Diagnostics
At Aberdeen Surgical we have a long standing interest in gastro-intestinal endoscopy both for diagnostic and therapeutic purposes.
An endoscopic procedure involves the passage of a flexible fibreoptic telescope into the gastrointestinal tract to visualise the lining and in certain situations may allow operations to be performed. If the gullet, stomach and duodenum are to be inspected (gastroscopy) an endoscope about the size of your little finger is passed through the mouth and into each of these organs. For examination of the large bowel (colonoscopy) a longer endoscope is required and this is passed through the back passage around the whole length of the large bowel. This is a longer procedure and is usually performed under sedation however if only the rectum and left side of the colon are required to be visualised a flexible sigmoidoscopy can be performed.
Diagnostic endoscopy is performed as part of the investigation of symptoms and is often performed as part of an ongoing process of investigation. In general , endoscopic examination allows us to visualise the gastro-intestinal tract and take biopsy specimens for microscopic examination and confirmation of many disease processes. Obviously endoscopy allows us to establish the diagnosis in many conditions but often it is as important to exclude other conditions.
Upper gastro-intestinal endoscopy (gastroscopy) allows visualisation of the oesophagus, stomach and duodenum and is particularly useful in the investigation of patients with indigestion, swallowing difficulties, upper abdominal pain, vomiting and any suggestion of bleeding from the upper GI tract. In particular patients with any of the following alarm symptoms should undergo an urgent endoscopy:
- Upper GI bleeding
- Progressive weight loss
- Difficulty swallowing
- Persistent vomiting
- Iron deficiency anaemia
- Epigastric mass
Examination of the lower GI tract is undertaken using a colonoscope passed via the anus. Traditionally patients with symptoms of rectal bleeding, lower abdominal pains and change in bowel habit would be considered for colonoscopy. Increasingly colonoscopy is being used as part of screening investigations for bowel cancer – the rational being that pre-cancerous conditions may be detected and prevented from progressing or alternatively cancers may be detected at an early stage when cure can be considered possible. Patients who have previously had a bowel cancer or certain types of polyps removed should undergo regular surveillance colonoscopy as they at increased risk of developing further polyps.
In addition to diagnostic procedures both upper and lower GI endoscopes can be used for a variety of therapeutic procedures such as removing polyps and small abnormalities in the lining of the intestine. Similarly endoscopes can be used to position dilators for stretching narrowed areas within the oesophagus (gullet), duodenum and/or colon. The spectrum of therapeutic procedures available endoscopically is constantly increasing and operations for reflux disease are now common place endoscopically.
Gastrointestinal endoscopy is a very safe procedure but as with all interventions there is a small risk of complications. In most cases these are minor and self limiting such as gaseous distention. Other complications include bleeding from the site of a biopsy or a tear in the lining of the intestine.
The commonly performed procedures are listed but other endoscopic interventions are also performed.
Diagnostic Flexible Sigmoidoscopy
Therapeutic Flexible Sigmoidoscopy
