The endoscope is a long, flexible tube passed through the mouth, down the esophagus and into the stomach. It contains fibres that carry light down the tube and project a picture up the tube. A camera is attached to the endoscope to take pictures during the procedure. This procedure is performed by a gastroenterologist (stomach doctor) at the request of your hematologist.
There is another open channel for taking a biopsy. An instrument called biopsy forceps is passed down this channel. A tiny bit of tissue is pinched and removed with the forceps. Since there are a very few nerve endings in the stomach, this procedure may feel uncomfortable, but should not hurt.
An endoscopic exam may be done to the upper or the lower gastrointestinal (GI) tract.
Upper Gastrointestinal (GI) Tract
An endoscopy of the upper gastrointestinal (GI) tract allows the physician to see the esophagus (the tube which attaches the mouth to the stomach), the stomach, and the duodenum (first part of the small bowel or intestine). This exam may be done to:
Locate bleeding in the upper gastrointestinal tract
Determine the reason for persistent nausea or vomiting
Diagnose ulcers (sores in the stomach or duodenum) or other problems
Collect a tissue sample (biopsy)
Lower Gastrointestinal (GI) Tract
An endoscopy of the lower gastrointestinal (GI) tract allows the physician to see the rectum and colon, the large bowel or intestine. The procedure may just extend to the first part of the colon, the sigmoid (a sigmoidoscopy) or, it may examine the entire inverted U-shaped colon (a colonoscopy). This exam may be done to:
Diagnose the cause of diarrhea and/or abdominal pain
Locate areas of bleeding
Collect a tissue sample - a biopsy
Patient Preparation For An Upper Gastrointestinal Tract Endoscopy
An upper GI endoscopy is done in the Gastroenterology Clinic on the Ground Floor of the Centennial Pavilion.
You should not eat or drink anything from midnight the day before the exam. The physician may order some medication to be given before the exam to help you relax. Your throat will be sprayed with a local anaesthetic; this will help prevent gagging during the procedure. The anaesthetic takes about 2-3 minutes to work. It may taste bitter and make your tongue and throat feel swollen.
The Procedure - What to Expect
You will be asked to lie on your left side. This provides the best view of the stomach. You will be given an intravenous sedative to help with relaxation. A mouthpiece may be put between the teeth to stop the accidental biting of the endoscope. This will not affect breathing. Suctioning may be used during the procedure to clear saliva from the mouth.
When the endoscope is passed down into the stomach, you may feel uncomfortable or may retch. You should breathe slowly and deeply to relax the stomach muscles. If you have been practising relaxation techniques, you should try using them. Some people feel full in the stomach, or feel the urge to move their bowels. This is from air passing into the stomach and intestine.
After an upper GI endoscopy, you may feel groggy from the sedative and may have a sore throat. To relieve the sore throat, drinking fluids or using throat lozenges after the gag reflex returns may help. The nurse will advise when it is safe to drink and eat again.
The procedure takes about half an hour but you may be away from your room for about 1 ½ hours. If your counts are low, you will be asked to wear a mask.
A lower GI tract endoscopy is done in the Gastroenterology Clinic on the Ground Floor of the Centennial Pavilion.
You should not eat or drink anything after midnight the day before and an oral laxative is usually given to empty the intestine, so that the bowel lining can be better seen.
The Procedure - What to Expect
You will be asked to lie on your side and an intravenous sedation is given. The endoscope is then inserted into the rectum and gradually advanced. The instrument used for sigmoidoscopy and colonoscopy is similar to the upper gastrointestinal tract endoscope and the procedure time and recovery is much the same.