An endoscopy is a medical procedure that provides a close look at the inside of the upper digestive system. This system includes the esophagus, stomach, and the first part of the small intestine, known as the duodenum. A long, thin, flexible tube equipped with a camera, called an endoscope, is gently guided through the mouth and throat to visualize these internal structures. This procedure is performed to diagnose various conditions and, at times, to provide direct treatment for certain issues within the upper gastrointestinal tract.
When an Endoscopy is Recommended
A healthcare provider may recommend an initial endoscopy to investigate persistent or concerning symptoms related to the upper digestive system. Common reasons include ongoing heartburn or acid reflux that does not improve with medication, difficulty swallowing (dysphagia), unexplained nausea, recurring vomiting, and chronic abdominal pain.
The procedure also identifies the source of gastrointestinal bleeding, such as blood in vomit or stool, or anemia. Unexplained weight loss is another symptom that may warrant an endoscopic evaluation. Endoscopies also screen for conditions like Barrett’s esophagus or celiac disease.
Factors Influencing Endoscopy Frequency
The frequency of follow-up endoscopies is highly personalized, depending on initial findings and the specific medical condition being monitored. For individuals diagnosed with non-dysplastic Barrett’s esophagus, surveillance is typically recommended every three to five years, with more frequent checks for longer segments.
When indefinite dysplasia is identified in Barrett’s esophagus, a repeat endoscopy is usually advised within three to six months. If this finding is confirmed, annual surveillance may be considered. For low-grade dysplasia, endoscopic eradication therapy is often recommended, with follow-up endoscopies at one, three, and five years after successful treatment.
High-grade dysplasia or intramucosal adenocarcinoma in Barrett’s esophagus typically requires endoscopic eradication therapy. Following successful treatment, surveillance endoscopies are performed more frequently, often annually. The presence and nature of polyps found during an initial endoscopy also determine future surveillance, depending on the polyp’s type.
Endoscopies also monitor chronic gastrointestinal conditions like Crohn’s disease or celiac disease to assess disease activity and treatment effectiveness. If symptoms that initially led to an endoscopy return or worsen, another procedure might be necessary. Repeat endoscopies are decided in consultation with a gastroenterologist, considering individual risk factors like age, gender, smoking history, and family history.
Preparing for and Undergoing an Endoscopy
Preparing for an endoscopy involves specific instructions to ensure a clear view of the digestive tract. Patients are typically required to fast, including specific times for food and liquids, for several hours before the procedure. Adjustments to certain medications may also be necessary in the days leading up to the endoscopy.
Upon arrival, monitors track vital signs like breathing, blood pressure, and heart rate. A sedative is usually administered intravenously to help the patient relax and feel comfortable. A numbing spray may also be applied to the throat, and a mouth guard is placed to protect teeth.
During the endoscopy, the endoscope is gently guided through the mouth, down the esophagus, and into the stomach and duodenum. Air may be gently inflated into the digestive tract to provide a better view. If any abnormal areas are observed, small tools can collect tissue samples (biopsies) or remove polyps. The procedure itself typically takes between ten to thirty minutes.
Understanding Endoscopy Results and Follow-Up
After an endoscopy, patients are moved to a recovery area where they are monitored as the sedative effects subside. Mild throat soreness or bloating is common and usually resolves quickly. A healthcare team member will provide initial information about the findings, though detailed results, especially for biopsies, may take several days to a few weeks to process.
Once all results are available, a follow-up appointment is scheduled to discuss the findings in detail and formulate a treatment or monitoring plan. Endoscopy outcomes directly influence future care recommendations. For example, if the endoscopy reveals no abnormalities, frequent follow-up may not be necessary.
However, if conditions like inflammation, ulcers, or precancerous changes are identified, the specialist will outline a specific follow-up strategy. This might include medication, lifestyle adjustments, or a schedule for repeat endoscopies, ensuring early detection and effective management. Your doctor’s guidance is essential for interpreting results and establishing a long-term health plan.