“What does an endoscopy feel like?”

Basic definition: An endoscopy is a procedure where organs inside your body are looked at using an instrument called an endoscope. An endoscope is a long, thin, flexible tube that has a light and camera at one end. Images of the inside of your body are shown on a television screen. Endoscopes can be put into the body through the mouth and down the throat, or through the rectum.

An endoscopy can be used to:

• investigate unusual symptoms 
• help perform certain types of surgery 

An endoscope can also be used to remove a small sample of tissue to be looked at more closely. This is called a biopsy.

Types of Endoscopy

An endoscopy can be recommended to investigate many symptoms, including:

• difficulty swallowing (known as dysphagia)
• tummy pain that does not go away or keeps coming back 
• having diarrhoea, or feeling or being sick often
• unintentional weight loss
• having heartburn or indigestion often
• blood in your stool

The most common types of endoscopy are:

•  gastroscopy – used to look at the oesophagus, stomach, or top part of the small intestine.
•  colonoscopy – used to look at the colon and rectum.

Endoscopy used in IBD

The above are very common in IBD but also:

• flexible sigmoidoscopy – used to look inside the lower part of the bowel
• capsule endoscopy – involves swallowing a small capsule that has a camera and light in it, which sends pictures to a computer
• ileosopy – used to look at the small bowel through a stoma

Diagnosis & Manintance

“Currently, endoscopy plays a central part in the care for the IBD patient at multiple stages, providing diagnostic and prognostic data, guiding medical and surgical therapy, treating disease-related complications, and assisting in the early detection of dysplasia and prevention of colorectal cancer in the setting of IBD. The fast-paced changes in the endoscopic world have been mirrored by equally rapid paradigm shifts in the therapeutic approach to IBD, with the introduction of multiple biologic therapies altering the natural history of the disease.”

For diagnostic purposes, endoscopy is a gold standard – it allows visual confirmation of disease, as well as being able to take biopsies for histology. While an FCP (faecal calprotectin) test is used to show active inflammation in the stool, seeing the disease up close – and personal – can determine its severity and what appropriate treatment is needed.

For maintenance, endoscopy can again, show the state of disease activity. For most patients, they undergo endoscopy regularly to check the stage of their disease, if medications are proving to be most beneficial or if treatment can be withdrawn. Most biologic recommendations require endoscopy to ensure funding.

Questions:

Is endoscopy painful?

It will be uncomfortable but not painful. If it is painful, you can be given more sedation, gas and air (a mix of oxygen and nitrous oxide) or buscapan to relax the spasms/movement in the bowel.

How long does it take to recover?

If you have sedation, they won’t allow you home without someone to watch you / being with you for 12-24 hrs.

With regards to the effects of preparation and the air added to the bowel during the procedure, it can take another day or two for all of this to be released from your system. You might become very gassy, windy or experience some referred pain in your shoulders, but this is all normal. It usually takes me a couple of days to get back into the routine of my normal activities and I always clear my schedule for the day following a scope.

What can I expect?

You’ll be taken into a scope suite and asked to lie on the couch on your left side. It can be a very daunting room to be in – even now, I get a little panicky and nervous when I go into the room – but they are always very kind and want the experience to be comfortable for you.

The procedure can take between 10-30 minutes depending on what you’re having done. If you choose the sedation, you have a wonderful fuzzy feeling while they do the procedure and it does make it go quicker, I think. You can say at any point for them to stop, or to have more medications. They will tell you exactly what they are doing and how they expect it to go.

What is the prep like?

Again, it depends on the procedure. For colonoscopy, they require a full bowel prep. It is less for a Flexi sigmoidoscopy and depending on your stoma, could be none. All require to be nil by mouth and for me, this is the hardest part.

Preparation is usually laxative, there are several that are used by various hospitals for various procedures. It is two doses, several hours apart and relates to when you’re procedure is due to take place. Your preoperative assessment will go through all of this. My notes for prep are:

1. Make it cold!
2. Make it hours in advance
3. Add a flavoured squash you don’t really like to make it palatable but forgettable.
4. Have extra bathroom supplies handy!
5. Don’t go out or plan anything you need to do. It’s best to relax and have this as your only task
6. Remember to hydrate in between – bowel prep flushes everything from your bowel and can leave you dehydrated.

Until next time,

Do you have any questions or queries? Or just want to share your own experiences? You can leave me a reply here or leave comments via my social media accounts – on Twitter, find my blog page on Facebook and over on Instagram

If you enjoyed this post check out “Will you always need check-ups for your IBD?” and Movieprep – The storm before the Scope

References:

IBD Relief – Endoscopy Tests for IBD

Sage Journals, Therapeutic Advances in Gastroentrology – Endoscopy in inflammatory bowel disease: from guidelines to real life, L Negreanu, T Voiosu, M State

NHS – Endoscopy