Endoscopic examinations are performed on the basis of a medical recommendation, hence a consultation usually precedes the examination.
Gastroenterological endoscopic examinations:
- Gastroscopy - stomach examination via endoscope
- Colonoscopy - colon examination via colonoscope
An endoscope is a medical device which allows a direct insight into the interior of hollow organs or body cavities. An endoscope is a flexible, fiber-optic device equipped with a small camera at one end. With the help of fiber optics and the camera, the condition of the esophagus, stomach and small intestine mucosa can be monitored and viewed on a screen. There are rigid and flexible endoscopes that can be used for both diagnostic and therapeutic purposes.
Endoscopic examinations are performed under comfortable conditions, for the most part using anesthesia, so they are painless. Much of therapeutic endoscopy is considered surgery, performed in an operating room under local or general anesthetic. The procedure typically has no side effects, but in rare cases a dry throat, coughing, and possibly mild bleeding may occur.
When and for what kind of complaints is an endoscopic examination performed?
If the patient's symptoms include recurrent abdominal pain, vomiting, bleeding, or anemia, our internal medicine physician may prescribe an endoscopic examination to establish the diagnosis. With an endoscope, small changes can be detected in the gastrointestinal tract that would easily remain undiagnosed by other methods.
What happens during the examination?
A gastroscopy is an examination in which an endoscope (a flexible fiber-optic tube) is inserted through the mouth into the upper digestive system. This allows the doctor to examine the mucous membranes of the esophagus, stomach and duodenum (the first part of the small intestine).
During a gastroscopy, if the doctor detects an abnormality or inflamed area, he may take a small tissue sample (biopsy) for histological analysis, culture tests and detection of bacteria.
A gastroscopy is suitable for detecting ulcer disease, inflammation, and the possible source of bleeding. It more accurately recognizes inflammation, ulcers and abnormalities than non-interventional procedures (e.g., x-ray, ultrasound, MRI scans, etc.). It makes possible biopsy, culture tests, removal of polyps and benign growths, a widening of constrictions (stenosis dilation), and a cessation of bleeding (local hemostasis).
A gastroscopy can be performed on an empty stomach. The test is preceded by spraying the throat with a local anesthetic. The tube enters the esophagus, leaving the airways free, so it does not interfere with breathing. The procedure is well tolerated, although it may involve a little discomfort and burping. To avoid this, the test can also be performed under anesthesia. After anesthesia, as reflexes and common sense may be impaired by the medication received, it is not possible to drive for 24 hours. After gastroscopy under anesthesia, a few hours of hospital observation is required. You may experience a sore throat for a few hours, and short-term bloating may occur. After leaving the hospital, you can resume your normal diet.
A colonoscopy can be used to diagnose inflammatory conditions of the colon, to remove polyps located on the wall of the colon, or to perform biopsies. It can be used to detect sources of possible bleeding, inflammatory processes, anatomical abnormalities, and to diagnose tumors of the colon and rectum. Polyps in the colon may rarely bleed, but are largely asymptomatic, so it is necessary to periodically perform a colonoscopy as a screening test to detect them.
How should I arrive for the examination?
For a gastroscopy:
The examination is performed on an empty stomach, so do not eat for 6 hours, or drink for 3 hours beforehand. Milk and dairy products should be avoided if possible that day. Regular medications should be taken as usual on the morning of the procedure.
Medication that affects blood clotting should be discontinued or replaced as directed by a doctor prior to the procedure (based on the advice of your doctor or anesthetist).
For a colonoscopy:
The examination is performed on an empty stomach, and liquids should not be consumed for 3 hours before the test either. The day before the test, bowel cleansing should be performed with the received laxative-type medication, according to the instructions provided.
Regular medications should be taken as usual on the morning of the investigation.
Drugs that affect blood clotting should be discontinued or replaced as directed by a doctor prior to testing (based on the advice of your doctor or anesthetist).
Preparation for a colonoscopy:
On the day before the examination, you may eat a normal breakfast. At noon you should only consume fluids, mashed and low-fiber food, e.g., unthickened broth/stock, mashed potatoes, eggs, etc. Thereafter, solid foods should not be consumed before the examination. Afternoon fluid intake is not restricted.
At 7pm, drink one dose of Picoprep/Citrafleet dissolved in a glass of water (allow for it to cool) after which 2.5-3 liters of fluid should be consumed.
At 6am on the day of the colonoscopy, the second dose of Picoprep should be taken in a similar manner, with 2.5-3 liters of fluid (water, tea, juice) consumed up until 9-10am. The goal is to end up with only fluid leaving the intestines.
Consumable liquids: water, mineral water, soft drinks, herbal tea, unthickened broth/stock, fruit juice, English tea and morning coffee without milk!
Strictly avoid: pulpy tomato juice, beetroot juice!!
No liquid should be consumed for 3 hours before the test.