Gastrointestinal Endoscopy

In recent years, advancements in medical technology have led to the widespread use of gastrointestinal endoscopy in clinical practice. Once primarily a diagnostic tool, the gastrointestinal endoscopy procedure has now transformed into a diagnostic and therapeutic instrument due to its ability to help doctors visualize the digestive tract's complex structures, enabling early detection and minimally invasive treatment of digestive tract cancers.

What Is a Gastrointestinal Endoscopy?

Endoscopy is a medical procedure doctors use to examine and view images of structures inside the body through a flexible and long, thin, tube-like instrument with a light and tiny camera attached to the end called an endoscope. There are many types of endoscopy, each specially designed based on the body part being examined.

Gastrointestinal endoscopy enables doctors to diagnose and sometimes treat various digestive tract problems. The two main types of gastrointestinal endoscopy procedures are upper gastrointestinal tract and lower gastrointestinal endoscopy.

An upper gastrointestinal tract endoscopy uses an endoscope to view the inner lining of the upper digestive tract, including the esophagus, stomach and duodenum (the first part of the small intestine). The procedure is sometimes called an upper endoscopy or esophagogastroduodenoscopy (EGD).

The lower gastrointestinal endoscopy, better known as colonoscopy, is a procedure in which a doctor uses an endoscope or colonoscope to look inside the rectum and colon, which comprise most of the large intestine.

Performing a gastrointestinal endoscopy varies based on the purpose of the procedure. Generally, there are three primary reasons for conducting a digestive endoscopy:

• Diagnostic evaluation: To investigate and diagnose underlying conditions through biopsy
• Therapeutic Intervention: To treat or manage identified issues directly
• Screening and Surveillance: For routine monitoring or early detection of potential problems, such as a colonoscopy

What Is the Procedure for Gastrointestinal Endoscopy?

Doctors perform upper and lower gastrointestinal endoscopy procedures in hospitals or outpatient centers. These tests require preparation, such as following a special diet, fasting before the procedure and arranging transportation home afterward. Talk with your doctor for instructions on preparing for your gastrointestinal endoscopy.

Upper Gastrointestinal Tract Endoscopy

Before the procedure, an intravenous (IV) needle will be inserted into your arm or hand to administer the sedative, which keeps you relaxed during the examination. You may be given a liquid medicine to gargle or a throat-numbing spray to prevent gagging. As you lie on an exam table, your doctor will insert an endoscope through your esophagus to reach your stomach and duodenum. The endoscope will inflate your stomach and duodenum with air for better visibility and send images to a monitor for your doctor to examine.

Upper GI endoscopy procedure can be used to help your doctor do the following:

• Find the cause of unexplained symptoms, such as ongoing pain or heartburn, vomiting or problems swallowing.
• Identify diseases and health conditions, such as gastroesophageal reflux disease, celiac disease, cancer and Barrett's esophagus.
• Remove polyps or other growths.
• Treat bleeding from ulcers and other conditions.
• Perform certain weight-loss procedures.

Lower Gastrointestinal Endoscopy (Colonoscopy)

Like upper gastrointestinal endoscopy, your doctor will insert an IV into your arm or hand to administer sedatives, anesthesia or pain medicine to ensure you will not feel pain or discomfort during the procedure. As you lie on the exam table, your doctor will insert a colonoscope through your anus to reach into your rectum and colon. The scope will then inflate your colon with air so the camera can send clear images to a monitor for examination. Your doctor may adjust the position of the scope for better visibility. Your doctor will slowly remove the scope once it reaches the small intestine opening. During this process, your doctor may remove some polyps (common and usually benign growths) for testing. If there is an abnormal tissue, your doctor may perform a biopsy.

A colonoscopy can help your doctor find the cause of symptoms, such as:

• Bleeding from your anus
• Changes in your bowel movements, such as diarrhea
• Pain in your abdomen or belly
• Unexplained weight loss

Regular screening for colon cancer beginning at age 45 is essential so your doctor can remove abnormal growths in the colon and rectum before they turn into cancer. People with increased risk should consult their doctor about when to begin screening, which tests to take and how often to get tested.

Risk factors refer to anything that raises your chances of developing a disease, such as cancer, but having a risk factor does not necessarily mean you will get the disease. The links between lifestyle-related factors and colon cancer risk are some of the strongest for any cancer. Colon cancer risk factors you can change include: 

• Being overweight or obese – the risk of developing and dying from colon cancer is higher among people who are overweight or obese, but the link seems to be stronger in men.
• Lack of physical activity – studies show that regular exercise and physical activity may prevent approximately 15% of colon cancers and six other types of cancers (breast cancer, endometrial cancer, lung cancer, esophageal cancer, pancreatic cancer and meningioma) 
• Some types of diets – a diet that is high in red meats (beef, pork, lamb or liver) and processed meats (hotdogs and some luncheon meats) as well as some food preparation and cooking techniques, such as frying, broiling or grilling create chemicals that can raise a person's colon cancer risk. 
• Smoking – long-time tobacco smokers are more likely to develop and die from colon cancer than people who don't smoke. Smoking is also a well-known cause of lung cancer. 
• Alcohol use – there is a strong link between moderate to heavy alcohol use and colon cancer. Even light-to-moderate alcohol intake is associated with some risk.

Other colon cancer risk factors you cannot change include: 

• Being older – colon cancer risk increases as a person gets older and is most common after age 50 
• A personal history of colorectal polyps or colon cancer – having a history of adenomatous polyps (adenomas) increases a person's risk of developing colon cancer later on, especially if the polyps are large, if there are many of them or if any of them show dysplasia which is a term used for abnormal cells in the lining of the colon or rectum that can change into cancer. People who have had their colon cancer completely removed are more likely to develop new cancers in other parts of the colon and rectum. 
• A personal history of inflammatory bowel disease (IBD) – having ulcerative colitis, Crohn's disease or IBD for many years increases one's risk of developing colon cancer 
• A family history of colon cancer or adenomatous polyps 
• Having an inherited syndrome – a very small portion of people with colon cancer have inherited gene mutations known to cause syndromes that can lead to them getting the disease. The most common inherited syndromes linked with colorectal cancers are Lynch syndrome (hereditary non-polyposis colorectal cancer, or HNPCC) and familial adenomatous polyposis (FAP), but other rarer syndromes can increase colon cancer risk, too. 
• Racial and ethnic background – of all racial groups in the United States, those of American Indian/Alaska Native descent have the highest colon cancer incidence rates and mortality rates. 
• Having Type 2 diabetes – both Type 2 diabetes and colon cancer share some of the same risk factors, such as obesity and physical inactivity. People with Type 2 diabetes also tend to have a less favorable prognosis after a colon cancer diagnosis. 

How Long Does a Gastrointestinal Endoscopy Take?

An upper gastrointestinal tract endoscopy typically takes 10 to 20 minutes, and a colonoscopy usually takes less than an hour.

Takeaways

Gastrointestinal endoscopy is a valuable tool for diagnosing and treating digestive tract tumors early. It accurately identifies tumors, enhances image quality, reduces the risk of misdiagnosis and missed diagnoses, shortens operation time, minimizes damage to the body and lowers post-operative complications.