An endoscopy is a medical procedure using a thin, flexible tube with a camera, called an endoscope, to visualize the interior of the digestive tract. Its purpose is to inspect for deviations from a healthy appearance. The focus is on identifying and understanding “abnormal” findings.
Understanding Abnormalities in Endoscopy Images
Abnormalities in endoscopy images are visual cues that differ from the typical, healthy appearance of the digestive tract’s internal lining. These deviations can manifest as changes in color, such as unusual redness indicating inflammation or a pale appearance suggesting a lack of blood flow. Texture may also appear altered, becoming rough or irregular instead of smooth. Changes in shape or the presence of raised areas or depressions can also signal an abnormality.
These visual signs indicate various issues. Inflammation often presents as erythema, or redness, and swelling of the mucosal lining. Ulcerations appear as open sores or breaks in the tissue, while polyps are growths that protrude from the lining. Strictures indicate a narrowing of the passage, and masses suggest a larger, abnormal growth. Recognizing these characteristics helps distinguish an unhealthy area from normal tissue.
Common Conditions Identified Through Abnormal Images
Abnormal endoscopy images can reveal specific medical conditions, each with distinct visual characteristics. Gastritis, an inflammation of the stomach lining, often appears as diffuse redness and swelling, sometimes accompanied by small erosions or superficial breaks in the tissue. Peptic ulcers, open sores in the stomach or duodenum, present as well-defined craters with a whitish base, surrounded by a rim of inflamed, reddened tissue. Their size can vary from a few millimeters to several centimeters.
Polyps are growths that project from the inner surface of the digestive tract, varying significantly in size, shape, and appearance. Some are small and flat (sessile), while others are stalked (pedunculated), resembling a mushroom. While many polyps are benign, certain types, like adenomatous polyps, carry a risk of becoming cancerous, making their identification and removal important. Visual characteristics such as surface pattern and color can provide clues about their potential for malignancy.
Barrett’s esophagus involves a change in the cell type lining the lower esophagus, often due to chronic acid reflux. Endoscopically, it is characterized by a reddish, salmon-colored lining extending upwards from the stomach into the esophagus, replacing normal pale pink esophageal tissue. Diverticulosis, particularly in the colon, appears as small, pouch-like outpouchings protruding from the intestinal wall. These diverticula can range from a few millimeters to over a centimeter and may appear as dark openings or small pockets.
Celiac disease, an autoimmune disorder triggered by gluten, can cause characteristic changes in the small intestine. Endoscopy may reveal a flattened appearance of the normally folded intestinal lining, a mosaic-like pattern, or a reduction in the number and height of the villi, which are finger-like projections responsible for nutrient absorption. Early signs of inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis, can manifest as patchy areas of inflammation, ulcers, strictures, or a cobblestone appearance of the intestinal lining.
Interpreting and Acting on Abnormal Endoscopy Findings
Upon observing an abnormal image during an endoscopy, a medical professional, typically a gastroenterologist, interprets the findings. This involves assessing visual characteristics like the size, shape, color, and location of the abnormality. However, visual information alone is often not enough for a definitive diagnosis.
Consequently, biopsies are frequently performed, where small tissue samples are collected from the abnormal area using instruments passed through the endoscope. These samples are then sent to a pathology laboratory for microscopic examination. The pathologist’s analysis confirms the presence of disease, identifies the specific cell type, and assesses the severity of any inflammation or cellular changes.
Once a diagnosis is confirmed through biopsy results, the medical team determines the appropriate course of action. Follow-up care is often necessary, including regular surveillance endoscopies to monitor the condition, especially for precancerous lesions like Barrett’s esophagus or certain types of polyps. Management strategies can range from medication to reduce inflammation or acid production, to lifestyle adjustments like dietary changes. In some instances, surgical intervention may be required to remove larger polyps, repair strictures, or address more advanced diseases.