Endoscopy

Page last reviewed: 13/07/2011

An endoscopy is a procedure where the inside of your body is examined internally using an endoscope.

An endoscopy is usually carried out while a person is awake. Before the procedure, a sedative (medication that has a calming effect) may be given to help the patient relax.

Endoscope

An endoscope is a thin, long, flexible tube that has a light source and a video camera at one end. Images of the inside of your body are relayed to an external television screen.

Endoscopes can be inserted into the body through a natural opening, such as through your throat or anus (the opening through which stools are passed out of the body). Alternatively, it can be inserted through a small surgical incision (cut) that is made in the skin.

When is an endoscopy used?

Endoscopies are used mainly to help diagnose health conditions, such as incontinence and urinary tract infections (UTIs). See Why endoscopy is necessary for more information.

Some specially adapted endoscopes can be used to treat certain conditions, such as gallstones.

See the Health A-Z topics about Diagnostic endoscopy and Therapeutic endoscopy for more information about these specific types of endoscopies.

Page last reviewed: 13/07/2011

Diagnosis and investigation

An endoscopy can be used to confirm a diagnosis when other diagnostic tools, such as an X-ray or magnetic resonance imaging (MRI) scan, are thought to be unsuitable. An MRI scan uses strong magnetic fields and radio waves to produce a detailed image of the inside of the body.

An endoscopy can also be used to investigate a known condition in order to measure the extent of any problems that it may have caused. This can help your doctor or specialist decide the most suitable course of treatment for you.

Some conditions that an endoscopy can help diagnose or investigate include:

  • urinary tract infections (UTIs)
  • incontinence
  • breathing disorders
  • internal bleeding
  • stomach ulcers
  • irritable bowel syndrome (IBS)
  • chronic diarrhoea

Sometimes, an endoscopy is used in conjunction with ultrasound (where high-frequency sound waves are used to create an image of part of the inside of the body). An ultrasound probe is attached to the endoscope to allow your doctor to capture images of organs that are otherwise difficult to reach, such as the pancreas.

Biopsies and cancer

Endoscopies can be used to help diagnose and treat cancer. During the procedure, an endoscope is used to obtain small tissue samples, which can be tested for the presence of cancerous cells. This is known as a biopsy.

Endoscopies are particularly useful for carrying out biopsies in parts of the body that would otherwise require major surgery, such as the colon (large intestine) or the lungs.

Surgical procedures

Modified endoscopes that have instruments, such as cutting tools, attached to them can be used to carry out some surgical procedures. For example, they may be used to:

  • remove the gallbladder
  • tie and seal the fallopian tubes (a technique that is carried out when a woman wishes to be sterilised) 
  • remove small tumours or other foreign objects from the lungs or digestive system, which is made up of the gullet (oesophagus), stomach, small intestine (duodenum) and large intestine (colon).

Laparoscopies

A type of endoscope called a laparoscope is used by surgeons as a visual aid when they are carrying out keyhole surgery (also known as laparoscopic surgery).

The benefit of using a laparoscope during keyhole surgery is that the surgeon only has to make a small incision (cut) in the body. This type of surgery can be used for a number of different procedures, such as an appendectomy (the removal of the appendix) or a hysterectomy (the removal of the womb).

In a laparoscopy, only a small incision is made, which means that the recovery time from keyhole surgery tends to be much quicker than other forms of surgery.

See the Health A-Z topic about laparoscopy for more information.

Page last reviewed: 13/07/2011

The endoscopy procedure is not new. The first endoscope was invented in 1805 and consisted of a large tube that was lit up by a candle. However, these primitive devices were often too bulky and awkward to be of much use.

Fibre optics

The invention of fibre optics during the 1960s helped to significantly improve the technology of the endoscope.

Fibre optics are very small pieces of glass that have the ability to transmit light. They are ideal for use in an endoscope because they are able to act as both a light source and a camera.

Fibre optics are also small and flexible, which means that an endoscope can be easily guided inside the body, without causing the patient any pain.

Small surgical instruments, such as tiny blades, can be passed down the tube of an endoscope, which can be used to remove tissue samples (a biopsy).

Pulses of heat and electricity can also be sent down the endoscope, which can be used to destroy unwanted tissue and growths, such as small tumours and gallstones.

Specialised endoscopes

There are several specialised endoscopes that are designed to examine different parts of the body. Some of the different types of endoscope include:

  • broncoscopes, which are used to examine your airways and lungs
  • colonoscopes, which are used to examine your large intestine (colon)
  • gastroscopes, which are used to examine your gullet, stomach and small intestine
  • arthroscopes, which are used to examine your joints
  • hysteroscopes, which are used to examine your womb (uterus)
  • cystoscopes, which are used to examine your bladder

Wireless capsule endoscopy

A wireless capsule endoscopy is a relatively new kind of endoscopy procedure. It involves swallowing a capsule about the size of a large pill. The capsule is able to wirelessly transmit images of the inside of your stomach and digestive system and leaves your body naturally when you go to the toilet (pass stools).

A wireless capsule endoscopy is often used to help diagnose cases where people are experiencing internal bleeding in their digestive system and there is no obvious cause.

Wireless capsule endoscopy has some associated complications. For example, swallowing the capsule can be difficult, as can passing it naturally after the procedure has been completed. There is also a chance of the capsule getting caught in the narrow areas of your bowel, causing the bowel to become blocked.
 
As wireless capsule endoscopy is a relatively new diagnostic procedure, you may need to be referred to a specialist clinic to have the procedure.

Tissues
Body tissue is made up of groups of cells that perform a specific job, such as protecting the body against infection, producing movement or storing fat.  
Joints
Joints are the connection point between two bones that allow movement.

Page last reviewed: 13/07/2011

Most endoscopies are carried out at a local hospital, although some larger GP surgeries may offer the procedure.

Before having an endoscopy

Depending on what part of your body is being examined, you may be asked to avoid eating food and drinking liquids for several hours before you have an endoscopy.

You may also be given a laxative (medicine to open your bowels and relieve constipation) to help clear out any stools or waste products from your bowels. In some cases, you may also require a dose of antibiotics to reduce the risk of an infection occurring.

If you are taking a medicine to thin your blood, such as warfarin, you may be asked to stop taking it for a few days before having your endoscopy. This is to prevent excessive bleeding occurring during the procedure. However, do not stop taking any prescribed medication unless your GP or specialist advises you to do so.

The endoscopy procedure

An endoscopy is not painful, although it may feel a little uncomfortable.

Endoscopies do not usually require general anaesthetic (medication that makes you lose consciousness completely, so that you do not feel any pain). However, you may be given a local anaesthetic, which is used to numb a specific area of your body and does not cause you to lose consciousness. Before the procedure, you may be given a numbing throat spray or lozenge to numb your throat.
 
The endoscope will be carefully guided into your body. Exactly where it enters your body will depend on what part of your body is being examined. Possible options include your:

  • throat
  • anus (the opening through which stools are passed out of the body)
  • urethra (the tube that connects the bladder to the vulva or penis, through which urine passes)

In some cases, the endoscope will be inserted into a small incision (cut) that your surgeon makes in your skin.

You are most likely to have an endoscopy to have the following areas examined:

  • gullet (oesophagus)
  • stomach
  • large intestine (colon)
  • first part of the small intestine (duodenum) that connects to the stomach

If your digestive system is being examined, after the local anaesthetic has taken effect, the healthcare professional who is carrying out the procedure will gently guide the endoscope down your gullet (oesophagus). You will be asked to swallow as they do this.

The endoscope will be passed through your oesophagus and into the area that is being examined, such as the stomach or small intestine (duodenum). The small camera at the end of the endoscope relays images of your stomach or duodenum to a television monitor, allowing the healthcare professional to examine any abnormal areas. If required, a small tissue sample (biopsy) will be taken using a small cutting instrument attached to the end of the endoscope.
 
Depending on the exact nature of the procedure and its objectives, an endoscopy can take 15-60 minutes to carry out. It will usually be performed on an outpatient basis, which means that you will not have to stay in hospital overnight.

After an endoscopy

After having an endoscopy, you will probably need to rest for about an hour until the effects of the local anaesthetic have worn off. It is not recommended that you drive immediately after having an endoscopy, so you will need to arrange for transport to take you home.

Your doctor will tell you when it is safe to drive. They will also tell you when you can do certain activities, such as operating heavy machinery, and when you can return to work.

If your bladder is being examined (cystoscopy), you may notice some blood in your urine following the endoscopy procedure. This should pass within 24 hours of having the procedure. Contact your GP for advice if you still have blood in your urine after this time.

Page last reviewed: 13/07/2011

An endoscopy is usually safe and the risk of complications is low (less than 1 in 100).

Possible complications of an endoscopy include:

  • an infection in the part of the body that the endoscope is used to examine
  • perforation (piercing or tearing) of an organ
  • excessive bleeding
  • an allergic reaction to the anaesthetic

Contact your GP if you notice any signs of infection in the area of your body where the endoscope was inserted. Signs of infection include:

  • redness
  • pain
  • swelling
  • a discharge of fluids or pus

Infections can usually be successfully treated with antibiotics.

Perforation of an organ or excessive bleeding may require surgery to repair any damage to the tissues or organ.

Antihistamines are a type of medicine that can be used in the event of an allergic reaction.

A number of other signs could indicate a complication after having an endoscopy. These include:

  • black or very dark coloured stools
  • shortness of breath
  • severe and persistent abdominal pain
  • vomiting blood
  • chest pain
  • a high temperature (fever) of 38C (100.4F) or above

Contact your GP or visit the accident and emergency (A&E) department of your local hospital immediately if you notice any of these signs and symptoms.

Anaesthetic
Anaesthetic is a drug used to either numb a part of the body (local) or to put a patient to sleep (general) during surgery.
Tissue
Body tissue is made up of groups of cells that perform a specific job, such as protecting the body against infection, producing movement or storing fat.  

Content provided by NHS Choices www.nhs.uk and adapted for Ireland by the Health A-Z.

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