A gastroscopy, also known as an endoscopy is a procedure performed by a doctor, a well-trained subspecialist who uses the endoscope to diagnose and, in some cases, treat problems of the upper digestive system.
The endoscope is a long, thin, flexible tube with a tiny video camera and light on the end.
By adjusting the various controls on the endoscope, the doctor can safely guide the instrument to carefully examine the inside lining of the upper digestive system.
Diagnostic Indications for Endoscopy
- Difficulty in Swallowing
- Persistent isolated nausea or vomiting. In the event of isolated nausea or vomiting persisting for more than 2 days, investigation of the upper gastrointestinal tract is justified after any non-gastrointestinal origin and acute intestinal occlusion have been eliminated
- Digestive disorders. Upper gastrointestinal endoscopy is recommended in
- In subjects aged over 45 years and/or if there are any warning signs or symptom’s such as anaemia, difficulty swallowing, weight loss or any other warning signs and symptoms
- In subjects aged under 45 years with no warning signs or symptoms, upper gastrointestinal endoscopy is recommended in the following situations
- Positive diagnostic test for Helicobacter pylori
- When symptomatic treatment has failed or recurrence occurs at the end of treatment
- Chronic anaemia and/or iron deficiency anaemia. Upper gastrointestinal endoscopy is recommended in iron-deficiency anaemia and/or iron deficiency, after any non-gastrointestinal origin has been eliminated
- Acute gastrointestinal bleeding originating in the upper gastrointestinal tract. Upper gastrointestinal endoscopy is recommended as first choice in acute digestive bleeding which is assumed to originate in the upper gastrointestinal tract (hematemesis or melena)
- Gastro Oesophageal reflux (GORD). Upper gastrointestinal endoscopy is recommended if there are symptoms of gastro oesophageal reflux combined with warning signs (weight loss, dysphagia, bleeding, anaemia), or if the patient is aged over 50 years, or if there is a recurrence on withdrawal of treatment or resistance to medical treatment
Colonoscopy is a procedure used to view the large intestine (colon and rectum) using an instrument called a colonoscope, a flexible tube with a small camera and light source attached to its tip. Colonoscopy can be performed for screening or diagnostic purposed. While diagnostic colonoscopy is performed to confirm the presence of colorectal cancer or colorectal polyps from a person showing symptoms (blood in stools, anaemia, etc.), screening colonoscopy is performed on an asymptomatic person without any prior history of the two conditions.
Screening colonoscopy is indicated for the following:
- Family history (first degree relative) of colon cancer or polyps
- Inflammatory bowel disease
Colonoscopy is usually performed under sedation on an outpatient basis. You will be given a laxative or enema preparation to clear your bowels before the procedure. Air will be pumped into the colon to expand it for better visibility. The colonoscope is inserted into the rectum and gently moved up the colon until it reaches the caecum (junction of small and large intestine). The colonoscope is then withdrawn slowly as the camera relays pictures of the colon and rectum lining onto a large screen for your doctor to view. Any polyps or growths detected by the colonoscope can be removed and sent to the lab for determining whether it is cancerous or not (biopsy).
Screening colonoscopy is a very sensitive test. However, some cancers, small polyps or non-polypoid lesions may go unnoticed, and the procedure may be associated with the risk of bleeding, tearing or perforation of the colon lining, especially during polypectomy.
Screening is recommended if you are50 years of age or older, with no risk factors. The test is ordered earlier if you have a family history (first-degree relative: parent, sibling or child) of colorectal cancer or polyps. If the relative was diagnosed at <60years of age or if two relatives were diagnosed at any age, you are advised to have a screening colonoscopy at 40 years of age or 10 years before the age of the earliest diagnosis (whichever comes first). The screening needs to be repeated every 5 years. If the relative was diagnosed at ≥60 years of age or if two relatives were diagnosed at any age, you are advised to have a screening colonoscopy at 40 years of age, and repeat every 10 years.
Laparoscopy is a procedure that enables your surgeon to look inside the abdominal cavity and pelvis to diagnose and treat a variety of abnormal conditions. A laparoscope is a long, narrow telescope with a light source and video camera at the end. The scope is passed through a tiny incision into the abdomen where images from the camera are projected onto a large monitor for the surgeon to view the abdominal cavity.
Laparoscopes have channels inside the scope enabling the surgeon to pass gas in and out to expand the viewing area or to insert tiny surgical instruments for treatment purposes. The surgical instruments used in operative laparoscopy are very small but appear much larger when viewed through a laparoscope.
Laparoscopy may be diagnostic, operative, or both:
- Diagnostic Laparoscopy
A laparoscopy is diagnostic when the surgeon is viewing the abdominal cavity and pelvis to make a diagnosis, without any treatment administered at that time. This is particularly useful when other tests such as X-rays, scans, or blood work are inconclusive. The laparoscope is usually smaller as no channel is needed for surgical instruments.
- Operative Laparoscopy
A laparoscopy is considered operative when the surgeon is treating a problem that is found during diagnostic laparoscopy with surgical instruments through the laparoscope.
If your surgeon sees an opportunity to treat a problem during a diagnostic laparoscopy, an operative laparoscopy will usually be performed at that time depending on the patient’s condition and the surgeon’s preference.