What is Endoscopy? Endoscopic Procedures

Doctors perform an endoscopy procedure in a clinical setting.

What is endoscopy?

Endoscopy is a safe, nonsurgical procedure used to examine a person’s digestive tract from the inside. Your doctor uses a long flexible tube, called an endoscope, that has a light and a camera attached to it. By sliding it down your throat, your doctor can get a close-up look at the inside of your gastrointestinal tract on a color TV monitor.

One of the most common types of endoscopy is upper endoscopy, also called esophagogastroduodenoscopy (EGD). An EGD is used to evaluate the esophagus, stomach, and the upper part of your small intestine, making it useful for evaluating abdominal pain, acid reflux, difficulty swallowing, and other upper GI symptoms.

In addition to diagnosing certain gastrointestinal (GI) issues, endoscopy can be used to treat specific conditions. By passing thin devices through the endoscope, your doctor can take tissue samples, screen for cancer, remove polyps, or administer other treatments.

Medical illustration an endoscopy procedure.

Wireless capsule endoscopy

Wireless capsule endoscopy is a less invasive type of endoscopy. For this procedure, a patient swallows a multivitamin-sized capsule that contains a camera, a light, batteries, and a transmitter. The capsule passes through the small intestine via the same muscle contractions that carry food, snapping two photos per second and transmitting them to a pager-sized receiver worn around the waist.

This technology at MedStar Health allows your doctor to see the entire length of the gastrointestinal tract that cannot be visualized using the traditional approach.

Specialized upper endoscopy techniques

Endoscopic ultrasound

Sometimes, an endoscopic ultrasound is performed. This is a long, flexible tube with a light, camera, and ultrasound transducer (probe) attached to it. The ultrasound uses sound waves to create detailed images, which your doctor can view on a monitor. The ultrasound allows us to see lesions that aren’t visible to the naked eye with a regular endoscopy and can also help us examine organs outside the digestive tract.

Endoscopic ultrasound may be used to:

Detect tumors in the gastrointestinal (GI) tract
Biopsy tumors in the GI tract using fine needle aspiration/biopsy (FNA/FBA). This is when the doctor removes a tissue sample from a suspicious mass or lymph node and sends it to a pathology lab for analysis and diagnosis
Stage tumors in the GI tract, which is when the doctor determines the extent of the spread of the cancerous tumor (Stages I, II, III, or IV)
Assess esophageal, gastric, pancreatic, and rectal cancers
Detect common bile duct stones
Aspirate fluid cysts in the GI tract
Treat cysts and other GI pathologies
Place markers for radiation therapy
Treat pancreatic disease in various ways, including:
- Pancreatic cyst drainage/Axios stent placement
- Placement of fiducials (small metal guides placed in and around tumors for radiation therapy)
- Pancreatic necrosis debridement

Endoscopic retrograde cholangiopancreatography (ERCP)

ERCP is a highly specialized technique that combines endoscopy with contrast dye to examine the pancreas, bile duct, liver, gallbladder, and the network of ducts that carry digestive fluids.

In addition to its diagnostic importance, ERCP also can be used to treat certain conditions immediately. These treatments require the experience of experts because ERCP is a highly specialized procedure. If a blockage is found in any of the ducts during an ERCP, your doctor may be able to use one of the following tools to remove or relieve the obstruction:

Sphincterotomy, in which your doctor cuts the muscle sphincter of the bile or pancreatic duct to remove stones.
Duct dilation and stenting, in which your doctor uses a balloon catheter to stretch a narrowed opening. MedStar Health experts use endoscopes to place stents in the esophagus, duodenum, and colon that help by propping open areas blocked by tumors or other obstructions.
Cholangioscopy, in which a smaller scope is used to examine the bile duct and pancreatic duct and deliver treatments.
Biliary lithotripsy, which allows your doctor to destroy gallstones trapped in your bile ducts.

Learn more

Treatment for gastrointestinal cancers

Argon Plasma Coagulation (APC) is an advanced approach that uses an endoscope to deliver a burst of heat to a lesion. It can treat tumors in the stomach, esophagus, or intestine and is a faster, simpler alternative to other laser treatments.
Endoscopic Mucosal Resection is used to treat and remove pre-cancer lesions or early cancer in the gastrointestinal tract.
Cryoablation is an advanced approach that uses liquid nitrogen to deliver extremely cold energy to treat tumors in the esophagus, stomach, or intestine.
Radiofrequency ablation (RFA) is an advanced approach to treat pre-cancer lesions in the esophagus, such as Barrett's esophagus, to prevent esophageal cancer.

What to expect

Your doctor will give you specific instructions based on the type of endoscopy planned. In general, here is what you can expect.

Before the procedure
Inform your doctor about any allergies, health issues, or medications you take. If your doctor will also be performing fine needle aspiration, you will be checked for proper blood clotting.

Your stomach needs to be empty. You cannot eat or drink anything after midnight prior to the procedure.

You will be sedated. Plan to have someone there to drive you home after the procedure. You will not be able to return to work for 24 hours.

The procedure may be performed in an outpatient facility, so you can return home the same day.
During the procedure
You receive an IV, which is used to give you sedatives as well as other medications and fluids.

Your doctor uses the endoscope, sometimes with an ultrasound probe attached, and observes the inside of your GI tract. The images are shown on a nearby monitor.

Fine needle aspiration/biopsy is performed if necessary.

The procedure lasts between 30 and 90 minutes.

Once the procedure is finished and the effects of the anesthesia have worn off, your doctor discusses the findings with you.

You can go home, where you should rest for the remainder of the day.
After the procedure
Your healthcare provider will let you know when to expect results and next steps.

If you have an upper endoscopy, it’s normal to have a sore throat for 20 to 30 minutes after the procedure.

Most patients can return to work and normal activities the day after the procedure.