Endoscopy is the best technique for evaluating diseases of the digestive tract. Endoscopy, which means “looking inside,” allows a physician to see directly inside the GI tract.
An endoscope is a flexible fiber-optic tube which can be directed and moved around the digestive tract. At the end of the endoscope tube is a tiny camera connected to a video screen. The tube is placed in the body through the mouth or anus and advanced to the area being examined.
Endoscopy, a minimally invasive procedure requiring expert technical skill and experience, often enables both the diagnosis and treatment of disease in one procedure. Today, technological advances have made endoscopic treatments a preferred alternative to surgery for many procedures involving the digestive tract.
- Upper endoscopy is an examination of the inside of the upper digestive tract — the esophagus, stomach and duodenum (first part of the small intestine). The procedure is used to diagnose the reason for swallowing difficulties, nausea, vomiting, reflux, bleeding, indigestion, abdominal pain or chest pain.
- Lower endoscopy is an examination of the inside of the colon (lower digestive tract). A flexible endoscope is inserted through the anus and rectum and moved into the colon to obtain tissue samples, remove polyps, detect cancer and diagnose causes of bleeding or inflammation. A colonoscopy examines the entire colon.
Froedtert & The Medical College of Wisconsin use a variety of endoscopic techniques to diagnose and evaluate disorders of the digestive tract. These include:
- Endoscopic retrograde cholangiopancreatography (ERCP), which combines video endoscopy and fluoroscopy. ERCP is commonly performed to diagnose conditions of bile ducts and pancreatic ducts, such as narrowing, stones, blockages, tumors and cysts. ERCP is also used to treat these conditions. In addition, ERCP can provide access for pressure probes that measure the pressure level in the sphincter muscle of the common bile and pancreatic duct.
- Capsule endoscopy, used to detect disease of the esophagus and the small intestine. In this procedure, the patient swallows a tiny digital camera shaped like a capsule (“camera pill”). As it travels down the esophagus, the camera takes many pictures and sends them to a wireless receiver. A computer assembles the images into a digital movie. The 30-minute procedure requires no sedation and allows the diagnosis of many diseases.
In the esophagus, the camera pill is used to look for conditions such as gastroesophageal reflux disease (GERD). Left untreated, GERD may lead to a pre-cancerous condition called Barrett’s esophagus. In the small intestine, the capsule can help determine the cause of persistent abdominal pain, unexplained rectal bleeding or diarrhea, and detect polyps, cancer and other causes of bleeding and anemia, such as Crohn’s disease.
- Endoscopic ultrasound (EUS), combines ultrasound and endoscopy to view the lining and the walls of the upper and lower gastrointestinal tract. An EUS exam may be performed through the mouth or the anus. EUS allows accessing and imaging otherwise unseen areas and is primarily used to detect suspected cancers and benign lesions of the digestive tract and to evaluate the spread (stage) of cancer in order to determine treatment. EUS is used to stage cancers of the esophagus, stomach, pancreas and rectum, as well as cancer that has spread to adjacent lymph nodes and blood vessels (combining the imaging and fine-needle aspiration capabilities of EUS).
In the digestive tract, EUS is used to evaluate:
- Muscles of the lower rectum/anus and fecal incontinence
- Barrett’s esophagus
- Bile duct abnormalities (stones in the bile duct or gallbladder)
- Tumors in the bile duct, gallbladder or liver
- Acute and chronic pancreatitis
- Cancer of the stomach, esophagus, rectum and pancreas
- Pancreatic cysts and other masses
EUS is also used to treat various conditions.
Author: Marla Fraunfelder
Date: Oct. 17, 2007
|Medical Reviewer: ||Kia Saeian, MD, MSC, EPi, FAGG|
|Medical College of Wisconsin gastroenterologist/hepatologist|
Last Review Date: June 18, 2013
Online Editor(s): Tim Gehr