Diagnostic endoscopy at Cheltenham Hospital

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 or a bronchoscopy to look at the airways will be introduced by the throat. 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.

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 is usually carried out with the patient under sedation, or general anaesthetic in some cases. Your consultant will discuss the best method with you.

If you are having a general anaesthetic, then you will be asleep during the whole procedure and wake up once it is finished.

If you are not having a general anaesthetic, you will be given a local anaesthetic where the endoscope will be inserted to numb the area and make the procedure easier. 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. This can be done as an ‘outpatient’, which means you won’t have to stay in the hospital overnight.

Recovery from diagnostic endoscopy

Although a diagnostic endoscopy is invasive, it is a fairly minor procedure. However, it is recommended to allow for some time to rest and recover afterwards. If you have had a local anaesthetic, it should take around an hour to completely wear off. Sedation can take up to 24 hours to completely wear off, and it is recommended that you do not drive or operate heavy machinery, so it is important to organise alternative transport home. General anaesthetics can take a little longer to recover from.

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