Upper endoscopy allows for examination of the lining of the upper part of the gastrointestinal (GI) tract, which includes the esophagus, stomach and duodenum (first portion of the small intestine). In upper endoscopy, the physician uses a thin, flexible tube called an endoscope. The endoscope has a lens and light source, which projects images on a video monitor. This procedure is also referred to as upper GI endoscopy, or esophagogastroduodenoscopy (EGD). Upper endoscopy is often done under sedation to assure maximal patient comfort.
Upper endoscopy helps the doctor evaluate symptoms of persistent upper abdominal pain, nausea, vomiting or difficulty swallowing. It is the best test for finding the cause of bleeding from the upper GI tract and is also more accurate than X-rays for detecting inflammation, ulcers and tumors of the esophagus, stomach, and duodenum.
Colonoscopy is a common, safe test to examine the lining of the large bowel. During a colonoscopy, doctors who are trained in this procedure (endoscopists) can also see part of the small intestine (small bowel) and the end of the GI tract (the rectum). This procedure is often done under sedation to assure maximal patient comfort.
During a colonoscopy, the endoscopist uses a flexible tube, about the width of your index finger, fitted with a miniature camera and light source. This device is connected to a video monitor that the doctor watches while performing the test. Various miniaturized tools can be inserted through the scope to help the doctor obtain samples (biopsies) of the colon and to perform maneuvers to diagnose or treat conditions.
Colonoscopy can detect and sometimes treat polyps, colorectal bleeding, fissures, strictures, fistulas, foreign bodies, Crohn's Disease, and colorectal cancer.
Sigmoidoscopy, or "flexible sigmoidoscopy," lets a physician examine the lining of the rectum and a portion of the colon (large intestine) by inserting a flexible tube about the thickness of your finger into the anus and slowly advancing it into the rectum and lower part of the colon. This procedure evaluates only the lower third of the colon. Sigmoidoscopy is often done without any sedation, although sedation can be used if necessary.
Various miniaturized tools can be inserted through the scope to help the doctor obtain samples (biopsies) of the colon and to perform maneuvers to diagnose or treat conditions.
Flexible sigmoidoscopy can detect and sometimes treat polyps, rectal bleeding, fissures, strictures, fistulas, foreign bodies, colorectal cancer, and benign and malignant lesions.
Enteroscopy includes several types of procedures that allow a physician to look further into the small bowel (which is up to 20 feet long) than is possible with other methods mentioned here. A physician may use a longer conventional endoscope, a double-balloon endoscope or a capsule endoscope. Enteroscopy is primarily used to find the source of intestinal bleeding, but can also be used to find lesions and determine causes for nutritional malabsorption.
An extended version of the conventional endoscope, called a "push endoscope,"may be employed to study the upper part of the small intestine down to about 40 inches beyond the stomach. While more of the small bowel is accessible with this type of endoscopy than with EGD, it is able to visualize only a limited portion of the small bowel. The same techniques for therapy used during EGDs are possible during push enteroscopy.
There are several types of endoscopy. Those using natural body openings include esophagogastroduodenoscopy (EGD) which is often called upper endoscopy, gastroscopy, enteroscopy, endoscopic ultrasound (EUS), endoscopic retrograde cholangiopancreatography (ERCP), colonoscopy, and sigmoidoscopy.
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Endoscopic Ultrasound (EUS)
A flexible endoscope which has a small ultrasound device built into the end can be used to see the lining and wall of the esophagus, stomach, small bowel, or colon. The ultrasound component produces sound waves that create visual images of the digestive tract which extend beyond the inner surface lining and also allows visualization of adjacent organs. Endoscopic ultrasound examinations (also called endoluminal endosonography) may be performed through the mouth or through the anus. EUS is performed under sedation.
Endoscopic Retrograde Cholangiopancreatography (ERCP)
Endoscopic retrograde cholangiopancreatography (ERCP) is a specialized technique used to study and treat problems of the liver, pancreas and, on occasion, the gallbladder. ERCP is performed under sedation. Generally, the level of sedation for ERCP is deeper than upper endoscopy and colonoscopy due to the complexity and length of the procedure.
To reach the small passageways, known as ducts, that connect these organs, an endoscope is passed through the mouth, beyond the stomach and into the small intestine (duodenum). The ducts from the liver and pancreas drain into the duodenum via a small opening known as the papilla. A thin tube (catheter) is then inserted through the endoscope into the papilla, thereby gaining access to the common bile duct and pancreatic duct that connect the liver and pancreas to the intestine.
A contrast material (dye) is injected through the catheter and flows into the liver and pancreas, outlining those ducts as X-rays are taken. The X-rays can show narrowing or blockages in the ducts that may be due to a cancer, gallstones or other abnormalities. During the test, a small brush or biopsy forceps can be put through the endoscope to remove cells for study under a microscope. In addition, small cylindrical tubes (stents) can be placed within the bile duct and/or pancreatic duct to treat obstructions from either benign or malignant diseases.