The word "endoscopy" is frequently used as though it refers to one test. In gastroenterology, however, several endoscopic techniques are available, and each answers a different clinical question.
Choosing an endoscopy specialist begins with determining which procedure, if any, is appropriate for the symptoms being investigated.
Upper GI Endoscopy
Upper gastrointestinal endoscopy, also called gastroscopy or EGD, examines the upper digestive tract.
The doctor can view the:
- Oesophagus
- Stomach
- First part of the small intestine
It may be considered when evaluating persistent upper abdominal symptoms, swallowing difficulty, gastrointestinal bleeding, recurrent vomiting or other clinically relevant problems.
Biopsies can be collected during the procedure when necessary.
Endoscopic Ultrasound
Endoscopic ultrasound, commonly known as EUS, combines endoscopy with ultrasound technology.
It can provide detailed images of the digestive tract and nearby structures. Depending on the indication, EUS may be useful in assessing abnormalities involving the pancreas, bile ducts, gastrointestinal wall or surrounding tissues.
It can also assist with tissue sampling in selected situations.
ERCP
Endoscopic retrograde cholangiopancreatography, or ERCP, is primarily used for specific conditions involving the bile and pancreatic ducts.
Unlike a routine diagnostic upper endoscopy, ERCP is often performed when an intervention may be required, such as managing certain bile duct stones or relieving an obstruction.
Because ERCP has specific indications and potential complications, it is not used as a routine investigation for ordinary acidity or stomach pain.
Capsule Endoscopy
Capsule endoscopy uses a small camera contained within a swallowable capsule to capture images as it passes through the gastrointestinal tract.
It can be particularly useful for examining areas of the small intestine that are difficult to reach with standard upper endoscopy or colonoscopy.
However, capsule endoscopy cannot perform a biopsy or treatment while images are being recorded.
Which Test Is Better?
There is no single "best" endoscopy.
The appropriate procedure depends on what needs to be examined. Upper endoscopy is useful for direct assessment of the oesophagus and stomach. EUS provides additional imaging of deeper and nearby structures. ERCP has an important therapeutic role in selected pancreatic and biliary disorders. Capsule endoscopy can provide information about the small bowel.
Using the wrong test simply because it sounds more advanced does not improve diagnosis.
Questions to Discuss With Your Gastroenterologist
Before undergoing an endoscopic procedure, patients can ask why the test is necessary, what information it is expected to provide and whether an alternative investigation is appropriate.
It is also useful to discuss preparation, sedation, medications, recovery and what happens if an abnormality is discovered.
For patients in Mira Road and neighbouring parts of the Mumbai metropolitan area, Dr Ravindra Surude provides gastroenterology evaluation for digestive conditions that may require endoscopic assessment.
The most important decision is not merely where to have an endoscopy. It is determining the correct procedure for the clinical problem being investigated.
