What is a gastrointestinal endoscopic examination?

    Gastrointestinal endoscopic examination is the most common and direct method used to look at your digestive tract. During the procedure, a flexible tube with a camera attached is passed through your digestive tract to capture pictures on a color TV monitor.

    Endoscopic examination has been around for a long time and is a relatively fast and safe procedure. It is mainly used to detect inflammatory changes of the layers of the digestive tract, ulcers, cancer, and other diseases.

    Gastrointestinal endoscopic examination is superior to ultrasound and computed tomography (CT) examination because besides being the most direct way to look at lesions and abnormal changes in the digestive tract, some tissue can be removed (biopsy) at the same time to confirm the nature of disease – whether it is inflammatory, benign growth, or malignant cancer. In addition, treatments can also be carried out using endoscopy.


    What are the different types of gastrointestinal endoscopic examination?

    Gastrointestinal endoscopic examination can be broadly divided into 3 types:

    Other types of gastrointestinal endoscopic examination include endoscopic ultrasound, capsule endoscopy and enteroscopy (small intestines).


    What are the treatments that can be done under gastrointestinal endoscopic examination?

    The treatments that can be done include but are not limited to the following:

    •   Removal of polyps from the stomach and intestines

    •   Digestive tract bleeding control and treatment

    •   Treatment for early cancer in gastrointestinal tract

    •   Intestine dilation and placement of stents

    •   Pancreas and bile duct treatment – removal or stones, cysts drainage, and placement of stents


    Why do I need a gastrointestinal endoscopic examination? 

    Digestive tract problems are very common and occur frequently among people nowadays because of work stress, unhealthy eating habits, and sedentary lifestyle. These cause undesirable effects such as stomach discomfort, stomach pain, acid reflux, gas, stomach distension, heartburn, diarrhea, constipation, and at times blood in the stools.

    These symptoms may be caused by any of the following digestive tract problems: 

    •   Chronic gastritis

    •   Esophageal reflux

    •   Gastrointestinal functional disorders

    •   Ulcers in the stomach or intestines

    •   Polyps in the stomach or intestines

    •   Inflammatory bowel disease

    •   Cancers of the digestive tract

    Endoscopic examination provides the most accurate visual inspection of the digestive tract. It can detect cancer at an early stage, especially colon cancer and gastric cancer which are ranked 2nd and 3rd as the most common cancers respectively.

    Early detection, early diagnosis, and early treatment can greatly improve your chances of recovering from cancer of the digestive tract. Thus, it is generally recommended that for people aged 40 years and above to have regular gastroscopy screening and those over the age of 50 to have regular colonoscopy screening. If you have digestive tract symptoms or a family history of digestive tract cancer, screening should be started at an earlier age.


    Is gastrointestinal endoscopic examination painful

    Gastrointestinal endoscopic examination generally does not cause great discomfort. However, some may feel nauseous during a routine gastroscopy examination. Others may feel stomach distension or discomfort during routine colonoscopy. If you wish to avoid these unpleasant side effects, you can choose a sedative endoscopic examination.

    Sedative endoscopic examination uses a combination of sedatives (medicines that help you to sleep or reduce your anxiety) and anesthesia drugs (medicines that prevent pain during procedure or surgery) on top of the routine gastroscopy or colonoscopy to achieve a state of light quiet sleep. The whole procedure takes about 30 to 60 minutes. It effectively reduces nausea, vomiting, pain, and other unpleasant side effects.

    Reducing your anxiety and discomfort will help you to tolerate the examination and have a more satisfactory experience. After the procedure, your doctor and nurses will observe you closely till you are fully awake and well before discharging you.

    Am I suitable for sedative endoscopy?

    If you have any of the following conditions, please discuss with your doctor to determine whether you are a suitable candidate for sedative endoscopy:

    •   Serious heart or lung diseases 

    •   Sleep apnea or snoring 

    •   Bleeding in the digestive tract

    •   Declined liver function or severe anemia

    •   Severe neurological disease (such as stroke, convulsions, frequent epilepsy relapse)

    •   History of drug abuse or history of allergies to sedative drugs


    What are the risks of doing sedative endoscopy?

    The sedative medication that is used to help you to sleep during the procedure is called Propofol. This medication helps you to fall asleep quickly before the procedure and wake up quickly after the procedure. It acts fast and clears the body fast, thus it has relatively few side effects. A small number of patients may experience a short period of drowsiness, giddiness, nausea, vomiting or other unpleasant effects which the anesthesiologist can help you to manage.

    Endoscopic examination, with or without sedation, is an invasive procedure and there are risks of injury, bleeding, and infection. However, the chances of these happening are rare. There is also a small possibility of it affecting the heart and lungs or drug allergies occurring, depending on the patient’s current health condition. Some complications caused by endoscopic examination such as bleeding, perforation, etc. are usually managed during the procedure itself. Talk with your doctor about your current health condition and obtain a good risk profile before your procedure.

    Endoscopic examination generally does not produce unpleasant side effects, however a small number of patients may experience the following for a short period of time: 

    •   Hoarseness or throat discomfort

    •   Small amount of bleeding (due to biopsy or severe nausea and vomiting)

    •   Stomach bloating or distension

    Over time the above symptoms or discomfort will resolve by themselves. Avoid food and drinks that may irritate your gut. Drinking salt water or sucking lozenges can help to reduce throat discomfort. On the day after the procedure, consume cool and easily digestible food and avoid strenuous activity to reduce the chances of any gastrointestinal tract bleeding.

    Click the link for more information on Gastroenterology Clinical Service



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