Endoscopy

A diagnostic endoscopy is an examination to look at your internal organs using an instrument called an endoscope.

What is a diagnostic endoscopy?

A diagnostic endoscopy allows specialists to visualise internal structures and organs by inserting a long, tube-like instrument with a lens and light at the end of it (an endoscope) through a natural opening, such as the mouth or anus.

What are the benefits of diagnostic endoscopy?

A diagnostic endoscopy allows specialists to check for abnormal tissue, irritations, ulcers and inflammation of internal organs. An endoscopy can also be used to extract tissue samples from the body (biopsy) or insert dye into a particular organ to create a clearer view under x-ray.

Is a diagnostic endoscopy right for me?

Your consultant should explain to you whether your endoscopy is purely diagnostic to investigate symptoms, or whether there is any treatment involved. Sometimes, the endoscopy may encompass both (e.g. having an upper endoscopy to look for potential stomach ulcers and then treating any that are found).

Endoscopies also vary by location and so the endoscope itself may be introduced in several different ways. For example, an upper endoscopy to look at the stomach. A colonoscopy to look at the large bowel will be introduced through the rectum (back passage), and a hysteroscopy to look at the inside of the uterus (womb) would be introduced through the vagina. A cystoscopy looks inside the bladder and may be suggested if you have blood in your urine, problems with urinary incontinence or recurrent urinary tract infections.

It is very helpful to know what to expect when it comes to your endoscopy, and your consultant should explain all of this to you when the endoscopy is arranged.

What happens during a diagnostic endoscopy?

Preparing for a diagnostic endoscopy

Depending on the type of procedure you are going to have, preparation may include checking your medications and potentially fasting before the procedure.

Before having an endoscope passed through the mouth, you must avoid food for several hours as food in the stomach can obstruct the consultant’s view.

You are usually given laxatives before an endoscope is inserted into the rectum and colon.

During a diagnostic endoscopy

The examination can be carried out under sedation. Your consultant will discuss the best method with you. You should not experience any pain during the endoscopy, but it may be quite uncomfortable. You will also be offered some sedation, which may help you to relax and may make everything more comfortable throughout.

These procedures can take between 15 minutes and 1 hour, and you will be monitored throughout.

After the endoscopy

Following the endoscopy, it is recommended that you rest for a while to recover:

• If you have had a local anaesthetic only, this will take an hour or so to wear off
• If you have had any sedation, you may be drowsy for the following 24 hours. During this time, it is important that you do not drive, do not drink alcohol and do not operate machinery. It is recommended that you arrange an alternative way to get home

You may also experience a small amount of bleeding from the endoscopy site:

• Cystoscopy – you can expect to have blood in the urine for up to 24 hours afterwards
• Colonoscopy – you may have some blood in the stools which should settle after a day or so

If you have any significant or prolonged bleeding, then you should see your GP.

Follow up appointments with my consultant

You may learn the results of the endoscopy during the procedure itself, or straight afterwards. Depending on the reason for your endoscopy, you are likely to have a follow–up appointment with the specialist who ordered the procedure in order to discuss the results and the plan moving forward. This will also be a good opportunity to ask any more questions you have regarding the procedure, your recovery and the next steps in terms of investigations and managing any ongoing symptoms or problems.

Generally, endoscopies are considered to be very safe procedures, with a low risk of complications. If you experience any of the following after your endoscopy, please contact your GP or the Accident and Emergency department at your local hospital:

• Redness, pain and swelling around where you’ve had the endoscopy, and fever
• Prolonged or unexpected bleeding from the endoscopy site
• Black or dark stools
• Marked shortness of breath
• Chest pain
• Severe and persistent abdominal pain
• Vomiting blood

There are several potential adverse events, which do occur rarely, that it is advisable to know about before having an endoscopy:

• Infection: as with all invasive procedures, there is a small risk of introducing an infection during endoscopy, although all precautions necessary to minimise this risk will be taken
• Bleeding: for some types of endoscopy (cystoscopy and colonoscopy) a small amount of bleeding should be expected for a day or so after the procedure
• Perforation: this occurs when the scope breaks through the wall of the organ. It is a very rare complication, only occurring 1-2 times per 1,000 colonoscopies for example. Should this issue arise during the procedure, it will be managed immediately with surgery to minimise the damage caused
• Reaction to sedation/anaesthetic: this risk will apply to any procedure using sedation or anaesthetic. Many people find that sedation can make them feel quite nauseous (a mild reaction), but there is a small chance of having an allergic or adverse reaction to the drugs used

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