Frequently Asked QuestionsFrequently asked questions about endoscopy
An endoscopy is a procedure in which a veterinarian places a lighted tube-like instrument into a natural body opening such as the mouth. The instrument has a video camera for viewing with a high degree of precision and magnification. It can be used to take still pictures of abnormalities for review and documentation in the medical record. Instruments can also be passed thorough the tube to take specimens for further analysis. Other instruments such as snares and balloons can be used to remove foreign bodies or treat abnormalities that are seen.
What are the benefits of endoscopy?
What are the common uses of this procedure in veterinary medicine? Endoscopy is commonly used as an alternative to surgery to examine and obtain samples from the esophagus, stomach, small intestine, colon, urinary bladder and nasal cavity. It is also used to non-surgically remove swallowed foreign bodies from the GI tract. Endoscopy is a very safe procedure, especially relative to traditional surgery. Like any medical procedure, complications are possible. Accidental perforation of the intestinal tract during endoscopy is the most serious and rarest complication. This occurs in only about one out of 1000 procedures and requires surgery to repair when it happens. In endoscopy of the nose (rhinoscopy) some bleeding from the nose is expected as a consequence of the examination. In most cases the bleeding is minor and stops spontaneously within minutes. In rare cases, mostly where fungal infections or tumors of the nose are encountered, this bleeding requires medical intervention to control. With endoscopy of the urinary tract (urethroscopy and cystoscopy), urinary tract infection is a possible complication. Patients undergoing these procedures are routinely treated with antibiotics for several days following the procedure to prevent infection. How does the cost for endoscopy compare to traditional, open surgery? In most cases the cost for an endoscopic procedure is less than a surgery to accomplish the same result. Endoscopic procedures are less invasive and generally shorter than surgery. Hospital stays are shorter and there are no incisions, a common cause of complications. There is no post-surgical discomfort, so the need for medication is minimized. Should I just skip other testing and go directly to endoscopy to diagnose my pet's problem? It is important to rule
out other diseases such as parasitism before endoscopy. A fecal flotation for
worms is a good idea. Parasites such as whipworms or giardia may be difficult
to detect so a short course of treatment to rule out their presence might also
be a good idea, especially in the dog. These are examples of diseases that cannot be diagnosed by the endoscopic examination. It is important to rule out other diseases that could more easily be diagnosed with a fecal exam or blood test before resorting to endoscopy. Will my pet be painful or sick after the endoscopic procedure? One of the advantages of endoscopy is the rapid recovery and the lack of discomfort compared to traditional surgical procedures. In most cases your pet will not experience any discomfort after the procedure and will behave normally as soon as they have recovered fully from anesthesia, usually by the next morning. What are the limitations of endoscopy? Not all foreign bodies can be removed endoscopically and there is no guarantee that a specific foreign body can be removed in this manner. Not all areas of the small intestine can be reached with the available endoscopes. Some diseases can require a full-thickness biopsy of the intestinal tract to diagnose, necessitating surgical biopsy. When should I ask for an endoscopic procedure?
Endoscopy can be useful to remove foreign bodies from the nose, the lungs and the ears and allow diagnostic biopsy samples to be taken from these and other areas without the need for surgery. The goal for using endoscopes for surgery is to reduce the tissue trauma and body's response to the injury of traditional (or open) surgery. As compared to minimally invasive surgery, traditional surgery requires much longer incisions and the stretching of incisions with retractors. Controlled studies in patients and laboratory animals have found decreased stress response in patients operated endoscopically as compared to traditional surgery.
How long will the appointment take? This can vary depending on the nature of the problem your pet for which your pet is examined. Most endoscopy exams require approximately 1 ½ hours once your pet is ready for the exam. Because endoscopy procedures require general anesthesia, your pet will need time in the hospital to recover before going home. Most pets will go home the same day. What
is Inflammatory Bowel Disease (IBD)? Inflammatory bowel disease (IBD) refers to the condition that results when cells involved in inflammation and immune response are called into the lining of the GI tract. This infiltration thickens the bowel lining and interferes with absorption and motility (the ability of the bowel to contract and move food). With abnormal ability to contract and abnormal ability to absorb, the bowel's function is disrupted. Chronic vomiting results if the infiltration is in the stomach or higher areas of the small intestine. A watery diarrhea with weight loss results if the infiltration is in the lower small intestine. A mucous diarrhea with fresh blood (colitis) results if the infiltration occurs in the large intestine. Of course, the entire tract from top to bottom may be involved. Many people confuse inflammatory bowel disease with irritable bowel syndrome, a stress-related diarrhea problem. Treatment for IBS is aimed at stress; it is a completely different condition from IBD. Is it at all reasonable to just try treatment and skip the expensive diagnostics for IBD? The problem with the prednisone trial involves the possibility of intestinal lymphosarcoma (also called lymphoma). This is a type of cancer that produces chronic diarrhea or vomiting just as inflammatory bowel disease can. Lymphoma is temporarily responsive to prednisone but the response is short-lived. Exposure to prednisone will make the lymphoma much more difficult to diagnose should biopsies be obtained later. Plus exposure to prednisone can lead to resistance to other medications. (This is less of a problem for cats, but in dogs even a few days of prednisone can make a lasting remission impossible to achieve.) In short, if one tries prednisone without confirming a diagnosis, harm can be caused should a lymphoma be present instead of inflammatory bowel disease. Colitis: Inflammation of the large bowel. Colon: The part of the large bowel between the end of the small intestine (the ileum, part of the small bowel) and the rectum Duodenum: The first portion of the small intestine after leaving the stomach. The stomach empties into the duodenum Ileum: The lower half of the small bowel, which joins up with the colon Malignant: Cancerous Benign:
Non cancerous. Polyp: An overgrowth
of tissue projecting into the bowel cavity which may be benign or malignant. Gastritis: Inflammation
of the stomach, especially the mucous membrane lining. Esophageal reflux: The back flow of acid contents of the stomach into the esophagus. |
© 2006-2007 All rights reserved
Chris D. Miller, D.V.M.