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Abdomen was termed as the "Pandora's box" for one did not know as to what was going on inside. The advent of fibreoptic endoscopy revolutionized the way the gastrointestinal tract could be viewed live. Organs that can be visualized by endoscopy include the esophagus, stomach, duodenum, colon, pancreas, and gallbladder. The pancreas and gallbladder can only be seen by a combination of highly specialized endoscopic techniques performed by gastroenterologists using x-ray guidance.

The term endoscopy refers to the inspection of the digestive tract (esophagus, stomach, duodenum, colon) by a fibreoptic flexible instument attached to a cold light source. In another variation of the technology, video endoscopes utilize a video chip and strobe light so as to capture an image which is then displayed on a video monitor. This allows careful visual inspection of the entire lining surface of the organ being examined. This is most frequently performed in order to diagnose luminal GI disease presenting with abdominal pain, heartburn and bleeding. Common lesions diagnosed with upper GI endoscopy include ulcers, esophagitis and cancer. Inspection of the lower digestive tract is called colonoscopy. This is most frequently utilized to diagnose colitis, polyps (small growths within the colon that may become cancerous over time) and cancers. Apart from its diagnostic value endoscopy is also used as a therapeutic modality especially in treatment of GI bleeding. Colonoscopy and upper endoscopy may also be suggested in order to perform laser therapy, dilation of strictures (narrowings) within the esophagus, and the removal of colon polyps or precancerous growths.

One further examination is called Endoscopic Retrograde CholangioPancreatography, or ERCP. This highly technical procedure is used to remove gallstones stuck between the gallbladder and intestines, as well as to aid in the diagnosis of many diseases of the pancreas. This procedure is performed with the help of sequential x-rays.

Generally all these endoscopic procedures are performed with light sedation, so that there is minimal discomfort. The preparation for these examinations has improved tremendously, and is no longer difficult. Endoscopy is safe and easy to perform in the hands of trained gastroenterologists and many a times obviates the need for a surgical procedure.

Dr. Sharat C. Misra
MD, DM (Gastroenterology)
Consultant in Gastroenterology & Liver Diseases

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