scanning can be performed, and biopsies can also be taken of these tumours or abnormal tissues.
In general
An EUS is:
- Fairly complex and advanced, and is not widely available in most hospitals
- Not painful
- Takes about 40 minutes
- Done under Daycare (patient does not need to stay overnight in hospital). However, a small proportion of EUS procedures are sufficiently risky, that the doctor may choose to admit you to hospital
- You will be given sedation, so you will be asleep during the procedure.
To prepare for an EUS, you will need to fast for 6 hours before the procedure.
Risks
EUS is very safe procedure, but some of the risks you should be aware of include:
- Infection
- Injury or tear to the lining of the intestine
- Bleeding
- Insufficient sampling, especially if biopsies are taken from a tumour
ERCP
What is it?
ERCP is short for Endoscopic Retrograde Cholangiopancreatography. ERCP is a procedure which doctors use to treat problems such as narrowing, tumours, and stones affecting the bile ducts or pancreas.
Who should undergo ERCP?
Patients who have conditions affecting their pancreas and bile ducts will usually need to undergo an ERCP. They may have experienced abdominal pain, jaundice, fever, and weight loss.
A prior test usually would have already been done (either MRI scan, CT scan or EUS) before the patient is referred for ERCP.
In general
An ERCP is:
- Fairly complex and advanced, yet is widely available in most hospitals
- Not painful
- Can take as little as 15 minutes, up to 2 hours to do, depending on the difficulty
- Usually done as an inpatient admission (in certain circumstances, these procedures are done under Daycare)
- You will be given sedation, so you will be asleep during the procedure.
To prepare for an ERCP, you will need to fast for 6 hours before the procedure.
Risks
ERCP is considered one of the most challenging procedures in the field of endoscopy. Some of the risks you should be aware of include:
- Infection
- Injury or tear to the lining of the intestine
- Bleeding
- Pancreatitis (inflammation of the pancreas), which can be mild or severe. If severe, this may result in the patient becoming very ill
- Failure of the procedure
Do's and Don'ts
It is very important for us to know what medications you are on. Please declare all the medications you take.
Certain medications such as blood thinners can increase the risk of bleeding, so will need to be stopped 1 week before the procedure.
These blood thinners are usually started by your cardiologist if you have certain heart conditions. I will usually ask you to get a letter of approval from your cardiologist to see if the blood thinner can be stopped safely before the procedure. Please do not stop taking these blood thinners without official approval from your cardiologist.
You may be taking GLP-1 medications such as Ozempic, Wegovy, Mounjaro for treatment of diabetes and obesity. GLP-1 medications must be stopped for 1 week before your endoscopy.
Please take your blood pressure medications as usual on the day of endoscopy. Do not skip it, otherwise, your blood pressure might rise to dangerously high levels on the day of procedure.
If you are undergoing a colonoscopy, bowel preparation is a very important aspect of preparation. Please read the section on bowel preparation properly; help me to help you undergo a high quality colonoscopy
