Endoscopy (Gastrointestinal) – Procedure, Complications, Costs

What is an Endoscopy?

An endoscopy, sometimes referred to as a gastroscopy, is a procedure whereby a device known as an endoscope is inserted through the mouth to examine the interior of a the gastrointestinal tract (throat, food pipe, stomach and small intestine). This provides high definition video images in real time and any abnormalities in the gut can be identified and small samples of diseased tissue can be taken if necessary (biopsy).

Types of Endoscopy

There are three types of endoscopy, all of which perform a similar function.

• Upper gastrointestinal endoscopy which is the most commonly performed of the three and allows the doctor to reach up to the first part of the small intestine (duodenum).

• Double balloon endoscopy which can reach the last part of the small intestine (ileum) due to two inflatable devices which opens the lumen of the intestine and allows for the endoscope to travel through.

• Capsule endoscopy is a small device, less than 30 mm wide, that is swallowed. It is battery powered and transmits images to a recorder. The capsule will be passed out of the gut within 8 hours.

Endoscopic Procedure

An endoscopy does not require hospitalisation in most cases unless there is a risk of serious complications in patients with certain chronic diseases or known risk factors. Ideally you would have fasted from the night before or for at least 8 hours.

• You will be given a light sedation and placed on your side. The sedation helps to prevent gagging and limit any pain or discomfort caused by the procedure.
• A mouthpiece will be inserted to keep your mouth open and allow the endoscopic tube to be guided towards your throat..
• The entire procedure will take 10 to 15 minutes, sometime less, unless your doctor needs to perform a biopsy or remove a foreign object.

You cannot drive or return to work after the procedure so ensure that you have made the appropriate arrangements.

Complications

An endoscopy is a safe procedure and should be conducted by a gastroenterologist. Complications are rare and your doctor will take all the necessary precautions to ensure that any side effects will be minimised. Some of the complications that are reported include :

• Jaw pain after the procedure in a person with temporomandibular joint (TMJ) dysfunction (popping jaw).
• Aspiration pneumonia where the contents of the stomach enter the lungs and damage tissue. This is uncommon if you have fasted for 8 to 10 hours like your doctor advised.
• Perforation of the gut. This is rare if the procedure is conducted by a trained medical specialist.
• Abdominal pain. This may last for a few days but if the pain is getting worse over time or if you are vomiting blood or passing blood in your stool then you need to see a doctor immediately.
• Reduced heart and lung activity due to sedation. This is uncommon.

Costs of an Endoscopy

The costs of the procedure may be covered in full or partly by most medical aids in South Africa. Always speak to your medical aid about the costs to you for undergoing this procedure. Most medical aids do not allow you to be hospitalised solely for the purpose of an endoscopy. However, if you are already in hospital, the costs of an endoscopy will be covered as part of the in-hospital cost but this depends on your medical aid and individual plan.

The price of an endoscopy may vary depending on the doctor’s fees (medical aid or private rates) and the cost of using the equipment owned by a hospital or clinic. This may mean that an upper gastrointestinal endoscopy may cost between R1,000 to R4,000 (2010) but the final cost could vary depending on the individual practitioner, clinic or hospital.

A diagnostic gastrointestinal endoscopy should not be confused with gastrointestinal endoscopic surgery. The latter is significantly more expensive.