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Endoscopy – Internal Examination Explained

Endoscopy is a medical procedure in which a flexible or rigid optical instrument is used to examine the inside of hollow organs and body cavities.

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Things worth knowing about "Endoscopy"

Endoscopy is a medical procedure in which a flexible or rigid optical instrument is used to examine the inside of hollow organs and body cavities.

What is Endoscopy?

Endoscopy is a diagnostic and therapeutic procedure in which an endoscope – a thin, tube-shaped optical instrument – is inserted into natural body openings or small incisions to view the inside of the body. The endoscope is equipped with a camera and a light source that transmits real-time images to a monitor. This allows the physician to directly inspect mucous membranes, organs, and body cavities, and to take tissue samples or perform minor procedures as needed.

Types of Endoscopy

Various endoscopic procedures are used depending on the area of the body being examined:

Gastroscopy: Examination of the esophagus, stomach, and duodenum.
Colonoscopy: Examination of the large intestine and the final section of the small intestine.
Bronchoscopy: Examination of the airways and lungs.
Cystoscopy: Examination of the bladder and urinary tract.
Arthroscopy: Examination and treatment of joints.
Laparoscopy: Examination of the abdominal cavity through small incisions in the abdominal wall.
Hysteroscopy: Examination of the uterine cavity.

When is Endoscopy Performed?

Endoscopy is recommended for a variety of reasons:

Investigation of symptoms such as persistent abdominal pain, difficulty swallowing, bleeding, or changes in bowel habits.
Early detection and screening, for example for colorectal cancer prevention.
Collection of tissue samples (biopsies) for laboratory analysis.
Treatment of conditions such as polyps, bleeding, narrowing of passages (stenosis), or foreign bodies.
Monitoring the healing process after illness or surgery.

How is Endoscopy Performed?

Preparation for an endoscopy depends on the area being examined. For a gastroscopy, fasting for several hours is typically required. For a colonoscopy, the bowel must be cleared in advance using special laxatives.

The procedure is often performed under mild sedation or local anesthesia, so the patient experiences little to no discomfort. The endoscope is introduced through a natural body opening (e.g., the mouth or rectum) or a small incision. Depending on the procedure, the examination takes between 10 and 60 minutes. After the procedure, the patient is monitored until the effects of the sedation wear off.

Diagnosis and Treatment

Endoscopy is not only used for diagnosis but also enables direct therapeutic interventions during the same examination:

Removal of polyps (polypectomy)
Control of bleeding through cauterization or clips
Widening of narrowed passages (stenoses) using balloon dilation or stents
Removal of foreign bodies
Injection of medications directly into affected tissue areas

Risks and Side Effects

Endoscopy is generally considered a safe procedure. Possible risks and side effects include:

Mild bloating or a feeling of pressure after the examination
Temporary sore throat following a gastroscopy
In rare cases: bleeding, infection, or injury to the examined organs (perforation)
Reactions to sedation

The physician thoroughly informs the patient about possible risks before the procedure and obtains written consent.

References

American Society for Gastrointestinal Endoscopy (ASGE): Understanding Endoscopy, www.asge.org
World Health Organization (WHO): Surgical Care at the District Hospital, WHO Press, Geneva.
Kochhar R, Lal A: Gastrointestinal Endoscopy – Principles and Practice. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease, Elsevier, 2021.

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