Endoscopy

Endoscopy is a minimally-invasive medical procedure that is used to observe a tissue or an internal organ in detail. It is helpful to carry out minor surgeries and diagnostic procedures. 

A long, flexible, thin lighted tube with a camera on one end is known as an endoscope. It is inserted through the openings of the body such as the mouth or the anus to carry out an endoscopy.

The different types of endoscopy procedures include:

1. Arthroscopy: The procedure helps in examining and treating the joints. It involves the insertion of an endoscope through a small cut or incision near a joint.
2. Bronchoscopy: The procedure helps in examining and treating the lungs and airways. It involves the insertion of an endoscope through the nose or mouth into the windpipe and lungs.
3. Colonoscopy and sigmoidoscopy: The procedure helps in examining and treating the large intestine. It involves the insertion of an endoscope into the large intestine through the anus (from where stools are excreted).
4. Cystoscopy and ureteroscopy: The procedure helps in examining and treating the urethra (from where urine is excreted), bladder (where urine is stored), and ureters (tubes that run from kidneys to bladder).
5. Laparoscopy: The procedure helps in examining and treating the abdomen (stomach) or pelvis (area below the stomach). It involves the insertion of an endoscope through a small cut or incision in the abdominal or pelvic area.
6. Upper gastrointestinal endoscopy: The procedure helps in examining and treating the esophagus (food pipe), stomach, and duodenum (first part of the small intestine). When only the esophagus is involved, the procedure is known as esophagoscopy. When all the organs are involved the procedure is called esophagogastroduodenoscopy. The procedure is done by inserting an endoscope through the mouth into the food pipe, stomach, and duodenum.
7. Hysteroscopy: The procedure involves the insertion of an endoscope through the cervix (the outer portion of the vagina) to examine the uterus (womb).

An endoscopy may be performed for the following reasons:

1. Investigation of symptoms and diagnosis: Endoscopy is done for the investigation of any abnormal symptoms whose cause needs to be identified.
2. Biopsy: A small sample of any abnormal tissue or mass that may be present is excised by the doctor and sent to the laboratory for pathological investigation. This helps in the detection of conditions like anemia (lack of red blood cells in the body), inflammation, bleeding, diarrhea, or cancer of the gastrointestinal (digestive) system.
3. Treatment: A minor surgery can be performed for the treatment of certain diseases using endoscopy. Endoscopy also helps in the treatment of a few problems in the digestive system such as widening of a narrow esophagus (food pipe), burning off a blood vessel to stop bleeding, removal of any foreign body, or removal of a polyp (abnormal tissue growth in the body).

An endoscopy is recommended for a person having one or more of the following symptoms:

1. Gastrointestinal symptoms: Stomach pain, acidity, vomiting of blood, acid reflux, diarrhea, constipation, blood in stools, unexplained and sudden weight loss.
2. Female Reproductive System symptoms: Abnormal bleeding from the vagina, excess bleeding during menstruation, abnormal discharge from the vagina, inability to conceive, pain in the lower part of the abdomen.
3. Respiratory symptoms: Difficulty in swallowing food, blood in sputum, chronic cough, difficulty in breathing, breathlessness, pain, or exertion on breathing.
4. Urinary System symptoms: Increased frequency of urination, blood is seen in urine, urinary retention, weak stream of urine, discharge from the urethra, presence of a stone in the urinary tract.
5. Musculoskeletal symptoms: Joint pain, restriction in movement, sound on moving of the joint, displacement of the joint.

Depending on the type of endoscopy being done, the following doctors can perform the procedure:

• Orthopedic surgeon
• Thoracic surgeon
• Pulmonologist
• Gastroenterologist
• Urologist
• General surgeon
• Obstetrician-gynecologist

The following preparation is required for an endoscopy procedure:

• Inform the doctor if you are currently taking any medications, supplements, or herbs.
• If you are suffering from any medical diseases, inform the doctor about the same.
• Tell your doctor if you are allergic to any medications, anesthetic agents, latex, iodine, or tape.
• Your doctor may give you enemas or laxatives a night before the procedure to clear your bowels.
• The doctor may instruct you to stop taking blood-thinning medications like warfarin and aspirin a few days before the procedure.
• Most types of endoscopies require you to stop eating about 12 hours before the procedure. Clear liquids like juice or water may be allowed for up to two hours prior to the procedure.

• The procedure may be performed under local anesthesia (the site of endoscope insertion is numbed) or general anesthesia (the patient is put to sleep during the procedure).
• The endoscopy procedure varies depending on the type of procedure being performed, the symptoms of the patient, and the diagnosis.
• The endoscope is carefully put into the body by the doctor. 
• Depending on the part of the body that is being looked at, the endoscope may be placed into the mouth and down the throat, anus, or urethra. The doctor may sometimes put the endoscope through a small cut or incision.
• The diagnostic or treatment procedure is then carried out by the doctor.
• The procedure may take about 15 to 45 minutes to complete, depending on the type of procedure being performed.

• Most of the endoscopies are outpatient procedures, which means that the patient can go home on the same day of the procedure.
• The patient will most likely stay in the hospital for an hour or two for observation and later be discharged.
• The doctor gives instructions on how to care for the wound at home.
• Some endoscopy procedures may cause pain and discomfort.
• Your doctor may prescribe pain-relieving medications to relieve the pain.
• It is normal to have some nausea and drowsiness for 24 hours after the procedure.
• You may have a sore throat if the endoscope was placed in the windpipe during the surgery.
• Most people are able to resume their daily activities within a day or so after the procedure.

Contact your doctor if you notice the following symptoms after the procedure:

• Pain, swelling, or redness in the area of the endoscope insertion
• High fever
• Pus or discharge of fluid at the site of the endoscope insertion
• Black or dark-colored stools
• Shortness of breath
• Vomiting of blood
• Severe stomach pain
• Chest pain
• Difficulty in swallowing

The complications associated with an endoscopy procedure include:

• Bleeding
• Infection
• Allergic reaction to anesthetics
• Blood clot formation
• Swelling of the joints
• Nerve or blood vessel damage
• Sore throat
• Fever
• Pneumonia
• Hoarseness 
• Pneumothorax (collapsed lung)
• Chest pain
• Fever
• Damage to the body organs, and possible organ perforation
• Redness and swelling at the site of incision
• Persistent pain in the endoscopy area
• Nausea
• Vomiting
• Bloody urine
• Urinary tract infection
• Dark-colored stools

The cost of endoscopy varies depending on the type of procedure performed, the purpose of the procedure, and the overall health of the patient.
The cost varies amongst different doctors in different hospitals. Usually, the cost of endoscopy in India varies between INR 10,000 to INR 50,000.