Endoscopy is a medical procedure that allows doctors to look inside a patient’s body without major surgery. This technique uses a flexible, slender tube, known as an endoscope, equipped with a light and a tiny video camera to transmit images to a monitor. Endoscopy is a powerful tool for investigating symptoms and diagnosing various conditions. While hospitals certainly perform endoscopies, these procedures are also commonly done in specialized outpatient facilities.
Understanding the Procedure
An endoscope is a flexible tube inserted through a natural body opening (such as the mouth or anus) or occasionally through a small incision. The camera captures magnified images displayed on a screen, allowing the physician to examine the lining of organs like the stomach or colon. The procedure is considered minimally invasive because it avoids the need for large surgical cuts.
The primary purpose of an endoscopy is often diagnostic, used to investigate symptoms like abdominal pain, chronic nausea, vomiting, or gastrointestinal bleeding. However, the endoscope also has a working channel through which small instruments can be passed. This allows the doctor to perform minor interventions, such as taking a tissue sample (biopsy) to test for disease or removing growths like polyps.
Where Endoscopies Take Place
Endoscopic procedures are performed in several settings, depending on the patient’s health status and the complexity of the intervention. Hospitals, particularly their outpatient departments, perform a wide range of these procedures. These facilities are equipped to handle complex cases, especially for patients with severe underlying health conditions, and offer immediate access to intensive care support and general anesthesia if needed.
Routine, elective, and screening procedures, such as a standard colonoscopy for cancer screening, are frequently performed at Ambulatory Surgery Centers (ASCs) or dedicated endoscopy clinics. These specialized, non-hospital facilities are designed for high-volume, low-risk procedures and offer a more streamlined, convenient, and often more cost-effective experience. Generally healthy individuals undergoing a straightforward procedure are well-suited for an ASC.
Common Types of Endoscopic Procedures
The two most common types of gastrointestinal endoscopy are the Upper Endoscopy and the Colonoscopy. An Upper Endoscopy, also known as Esophagogastroduodenoscopy (EGD), involves inserting the scope through the mouth to examine the esophagus, stomach, and the first part of the small intestine (duodenum). This procedure is used to investigate symptoms like difficulty swallowing or persistent heartburn.
A Colonoscopy involves guiding the endoscope through the rectum to examine the entire large intestine, or colon. It is the accepted standard procedure for colorectal cancer screening and is used to detect and remove precancerous polyps. In contrast to the EGD, which requires an overnight fast, a colonoscopy demands a more rigorous bowel preparation to ensure the colon is completely clean for clear visualization.
Capsule Endoscopy is another specialized type, where the patient swallows a vitamin-sized capsule containing a camera. It takes thousands of pictures as it travels through the small intestine, a section difficult to reach with traditional scopes. Sigmoidoscopy is a variation of the colonoscopy that examines only the lower part of the colon.
Preparing for Your Endoscopy
Proper preparation is necessary to ensure the success and accuracy of any endoscopic procedure. Patients are typically required to follow a period of fasting, known as NPO (nil per os, meaning nothing by mouth), usually for eight hours before the procedure. For procedures like a colonoscopy, a specific bowel preparation regimen, often involving laxative solutions, must be followed to clear the digestive tract.
A provider will review all current medications with the patient well in advance of the appointment. It is particularly important to discuss blood-thinning medications, such as aspirin or warfarin, as these may need to be temporarily stopped several days prior to reduce the risk of bleeding if a biopsy or polyp removal is planned. Since most endoscopies involve sedation to ensure patient comfort, arranging for a responsible adult to drive the patient home afterward is mandatory.