Meet Dr Carl Streicher, a specialist surgeon at Mediclinic Bloemfontein. After qualifying from the University of the Free State, he completed a year-long laparoscopic surgery fellowship at the University of Surrey and the Royal Surrey County Hospital in Guildford. He’s passionate about laparoscopic surgery and performing endoscopy-assisted interventions to treat problems of the pancreatic and bile ducts.
Why would my doctor opt to perform an endoscopy?
An endoscope is a flexible tube with a camera lens and a small light source attached to the front tip that is threaded into your gastro-intestinal tract. Images of the intestines are then projected back to the doctor. It is often the easiest way to find the cause of gastro-intestinal problems. An endoscope also contains a channel through which instruments can be passed for performing small procedures such as biopsies or sutures.
What is the difference between a gastroscopy and a colonoscopy?
A gastroscopy is performed to examine the upper part of your gastro-intestinal tract. Your doctor will pass a gastroscope through your mouth, down your oesophagus towards your stomach and then into the first part of the small bowel. A gastroscopy is often used to diagnose the cause of upper-abdominal pain, indigestion, vomiting or heartburn, or to stop acute bleeding in the stomach or early part of the small bowel. During a colonoscopy, a colonoscope is passed through the anus into the colon to examine the entire length of your colon. A colonoscopy is most often used to search for the cause of lower-abdominal pain or bleeding.
An endoscopic examination sounds daunting. What should I expect during the procedure?
Endoscopic examinations are routinely performed using sedation, so you won’t be awake or feel any discomfort during the procedure. A drip is used to deliver the sedation intravenously. A gastroscopy usually takes about 15 minutes, and a colonoscopy about half-an-hour. After a colonoscopy, you may feel very bloated, which could cause discomfort. However, once the air in the colon is passed, the pain will settle quickly.
How should I prepare for a gastroscopy or a colonoscopy?
For a gastroscopy, the stomach needs to be empty, so you won’t be allowed to eat or drink anything for about eight hours before the procedure. For a colonoscopy, the colon needs to be clean. You will have to take a special laxative and bowel cleansing preparation on the day before the procedure. Although this may be uncomfortable, it is important to follow the instructions for the bowel preparation carefully. If the colon is not adequately clean, it will be very unpleasant to perform the procedure and the visualisation will not be optimal.
How is the scope cleaned between examinations?
The endoscope itself is cleaned between procedures in an endoscope-cleaning machine using specifically formulated disinfectants. Instruments that cannot be cleaned properly, for example biopsy forceps, are disposed of.
Can endoscopy be used for any other examinations or procedures?
Endoscopy has advanced dramatically over the past few years. More complex procedures can be performed with and through an endoscope. For example, a duodenoscope can be used to perform procedures along the bile duct or pancreatic duct, rendering potentially serious conventional surgery unnecessary. Endoscopy also aids in the removal of small growths from the intestines, or is used to stop intestinal bleeding or insert stents to keep narrowed passages open. During surgery, endoscopes can be used to locate a lesion in a hard-to-see place, to assess the outcome of a surgical procedure or examine tissue for bleeding. An endoscope with an ultrasound probe, which allows a view through the wall of the intestines can be used for fluid collections or biopsies from areas beyond the intestinal wall.