The exploration of the digestive tract is very important to detect any abnormality that may be affecting the patient’s daily life. Dr. Matas, expert in Digestive System, talks to us about the main diagnostic tests used to analyze the inside of the digestive tract.
Digestive endoscopy is the main diagnostic test for the exploration of the digestive tract. It consists of analyzing the interior of the digestive tract by directly visualizing it through a television monitor, which picks up the image from a camera located at the tip of the endoscope, a flexible tube that is introduced through the mouth in the case of gastroscopy or through the anus if a colonoscopy is performed. These tubes have several channels through which air can be insufflated or aspirated and forceps can be introduced to allow the taking of biopsy samples to study a certain tissue, as well as to remove polyps and other outgrowth lesions, both processes being completely painless.
Indications for endoscopy
Endoscopy is indicated as a complementary test in the diagnosis of anomalies or problems of the digestive tract, such as tumors, malformations, hemorrhages, polyps, gastroesophageal reflux, celiac disease, problems in the absorption of food, poor digestion of food, study of chronic diarrhea or suspicion of a gastric or duodenal ulcer, among others.
In addition, endoscopy makes it possible to perform “surgical interventions” inside the digestive tract, take tissue biopsies, remove foreign bodies or perform sutures, reducing the possibility of complications and avoiding the need for hospitalization.
Pre-diet for gastroscopy and colonoscopy
To perform a gastroscopy, also known as oral panendoscopy, to visualize the esophagus, stomach and the beginning of the duodenum, it is only necessary to fast for 8 hours. This is enough to ensure that this part of the digestive tract is free of food and can be seen clearly. Before starting the gastroscopy, vomiting reflexes can be reduced by applying a local anesthetic which is generally administered by means of a lidocaine spray in the throat.
Colonoscopy requires more preparation beforehand: in addition to fasting, as the colon or large intestine needs to be cleaned as perfectly as possible, the patient must follow a low-residue diet for a few days prior to the examination, as well as take a bowel cleansing solution. Sometimes it is even necessary to apply a cleansing enema if the stool is not clean enough.
Duration of gastroscopy and colonoscopy
Gastroscopy is an exploration of average duration of about 5-15 minutes, although when it is required to take biopsies or perform some other intervention such as removing a polyp can be longer, about 10-30 minutes.
Total colonoscopy is an exploration of the entire colon, from the anus to the cecum or appendicular area, and sometimes it is even necessary to explore the last part of the small intestine called the terminal ileum. Therefore, it may require a very variable time, from 15 to 60 minutes depending on the characteristics of the colon and the experience of the digestive system specialist who performs the exploration.
Are gastroscopy and colonoscopy painful?
Gastroscopy is generally well accepted once performed, although it has a certain reputation of being very uncomfortable. The local anesthesia administered to the throat is usually enough to make it quite bearable, since it is not a painful exploration and does not present the discomfort of the passage of an endoscope down the throat, which is an area with many reflexes. As the path it follows is the same as the food, the airway is free and you can breathe freely through the nose, mouth or both. The gastroscope is approximately one meter long and the colonoscope is between 1.5 and 1.8 meters long. There are also shorter colonoscopes, about 60 cms, which are called sigmoidoscopes, but they are hardly used nowadays.
Total colonoscopy, unlike gastroscopy, is an uncomfortable and painful exploration due to the insufflation of air and the tractions produced by the endoscope. For this reason, in recent years many Digestive Services have adopted sedation or mild general anesthesia as a formula to avoid discomfort.
Currently, the practice of sedation in endoscopies is the norm, except in exceptions indicated by the doctor prescribing the test or at the request of the patient himself.
Risks after gastroscopy or colonoscopy
Both gastroscopy and colonoscopy are very safe explorations in the hands of good specialists, and there is only a risk of complications (generally perforations) in very exceptional cases with inexperienced professionals.
After the end of the examinations it is not necessary to follow any type of recommendation, except for the one stipulated by the sedation and in the case of any therapeutic intervention, taking into account each patient.
Regarding the medical material, once the endoscopic exploration is finished, the endoscopes follow an intense cleaning and sterilization process in order to avoid the transmission of diseases.