Will the test hurt?

Painful gastroscopy, colonoscopyOne of the most common questions our patients ask when having a gastrointestinal examination is whether it will hurt.

Among the testing methods, we distinguish imaging techniques, direct and indirect diagnostic tests and instrumental tests.

The best-known imaging modalities are radiological examinations, including ultrasound and X-ray examinations.

From ultrasound examination not painful. During the examination, our examining doctor will scan the area to be examined with the ultrasound-emitting probe, which in our case is mainly the abdominal and pelvic organs.

An ultrasound scan can provide a wealth of information about the condition and function of internal organs and abnormalities within them. It also allows targeted sampling of lesions detected in the organ under investigation. Thinner or thicker needles can be used to obtain fluid or tissue samples from certain organs or from the abdominal cavity itself, after local anaesthesia. The sampling is slightly uncomfortable, but the anaesthetic is not unbearable. Ultrasound-guided sampling is most often necessary for lesions of the liver, the pancreas (tumours, cysts, inflammatory nodules), kidney diseases in some cases, and abnormal abdominal fluid (ascites).

Although ultrasound also plays an important role in the examination and diagnosis of the stomach, small intestine and colon, unfortunately, the assessment of the internal mucosal surface of these hollow organs and, if necessary, biopsy histological sampling is only possible with instrumental examinations, gastroscopy and colonoscopy.

A X-ray based testing procedures of the conventional X-ray examinations (e.g. native abdominal X-ray), their role is rather narrow today: they are mainly of importance in the diagnosis of acute abdominal pathologies (e.g. intestinal obstruction, intestinal stricture, perforation of the hollow abdominal organ, worm inflammation, etc.), especially in hospital settings. The examination itself is painless.
The more familiar X-ray-based tests are CT scans of the abdomen and pelvis. Here, X-ray signals from one or more radiation sources are picked up by detection units and a computer is used to create a 2 or even 3-dimensional image of the area being examined. It is a widely used examination procedure to obtain information on the structure, function and blood supply of internal organs and, as with ultrasound, it also allows targeted sampling. It may also require the administration of contrast material. This may be given intravenously and orally (by mouth). It is very important that patients with known iodine sensitivity or who are taking metformin containing medication for diabetes should make sure that their doctor is aware of this before the test. CT scans are a painless procedure.

A special type of CT scan is called virtual colonoscopy (CT-colonoscopy), which involves injecting a mixture of air and liquid contrast medium through the rectum into the colon, which has been properly prepared with a laxative. Many people think that this is a less stressful or uncomfortable test than a traditional colonoscopy. However, the inflation and massaging of the colon can cause cramping abdominal pain, and there is no possibility of taking a histological sample if any lesion is detected. With current equipment, virtual colonoscopy can detect abnormalities (ulcers, polyps, tumours) up to about 5 mm in size. If an abnormality is detected during the examination, a colonoscopy is always recommended for further histological sampling.

Magnetic resonance imaging (MR, MRI) is another imaging technique that, like CT, produces a 2- and 3-dimensional image of the organs being examined, but without X-rays and in a strong magnetic field. Of the abdominal organs, it is of particular importance in the investigation of diseases of the liver and the biliary tract. It is a painless procedure, but it is somewhat time-consuming, noisy and uncomfortable in cases of claustrophobia (the patient is lying in a thin tube).

Isotope studies are a special combination of imaging and functional studies, which can be used to examine the function, movement and blood supply of the stomach and intestinal tract, bile ducts and blood supply. They are painless but time-consuming tests.

A functional diagnostic tests is mainly used in the diagnosis of the small intestine, bile ducts, gall bladder and pancreas. In these tests, information about the function of the organs and organ systems under investigation can be obtained from the air exhaled or from venous blood, urine or intestinal fluid after ingestion of certain test foods or test substances. The tests are basically are not associated with any pain, but the test meal or test material consumed may cause unpleasant symptoms (bloating, diarrhoea, crampy abdominal pain, etc.) - our doctors will of course inform you about this in advance.

The instrumental examination of the gastrointestinal tract includes gastroscopy, small bowel, biliary tract, pancreatic duct and colonoscopy (depending on the height of the individual sections, rectal, sigmoid or total colonoscopy can be performed).

A colonoscopy is a lengthy, unpleasant examination performed under general anaesthesia (therefore painless). It is mainly used to investigate bleeding of unknown origin, malabsorption, inflammatory bowel diseases and small bowel cancer. It has the advantage of allowing sampling. It can be replaced, in some cases, by a completely painless examination of the small intestine using a video capsule.

ERCP (endoscopic retrograde cholangiopancreatography) is a relatively time-consuming, uncomfortable examination of the bile ducts and pancreatic duct, which involves swallowing a thin fibre-optic instrument similar to a gastroscopy, This allows the bile ducts and pancreatic duct to be examined retrogradely (i.e. backwards from the intestinal cavity), and if necessary, bile duct strictures can be relieved and gallstones removed. By performing the test under anaesthesia, the discomfort caused by the test can be significantly reduced.

A gastroscopy involves swallowing a thin fibre-optic instrument to examine the initial stages of the oesophagus, stomach and small intestine. The test itself is uncomfortable rather than painful. At the start of the test, an anaesthetic spray is sprayed into the pharynx, which is swallowed and the sensory nerves in the pharynx become numb, reducing the feeling of nausea. The test involves blowing in air, which produces a sensation similar to flatulence: like drinking a fizzy drink. The test usually takes a short time, depending on what the examining doctor finds. At Endomedix medical centres, gastroscopy can be performed under general anaesthesia, which completely eliminates discomfort and possible pain!

Related Endomedix studies: Gastroenterology consultation, Gastroscopy with or without anaesthesia

A colonoscopy in which a small-finger-thick fibre-optic device is inserted through the anus into the colon, which has been properly prepared and cleansed with a laxative. During the test, air is blown into the colon, and traction of the colon with the instrument can cause cramping abdominal pain, which is uncomfortable. At Endomedix medical centres, colonoscopy can be performed under general anaesthesia, which completely eliminates discomfort and possible pain!

Related Endomedix studies: Gastroenterology consultation, Colonoscopy with or without anaesthesia