Endoscopy

What is an endoscope?

An endoscope is a long, flexible tube that can be inserted into an opening or small cuts in your body. Endoscopes have a camera or video camera and light on the end so the endoscopist can see inside your body and take images. An endoscopist is the health professional who performs the procedure.

An endoscope may sometimes have other features too, like forceps or scissors to remove tissue or perform surgery.

Types of endoscopy

There are different types of endoscopy that are used for different parts of your body. These include:

• Gastroscopy – passed through your mouth to look at parts of your digestive system, such as the digestive tract. This includes your oesophagus (food pipe), stomach and duodenum (the first part of your small bowel). It’s also called an upper gastrointestinal endoscopy, an upper GI endoscopy or an oesophago-gastro-duodenoscopy (OGD).
• Bronchoscopy – passed through your mouth or nose to look at the bronchial tubes in your lungs.
• Cystoscopy – passed through your urethra (the tube where you pass urine) to check your bladder.
• Hysteroscopy – passed through your vagina to look inside your womb.
• Colonoscopy – passed into your back passage (rectum) to look inside your large bowel.
• Flexible sigmoidoscopy – passed into your back passage to check the lower part of your large bowel.
• Laparoscopy – inserted through small incisions in your abdomen or pelvis to examine organs or perform surgery.
• Arthroscopy – inserted through small incisions to examine or treat a joint, such as your knee.

Why do I need an endoscopy?

The main reasons why your doctor might suggest an endoscopy procedure include:

• To investigate symptoms. These can include things like abdominal pain, difficulty swallowing, persistent heartburn, breathing difficulties or abnormal bleeding.
• To confirm a diagnosis. For example, your doctor may use an endoscopy to do a biopsy to confirm whether symptoms are due to cancer.
• To treat a health problem or condition, such as repairing a stomach ulcer or removing a polyp (growth).

The endoscopy can be used to help diagnose cancer or other health conditions. These can include stomach ulcers, gallstones, inflammatory bowel disease or gastro-oesophageal reflux disease (GORD).

Private care for endoscopy

Endoscopy is available both on the NHS and privately. Either way, you will usually need a referral from a consultant or GP. Depending on why you need an endoscopy, you’re likely to be able to access it faster through private care. If you have health insurance, check whether it covers endoscopy.

An endoscopy procedure is similar, whether it’s in the NHS or the private sector. But there will tend to be differences in how you receive your care. There is likely to be a greater choice of when and where you can have the procedure. Depending on why you’re having your endoscopy procedure, you’re likely to be able to have the procedure done faster through private care.

What happens in an endoscopy?

Depending on the type of endoscopy, this is usually done as an outpatient or daycase procedure. This means you go home on the same day. Depending on what type of endoscopy you are having, you might have local anaesthesia to numb the area. You may also have sedation. Sedation will make you feel drowsy during the procedure. Surgery involving laparoscopy will require general anaesthesia.

The endoscopist will gently pass the endoscope through the opening or cuts in your skin. They will be able to see images from the endoscope on a screen. Sometimes, they may use ultrasound with the endoscopy to create clearer, or more detailed images. This is known as endoscopic ultrasound.

Depending on why you’re having the endoscopy and what your endoscopist finds, they may do the following as part of the procedure.

• Take a biopsy (tissue sample)
• Remove polyps or tumours (small growths of tissue)
• Place stents or feeding tubes
• Drain cysts
• Treat abnormal areas of tissue
• Stop bleeding by sealing blood vessels

Recovery and what to expect after endoscopy

If you had sedation, you’ll need to rest at the hospital until it’s worn off. You’ll need a friend or relative to drive you home. You’ll usually be able to go home the same day. 

If you have had a general anaesthesia, you will need to fully recover from the procedure before you can be discharged home that day. You will be advised not to drive for 24 hours.

You may feel uncomfortable for a couple of days after an endoscopy and have some side effects. For example, you may have a sore throat after a gastroscopy.

Potential complications of endoscopy

Endoscopy is considered a relatively safe procedure. But as with any medical procedures there is still some risk of complications. These will depend on the exact type of endoscopy you’re having. But they may include:

• Bleeding
• Infection
• Damage to your internal organs, such as perforation (tearing)
• Redness, swelling or pain where the endoscope was inserted

There is also a risk of having a reaction to the sedative or general anaesthetic, if you have one. The risk of serious complications is rare.

Endoscopy costs and fees

If you have private medical insurance, check with your insurer whether they will cover the cost of endoscopy. This may depend on why you are having it.

You can also pay for endoscopy yourself (known as self-funding). How much it costs will depend on the type of endoscopy you’re having. Typically, an initial consultation for a diagnostic gastroscopy will cost between £180 and £250. The procedure itself costs between £150 and £450. Endoscopy costs in the UK vary depending on where you live. If you go ahead with the procedure, you’ll be offered one of the following.

• An all-inclusive ‘package price’, where you know the full costs before undergoing the procedure. Not all consultants and hospitals offer this.
• A ‘fee-per-service’ deal, where you receive different invoices from the consultant, the anaesthetist and the hospital. You often won’t know the full costs until you receive the invoices.

For more information, you can read our guide on self-pay.

References

1. Endoscopy. Encyclopaedia Britannica. https://www.britannica.com/science/endoscopy, last updated 8 September 2023.
2. Endoscopy. MSD Manual Professional. https://www.msdmanuals.com/en-gb/professional/gastrointestinal-disorders/diagnostic-and-therapeutic-gastrointestinal-procedures/endoscopy, reviewed/revised March 2023.
3. Endoscopy. Healthline. https://www.healthline.com/health/endoscopy, last reviewed 12 March 2018.
4. Endoscopy: What to know. MedicalNewsToday. https://www.medicalnewstoday.com/articles/153737, updated 6 January 2023.
5. Gastroscopy. Cancer Research UK. https://www.cancerresearchuk.org/about-cancer/tests-and-scans/gastroscopy, last reviewed 9 September 2022.
6. Endoscopy. Cancer Research UK. https://www.cancerresearchuk.org/about-cancer/tests-and-scans/endoscopy, last reviewed 10 August 2022.
7. Suspected cancer: recognition and referral. 1.2. Upper gastrointestinal tract cancers. National Institute for Health and Care Excellence (NICE). https://www.nice.org.uk/guidance/ng12/chapter/1-Recommendations-organised-by-site-of-cancer#upper-gastrointestinal-tract-cancers, last updated 24 August 2023.
8. EGD Test (Esophagogastroduodenoscopy). Healthline. https://www.healthline.com/health/egd-esophagogastroduodenoscopy, updated 15 December 2021.