Endoscopic Procedures

A colonoscopy is used to examine the colon and rectum for abnormalities that may indicate disease. It is recommended in several situations, ranging from routine cancer screening to the investigation of ongoing digestive symptoms.

Colorectal cancer screening: Conducted to detect polyps, abnormal growths, or early signs of cancer. It is typically recommended for individuals over 50 or those at higher risk due to family history or other factors.

Evaluation of symptoms: Advised for individuals experiencing persistent digestive issues such as rectal bleeding, unexplained changes in bowel habits, prolonged diarrhoea, constipation, or recurrent abdominal pain.

Polyp and cancer surveillance: Recommended for those with a history of colorectal polyps, previous colorectal cancer, or chronic conditions such as inflammatory bowel disease (IBD), which increase the risk of developing colorectal abnormalities.

A colonoscopy is typically performed as a day procedure and involves a series of steps to ensure a thorough examination of the colon.

Sedation: A sedative is administered to help patients relax and remain comfortable throughout the procedure, ensuring a smooth and thorough examination of the colon.

Insertion of the colonoscope: The scope is carefully inserted through the rectum and advanced through the colon. Air or carbon dioxide is introduced to expand the colon, improving visibility.

Examination and biopsy: The doctor examines the colon lining for abnormalities, removes any detected polyps, and collects tissue samples if further analysis is required.

Completion: The scope is gradually withdrawn, and the procedure typically takes 30 to 45 minutes, depending on whether polyps need to be removed or biopsies taken.

Gastroscopy is used to investigate symptoms affecting the upper digestive tract and to detect or treat certain conditions. It is recommended in the following situations:

Persistent acid reflux or heartburn: Used to evaluate symptoms of gastro-oesophageal reflux disease (GORD) and identify conditions such as oesophagitis or Barrett’s oesophagus, which can increase the risk of further complications.

Swallowing difficulties: Used to evaluate structural abnormalities, inflammation, or narrowing of the oesophagus that may cause difficulty swallowing (dysphagia). In some cases, the procedure may include treatment to widen the oesophagus.

Unexplained stomach pain or bloating: Helps identify underlying causes of upper abdominal discomfort, such as gastritis, stomach ulcers, or other disorders affecting digestion.

Gastrointestinal bleeding: Used to locate the source of bleeding in the digestive tract, which may be caused by ulcers, abnormal blood vessels, or small tears in the oesophagus or stomach lining.

H. pylori infection detection: Biopsy samples may be taken to test for Helicobacter pylori, a bacterial infection associated with stomach ulcers and an increased risk of stomach cancer.

A gastroscopy is typically performed as an outpatient procedure and involves several steps to ensure a thorough examination.

Sedation or throat spray: A mild sedative may be given to help patients relax, or a numbing throat spray may be used to reduce discomfort when swallowing the scope.

Insertion of the gastroscope: The flexible tube is gently passed through the mouth and guided down into the oesophagus, stomach, and duodenum. Air is introduced to expand the digestive tract, improving visibility.

Examination and biopsy: The doctor inspects the lining of the upper digestive tract for abnormalities. If necessary, small tissue samples (biopsies) are taken for further analysis, and bleeding areas may be treated during the procedure.

Completion: The gastroscope is carefully removed, and the procedure typically lasts 15 to 20 minutes, depending on whether additional biopsies or treatments are required.

EMR is used in cases where standard endoscopic removal methods are insufficient. It is typically recommended for:

Removal of large polyps: Applied when polyps detected during a colonoscopy or gastroscopy are too large for standard polyp removal and require a more specialised approach to ensure complete and safe extraction.

Early-stage cancer treatment: Suitable for certain early-stage cancers in the oesophagus, stomach, or colon, provided the abnormal cells are confined to the surface layer of the digestive tract and have not invaded deeper tissues.

Precancerous lesion removal: Used to extract high-risk lesions that have the potential to develop into cancer, particularly in individuals with a history of abnormal tissue growth in the digestive tract. Early removal helps reduce the likelihood of progression to more advanced disease.

EMR is typically performed as an outpatient procedure and follows a structured process to ensure effective removal of abnormal tissue.

Sedation: A sedative is administered to help patients remain relaxed and comfortable throughout the procedure. This also allows for a smoother and more controlled removal process.

Injection of saline: A small amount of liquid is injected beneath the lesion to separate it from the deeper layers of tissue. This technique creates a protective cushion, reducing the risk of damage to the surrounding structures.

Tissue removal: A specialised snare or cutting device is used to excise the lesion. The extracted tissue is sent for laboratory analysis to determine whether further treatment or monitoring is necessary.

Completion: The treated area is carefully assessed to ensure that all abnormal tissue has been successfully removed. The procedure typically lasts 30 to 60 minutes, depending on the size and location of the lesion.