Failure to prevent or overlooking the symptoms of digestive disorders may lead to a malfunction of the digestive system. These problems then result in endoscopy procedures. If symptoms point to the upper dyspeptic disorders, then the assessment usually targets oral cavity, oesophagus, stomach, pancreas, liver, duodenum, gall bladder and bile ducts. The lower dyspeptic syndromes include the small and large intestine and the rectum.
Digestive tract assessment uses an optical device called endoscope and its camera helps to reveal digestive problems and to establish a correct diagnosis. That is why the assessment is called endoscopy. Apart from the digestive tract, endoscopy can examine urinary tract, respiratory tract or genital organs. In gastroenterology (diagnosis and treatment of the digestive tract), types of endoscopy are divided into gastroscopy, colonoscopy, sigmoidoscopy, double-balloon endoscopy and capsule endoscopy.
Colonoscopy is a method of examining the large or small intestine via insertion of an optical device – endoscope.
Colonoscopy assessment follows a dietary regime and application of a laxative solution to empty the patient’s bowels completely. Immediately before the assessment an injection is given to calm down the patient and for pain relief; general anaesthesia is given if required. Colonoscopy uses an endoscope which is introduced via the rectum into the colon or the end of the small intestine which is the primary area affected by inflammation, particularly in Crohn’s disease. During colonoscopy it is possible to take tissue samples or to perform a surgical procedure if required.
Assessment of the digestive tract via colonoscopy helps surgeons to diagnose a wide range of bowel inflammations or cancers such as colorectal cancer.
Assessment of the upper digestive tract (oesophagus, stomach, duodenum) using an endoscope is called gastroscopy.
Gastroscopy assessment method is performed by inserting an optical device via oral cavity, oesophageal sphincter, and oesophagus and into the stomach and duodenum. Prior to assessment the patient must have an empty stomach, because the remains of food during gastroscopy could prevent a clear visibility or cause aspiration. If a patient is concerned about the assessment, a calming injection may be given. In this case the patient is advised to be accompanied for the assessment.
Gastroscopic assessment enables to detect changes to the upper tract mucosa, possible bleeding, inflammation, ulcers or a tumour.
Sigmoidoscopy is identical to colonoscopy, but it is shorter. In a shorter assessment by an endoscope only the rectum, sigmoid loop or the descending colon are examined.
The preparation and the sigmoidoscopy itself are less demanding compared to other colonoscopy procedures. Several days prior to sigmoidoscopy, the diet should be mashed. Just before the examination, the rectum is cleaned by a special solution.
The purpose of sigmoidoscopy is to reveal diverticula that may lead to colon cancer.
Double-balloon endoscopy presents the most modern assessment technique of the small intestine. It uses a videoendoscope, a double-balloon endoscope which enables a very careful insertion through the gut.
Double-balloon endoscopy assessment is similar to colonoscopy and it requires a similar preparation. However, unlike colonoscopy it is gentler and less painful.
Double-balloon method is performed in patients who have abdominal adhesions. During assessment, it enables to remove polyps, to stop bleeding, to remove a foreign object or to enlarge narrow areas.
Other alternatives include a small intestine assessment by the capsule endoscopy and it is performed as a supplementary examination to the conventional diagnostic endoscopy.
Capsule endoscopy takes longer, up to 8 hours, and it uses a capsule with a microcamera that is swallowed. During the eight-hour passage through the digestive system images of the digestive tract are recorded. The capsule leaves the body naturally.
This technique is used particularly in patients with Crohn’s disease who are examined for the extent of their small intestine disorder. The capsule method can also detect the source of bleeding in the digestive tract.