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GI Endoscopy Bronchoscopy

GI Endoscopy

What is gastrointestinal (GI) endoscopy?

GI endoscopy is a procedure in which a doctor uses an endoscope—a long, flexible tube with a camera—to see the lining of your GI tract. A gastroenterologist, surgeon, or other trained health care provider performs the procedure, most often while you receive light sedation. Your doctor may also call the procedure an EGD or esophagogastroduodenoscopy.

Why do doctors use GI endoscopy?

GI Endoscopy can help find the cause of unexplained symptoms, such as

  • persistent heartburn
  • bleeding
  • nausea and vomiting
  • pain
  • problems swallowing
  • unexplained weight loss

GI endoscopy can also find the cause of abnormal lab tests, such as

  • anemia
  • ​nutritional deficiencies

GI endoscopy can identify many different diseases

  • anemia
  • gastroesophageal reflux disease
  • ulcers
  • cancer
  • inflammation, or swelling
  • precancerous abnormalities
  • celiac disease​

During GI endoscopy, a doctor obtains biopsies by passing an instrument through the endoscope to obtain a small piece of tissue. Biopsies are needed to diagnose conditions such as

  • cancer
  • celiac disease
  • gastritis

How do I prepare for GI endoscopy?

Talk with your doctor

You should talk with your doctor about medical conditions you have and all prescribed and over-the-counter medicines, vitamins, and supplements you take, including

  • aspirin or medicines that contain aspirin
  • arthritis medicines
  • nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen
  • blood thinners
  • blood pressure medicines
  • diabetes medicines

Arrange for a ride home

For safety reasons, you can't drive for 24 hours after the procedure, as the sedatives used during the procedure need time to wear off. You will need to make plans for getting a ride home after the procedure.

Do not eat or drink before the procedure

The doctor needs to examine the lining of your upper GI tract during the procedure. If food or drink is in your upper GI tract when you have the procedure, the doctor will not be able to see this lining clearly. To make sure your upper GI tract is clear, the doctor will most often advise you not to eat, drink, smoke, or chew gum during the 8 hours before the procedure.

How do doctors perform an GI endoscopy?

A doctor performs an upper GI endoscopy in a hospital or an outpatient center. An intravenous (IV) needle will be placed in your arm to provide a sedative. Sedatives help you stay relaxed and comfortable during the procedure. In some cases, the procedure can be performed without sedation. You will be given a liquid anesthetic to gargle or spray anesthetic on the back of your throat. The anesthetic numbs your throat and calms the gag reflex. The health care staff will monitor your vital signsExternal NIH Link and keep you as comfortable as possible.

You’ll be asked to lie on your side on an exam table. The doctor will carefully feed the endoscope down your esophagus and into your stomach and duodenum.A small camera mounted on the endoscope will send a video image to a monitor, allowing close examination of the lining of your upper GI tract. The endoscope pumps air into your stomach and duodenum, making them easier to see.

Bronchoscopy

Bronchoscopy is an endoscopic technique of visualizing the inside of the airways for diagnostic and therapeutic purposes. An instrument (bronchoscope) is inserted into the airways, usually through the nose or mouth, or occasionally through a tracheostomy. This allows the practitioner to examine the patient's airways for abnormalities such as foreign bodies, bleeding, tumors, or inflammation. Specimens may be taken from inside the lungs. The construction of bronchoscopes ranges from rigid metal tubes with attached lighting devices to flexible optical fiber instruments with realtime video equipment.

Purposes

Diagnostic

  • To view abnormalities of the airway
  • To obtain tissue specimens of the lung in a variety of disorders. Specimens may be taken from inside the lungs by biopsy, bronchoalveolar lavage, or endobronchial brushing.
  • To evaluate a person who has bleeding in the lungs, possible lung cancer, a chronic cough, or sarcoidosis

Therapeutic

  • To remove secretions, blood, or foreign objects lodged in the airway
  • Laser resection of tumors or benign tracheal and bronchial strictures
  • Stent insertion to palliate extrinsic compression of the tracheobronchial lumen from either malignant or benign disease processes
  • Bronchoscopy is also employed in percutaneous tracheostomy
  • Tracheal intubation of patients with difficult airways is often performed using a flexible bronchoscope

Procedure

Bronchoscopy can be performed in a special room designated for such procedures, operating room, intensive care unit, or other location with resources for the management of airway emergencies. The patient will often be given antianxiety and antisecretory medications (to prevent oral secretions from obstructing the view), generally atropine, and sometimes an analgesic such as morphine. During the procedure, sedatives such as midazolam or propofol may be used. A local anesthetic is often given to anesthetise the mucous membranes of the pharynx, larynx, and trachea. The patient is monitored during the procedure with periodic blood pressure checks, continuous ECG monitoring of the heart, and pulse oximetry.

A flexible bronchoscope is inserted with the patient in a sitting or supine position. Once the bronchoscope is inserted into the upper airway, the vocal cords are inspected. The instrument is advanced to the trachea and further down into the bronchial system and each area is inspected as the bronchoscope passes. If an abnormality is discovered, it may be sampled, using a brush, a needle, or forceps. Specimen of lung tissue (transbronchial biopsy) may be sampled using a real-time x-ray (fluoroscopy) or an electromagnetic tracking system. Flexible bronchoscopy can also be performed on intubated patients, such as patients in intensive care. In this case, the instrument is inserted through an adapter connected to the tracheal tube.