Endoscopy is the term used to describe inspection of the inside of your body using a small television camera. This type of investigation is commonly used to look inside the spaces within your body which can be accessed via one of the natural openings, the mouth, nose, ears, urethra, anus. In General Surgery the most common examinations are Gastroscopy and Colonoscopy.
Gastroscopy is the inspection of the mouth, gullet, stomach, and upper small bowel. This is done by passing a very small endoscope through the mouth, over the back of the tongue and down the oesophagus, following the route usually taken by food and fluids as you eat. Some patients find thinking about swallowing a mouth full of water helps when swallowing the telescope.
The telescope is much smaller than the gullet and passes easily into the stomach. As the telescope crosses the back of the tongue and also when it enters the stomach it can trigger somthing called the "gag relex". The gag reflex is part of our natural defence against swallowing the "wrong thing". Your body can recognise that the telescope is not food and tries to push it back out again. This reaction can be very much reduced by numbing the mouth and gullet with a local anaesthetic prior to the procedure.
Once the telescope is in the stomach things tend to settle down and the Endoscope can be manoeuvred to look at the whole of the inside of the stomach and the very upper part of the small intestine. If any abnormality is seen it can be biopsied or removed by passing a very small instrument down throught the endoscope. There are a large number of specialised instruments that can be used and so it is possible to perform quite complex procedures within the stomach using a gastroscope.
In General Surgery gastroscopy is often used as part of the investigation of anaemia and upper abdominal pain. Gastroscopy is also used to investigate indigestion and to look for cancers of the gullet and stomach.
The colonoscope is a very similar insrument to the gastroscope although it is a little longer, larger diameter and a little stiffer. The colonoscope is used to look at the colon and rectum and also the very end of the small bowel.
Before you have your colonoscopy your bowel must be washed out to remove all of the faecal material which it normally contains. This is done by taking medicine called Bowel Prep. If you would like to know more about this please click on the words Bowel Prep.
Colonosocpy can be uncomfortable and we recognise this. Normally you have no sense of your colon or what it is doing. This is because your colon does not have the same type of nerve supply as your skin and bones. The inside lining of your colon, for instance, has no sense of touch or pain and so biopsies can be taken without any discomfort at all. The colon is however particularly sensitive to stretch and it is this which can give a quite unpleasent cramping during the procedure. For this reason almost all patients choose to have some form of sedation and pain relief during there examination. To learn more about the Sedation used during colonoscopy and other procedures click the word Sedation
A polyp viewed through a colonscope
Colonoscopy is used as part of the investigation of the large bowel. Patients who present with a; change of bowel habit for more than 2 weeks, abdominal pain or rectal bleeding may be offered a colonoscopy to find out the cause of their problem but also to make sure that their symptom are not an indication of bowel cancer. Often colonosocpy reveals benign colonic polyps which can be removed using the colonoscope.
A cancer viewed through a colonscope
Patients who are found to have blood in their stool as part of the screening program for bowel cancer will have a colonoscopy to find the source of the bleeding.