Endoscopic Procedures

Capsule endoscopy uses a swallowable capsule containing tiny video cameras. The capsule, about the size of a large vitamin pill, contains a light source, batteries, a radio transmitter and an antenna. The capsule transmits the images to a recording device worn around the patient's waist. When complete, the recording is downloaded to a computer which displays it on a screen. The capsule is disposable and usually takes eight hours to move through the digestive system, after which it is passed harmlessly in a bowel movement. Capsule endoscopy does not require sedation and is painless. Capsule endoscopy can be used to diagnose hidden GI bleeding, Crohn's disease, celiac disease, and other malabsorption problems, tumors (benign and malignant), vascular malformations, medication injury, and to a lesser extent, esophageal disease. Currently, capsule endoscopy cannot be used to biopsy or treat any conditions.

Colonoscopy is a common, safe test to examine the lining of the large bowel. During a colonoscopy, specially trained endoscopists also might see part of the small intestine (small bowel) and the end of the GI tract (the rectum). This procedure often is done under sedation to assure maximum patient comfort.

A procedure using a specific technique to study and treat problems of the ducts involving the liver, pancreas and gallbladder. This procedure utilizes a specialized endoscope with a side-mounted camera that can facilitate passage of a catheter into the bile and pancreatic ducts.

This examination uses a special endoscope fitted with a small ultrasound device. It is used to look inside the layers of the wall of the gastrointestinal tract and visualize the surrounding organs including the pancreas, liver, gallbladder, spleen and adrenal glands. The scope is inserted in the mouth or anus in the same manner as a conventional endoscope.

Enteroscopy includes several types of procedures that allow a physician to look further into the small bowel (which is up to 20 feet long) than is possible with other methods mentioned here. A physician may use a longer conventional endoscope, a double-balloon endoscope or a capsule endoscope. Enteroscopy is primarily used to find the source of intestinal bleeding, but can also be used to find lesions and determine causes for nutritional malabsorption.

The finding of a new, abnormally growing polyp during sigmoidoscopy is an indication for a colonoscopy to search for additional polyps or cancer.

Percutaneous endoscopic gastrostomy (PEG) is a procedure that utilizes endoscopy to help placement of a tube into the stomach; a small incision in the skin is also required. Endoscopies are usually performed under sedation to assure maximal patient comfort.

Sigmoidoscopy, or "flexible sigmoidoscopy," lets a physician examine the lining of the rectum and a portion of the colon (large intestine) by inserting a small, flexible tube about the thickness of a finger into the anus and slowly advancing it into the rectum and lower part of the colon. This procedure evaluates only the lower third of the colon. Sigmoidoscopy often is done without sedation, although sedation may be used if necessary.

Upper endoscopy allows for examination of the lining of the upper part of the gastrointestinal (GI) tract, which includes the esophagus, stomach and duodenum (first portion of the small intestine). In upper endoscopy, the physician uses a thin, flexible tube called an endoscope. The endoscope has a lens and light source, which projects images on a video monitor. This procedure also is referred to as upper GI endoscopy, or esophagogastroduodenoscopy (EGD). Upper endoscopy often is done under sedation to assure maximal patient comfort.

This procedure helps the doctor evaluate symptoms of persistent upper abdominal pain, nausea, vomiting or difficulty swallowing. It is the best test for finding the cause of bleeding from the upper GI tract and also is more accurate than X-rays for detecting inflammation, ulcers and tumors of the esophagus, stomach and duodenum.