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What is esophagoscopy?
Esophagoscopy may be done through the nose and involves inserting a long, flexible tube with a lighted camera to examine the inside of the esophagus.
Esophagoscopy is a procedure to examine the inner lining (mucosa) of the esophagus. During endoscopy a flexible tube with a lighted camera (endoscope) is inserted through the mouth and throat along the length of the esophagus.
What are the types of esophagoscopy?
- Rigid esophagoscopy: The doctor inserts a rigid tube through the mouth into the cervical esophagus. An eyepiece and light in the tube help the doctor visualize the esophagus. A rigid esophagoscopy was primarily performed to diagnose head and neck cancers and for removal of foreign bodies from the cervical esophagus. This procedure requires general anesthesia and typically not in use now.
- Flexible esophagoscopy: This is the most common procedure, using a flexible tube that can go through the entire upper gastrointestinal tract. The micro-camera transmits high-resolution images, and there is less risk of esophagus laceration compared with a rigid esophagoscopy. It may be performed with mild or no sedation.
- Transnasal esophagoscopy: This procedure is performed with an ultrathin tube inserted nasally into the esophagus. This procedure does not require sedation and is easily tolerated by most people.
- Esophageal capsule endoscopy: The patient swallows a capsule-sized camera which transmits high-resolution images as it passes through the esophagus.
Transnasal and capsule esophagoscopy are useful tools for diagnosis, but not for performing any surgical treatment or taking biopsy samples.
What is the difference between esophagoscopy and endoscopy?
Esophagoscopy is a type of endoscopy in which only the esophageal mucosa is examined. Esophagoscopy, only examining the esophagus, is not often performed alone; generally the entire upper gastrointestinal tract is examined.
Other types of endoscopy are
- Gastroscopy, which examines the esophagus and the stomach
- Esophagogastroduodenoscopy, which examines the esophagus, stomach and beginning of the small intestine (duodenum)
- Enteroscopy, which reaches further into the small intestine
What Is Esophagoscopy Used for?
An esophagoscopy may be performed as a diagnostic or therapeutic procedure. This procedure may also be performed as part of a full upper gastrointestinal endoscopy.
The doctor may recommend esophagoscopy for patients with symptoms such as
- Persistent pain in the upper abdomen
- Chronic heartburn
- Chronic cough
- Chest pain (not of heart origin)
- Difficulty or pain swallowing
- Feeling full with small quantity of food
- Nausea and vomiting
- Vomiting blood
- Anemia and weight loss
- Feeling of food stuck in the throat
- An esophagoscopy may be performed for
- Removal of food or foreign object stuck in the esophagus
- Management of gastroesophageal reflux disease (GERD)
- Screening and surveillance for diseases, such as Barrett’s esophagus
- Treatment of swollen veins (varices) in the esophagus
- Dilation of strictures in the esophagus
- Screening for neck, throat or head cancer
- Evaluation after abnormal imaging studies
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How is an esophagoscopy performed?
An esophagoscopy is usually performed by a gastroenterologist as an outpatient procedure. The procedure may take about 20 to 30 minutes.
Preparation
- The patient undergoes blood and imaging tests.
- The patient must not eat or drink 8 hours before the procedure.
- The patient must check with the doctor before taking any regular medications and inform them of any allergies.
Procedure
- The patient lies on their left side.
- The doctor administers pain medication and light sedation, and numbs the patient’s mouth and throat with a topical anesthetic.
- The doctor may place a mouthguard between the teeth to prevent the patient from biting the scope or their own tongue.
- The doctor may use air pressure to inflate the esophagus.
- The doctor gently inserts the esophagoscope through the mouth and passes it slowly through the esophagus.
- The doctor examines the esophagus on a monitor and may take a biopsy sample for testing or perform any treatment as needed.
- The esophagoscope is slowly withdrawn.
Post-procedure
- The patient is monitored in the recovery room and will be able to leave in about an hour.
- The patient must not eat or drink till they are able to swallow without gagging.
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What are the side effects of esophagoscopy?
Esophagoscopy may cause side effects such as
- sore throat
- gas and bloating
- cramping
These side effects usually resolve on their own within 24 hours.
What are the risks and complications of an esophagoscopy?
Esophagoscopy is a fairly routine and safe procedure for most people. Complications may include:
- Perforation of the esophagus
- Bleeding
- Infection
- Breathing problems
- Drop in blood pressure and heart rate
- Excessive sweating
- Spasm of the throat
- Allergic reaction to the medication