(Endoscopy is the process of evaluation of the upper (gastroscopy) and lower (colonscopy) gastro-intestinal tract using video endoscopes. Both procedures are usually carried out in the consulting rooms using conscious sedation rather than general anaesthetic.)

Endoscopy is the process of evaluation of the upper (gastroscopy) and lower (colonscopy) gastro-intestinal tract using video endoscopes. Both procedures are usually carried out in the consulting rooms using conscious sedation rather than general anaesthetic.

The human gut is long and tortuous. Diagnosis and localization of afflictions of the upper bowel (esophagus stomach and duodenum) and lower bowel (colon and terminal ileum) is preferably carried out by direct inspection using fiber-optic or video endoscopes. With the introduction of fully flexible and maneuverable endoscopes, the procedure has been greatly simplified and has largely superceded barium meal and enemas as the procedure of choice. These investigations are used both diagnostically and therapeutically and have made tissue sampling a routine procedure.

Gastroscopy (Upper Bowel)

Gastroscopy is carried out to diagnose esophagus, gastric and duodenal problems. The procedure is carried out in the consulting room under sedation, the only preparation being a 4 – 6 hour fast. Many patients fear GI endoscopy, but good sedation and technique have made this a minor procedure, which will be discussed and explained to you by Mediscapes staff.

The most common non-emergency indications are heartburn, indigestion, swallowing disorders, “ulcers” and assessing the possible complications of medical therapy including analgesics and anti-inflammatory tablets.

The discovery of Helicobacter pylorii, bacteria responsible for gastritis and ulceration modified the approach to diagnosis and therapy. Patients with certain types of anemia often require endoscopic evaluation.

Colonoscopy (Lower Bowel)

Colonoscopy is used to evaluate the colon, and when possible, the terminal ileum. The investigation requires prior cleaning of the bowel with the use of special laxatives that the patient can usually use at their residence, prior to the consultation. It may be necessary to combine the colonoscopy with a gastroscopy. The procedure is indicated to evaluate the colon for changes in bowel habit (including diarrhea and unexplained constipation). In addition, it is used to look for a cause of rectal bleeding.

Colon cancer is the second most important cause of cancer death in the USA. This dreaded disease usually starts in a benign growth called a polyp, a small percentage of which may undergo malignant change to become a cancer. Polyps are generally easily diagnosed and removed at endoscopy, and thereby a potential cancer may be averted. Unfortunately polyps are usually asymptomatic until they undergo cancer changes. Polyps may be sporadic or more commonly hereditary. Recognizing colon cancer as a potential hereditary disease has simplified the approach. Family members of affected first-degree relatives usually require screening at the age of 50 or 5 years before the index family case.

Other indications for colonoscopy include evaluation of anemia, abdominal pain and altered bowel habits.

While complications are rare and the discomfort is minimal, it must be stressed that endoscopy is considered an invasive procedure. Endoscopy may be selected where appropriate to Mediscreen (HEALTH RISK ASSESSMENT SCREENING PACKAGE)