An esophageal biopsy is a medical procedure that involves collecting small tissue samples from the esophagus, the muscular tube connecting your throat to your stomach. These samples are then examined under a microscope by a pathologist. This diagnostic tool helps healthcare professionals identify various conditions affecting the esophagus, providing precise information about the presence of diseases or abnormalities.
What an Esophageal Biopsy Is and Why It’s Performed
The main purpose of an esophageal biopsy is to obtain accurate information about potential diseases or abnormalities affecting the esophagus. This procedure is often recommended when symptoms like difficulty swallowing, chest pain, or bleeding suggest an esophageal disorder. It also plays a role in early detection of esophageal cancer by identifying abnormal cells.
Common reasons for an esophageal biopsy include diagnosing or monitoring conditions such as esophagitis, which is inflammation of the esophagus. It is also used for Barrett’s esophagus, a precancerous condition where the normal esophageal lining is replaced with intestinal-like tissue. Furthermore, biopsies can help identify infections, certain types of esophageal cancer, or suspicious growths.
Preparing For and Undergoing the Procedure
Preparation for an esophageal biopsy involves specific steps. Patients are instructed to avoid eating or drinking for 6 to 12 hours before the test to ensure an empty stomach. Healthcare providers also advise stopping certain medications, such as blood thinners or NSAIDs, several days in advance, as these can increase the risk of bleeding.
Upon arrival, an intravenous (IV) line is inserted to administer medication. A sedative is given through the IV to help the patient relax or sleep during the procedure. A local anesthetic spray may be used to numb the throat and minimize gagging. A mouth guard protects the teeth and the endoscope.
During the 5 to 15-minute procedure, the patient lies on their left side. A thin, flexible endoscope, equipped with a light and camera, is guided through the mouth, down the throat, and into the esophagus. The camera transmits images to a screen, allowing the doctor to examine the esophageal lining for abnormalities.
If suspicious areas like bleeding, ulcers, inflammation, or growths are identified, small tissue samples are collected. Specialized cutting tools, such as tiny forceps, are passed through the endoscope for this purpose. Air may also be introduced through the endoscope to expand the gastrointestinal tract, providing a clearer view.
After the Biopsy and Interpreting Results
After the biopsy, patients are moved to a recovery area where medical staff monitor them as sedation wears off, which takes a few hours. Common mild side effects include drowsiness, dizziness, and a sore throat from the endoscope, along with bloating or gas due to air introduced during the procedure. These symptoms are temporary and subside within a day or two.
Patients should rest for the remainder of the day and arrange for a ride home due to sedation’s lingering effects, which can impair judgment and coordination. Normal activities can be resumed the next day, though temporary restrictions on strenuous activity may apply if biopsies were taken. Drinking plenty of fluids is also recommended.
Rare complications can occur, such as bleeding from the biopsy site or, infrequently, a tear or perforation in the digestive tract lining. Symptoms warranting immediate medical attention include persistent abdominal pain, severe nausea or vomiting, bloody or black stools, fever, chest pain, or difficulty swallowing.
Collected tissue samples are sent to a pathology laboratory for examination. A pathologist studies the cells and tissues under a microscope to identify abnormalities like inflammation, infection, or abnormal cell growth, including precancerous or cancerous cells. Results are categorized as normal, abnormal, or inconclusive. The pathologist sends a report to the doctor, who discusses the findings with the patient to determine next steps and treatment.