The gastroenterology examination procedure: steps and information

Quick answer: The gastroenterological examination starts with a thorough consultation with a specialist and the taking of a medical history. This is followed by the necessary diagnostic procedures, most often gastroscopy or colonoscopy. At Endomedix centres, for professional reasons, these procedures are carried out exclusively under deep anaesthesia, completely painless, instead of anaesthesia, guaranteeing maximum accuracy of the examination and patient comfort.

Gastrointestinal complaints such as persistent abdominal pain, bloating, altered bowel movements or heartburn can significantly reduce quality of life. Many people delay seeking medical help because they fear discomfort and unknown interventions. However, modern medicine and the high professional protocols of Endomedix now allow even the most complex diagnostic procedures to be carried out without fear or pain.

Gastroenterology deals with diseases of the digestive tract. It includes the investigation and treatment of diseases of the oesophagus, stomach, small and large intestine, liver, bile and pancreas. Accurate diagnosis is essential for effective therapy, whether it is inflammatory bowel disease, ulcers, food intolerance or the prevention of cancer.

A proper and timely gastroenterological examination can be life-saving. Here's a detailed explanation of how the screening process works, the steps involved and how the expert team at Endomedix can ensure your safety and peace of mind at all times.

When do you need to see a specialist gastroenterologist?

Digestive symptoms can be varied and can be caused by many different conditions. It is particularly important to seek medical advice immediately if you experience so-called „alarming” (warning) symptoms. These signs require immediate and thorough investigation to rule out or treat more serious diseases in time.

The main alarming symptoms are:

• Significant weight loss without reason, without diet.
• Swallowing difficulties (dysphagia) or painful swallowing (odynophagia).
• Frequent, recurrent vomiting.
• Severe, persistent or sudden onset of abdominal pain.
• Passing black (pitch) or fresh bloody stools.
• Iron deficiency anaemia confirmed by laboratory tests.
• Jaundice not related to infection.
• Frequent, chronic diarrhoea or persistent constipation.

If you experience any of these symptoms, you should seek professional advice immediately. The first step is to make an appointment for a thorough assessment: Gastroenterology consultation.

How is the gastroenterology consultation carried out?

The investigation process always starts with a personal consultation. The experienced gastroenterologists at Endomedix place great emphasis on getting to know the patient's medical history in detail.

During the consultation, the first thing the specialist does is to take your medical history. This includes asking about the exact nature, onset and frequency of the complaints. The doctor will ask about any family history of digestive diseases (such as colon cancer, Crohn's disease or coeliac disease), any medicines taken, and lifestyle and eating habits.

This is followed by a physical examination, during which the doctor palpates the abdomen, looking for any painful spots, bloating or abnormalities. If necessary, the physical examination may also include a rectal digital rectal examination (RDV).

Based on the complaints and physical findings, the specialist will determine the next diagnostic steps. These may include laboratory tests (e.g. blood count, liver function, faecal blood or faecal calprotectin levels), imaging (abdominal ultrasound, CT, MRI) or endoscopic procedures.

What are endoscopic gastroenterology tests and why are they important?

Endoscopic examinations are an indispensable tool for diagnosing abnormalities of the digestive tract. Modern video endoscopic technology allows the doctor to obtain a high-resolution, real-time image of the mucosal status. These examinations are performed with the utmost precision in Endomedix's highly equipped instrument centres.

These interventions are not only diagnostic but also therapeutic. During the examination, the doctor can take a tissue sample (biopsy) from suspicious areas for histological analysis, remove polyps that may be precancerous or remove bleeding lesions.

Why does Endomedix only use anaesthesia instead of stunning?

When it comes to endoscopic examinations, patients' biggest fear is the dread of pain and discomfort. It is important to clarify the difference between sedation and general anaesthesia.

At Endomedix, for professional reasons, endoscopic procedures are performed under general anaesthesia only, without anaesthesia. During anaesthesia, the patient is only partially sedated, so he/she may feel discomfort, pain and may make the examination difficult by involuntary movements. In contrast, anaesthesia (using fast-acting propofol) induces a special deep sleep state supervised by a specialist anaesthetist.

The benefits of deep anaesthesia are twofold. On the one hand, the patient is completely relaxed and does not feel anything from the examination, so the process is completely painless and stress-free for them. On the other hand, the complete muscle relaxation caused by the anaesthesia allows the gastroenterologist to guide the endoscopic instrument more precisely, unhindered and thoroughly. This reduces the risk of complications and increases the accuracy of the diagnosis. The patient wakes up quickly after the examination with a clear conscience and no memory of the unpleasant procedure.

How is gastroscopy (gastroscopy under anaesthesia) done?

An esophagogastroduodenoscopy (EGD) is a visual examination of the inner surface of the oesophagus, stomach and duodenum. It is of particular importance in the detection of reflux disease (GERD), gastric ulcers, Helicobacter pylori infection, celiac disease or cancer.

In preparation for the test, the patient must arrive on an empty stomach, which means that they must not eat solid food for 6-8 hours before the procedure, and must not drink any liquids for 4 hours before.

Steps in the process:

1. Preparation: The patient is positioned on the examination bed in the left lateral position with the head tilted forward. The sensitivity of the pharynx is reduced with a local anaesthetic spray (lidocaine 10%).
2. Sleep: The anaesthetist administers the anaesthetic intravenously, which puts the patient into a deep sleep within seconds.
3. The investigation: The specialist guides a thin (6-9 mm diameter), flexible instrument (a gastroscope) with a fibre-optic camera through the mouth and down the oesophagus to the roof of the mouth. The mucosa is examined in detail.
4. Sampling: If necessary (e.g. in case of suspected Helicobacter pylori or inflammation), the doctor will take a tiny tissue sample (biopsy), which is completely painless for the patient.
5. Finish: The optimal time for a diagnostic test is just 7-10 minutes. The patient wakes up from anaesthesia shortly after the device is removed.

For more information and to book an appointment, please visit here: GASTROSCOPY UNDER ANAESTHESIA.

What is the procedure for colonoscopy under anaesthesia (colonoscopy)?

A colonoscopy is a thorough examination of the entire large intestine (rectum, sigmoid colon, descending colon, ileum and ascending colon) and the last part of the small intestine (terminal ileum). Colonoscopy is the gold standard for screening for colorectal cancer, detecting and removing polyps, and diagnosing inflammatory bowel diseases such as Crohn's disease or ulcerative colitis. Screening is recommended for everyone over the age of 45-50 even if they are free of symptoms.

The success of a colonoscopy depends on proper bowel cleansing. A low-fibre diet should be followed in the days before the test, followed by a special laxative liquid to ensure complete emptying of the intestinal tract. A properly clean bowel is essential for detecting even the smallest lesions (such as millimetre-sized polyps).

Steps in the process:

1. Preparation and anaesthesia: The patient lies comfortably and the anaesthetist administers the anaesthetic intravenously. The patient falls completely asleep.
2. The investigation: The specialist inserts a 9-12 mm diameter, 130-160 cm long flexible video endoscope through the anus. The instrument is passed slowly and carefully down to the cecum.
3. Carbon dioxide insufflation: At Endomedix, we use carbon dioxide gas (CO2) to gently dilate the intestines instead of traditional room air. The CO2 is absorbed much faster into the tissues, so the patient does not experience painful bloating or abdominal cramping upon waking.
4. Diagnostics and Therapy: During the colonoscope retraction (which optimally takes 6-10 minutes per section), the doctor examines the bowel wall millimetre by millimetre. If a polyp is found, it is removed immediately and painlessly using a special loop (polypectomy). This step is life-saving, as the vast majority of colorectal cancers develop from these benign polyps over the years.
5. Wake up: Once the procedure is complete, the patient wakes up in the recovery room under close supervision.

For more details and to book an appointment, click here: COLONOSCOPY UNDER ANAESTHESIA.

Can I have a gastroscopy and a colonoscopy at the same time?

Yes, combining the two tests is a very common and highly beneficial option. Opt for a combined test when both procedures are warranted (for example, in the case of iron deficiency anaemia, abdominal pain of uncertain origin or comprehensive cancer screening), as it can save considerable time and effort.

The biggest advantage of the combined procedure is that the patient only has to undergo the diet and the colon cleansing with laxative once. In addition, the two procedures are performed under a single anaesthetic, one after the other. The doctors perform the gastroscopy first and then the colonoscopy immediately afterwards. The whole process takes about 30-45 minutes. The patient sleeps through the whole thing and completes the entire digestive tract examination in one waking up.

Read more about the combined test here: GASTRIC AND COLONOSCOPY UNDER ANAESTHESIA.

What to look out for after the tests?

As the procedures are performed under general anaesthesia, the patient remains under observation in the clinic for a short time after waking up. Although the effect of modern anaesthetics wears off quickly and consciousness clears quickly, reflexes and decision-making skills may be dulled for the rest of the day.

It is therefore a strict rule that you are not allowed to drive, operate dangerous machinery or make important legal/financial decisions on the day of the test. An adult chaperone is required to leave the premises.

As for food, in most cases, the patient can drink fluids and then light, light meals within an hour of the test. If polypectomy or special surgery has been performed, the doctor will give specific dietary instructions. Before you return home, the gastroenterologist will discuss the findings with you in detail, give you the results and decide on any further action or therapeutic steps. Laboratory analysis of the histological samples (biopsies) usually takes 1-2 weeks.

Why Endomedix is the best choice for gastroenterology tests?

Endomedix is the largest private gastroenterology network in the country, with outstanding professional expertise and state-of-the-art equipment. Our medical directors and specialists have decades of clinical experience in the diagnosis and treatment of gastrointestinal diseases.

We focus on patient safety and maximum comfort. This is why we insist on exclusive anaesthesia as opposed to anaesthesia for professional reasons and why we use carbon dioxide insufflation during our tests. Our aim is to turn the dreaded „mirror” examinations into a reassuring, painless and life-saving healthcare experience. Our clinics offer a discreet, relaxed environment and empathetic and patient staff.

Frequently asked questions about gastroenterology tests

Is a gastroenterological endoscopic examination painful?

No. At the Endomedix centres, gastroscopy and colonoscopy are performed only under deep anaesthesia supervised by an anaesthesiologist. You will sleep through the procedure, so you will feel no pain or discomfort and will have no memory of the procedure.

How long does a gastroscopy and colonoscopy take?

A diagnostic gastroscopy itself takes about 7-10 minutes, while a colonoscopy takes about 15-25 minutes. When the two tests are combined under one anaesthetic, the medical procedure takes 30-45 minutes in total. Including the preparation and waking up time, you should expect a clinical stay of about 1.5-2 hours.

What are the risks of the intervention?

Like all medical procedures, endoscopy has rare risks, such as bleeding (especially after polyp removal) or damage to the intestinal wall. At Endomedix, examinations are carried out by highly experienced specialists using state-of-the-art equipment, and the anaesthesia, which provides complete muscle relaxation, minimises the chance of these complications.

When can I eat again after the test?

If you have only had a diagnostic scan, you can have fluids within an hour of waking up, followed by a light, light solid meal. In the case of a polypectomy, the doctor may prescribe an individualised, sparing diet for a few days.

Who should be screened for colorectal cancer?

Colonoscopy is recommended as a screening test for all adults over 45-50 years of age, even if there are no symptoms. If there is a family history of colorectal cancer, it is recommended to start screening 10 years earlier than the age of onset of the disease in the relative concerned, but no later than the age of 40.

Book an appointment and take action for your health

Prevention and early detection are the most important steps to stay healthy. Don't let fear or lack of information hold you back from recovery. The expert team at Endomedix is ready to provide you with the highest level of medical care in a safe, pain-free environment.

If you have gastrointestinal problems or have reached the recommended age for screening, don't delay. Contact us and make an appointment at our specialist clinic!

Book an appointment today: Gastroenterology consultation.