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How doctors look at your internal organs

How doctors look at your internal organs

I just turned 50 recently. I was told that after age 50, it is better to go through an endoscopy check-up to detect bowel cancer early. What is an endoscopy?

An endoscopy is a procedure in which the doctor (usually a gastroenterologist or a surgeon) uses an endoscope to view, and even operate, on the internal organs or tissues in your body without having to make large surgical incisions on your skin and flesh to access the said internal organ.

An endoscope is a general term for the instrument. There are many types of endoscopes, depending on the organ the doctor is trying to view.

It is usually a long, thin, flexible and very sophisticated tube, with an attached camera to allow the doctor to view the organ involved.

The tube will also allow the use of scissors and forceps to biopsy or operate on your internal organs. Therefore, an endoscope can be both an instrument of diagnosis and treatment.

Before you think that endoscopy is a new procedure, it is not – the first endoscope was designed in 1806.

Oh! What types of endoscopes are there?

An endoscope is named after the anatomical tract it is investigating.

These are the different types of endoscopes:

• Gastrointestinal tract: To view and treat your oesophagus (the tube that connects the pharynx to the stomach), stomach and duodenum.

This endoscope will be known as oesophagogastroduodenoscopy, or OGDS for short.

Your small intestine will be viewed via enteroscopy, which is an even longer tube.

Your large intestine/colon will be viewed via colonoscopy or sigmoidoscopy.

Your rectum can be viewed via rectoscopy, and anus via anoscopy.

• Respiratory tract: Your nose is viewed by an ENT (ear, nose and throat) surgeon using rhinoscopy.

Your lower respiratory tract, meaning bronchus, can be viewed via bronchoscopy by a respiratory physician.

• Ear: Otoscopy is done by an ENT surgeon.

• Urinary tract: Cystoscopy is done by a urologist.

• Female reproductive tract (gynoscopy): These procedures are usually done by a gynaecologist – colposcopy (cervix), hysteroscopy (uterus) and falloposcopy (fallopian tubes).

• The interior of a joint is viewed via arthroscopy by an orthopaedic surgeon.

• The organs of the chest can also be viewed via thoracoscopy and mediastinoscopy by a cardiopulmonary surgeon.

Wow. I didn’t know that there are so many types of endoscopy. I’m interested in the one I’m going for. I believe it is called OGDS and colonoscopy on the piece of paper they gave me during my appointment.

Yes. These two are included in many executive screening test packages these days, and are especially recommended for people over 50 years of age.

The OGDS is usually to screen for stomach ulcers, take a sample to test for Helicobacter pylori from the stomach lining (the cause for most stomach and duodenal ulcers) and to patch up any ulcer if needed.

The colonoscopy usually screens for any abnormal growth that could be colorectal cancer, or polyps or diverticuli (outpouches from our colon that are not cancerous).

If there is a polyp, the gastroenterologist will snip it off and send for biopsy. Most polyps are usually not cancerous.

Depending on what the doctor finds, he or she will recommend you to come for another OGDS/colonoscopy in one, three or five years’ time.

Naturally, the less they see in your colon, the least frequently you will have to follow up. And if you do have colorectal cancer, then thank goodness you caught it early!

I heard the OGDS and colonoscopy procedures are very painful. Is this true? This is the main point preventing me from undergoing them.

Not at all. You will be sedated.

The degree of sedation depends on which hospital you go to. Some private hospitals will give you general anaesthesia for the procedure.

You actually won’t feel much pain even if you are awake, but it is uncomfortable.

What about the solutions I have to drink for preparation? I’m alarmed at the thought of them.

You will be given a polyethylene glycol (PEG) and electrolytes solution to clear your bowels one day prior to the procedure.

Depending on the solution, you will be asked to take only light and clear foods on the day prior.

Then you will be asked to forgo food after a certain time (such as 4pm) and drink many litres of the solution to clear your bowels (not all at once, thank goodness).

As the solution does not get absorbed into your bloodstream, you will empty your bowels of the solution – and everything else.

Your bowels should be cleared by the next morning, ready for the procedure.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, e-mail starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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