Last updated date: 13-Mar-2023
Originally Written in English
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Physicians can view various parts of the digestive tract using endoscopy, a potent diagnostic technique. The portion of the digestive tract the doctor needs to examine can be reached by inserting a short, flexible tube with a camera at the tip through the mouth or rectum. Endoscopy has developed recently into a therapeutic technique that enables doctors to simultaneously assess, diagnose, and treat a patient's illness. Without requiring a skin incision, doctors can remove obstructions, eliminate dangerous tumors, and carry out other critical therapies using the same endoscopic tube that serves as a portal into the GI system.
Highly qualified therapeutic endoscopy experts can frequently diagnose and treat a patient's issue in a single visit using these minimally invasive procedures.
What is Endoscopy?
By introducing a medical tool through a small incision or a natural opening in the body, an endoscopy is a technique that enables your healthcare professional to inspect the body's internal organs. The tool utilized is an endoscope, which is a small, flexible tube with a connected camera, light, and occasionally a surgical tool. The camera sends a picture back onto a screen in the examination room, providing your doctor with a first-hand view of what's happening inside the body.
What is Therapeutic Endoscopy?
The term therapeutic endoscopy refers to an endoscopic treatment during which therapy is provided through the endoscope. In contrast, diagnostic endoscopy's sole purpose is to see a portion of the digestive, respiratory, or urinary tract to aid in diagnosis. According to the results, a procedure that begins as a diagnostic endoscopy may change to a therapeutic endoscopy, as in situations of upper gastrointestinal hemorrhage or the discovery of polyps during a colonoscopy. Endoscopic procedures can now be used to address conditions like bleeding, strictures, and polyps using a variety of techniques.
Therapeutic Endoscopy Advantages
One of the greatest diagnostic and therapeutic methods used by a gastroenterologist, a doctor who specializes in disorders of the GI tract, is endoscopy. It can also be used to treat illnesses that impact the GI tract; however, it is typically utilized to look into the reason for unexplained GI tract symptoms to aid in diagnosis.
An endoscopy is a diagnostic tool used by gastroenterologists to identify areas of internal bleeding as well as to diagnose inflammation, infections, ulcers, tumors, and polyps of the digestive tract. Additionally, they utilize it to collect samples of the intestinal lining (biopsy) to diagnose disorders like cancer and celiac disease.
It can be used as a therapeutic tool to release areas of blockage or stricture (dilation) areas. Using an endoscope, gastrointestinal bleeding can be controlled or avoided through banding, ablation, and cautery. The removal of colonic polyps is possible during a colonoscopy. It is a proven method for protecting persons who have precancerous colonic polyps from developing colon cancer. Endoscopy is quite safe and carries a very minimal risk of problems when carried out by medical professionals who have undergone gastrointestinal training.
Therapeutic Endoscopy Types
The detection of problems that may be difficult to spot with the endoscopic camera may be aided by the use of a specific endoscope that produces an ultrasonic image of your upper gastrointestinal tract.
Fine Needle Aspiration or Biopsy
Your gastroenterologist may collect biopsies of cysts or potentially malignant tissue during your endoscopy using a needle attachment and ultrasound guidance. The bile duct, liver, pancreas, and any other structures close to the upper or lower digestive tract can also be sampled using this method if necessary.
Your gastroenterologist can insert stents into your digestive tract to assist expand constricted regions using an endoscope. Stents can also be used with ultrasound guidance to drain fluid accumulations close to the GI tract.
Radiofrequency Ablation Therapy
Your gastroenterologist can eliminate scar tissue from your esophagus using an endoscope that has a unique attachment that emits high-frequency heat energy. Barrett's esophagus and esophageal strictures are both treated with this surgery.
Transoral Incisionless Fundoplication
The body's natural barrier to reflux, which prevents acid from exiting the stomach and entering the esophagus, is repaired or rebuilt using a specific device linked to the endoscope to treat gastroesophageal reflux disease. There are no incisions made with this non-surgical process, and everything is done from within.
Single Balloon Endoscopy
With this treatment, your gastroenterologist can penetrate your small intestine more fully than they could with an ordinary endoscope. This makes it possible to identify and treat diseases in the small intestine that are hidden during a routine upper endoscopy.
Endoscopic Mucosal Resection
Your gastroenterologist can excise polyps, precancerous growths, or even early-stage tumors from your upper and lower digestive system with this endoscopic treatment. Before the development of modern technology and surgical techniques, the bulk of these lesions could only be entirely removed from the inside by surgery.
Endoscopic Retrograde Cholangiopancreatography (ERCP)
Using the endoscopic camera and local X-rays, this kind of endoscopy aids your gastroenterologist in examining and diagnosing issues with your pancreas and bile ducts. As part of this surgery, you might receive treatment like bile duct stone removal or stent placement to keep blocked or narrowed channels open.
Esophageal dilation is a treatment that enables the esophagus's narrowed portion to be stretched out or widened.
Percutaneous Endoscopic Gastrostomy (PEG)
When a patient is unable to meet his or her nutritional requirements orally due to health problems, percutaneous endoscopic gastrostomy (PEG) is an endoscopic treatment in which a flexible tube is installed into the patient's stomach and/or small intestine to allow nutrition, fluids, and/or medication to transfer directly into the stomach or small intestine.
Condition Treated with Therapeutic Endoscopy
Upper gastrointestinal (GI) endoscopies for stomach-related disorders and colonoscopies for colon cancer screening are two of the more popular endoscopies; both are carried out by gastroenterologists because they specialize in the digestive system.
Your healthcare professional can examine the esophagus, stomach, and first section of the small intestines during an upper endoscopy for further investigation, possibly to evaluate symptoms like upper abdominal pain, identify the cause of suspected internal bleeding, or scan for malignancies. The endoscope is often inserted for this kind of endoscopy through the mouth and down into the abdomen.
Colonoscopies are frequently performed to identify and keep an eye on any alterations or abnormalities in the large intestine (colon). In this situation, the anus would be used to introduce the endoscope. For those who are older or have certain risk factors for colon cancer, colonoscopies are routinely utilized as a recommended screening method.
Other forms of endoscopy include the following:
- Arthroscopy. This process is used to identify and treat specific joint disorders, such as various forms of arthritis or excruciating knee or wrist problems. The endoscope is introduced through a very small skin incision, giving the medical professional immediate access to the problematic joint.
- Bronchoscopy. Lung disease may be diagnosed (and occasionally treated) with this approach. The endoscope is in this case placed into the mouth and down into the lungs' airways.
- Cystoscopy. Through this surgery, any abnormalities, bleeding, or obstructions in the bladder are found. The urethra, the anatomical passageway that leads up to the bladder, is where a medical professional will enter the endoscope.
If your healthcare professional needs to look into, confirm, or treat a suspected condition in a particular area, they will choose which form of endoscopy is best for you. For example, if you have unexplained symptoms like stomach pain, vomiting, or difficulty breathing or swallowing, your doctor may decide to use an endoscope to diagnose the problem.
The use of endoscopy for a biopsy may also be possible if there is a worry that you may have an illness like cancer. Or, a condition can be treated directly with endoscopy by having a polyp removed or a joint problem fixed.
Therapeutic Endoscopy Preparation
The specific technique will vary slightly depending on the sort of endoscopy you're getting and the reason for it when your healthcare professional establishes that you're a candidate for one. But for the majority of endoscopies, you can normally anticipate a similar procedure.
Endoscopies can be carried out in a hospital, an outpatient clinic, or a healthcare professional's office. If you have a potential underlying medical problem that would need special treatment, your healthcare practitioner will probably base their decision on where to treat you, at least in part.
Exact instructions will be given to you by your healthcare practitioner, and you must adhere to them for at least the day before the surgery. The majority of patients are instructed to fast for 12 hours before surgery. This is due to the possibility that body fluids or food could obstruct the endoscope's field of view.
Before the treatment, be sure to discuss whether and how to take any necessary daily drugs with your healthcare practitioner. Some of these medications may interact with the anesthetic being used or may cause a delay in healing.
For the doctor to see your intestines clearly during the colonoscopy, you should anticipate receiving a prescription-strength laxative that will thoroughly empty your bowels (you'll use the bathroom frequently).
Therapeutic Endoscopy Procedure
The goal of therapeutic endoscopy is to enhance the patient's quality of life and prognosis through a variety of endoscopic interventions that enable some lesions to be completely healed or others to be palliated. To access the lesion that has to be treated, a regular or special endoscope is inserted through the mouth or the anus. Depending on the sort of intervention, the length of the test varies substantially. The average duration is often a few minutes in the simplest circumstances and a few hours (rarely more than two hours) in the most complex. The great majority of these procedures are done as outpatient procedures. Although the methods differ, they always include inserting an endoscope into the mouth or anus until it reaches the lesion that needs to be treated. The patient is unconscious. Later, to treat the lesion, specialized instruments are inserted into the working channel of the endoscope under direct endoscopic vision or with the aid of X-rays or ultrasound.
Therapeutic Endoscopy Recovery
You will get sedative drugs via an IV after arriving at the medical center, which will make you feel at ease and sleepy throughout the surgery. As a result, you'll need a ride home afterward, and you should clear the rest of the day's schedule and enlist help if necessary for childcare or household tasks.
Some types of endoscopies can be completed in as little as 15-20 minutes. You can rest in a recovery room until the sedative drug has mostly gone off after it's over if you feel sleepy for several hours after it's over (due to the medication).
Your healthcare professional will provide you with after-care instructions on how and when to restart eating, drinking, and daily activities. After the surgery, some people experience no side effects, while others may feel pain or bloated and need to rest.
Depending on the type of endoscopy, a full recovery shouldn't take more than a few days. In a few days, if not sooner, your doctor should be able to discuss the endoscopy's findings with you.
Therapeutic Endoscopy Risks
You should be aware that while most endoscopic treatments are typically safe and seldom result in major consequences, there is always a chance of infection due to being in a hospital setting or an adverse event occurring either during or after the surgery.
Most endoscopies only result in minor complications. Any minor issues would, if anything, be discovered during the surgery or within a few days, and your medical staff would be able to handle them rapidly.
More serious consequences are less frequent, although they could result in bleeding, perforation of the bowel, or a rupture in the lining of the inner intestine. Additionally, there is always a risk of negative outcomes whenever an anesthetic is used. Before the treatment, be sure to go over your medical history and any particular concerns with your healthcare professional.
It's usually a good idea to notify your doctor if you experience any residual pain or if it worsens following the endoscopy. If you have any unexpected or severe symptoms, such as discomfort, bleeding, or vomiting blood, get immediate medical attention.
How Much Does Endoscopy Cost?
Endoscopies in the US typically cost $2,700 on average, although they can cost anywhere from $1,200 to $5,000. Whether you have the procedure done in an outpatient surgical center or an inpatient facility, such as a hospital, can have a significant impact on the cost of endoscopy.
Therapeutic endoscopy refers to an endoscopic procedure during which therapy is provided through the endoscope. In contrast, diagnostic endoscopy's sole purpose is to see a portion of the digestive, respiratory, or urinary tract to aid in diagnosis.