Endoscopy Purpose: Diagnosis, Treatment and Screening

An endoscopy is a multipurpose procedure in which your doctor uses specialized tool to view the various part of your internal organs, especially the digestive tract (gastrointestinal tract) commonly referred to GI tract. Endoscopy allows the doctor to view the internal components without having to make a large invasion incision. Endoscopy can be used for diagnosis, screening and treatment of digestive system problems. Endoscopy is a generic term that can be diagnosis of upper tract or lower tract.

There are generally two types of endoscopy procedures. Lower endoscopy is also known as Colonoscopy. Used to visualize lower GI tract from the anus to the proximal colon. Another type is called the upper endoscopy, also known as Esophagogastroduodenoscopy (EGD). Endoscopy is safe and generally comfortable compared to other more invasive procedures and has been the gold standard for diagnosis, screening and treatment for many conditions.

Endoscopy for Screening

Endoscopy play a huge role in screening for premalignant conditions like polyps. Polyps can transform into cancer if left untreated. Screening for colonic polyps and removal before they become cancerous is one of the main reasons why doctors encourage patients to go through colonoscopy screening especially in those with family history of colon cancer.

All individuals without any family history of colon cancer are recommended to perform a colonoscopy screening at the age of 50 years old and rescreened every 10 years. Individuals with family history of colon cancer should be screened 10 years before the age at which the family member is diagnosed with colon cancer or at 50 years old depending on which comes first.

Sometimes, patient with chronic gastrointestinal tract disease like ulcerative colitis, chron’s disease affecting the colon are at increased risk for colon cancer. Screening should also begin every 1-2 years if a patient has inflammatory bowel disease (especially UC and colon affecting chron’s disease) for 8-10 years.

Genetically predisposed mutations on tumor suppressor genes can further increase your chance of colon cancer. Common genetic predisposed colon cancer gene include HNPCC and FAP.  These conditions should be screening even earlier and more frequently. HNPCC (Hereditary Non-Polyposis Colorectal Cancer) should be screened from 25 years old onwards every 1-2 years. FAP (Familial Adenomatous Polyposis) should be screened with flexible sigmoidoscopy from 12 years old every 1-2 years. The reason is because these patients almost always have polyps and many become cancerous by the age of 50 years old. Therefore it is very important to schedule a colonoscopy to make sure you catch them early before they become difficult to treat.

Diagnosis of disease with Endoscopy

Endoscopy has many role in diagnosis of disease. One the most common gastrointestinal conditions that require endoscopy include peptic ulcer disease. Other upper GI diseases like gastritis, helicobacter pylori infection, gastric cancer, gastric polyps, esophageal cancer, esophagitis, GERD and schatski rings also diagnosed with upper endoscopy called EGD. Biopsy during endoscopy has made endoscopy the gold standard for definitive diagnosis in many conditions. Lower gastrointestinal disease that are diagnosed with lower endoscopy (also known as colonoscopy) include colon polyps, diverticulosis, hemorrhoids, angiodysplasia and inflammatory bowel disease. The non-invasive nature of endoscopy has really changes the way GI specialist (gastroenterologist) diagnose digestive system diseases.

Treatment of diseases with Endoscopy

Endoscopy can be used in treatment of several GI related illness. The most common few treatment include: stopping bleedings; removal of gall stones that lodged in common bile duct with a procedure called (ERCP); removal of polyps (polypectomy). Removal of foreign body can also be done with the help of endoscopy in some cases.



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