What is Endoscopy? How is Endoscopy Performed?
Endoscopy is a minimally invasive “endoscopic examination” method in which a thin, flexible tube (endoscope) with a light and camera on its end is advanced through natural openings or small incisions to directly view the inside of the body and administer treatment if necessary. Today, it is used not only for diagnosis but also for procedures such as polyp removal, stopping bleeding, widening stenosis, and stent placement.
What is Endoscopy?
Simply, it is the process of evaluating the inner surface of organs by viewing them on a screen with a long, thin tube with a camera called an endoscope. It is most often performed in the hospital, in the endoscopy unit.
In What Situations and Why Is Endoscopy Performed?
- Diagnosis and screening: Investigating the cause of symptoms such as ulcers, gastritis, reflux, difficulty swallowing, anemia, bleeding, and suspicion of polyps/masses; screening for bowel cancer with colonoscopy.
- Treatment: Procedures such as stopping bleeding, widening the narrow segment, removing polyps, removing foreign bodies, and placing stents.
- Biopsy: Making a definitive diagnosis by taking samples from suspicious areas.
Who is Endoscopy Applied To?
It is applied to patients deemed necessary by the physician based on their complaints and findings. It is frequently requested in cases such as digestive system complaints, bleeding/anemia, weight loss, difficulty swallowing, chronic diarrhea-constipation. Screening colonoscopy is also used in certain age and risk groups.
What are the Types of Endoscopy?
- Upper endoscopy (upper gastroscopy/EGD): It examines the esophagus, stomach, and duodenum.
- Colonoscopy/Sigmoidoscopy: It evaluates the large intestine (or lower part).
- Enteroscopy: It evaluates the small intestine.
- Others (by organ system): Bronchoscopy (lung), cystoscopy (bladder), hysteroscopy (uterus), laparoscopy (intra-abdominal, surgical)
Additionally, advanced technologies such as capsule endoscopy (swallowed camera capsule), endoscopic ultrasound (EUS), and narrow-band imaging are also used.
How is Endoscopy Performed?
You will be monitored before the procedure. Sedation (sleeping state) is administered for most endoscopies; local anesthesia with a throat spray may also be administered for upper endoscopy. The endoscope is gently advanced to the area to be evaluated; a biopsy or treatment is performed if necessary. Upper endoscopy usually takes 15–30 minutes; depending on the type of endoscopy, the total time can range from approximately 30–120 minutes.
Is Endoscopy a Risky Procedure?
It is generally safe; serious complications are rare. Rare risks include bleeding (especially when a biopsy/treatment is performed), infection, tear in the digestive tract, and reaction to sedation/anesthesia. Compliance with pre-procedure preparation reduces the risk.
What Should You Pay Attention to Before Endoscopy?
- Fasting: Generally, there is an 8-hour break from solid food and a 4-hour break from liquid.
- Medications: Follow your doctor's instructions regarding medications such as blood thinners etc.
- Bowel cleansing: Before colonoscopy/lower GIS procedures, “bowel preparation” is required.
- Companion/vehicle: If you have been sedated, you must have someone to drive you home.
What Should You Pay Attention to After Endoscopy?
- Most people go home the same day; if sedated, rest, do not drive for 24 hours, and do not make important decisions.
- Mild burning sensation in the throat, gas/bloating, and cramps usually subside within 1–2 days.
- Emergency warning signs: If you experience symptoms such as fever, chest pain, shortness of breath, black stools/severe bleeding, or severe abdominal pain, seek medical attention immediately.
Frequently Asked Questions About Endoscopy
Which Doctor Should You See for an Endoscopy Procedure?
The endoscopy doctor is usually a gastroenterologist; the procedure is performed in the endoscopy unit of the hospital. In some cases, physicians from relevant branches (Chest diseases, Urology, Gynecology and Obstetrics, etc.) perform their own endoscopies.
Who Should Not Have Endoscopy?
Absolute/relative contraindications are evaluated by your physician; it is generally not performed or postponed in cases such as shock, acute perforation, peritonitis, fulminant colitis, and recent acute myocardial infarction. Conditions such as serious arrhythmias and difficulty in cooperation may be "relative".
What Are the Latest Techniques in Endoscopy Technology?
- Capsule endoscopy (small camera that can be swallowed),
- Endoscopic ultrasound (EUS),
- Narrow-band imaging and high-resolution endoscopes,
- Third-space endoscopy (e.g., POEM), endobariatric procedures, and AI-assisted imaging/quality enhancement.
When Will the Endoscopy Results Be Available?
Most of the time, your doctor will share the initial findings after the procedure. If a biopsy has been taken, the pathology result usually requires a few days to be received; this may vary depending on the institution's processes.
How Long Does Endoscopy Take?
- Upper gastroscopy: Usually 15–30 minutes.
- Other endoscopies: Approximately 30–120 minutes, depending on the type of procedure.
How Should Nutrition Be After Endoscopy?
Do not eat or drink until the swallowing reflex returns (usually 45 minutes). Then, according to the institution's recommendations, you can start with light/infrequent meals and return to normal as tolerated.
Is There a Hospital Stay After Endoscopy?
Most endoscopies are performed as outpatient; some advanced procedures/comorbid conditions may require overnight stay.
Can You Drink Water Before Endoscopy?
The instructions of the institution are essential. Frequently, liquids are stopped 4 hours before the procedure; some centers may allow “clear liquid up to 2 hours beforehand". Follow the preparation instructions given to you before your appointment.
Is the patient anesthetized during endoscopy?
The procedure is performed using methods called conscious sedation or deep sedation. In the first one, the patient is not fully asleep, while in deep sedation, the patient sleeps under full anesthesia and does not feel anything during the procedure and does not remember the procedure afterwards.” Procedures are performed under deep sedation in the endoscopy unit of Koç University Hospital. "
Is anesthesia used during the endoscopy procedure?
Sedation (sleeping state) is used for most procedures; for upper endoscopy, a local anesthetic spray is applied for the throat. General anesthesia is required to a lesser extent. General anesthesia (full sedation) is not routine; it may only be preferred in selected cases such as children, very anxious/difficult patients, long/complex therapeutic procedures, or in cases where there is a risk of aspiration/respiratory tract.
Is there any pain during the endoscopy procedure?
Thanks to sedation and/or local anesthesia, pain/stinging is not expected; there may be a temporary feeling of pressure/gas during colonoscopy.
Where is examined by endoscopy?
In the digestive system, the main ones are the esophagus, stomach, duodenum (upper gastroscopy), colon and rectum (colonoscopy), and small intestine (enteroscopy). Endoscopic methods are also available for other organ systems (bronchoscopy, cystoscopy, hysteroscopy, etc.).
Is it dangerous to take a biopsy via endoscopy?
Biopsy is very valuable in diagnosis. Although the risk of bleeding increases when a biopsy/therapeutic procedure is performed, the overall risk is low and most bleeding is minor and manageable.