Endoscopy: What is it, to whom is it applied, how is it done, how long does it take, what should be considered?

Diseases related to the digestive system are one of the extremely important health problems that greatly affect a person’s quality of life, nutrition, immune system and body resistance. Delays, especially in the diagnosis phase, can lead to progression of the disease, weakening of body resistance and difficulty in treatment. For this reason, endoscopic methods have been developed for detailed examination of diseases related to the digestive system, and simultaneous treatment with diagnosis has become possible thanks to advanced endoscopic applications such as EMR.

Diseases related to the digestive system are one of the extremely important health problems that greatly affect a person’s quality of life, nutrition, immune system and body resistance. Delays, especially in the diagnosis phase, can lead to progression of the disease, weakening of body resistance and difficulty in treatment. For this reason, endoscopic methods have been developed for detailed examination of diseases related to the digestive system, and simultaneous treatment with diagnosis has become possible thanks to advanced endoscopic applications such as EMR.

What is Endoscopy?

Literally, endoscopy is a type of examination method that dates back to Hippocrates and is used in the diagnosis of many diseases. Nowadays, it can be defined as the process of imaging hollow organs such as the esophagus, stomach, intestines, bladder, uterus and vagina, through a flexible cable-like device with a camera attached to its end. All these interventions are named in various ways depending on the region where the procedure is performed, but in general use, the word endoscopy is preferred only for imaging the lower and upper digestive system organs.

In particular, digestive system endoscopy has become used for the treatment of diseases related to this system rather than diagnosis. For this reason, endoscopy is not only an imaging procedure, but also one of the most effective treatment options for many diseases, from reflux to digestive system cancers.

In what cases is endoscopy performed?

Endoscopy performed on the upper digestive system is called esophagoscopy, gastroscopy and duodenoscopy. Esophagoscopy is the process of detailed imaging of the esophagus, gastroscopy of the stomach, and duodenoscopy of the duodenum. Conditions that require endoscopic imaging of the upper digestive system for diagnostic purposes are as follows:

Indigestion

This condition, which is popularly defined as indigestion, can be explained as the loss of function in the stomach and duodenum. Dyspepsia causes various digestive problems in the person, and when evaluated together with other complaints, it can be a sign of more serious health problems.

Swallowing Problems Such as Dysphagia and Odynophagia

Difficulty in swallowing (dysphagia) and painful swallowing (odynophagia) problems may indicate extremely serious health problems. Therefore, if these symptoms occur, urgent endoscopy is recommended.

Gastroesophageal Reflux Disease

The diagnosis of gastroesophageal reflux is often made based on typical findings, without the need for endoscopy. However, if there are various health problems such as iron deficiency anemia, undesirable weight loss, painful swallowing problems accompanying the current diagnosis, endoscopy of the upper digestive system may be preferred.

Upper Digestive System Bleeding

If the patient has symptoms such as bloody vomiting and/or bloody stools that indicate digestive system bleeding, endoscopy may be performed for both diagnosis and treatment purposes.

Iron Deficiency Anemia of Unknown Cause

Iron deficiency anemia can be a sign of many diseases, especially those related to the digestive system. Therefore, in cases of iron deficiency of unknown cause, upper and lower digestive system endoscopy is preferred.

Suspicious Mass Presence

After the mass detected during upper abdominal examination is confirmed by radiological imaging methods, endoscopy may be required for detailed examination and diagnosis.

He does not know

Achalasia can be briefly defined as the permanent relaxation of the muscles surrounding the esophagus and the loss of the opening and closing function of the stomach valve. Endoscopic interventions are used in the diagnosis, treatment and follow-up phase of this disease, which causes serious discomfort in the person.

In addition to all these, diagnosis and treatment of masses and lesions related to the digestive system, removal of polypoid lesions, dilation of benign strictures, evacuation of cysts occurring in the pancreas through drainage, and endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD) are performed. Upper digestive system endoscopy is used for advanced endoscopic interventions.

The process of detailed imaging of the large intestine and rectum through an endoscope is called colonoscopy and is often performed in the following cases:

Cancer Screening

Colon cancer is one of the types of cancer that is detected late and can progress extremely quickly and cause death. For this reason, colonoscopy is preferred in routine cancer screenings of especially risky people.

Conditions Such as Tumor, Stenosis, Ulcer or Obstruction

Lesions, stenosis, ulcers or obstructions in the large intestine may indicate other diseases and in some cases require urgent intervention. In this case, colonoscopy may be preferred for both diagnosis and treatment.

Inflammatory Bowel Disease

Inflammatory bowel disease can lead to the development of benign or malignant tumoral tissue on the intestinal surface. For this reason, diagnosed people and their relatives showing symptoms should be followed and the colonoscopy procedure should be repeated at appropriate frequency.

Large Intestinal Polyps

Polyps and similar lesions that occur in the large intestine are removed with the same procedure after being confirmed by colonoscopy. However, in the definitive diagnosis of some diseases, it may be necessary to take a biopsy culture from the intestine via colonoscopy.

How is the Endoscopy Procedure Done?

Endoscopy must be performed by experienced people under appropriate conditions. Before the procedure, the patient is given the necessary anesthetic treatment and positioned. Regional anesthesia is generally preferred for upper digestive system endoscopy. The patient is placed on the procedure table and laid on the left side with both shoulders in the same plane. Then, a device that looks like a thick cable with a camera at the end is entered through the mouth and progresses towards the throat and esophagus. In the meantime, it is important to act as gently and slowly as possible to avoid complications such as tearing or bleeding in the patient’s digestive system mucosa.

As it progresses through the esophagus, the digestive system is examined on the screen reflected by the camera. After examination of this area, the endoscope device is advanced towards the stomach and detailed imaging is provided, starting from the stomach lid. If there is a pathological finding in all these structures, a biopsy can be taken from that area and sent to the laboratory for examination.

In the endoscopy procedure performed on the large intestine, general anesthesia is most likely preferred. Before the procedure, an enema is applied to the patient and the intestinal surface is completely emptied. Then, the patient is laid on his side so that both shoulders are on the same plane, and he is asked to pull his kneecaps up to chest level. After anesthesia is applied, the anus is opened and first the rectum and then the colon areas are imaged sequentially.

How Long Does the Endoscopy Procedure Take?

The duration of the endoscopy procedure varies depending on many factors. Important points such as the person’s age, general health condition, anxiety and anxiety level, purpose of the procedure, intervention method, experience of the physician, adequacy of the application center, and type of anesthesia preferred during the procedure are some of these.

Procedures performed on the lower digestive system may take longer than upper digestive system endoscopy due to the need for sensitivity and the preference for general anesthesia. It is extremely important to carry out the procedure slowly and carefully, with as gentle movements as possible, in order to avoid any complications related to the procedure. For this reason, endoscopy applications, especially to the lower digestive system, may take more than 1 hour, including the recovery time after anesthesia. Upper digestive system endoscopies are completed in approximately 30-40 minutes, depending on the patient’s general health condition.

However, endoscopy procedures performed for treatment purposes may take a little longer depending on the plan. Some procedures, such as opening a stenosis anywhere in the digestive tract, removing foreign objects causing obstruction from the digestive tract, if any, detecting possible lesions and removing polyps from the mucosal surface, take longer to complete than standard endoscopy procedures performed for diagnostic purposes.