Digestive Diseases and Endoscopy

Medically Reviewed by Jabeen Begum, MD on January 05, 2024
Written by Shawna Seed
7 min read

Endoscopy is a nonsurgical procedure that can be used to examine your digestive tract. Using an endoscope, a flexible tube with a light and camera attached to it, your doctor can view pictures of your digestive tract on a color TV monitor.

Some endoscopes have a space where a doctor can insert a surgical instrument to allow surgery or removal of tissue. 

Specific procedures have different names based on the body part examined and the type of scope used.

Laparoscopy vs. endoscopy

Laparoscopy is a type of endoscopy. A flexible tube is inserted, usually through an incision near your belly button, to give doctors a view of your abdominal cavity. It's also used to look at reproductive organs.

Some types of endoscopy for digestive conditions have names that may be familiar to you. 

During an upper endoscopy, an endoscope is passed through your mouth and throat and into your esophagus, allowing the doctor to view the esophagus, stomach, and upper part of the small intestine.

Similarly, endoscopes can be passed into your large intestine (colon) through the rectum to examine this area of the intestine. This procedure is called sigmoidoscopy or colonoscopy depending on how far up the colon is examined.

A special form of endoscopy called endoscopic retrograde cholangiopancreaticography, or ERCP, allows pictures of the pancreas, gallbladder, and related structures. ERCP is also used for stent placement and biopsies.

Endoscopic ultrasound or EUS combines upper endoscopy and ultrasound examination to obtain images and information about various parts of the digestive tract.

Capsule endoscopy

For this type of endoscopy, you swallow a capsule that contains a camera. The capsule is about the size of a vitamin pill. As the capsule makes its way through your digestive tract, the camera takes pictures and sends them wirelessly to a recorder you wear on a belt. This procedure is especially good at capturing images of the small intestine, which is hard to do with with a regular endoscope. The capsule is designed to leave your body in a bowel movement after a couple of days. 

Doctors will often recommend endoscopy to evaluate:

In addition, your doctor may use an endoscope to take a biopsy (removal of tissue) to look for the presence of disease.

Endoscopy may also be used to treat a digestive tract problem. For example, the endoscope might not only detect active bleeding from an ulcer, but devices can be passed through the endoscope that can stop the bleeding. In the colon, polyps can be removed through the scope to prevent the development of colon cancer.

Also, using ERCP, gallstones that have passed outside the gallbladder and into the bile duct can often be removed.

What diseases can be found by endoscopy?

Among the conditions than can be seen by endoscopy are:

  • Cancer 
  • Bile duct problems 
  • Gastrointestinal bleeding, whether from a peptic ulcer or other cause 
  • Gastroesophageal reflux disease (GERD) 
  • Barrett's esophagus, a condition in which the esophagus is damaged by acid reflux 
  • Familial adenomatous polyposis (FAP), a rare genetic disorder that causes your body to form polyps (extra tissue) in your colon,  rectum, and upper GI tract. These can become cancerous.

Is endoscopy safe? Overall, endoscopy is very safe, but the procedure does have a few potential complications, which may include:

  • Perforation (tear in the gut wall)
  • Reaction to sedation
  • Infection
  • Bleeding
  • Pancreatitis as a result of ERCP

If you react to the sedation, the health care team will treat you right away with medicine or fluids in an IV. 

Bleeding from an upper GI endoscopy is usually minor and you may not need any treatment. If you bleed during your colonoscopy, the doctor may be able to treat it during the procedure. Studies have shown you're more likely to have bleeding or a perforation during colonoscopy if the doctor removes polyps. You might continue to bleed for 2 weeks after a colonoscopy. Talk to your doctor about your symptoms. You might need a second procedure to diagnose or treat your bleeding. 

If you have a perforation, you may need surgery to repair the tear.

Your internist or family doctor may perform sigmoidoscopy in their office. However, all of the other endoscopy procedures are usually performed by gastroenterology specialists (gastroenterologists). Other specialists such as gastrointestinal surgeons also can perform many of these procedures.

Gut preparation. Examining the upper digestive tract (upper endoscopy or ERCP) requires nothing more than fasting for 6-8 hours prior to the procedure. To examine the colon, it must be cleared of stool. Therefore, a laxative or group of laxatives is given on the day before the procedure.

Sedation. For most examinations with an endoscope, you're sedated. This increases your comfort. The sedative, which is administered via an injection into the vein, produces relaxation and light sleep. There are usually few if any recollections of the procedure. Patients wake up within an hour, but the effects of the medicines are more prolonged, so it is not safe to drive until the next day.

General anesthesia (puts you totally asleep for a period of time) is given in only very special circumstances (in young children, and when very complex procedures are planned).

The first step in your endoscopy is sedation. Once you're asleep, your health care provider will insert the scope and begin the exam. 

After the scope reaches the area to be checked, the doctor will note any areas that appear irregular or abnormal. If they need to remove tissue for more analysis, they'll use a special tool to do that. They can also perform certain treatments during the procedure. 

At the conclusion, they'll remove the scope and close any incisions they've made. 

If you need both an upper endoscopy and a colonoscopy, studies have shown you can safely have them at the same time. In fact, "bundling" the two procedures can save money. It also lowers risks associated with sedation and having blood drawn, because you'll need that done once rather than twice. You may want to ask your doctor whether you can have your endoscopy and colonoscopy at the same time.

How long does an endoscopy take?

An endoscopy usually takes 30 minutes to 2 hours. The length depends on the procedure. 

Is endoscopy painful?

You're sedated during the procedure, so you shouldn't feel any pain. Sometimes patients feel pressure when the scope is inserted, but that passes quickly. 

If the endoscope was inserted in your mouth, you might be hoarse or have a sore throat for a couple days. If the scope entered your intestines, you might be bloated or have cramps.

Post-endoscopy care

You'll stay at the hospital or outpatient clinic while the sedation wears off. The team there will watch your vital signs to make sure you're recovering well. That may take up to an hour. You'll need someone to drive you home because it's not safe for you to drive after sedation.

Your care team will give you – or your driver – instructions on what you should after your procedure. If you've had a colonoscopy, you should be able to go back to your normal routine in 24 hours.

Call your doctor right away if you have: 

  • Severe pain in your abdomen
  • Fever 
  • Bloody bowel movements that don't get better
  • Bleeding from your rectum that doesn't get better 
  • Dizziness or weakness
  • Problems breathing 
  • Sort throat that gets worse or problems swallowing
  • Vomiting, especially if you see blood or something that looks like coffee grounds 

Endoscopy is a procedure that uses a long, thin tube with a light and camera attached. When it's inserted into your body, your doctor can diagnose – and in some cases treat – conditions in your digestive tract. Some common types are an upper GI endoscopy and a colonoscopy. 

Do they put you to sleep for an endoscopy?

Very rarely, doctors use general anesthesia for an endoscopy. That means you have a breathing tube in place. For most endoscopies, you'll have moderate sedation that goes through an IV in your arm. You'll be asleep and won't feel pain. 

How long does it take to recover from an endoscopy?

Your recovery time depends on the procedure. Most people go home the same day, once the sedation has worn off and they've rested for an hour or so. 

Is an endoscopy a serious procedure?

Endoscopy is a common, safe procedure. You'll need to take it easy for at least the rest of the day. Mild side effects go away within a day or two, usually. Your doctor will let you know what to expect.