An endoscopy is a procedure which is performed by a specialist (Surgeon or Gastroenterologist) to visualize the internal aspect of a luminal organ with the aid of a scope. A scope can be rigid or flexible and is a tube-like instrument inserted through an orificce in the body. A basic flexible endoscope will have a light source, a eye-piece which is usually mounted with a camera to view images onto a TV, an air inflator and a suction channel and also a working channel for added procedures like taking biopsies and washings.

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The two main scopes discussed here will be the OGDS (oesophago-gastric-duodeno-scopy) for the upper gastrointestinal tract from the start of esopohagus all the way to the duodenum, and the colonoscopy for the large intestine beginning at the anus all the way to the caecum or terminal ileum.

This article would be about OGDS. I will cover the colonoscopy later.

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How is it done, the OGDS?

This procedure is done as an outpatient.

    One cannot eat or drink for about 8 hours before the test so that your stomach and duodenum are empty.

    Most people have a choice between having the procedure while they are awake, or after having a medicine to make them drowsy (a sedative).

    One will have a spray to numb the back of your throat and make it easier for you to swallow the endoscopy tube.

    You will be instructed to lie on your left side.

    Doctor will pass the endoscope tube down your throat to the area being investigated.

    The test lasts about 5 to 20 minutes.

    If there are any abnormalities, the doctor will take pieces of tissue from the abnormal looking area to send to the laboratory for closer inspection under a microscope. These tissue samples are called biopsies.

    There may be a sensation of gas, and the movement of the scope may be felt in the abdomen. Biopsies cannot be felt.

    The test lasts about 5 to 20 minutes.

    If one was given sedation, you will need to take someone with you to the hospital appointment. You won’t be able to drive for the rest of the day and should have someone to go home with you.

Who should have the test done?

People who are at low risk for cancer, or even have no symptoms, should schedule a scope every 3-5 years after age 50 years. Those who are high-risk should begin regular screening prior to age 40 years.

Those below 50years old would require an OGDS if there are the alarm symptoms as below:

  • 1. familial history of gastointestinal cancers
    2. dysphagia (difficulty in swallowing)
    3. loss of weight
    4. vomiting blood or passing black tarry stools (gastrointestinal bleeding)
    5. persistent or severe dyspeptic symptoms
    6. previous history of peptic ulcer disease
    7. anaemia
    8. abdominal mass

  • Complications

    Possible complications of upper endoscopy include bleeding and puncture of the stomach lining. However, such complications are rare. The overall risk is less than 1 out of 1,000 people. Most people will probably have nothing more than a mild sore throat after the procedure.

    Is endoscopy always necessary?

    Well, actually apart from the indications I mentioned above, where one is less than <50years old or without any alarm symptoms, can be treated with medications first and reassessed for persistence or improvements. Persistence or failure of treatment would require this procedure to be done.