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Endoscopy

Endoscopy is the term that is used to describe the direct visual examination of any part of the inside of the body that can be reached through a natural orifice.

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The Joint Advisory Group-accredited Endoscopy Unit, at Harrogate District Hospital, offers a variety of endoscopic procedures, including gastroscopy, colonoscopy, bronchoscopy and ERCP (endoscopic retrograde cholangio-pancreatography).

What is an endoscopy?

An endoscopy is a procedure in which your endoscopist uses specialised instruments (endoscopes) to examine you internally.

An endoscope is a flexible tube with an attached camera that allows your endoscopist to view the lining of your stomach, small bowel or colon (the gut). In addition to viewing the gut, it is possible to take pieces of tissue (biopsies) and to remove abnormalities such as polyps.

Department Location

When entering Harrogate District Hospital via the front entrance, go straight ahead and take the first stairs or lift on the left hand side up to the first floor.

Turn left and follow the main corridor, you will see the Endoscopy Unit sign posted on your right.

Why do I need an endoscopy?

Endoscopy allows your endoscopist to examine the gut with a telescope.  A screen in the endoscopy room gives a high definition view of the lining of your stomach, small bowel or colon.

Endoscopy typically is used to:

  • Help your doctor determine the cause of any abnormal symptoms you’re having
  • Remove a small sample of tissue, which can then be sent to a lab for further testing; this is called an endoscopic biopsy
  • Help your endoscopist see inside the body during a surgical procedure, such as repairing a stomach ulcer, or removing gallstones or tumours.

Your doctor may request an endoscopy if you are suspected of having symptoms related to

  • Inflammatory bowel diseases (IBD), such as ulcerative colitis (UC) and Crohn’s disease
  • Stomach ulcer
  • Chronic constipation
  • Pancreatitis
  • Gallstones
  • Unexplained bleeding in the digestive tract
  • Tumours
  • Infections
  • Difficulty swallowing
  • Gastroesophageal reflux disease (GORD)
  • Hiatus hernia
  • Other digestive tract issues

Your doctor will review your symptoms, perform a physical examination, and possibly order some blood tests prior to an endoscopy. These tests will help your doctor gain a more accurate understanding of the possible cause of your symptoms. These tests may also help them determine if the problems can be treated without endoscopy or surgery.

How do I prepare for an endoscopy?

You will receive specific instructions on how to prepare for your procedure. Most types of endoscopy require you to stop eating solid foods for up to 12 hours before the procedure. Some types of clear liquids might be allowed for up to two hours before the procedure.

Your doctor may give you bowel preparation or an enema to use before the procedure to clear your system. This is common in procedures involving the gastrointestinal (GI) tract.

Prior to the endoscopy, your doctor will do a physical examination and go over your complete medical history, including any previous surgery.

Be sure to tell your doctor about any medications you’re taking, including over-the-counter drugs and nutritional supplements. Also alert your doctor about any allergies you might have. You may need to stop taking certain medications if they might affect bleeding, especially anticoagulant or antiplatelet drugs.

You may want to plan for someone else to drive you home after the procedure because you might not feel like doing this.

What are the types of endoscopy?

What are the latest techniques in endoscopy technology?

Like most technologies, endoscopy is constantly advancing. Newer generations of endoscopes use high-definition imaging to create images in incredible detail. Innovative techniques also combine endoscopy with imaging technology or surgical procedures.

Here are some examples of the latest endoscopy technologies.

Capsule endoscopy

A revolutionary procedure known as a capsule endoscopy may be used when other tests aren’t conclusive. During a capsule endoscopy, you swallow a small pill with a tiny camera inside. The capsule passes through your digestive tract, without any discomfort to you, and creates thousands of images of the intestines as it moves through.

Cytosponge

Cytosponge is a new diagnostic test being introduced to identify important oesophageal conditions such as Barrett’s oesophagus.

Identifying cell changes in screening is important to ensure conditions such as Barrett’s do not progress to become oesophageal cancer. Screening allows cell changes to be identified and simple, curative treatment to be offered.

The Cytosponge is a small capsule which is attached to a fine string. After swallowing, the capsule coating (vegetarian gelatin) dissolves in the stomach to release a small brush which when removed allows cell collection from the lining of the oesophagus (gullet or food-pipe). These cells are then analysed for abnormalities.

The test itself takes around 15 minutes and has been found in several studies to be safe, well-tolerated and effective.

Endoscopic retrograde cholangiopancreatography (ERCP)

ERCP combines X-rays with upper GI endoscopy to diagnose or treat problems with the bile and pancreatic ducts.

Chromoendoscopy

Chromoendoscopy is a technique that uses a specialized stain or dye on the lining of the intestine during an endoscopy procedure. The dye helps the doctor better visualize if there’s anything abnormal on the intestinal lining.

Endoscopic mucosal resection (EMR)

EMR is a technique used to help doctors remove flat polyps in the digestive tract. In EMR, a needle is passed through the endoscope to inject a liquid underneath the abnormal tissue. This helps separate the  tissue from the other layers so it can be more easily removed.

What are the risks of an endoscopy?

Endoscopy has a much lower risk of bleeding and infection than open surgery. Still, endoscopy is a medical procedure, so it has some risk of bleeding, infection, and other rare complications such as:

  • Chest pain
  • Damage to your organs, including possible perforation
  • Bleeding
  • Fever
  • Persistent pain in the area of the endoscopy

The risks for each type depend on the location of the procedure and your own condition.

For example, abdominal pain, dark-coloured stools or vomiting after a colonoscopy could indicate that something is wrong

If you have a capsule endoscopy, there is a small risk that the capsule can get stuck somewhere in the digestive tract. The risk is higher for people with a condition that causes narrowing of the digestive tract, like a tumor. The capsule may then need to be surgically removed.

Ask your doctors about symptoms to look out for following your endoscopy.

What happens after an endoscopy?

Most endoscopies are outpatient procedures. This means you can go home the same day.

Afterward, you’ll likely have to wait for one to two hours in the hospital for the effects of the sedation to wear off. A friend or family member will drive you home. Once you’re home, you should plan to spend the remainder of the day resting.

Some procedures may leave you slightly uncomfortable. It may require some time to feel well enough to go about your daily business. For example, following an upper GI endoscopy, you may have a sore throat and need to eat soft foods for a couple days but you should contact your doctor if this persists.

If your doctor suspects a cancerous growth, they will perform a biopsy during your endoscopy. The results will take a few days. Your doctor will discuss the results with you after they get them back from the laboratory.

Key staff

Unit Managers: Grace Emovon / Helen Allan

Booking Team Leads: Jason Worsnop, Andy Whitehead and Jemma Tyreman

Management Lead: Mr. Alistair Walker

Clinical Lead:  Mr. Jon Harrison

Endoscopy Training

Patient Information

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