Camera Tests: Endoscopy and Scopes

Endoscopy means looking inside the body with a specialised instrument. Common camera tests use a flexible scope passed through the mouth, nose, bottom or urethra. They show internal surfaces and can collect samples, but they do not replace every scan or prove a diagnosis alone.

What endoscopy means Endoscopy means examining an internal space or surface using a specialised viewing instrument. The instrument is called an endoscope. Many common endoscopes are thin and flexible. Others are rigid, and some procedures use a small incision rather than a natural body opening. This lesson focuses on common scopes passed through the digestive tract, airways or urinary tract. The trained professional performing the procedure is called an endoscopist. Different scopes examine different areas A gastroscopy examines the oesophagus, stomach and duodenum. The duodenum is the first part of the small intestine. The gastroscope usually passes through the mouth. Some services can use a thinner scope through the nose for selected examinations. A colonoscopy passes through the bottom to examine the rectum and colon. The endoscopist may also inspect the end of the small intestine when this is possible and relevant. A bronchoscopy passes through the nose or mouth to examine the trachea and bronchi. It can also collect fluid, cells or tissue from the airways. A cystoscopy passes through the urethra to examine the urethra and bladder. Flexible and rigid cystoscopes are used for different purposes. Endoscopy and imaging answer different questions An endoscope gives a direct view of the surface lining and the open passage inside an organ. It can show ulcers, inflammation, bleeding, narrowing or a polyp. A scan can show the organ wall, surrounding tissues and areas beyond the scope's reach. CT, MRI, ultrasound and endoscopy can therefore provide complementary information. Endoscopy is not automatically more accurate than imaging. The best test depends on the suspected condition, body area, urgency and information needed. A visible abnormality does not identify its cause by appearance alone. A normal looking examination also does not exclude every condition. Some disease is microscopic, and some abnormalities can be missed because of poor preparation, incomplete examination, folds, narrowing or technical limitations. Looking, sampling and treating A diagnostic endoscopy mainly gathers information. The endoscopist may take photographs, washings, brush samples or a biopsy. A biopsy is a small tissue sample sent for laboratory examination. The visual finding and the biopsy result provide different information. Samples may sometimes be taken from lining that looks normal because important changes can be microscopic. Results usually arrive later rather than during the procedure. A therapeutic endoscopy includes treatment. Examples include removing a polyp, controlling bleeding, widening a narrowing, placing a stent or removing a foreign object. Not every endoscopy allows every intervention. The planned possibilities, benefits, risks and reasonable alternatives should be discussed during consent. Preparation is procedure specific Preparation instructions depend on the scope, the planned intervention and the person's health. Follow the instructions supplied by the endoscopy service rather than applying one general rule. Fasting before gastroscopy can improve the view. Fasting before gastroscopy or bronchoscopy also reduces the risk of stomach contents entering the lungs. Exact food and drink times vary between procedures and services. Bowel preparation uses diet instructions and laxatives to clear the colon before colonoscopy. Inadequate preparation can hide abnormalities, prevent completion or require another procedure. Bowel preparation can cause frequent diarrhoea, dehydration or changes in body salts. Drink the permitted fluids and follow the service's instructions carefully. Some medicines need an individual plan. Blood thinning medicines, diabetes treatment, iron tablets and medicines affecting constipation may require particular instructions. Do not stop or alter a prescribed medicine independently. Contact the endoscopy service when the medicine instructions are missing or unclear. Comfort, anaesthesia and sedation differ Options may include local anaesthetic spray, pain relief, gas and air, conscious sedation, deeper sedation or general anaesthesia. The available choices depend on the procedure and service. Conscious sedation usually makes a person relaxed and drowsy without making them fully unconscious. Memory of the procedure varies, so amnesia is not guaranteed. Some gastrointestinal endoscopies can be performed without sedation. Shared decisions should consider the person's preferences, health, expected discomfort and procedure complexity. Sedation can affect breathing, blood pressure, judgement and coordination. Staff monitor the person and provide recovery instructions after the procedure. Endoscopy has limitations and risks Temporary bloating, cramps, sore throat or mild discomfort can occur, depending on the procedure. Small amounts of bleeding may follow some biopsies or polyp removal. Less common complications include significant bleeding, infection, a tear or perforation and reactions to sedation. Risk is generally higher when treatment is performed than during simple looking. Bronchoscopy has additional risks, including low oxygen levels, significant airway bleeding and a collapsed lung after selected biopsy techniques. The clinical team assesses these risks before proceeding. Risk is not identical for everyone. Age, heart or lung disease, pregnancy, medicines and the intended intervention can change the plan. Colonoscopy and bowel cancer screening In the NHS bowel cancer screening programme in England, the first test is a home faecal immunochemical test, called FIT. It checks stool for small amounts of blood. When blood is found at or above the screening threshold, the person is offered an assessment to discuss colonoscopy. The FIT result does not diagnose cancer or identify the bleeding source. Colonoscopy can then inspect the bowel lining and remove some polyps or take a biopsy. CT colonography may be considered when colonoscopy is unsuitable or incomplete. Results and aftercare The endoscopist may explain the visual findings soon after the procedure. Laboratory results from a biopsy, brushing or fluid sample take longer. The report should state what area was examined, whether the procedure was complete and whether preparation limited the view. Follow up depends on the findings and any laboratory results. If you had sedation, follow the discharge rules about an escort, driving, alcohol, machinery and important decisions. These restrictions commonly last 24 hours, but your own instructions take priority. Follow the procedure specific discharge advice. Contact the endoscopy service or NHS 111 for fever, persistent vomiting, worsening breathlessness, heavy or increasing bleeding, or severe or worsening chest or abdominal pain. Call 999 for severe breathing difficulty, collapse, vomiting blood or heavy ongoing bleeding with faintness. Do not wait to interpret the endoscopy report yourself. This lesson explains general endoscopy principles. It cannot determine which procedure, preparation, sedation or follow up is appropriate for an individual person.

Endoscopy directly examines a selected internal surface and may collect samples or provide treatment. It complements rather than replaces imaging, and its meaning depends on preparation, completeness, pathology results and clinical context.