Which diagnostic procedure is more effective? Explore the advantages and disadvantages of CT scans and endoscopies for upper digestive tract examinations. Get insights on the accuracy, preparation, and outcomes of these non-invasive and invasive techniques.

Understanding Upper Endoscopy

An upper endoscopy, also known as an esophagogastroduodenoscopy (EGD) or gastroscopy, is a medical procedure used to examine the lining of the upper digestive tract, including the esophagus, stomach, and duodenum (the first part of the small intestine). During this procedure, a thin, flexible tube equipped with a light and small video camera is inserted through the mouth and guided down the throat to allow the doctor to visualize and assess any abnormalities in these areas.

Reasons for Undergoing an Upper Endoscopy

Doctors may recommend an upper endoscopy for various reasons, including:

• Investigating symptoms such as trouble swallowing, heartburn, sudden feeling of fullness, bloody vomit or cough, or unexplained weight loss
• Examining an abnormal area seen on another imaging test, such as an X-ray or computed tomography (CT) scan
• Taking biopsy samples to determine if cancer is present in the esophagus, stomach, or small intestine
• Treating a blockage or other issues caused by a tumor in the digestive tract
• Monitoring the effectiveness of cancer treatment

Preparing for an Upper Endoscopy

Before an upper endoscopy, patients are typically advised to:

1. Remove any watches, jewelry, or dentures
2. Inform the care team about any medications, including vitamins, herbs, and supplements, as well as any allergies
3. Stop taking blood thinners a few days before the procedure, if recommended
4. Avoid eating or drinking for six to eight hours prior to the procedure
5. Arrange for someone to drive them home after the procedure, as sedation is often used
6. Ask questions if there are any concerns or uncertainties about the procedure

The Upper Endoscopy Procedure

The upper endoscopy procedure typically takes 15 minutes to half an hour and is usually performed as an outpatient procedure. During the procedure:

• The throat is numbed with a spray or liquid
• The patient is given a sedative to help them remain comfortable
• A mouthpiece is placed to keep the mouth open
• The scope is guided down the throat and into the upper digestive tract, allowing the doctor to examine the area and take photographs or biopsies as needed
• Air may be pumped into the stomach to improve the visibility of the images

Potential Risks and Benefits of Upper Endoscopy

Upper endoscopy provides more detailed information than imaging tests like CT scans or upper gastrointestinal (GI) series, which use X-rays. However, it is an invasive procedure and carries some risks, including:

• Bleeding at the biopsy site
• Numbness or hoarseness of the mouth and throat for a few hours or days
• Adverse reactions to the sedative or anesthesia, such as breathing difficulties, low blood pressure, or slow heartbeat
• Perforation of the digestive tract lining, which may require surgery
• Infection

Patients should contact their doctor if they experience any unexpected symptoms or complications after the procedure.

Comparing CT Scan and Endoscopy

A study published in 2020 examined the accuracy of CT scans and endoscopies in identifying the distance from the anal verge (the point where the rectum ends and the anus begins) for left-sided colon cancer. The study found that CT scans were more accurate than endoscopies in this specific measure.

Understanding the Findings

The study suggests that CT scans may be more effective than endoscopies in certain diagnostic applications, such as determining the location of left-sided colon cancer. However, it’s important to note that endoscopies still provide valuable information and are often necessary for other diagnostic purposes, such as taking biopsies or examining the upper digestive tract.

The choice between CT scans and endoscopies ultimately depends on the specific medical condition being investigated and the information the healthcare provider needs to make an accurate diagnosis and develop an appropriate treatment plan.

Upper endoscopy

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science.

This page was reviewed on March 3, 2022.

Your upper digestive tract consists of your esophagus, stomach and duodenum, which is where your small intestine starts. Sometimes, it’s necessary for doctors to examine the lining of your upper digestive tract. An upper endoscopy may be the best way to see it.

Your doctor may refer to an upper endoscopy as an esophagogastroduodenoscopy, or EGD. They are the same procedure. Another term that may be used for it is gastroscopy.

During an upper endoscopy, a thin, flexible tube equipped with a light and small video camera is inserted into your mouth and threaded down your throat into your esophagus and stomach until it reaches your small intestine.

Why you may need an upper endoscopy

• Investigate why you’re experiencing symptoms such as trouble swallowing, heartburn, fullness that comes on quickly, bloody vomit or cough, or unexplained weight loss
• Examine an abnormal area seen on another imaging test such as an X-ray or computed tomography (CT) scan 
• Take biopsy samples of the esophagus, stomach or small intestine, and determine whether cancer is present
• Treat a blockage in your digestive tract or other issues caused by a tumor
• Monitor how well your cancer treatment is working

Six ways to prepare for an upper endoscopy

• Before your procedure, be sure to remove your watch or other jewelry. If you wear dentures, you must remove them too.
• Tell your care team about any medicines you take, including vitamins, herbs and supplements, and whether you are allergic to any medicines.
• If you take a blood thinner, you may be asked to stop a few days before the procedure. This includes baby aspirin.
• Don’t eat or drink for six to eight hours before your upper endoscopy.
• This test is done under a sedative to help keep you comfortable. Arrange for someone to drive you home afterward.
• Be sure to ask questions if there’s anything you don’t understand.

What happens during an upper endoscopy

The procedure is typically performed as an outpatient procedure.

First, your throat is sprayed with numbing medicine. Or, you may be asked to gargle with a liquid that numbs the throat.

Next, you’ll be asked to lie on your left side on the examination table and given a sedative. Some sedatives keep you drowsy but awake. If necessary, your doctor may perform your upper endoscopy under general anesthesia. Speak with your doctor about which option is best for you.

A mouthpiece is placed to keep your mouth open during the procedure.

The scope is guided down your throat as far as the start of your small intestine. Doctors are able to see images of your digestive tract and to examine specific areas of concern. They can take color photographs for further review.

Sometimes, it’s necessary to pump air into your stomach so the images are easier to see.

The procedure takes about 15 minutes to a half hour.

You will be observed for a while to make sure you’re OK and until the sedative wears off. You should be able to go home after a few hours. In rare cases, some people may stay in the hospital overnight.

Benefits and risks of upper endoscopy

An upper endoscopy provides better detail than a CT scan or an upper gastrointestinal (GI) series, which uses X-rays.

However, there are some risks to consider. These include:

• If you had a biopsy as part of your procedure, you may experience bleeding at the site.
• Your mouth and throat may be numb for a couple of hours. You may be hoarse or cough for a couple of days afterward.
• Some people react to the sedative with breathing difficulties, low blood pressure and a slow heartbeat. Or, you may have a reaction to the anesthesia.
• A perforation could occur in the lining of your digestive tract during the procedure and require surgery.
• It’s possible to develop an infection.

If you have any symptoms that are unexplained, including bleeding that doesn’t stop, call your doctor’s office and ask what you should do.

When you can expect results

Results typically take a few days. If you had a biopsy during the procedure, the results may take a little longer. The samples that were taken need to be studied in a pathology laboratory.

Your doctors should follow up with you once the results are available. The results can help guide your treatment.

“Is CT Scan more Accurate than Endoscopy in Identifying Distance from the Anal Verge for Left Sided Colon Cancer? A Comparative Cohort Analysis”

. 2020 Mar;33(3):273-280.

doi: 10.1080/08941939.2018.1492650.

Epub 2018 Aug 8.

Renato Costi, Matteo Ricco’ 
¹
, Giulio Negrini 
²
, Philippe Wind 
³
, Vincenzo Violi 
^4
 
5
, Alban Zarzavadjian Le Bian 
³

Affiliations

Affiliations

• ¹ Dipartimento di Prevenzione, Unità Operativa di Prevenzione e Sicurezza sui Luoghi di Lavoro, Azienda Provinciale per i Servizi Sanitari, Trento, Italy.
• ² Servizio di Radiologia, Azienda Ospedaliero-Universita di Parma, Parma, Italia.
• ³ Department of Digestive Surgery and Surgical Oncology, Hôpital Avicenne, Assistance Publique – Hôpitaux de Paris, Université Paris XIII, Bobigny, France.
• ⁴ Dipartimento di Scienze Chirurgiche, Università di Parma, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, Italia, Parma.
• ⁵ Dipartimento di Chirurgia Generale e Specialistica, Unità Operativa di Chirurgia Generale, Ospedale di Fidenza, AUSL Parma, Fidenza, Italia.

• PMID:

  30089423

• DOI:

  10. 1080/08941939.2018.1492650

Renato Costi et al.

J Invest Surg.

2020 Mar.

. 2020 Mar;33(3):273-280.

doi: 10.1080/08941939.2018.1492650.

Epub 2018 Aug 8.

Authors

Renato Costi, Matteo Ricco’ 
¹
, Giulio Negrini 
²
, Philippe Wind 
³
, Vincenzo Violi 
^4
 
5
, Alban Zarzavadjian Le Bian 
³

Affiliations

• ¹ Dipartimento di Prevenzione, Unità Operativa di Prevenzione e Sicurezza sui Luoghi di Lavoro, Azienda Provinciale per i Servizi Sanitari, Trento, Italy.
• ² Servizio di Radiologia, Azienda Ospedaliero-Universita di Parma, Parma, Italia.
• ³ Department of Digestive Surgery and Surgical Oncology, Hôpital Avicenne, Assistance Publique – Hôpitaux de Paris, Université Paris XIII, Bobigny, France.
• ⁴ Dipartimento di Scienze Chirurgiche, Università di Parma, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, Italia, Parma.
• ⁵ Dipartimento di Chirurgia Generale e Specialistica, Unità Operativa di Chirurgia Generale, Ospedale di Fidenza, AUSL Parma, Fidenza, Italia.

• PMID:

  30089423

• DOI:

  10. 1080/08941939.2018.1492650

Abstract

Purposes: Accurately localizing colorectal cancer during surgery may be challenging due to intraoperative limitations. In the present study, localization of left-sided colon cancer (LCC) by CT scan is compared to colonoscopy. Material and methods: Consecutive patients with LCC located by colonoscopy and CT scan and undergoing left-hemicolectomy were included. Tumor distance from the anal verge (TDAV) was calculated by both CT-scan and colonoscopy, and then compared, using as reference TDAV measured intraoperatively. Statistical analysis was performed including (1) comparison of means between all three TDAVs, (2) comparison of mean differences between all three TDAVs, (3) comparison of number of patients with a difference between endoscopic TDAV and intraoperative TDAV ≤5 cm and the number of patients with a difference between CT scan TDAV and intraoperative TDAV ≤5 cm (4) statistical relationship between either CT scan and endoscopic and intraoperative TDAVs. Results: Both CT scan and endoscopy overestimate TDAV (25.8 ± 12.5 cm and 24.6 ± 10.6 cm vs. 21.5 ± 7.4 cm, p = 0.005), but CT scan TDAV resulted as being different from intraoperative TDAV (p < 0.01). Regression analysis reported an increasing divergence of measurements with increasing values of intraoperative TDAV, which resulted greater for CT. Tumors within 5 cm of intraoperative TDAV were 22/28 (78.6%) for endoscopy, and 17/28 (60.7%) for CT (p = 0.2448). Conclusions: Accuracy of both examinations seems poor, with a mean overestimation >3 cm and a significant number of tumors found at >5 cm from preoperative evaluation. Preoperative examinations’ bias increase proportionally with TDAV length, decreasing their interest especially for tumors located at a greater distance from anal verge.

Keywords:

CT scan; colectomy; colon cancer; colonoscopy; endoscopy; localization.

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90,000 Ultrasound, MRI, CT or endoscopy? Doctor Maskin called the most harmful research method

• Health

Often at the doctor’s office we hear that it is necessary to do an ultrasound, undergo an endoscopy or perform an MRI. How safe are these procedures, can they harm?

April 17 202324

Source:

iStockphoto

Today, to make an accurate diagnosis, doctors rarely get by with just a conversation with a person and the results of simple tests. To accurately determine the disease itself and its severity, the level of damage to internal organs, specialists prescribe a number of diagnostic procedures.

Ultrasound, MRI, CT, X-ray, endoscopy are prescribed for children and adults. How these diagnostic methods differ from each other and how often such studies can be carried out so as not to harm health, Maxim Maskin, the head physician of the Hemotest laboratory, told Doctor Peter.

Ultrasound: fast, painless and visual

Most often, people are prescribed an ultrasound examination of various organs or parts of the body. It is done using a special device equipped with a sensor and a computer, on the screen of which the doctor sees the results.

In fact, ultrasound is the effect of a sound wave, thanks to which the doctor sees the organ “alive”, in dynamics. For example, it may consider the inflection of the vessel, contraction of the stomach or bladder. This makes it possible to obtain maximum information about the patient’s condition. Ultrasound is an absolutely safe and painless method that can be used as often as necessary to monitor health, Maxim Maskin explained.

See also

If you want to take pictures

CT, MRI and radiography, unlike ultrasound, are static diagnostic methods, that is, the doctor takes an image of an organ or a series of images of individual areas – the so-called sections. With radiography, this is more often one picture or two or three – in a direct, lateral or oblique projection, with CT and MRI – several hundred. There is also, for example, an X-ray examination with the introduction of contrast agents, when the diagnostician takes a series of images. As a result, it seems that it is possible to study the work of the organ in dynamics.

It’s radiation, but don’t worry

CT (computed tomography), like the familiar X-ray, is an examination using ionizing radiation. If a patient is prescribed a regular X-ray even several times in a row, there is no need to worry and refuse. Modern x-ray tubes give minimal radiation, so you need to take pictures as many times as the doctor recommends. But computed tomography (CT) should not be done more often 3-4 times a year , because the ionizing radiation in this study is quite high – comparable to 20-30 conventional x-rays.

Read also

A safe alternative – MRI

Another completely safe type of examination is MRI (magnetic resonance imaging). This method is based on the work of a magnetic field, and you and I already live in a magnetic field, it’s just that it is a little stronger inside the apparatus. However, there are some limitations to the study. For example, if a person has a pacemaker installed, an MRI cannot be done, otherwise catastrophic consequences cannot be avoided.

People with modern non-magnetic dental implants or joint prostheses have no contraindications for MRI. But if the prostheses are old, there is a risk that classic metal was used in them. Therefore, before the examination, a person is always asked when the prosthesis was installed, or they are asked to show the so-called implant passport – a document that always indicates whether an MRI can be done or not.

Each MRI room also has a metal detector like those used at airports or customs. If the device detects metal when testing a patient, the test is rejected . Otherwise, MRI, like ultrasound, can be done as many times as you like.

Flexible tube with light bulb

Endoscopy – inspection of abdominal organs using a flexible tube with a camera at the end. This is a method that is prescribed only according to indications. A competent doctor knows how to use an endoscope well, so the procedure is normally unpleasant, but not dangerous. However, do not forget about the possible individual reaction – such a study has slightly more risks than MRI, ultrasound, CT. The most uncomfortable endoscopy is colonoscopy, so it is is performed under general or local anesthesia. It’s not exactly anesthesia, just deep sleep so that the patient is not in pain.

In some serious illnesses, such as the risk of gastrointestinal bleeding, the patient’s condition must be constantly monitored, so in the hospital, endoscopy can be performed up to 3-4 times a day. Such a procedure does not cause any harm to health, because the doctor weighs the risks and benefits when prescribing an examination.

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Substitution not always possible

Fearing discomfort due to endoscopy, patients often request an ultrasound instead, but these are not interchangeable. Modern CT machines have a mode that can conditionally be considered a replacement for colonoscopy, it is called “virtual colonography”.

During the study, a 3D model of the large intestine lumen is built using a special program and preparation. However, if the doctor suspects some kind of pathology, it will still be necessary to do a classic colonoscopy.

Text author: Alena Paretskaya

MRI or CT of the intestine – which is better?

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• MRI or CT of the intestine – which is better?

Does your doctor suspect you have a bowel disease? IN
In this case, you may be assigned such methods of hardware
diagnostics such as CT or MRI.
What are the features of these methods of examination and which of them
more effective – we tell in this article!

Diagnosis of intestinal pathologies

The main methods for diagnosing diseases of the gastrointestinal tract are:

• Instrumental diagnostics:
  • Endoscopy of the stomach and intestines
  • Colonoscopy
• Hardware diagnostics:
  • KT
  • MRI
• Laboratory tests:
  • Blood test
  • Fecal analysis and others

Most common laboratory tests for diagnosis
not enough. And then doctors often use instrumental
diagnostic methods are effective procedures that allow not only
detect pathologies, but also carry out therapy, remove small
neoplasms and foreign objects. However, instrumental methods
are inextricably linked to the discomfort or pain of the patient, and sometimes his
cannot be carried out due to special contraindications.

In this case, one cannot do without hardware diagnostic methods – CT
and MRI. Which one is better for the task? This question can
only the doctor can answer, but the patient will also not be superfluous
get information about these surveys.

Intestinal CT

• Intestinal CT can detect the following pathologies:
• Ulcers and polyps
• Perforation of the stomach and intestines
• Acute intestinal obstruction
• Condition of the sphincters

If these diseases are suspected, the most commonly prescribed
computed tomography of the intestine. However, it should be remembered that CT
contraindicated in pregnant women due to harmful radiation, on
which is based on the principle of computed tomography.

MRI in our center

Power
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Recording on disc
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Intestinal MRI

Intestinal MRI reveals diseases:

• Malignant tumors,
  precancerous condition
• Benign tumors, cysts,
  polyps
• Gallstone disease
• Inflammation in the pancreas

Sometimes MRI is prescribed as an auxiliary method to computer
tomography, if it was not possible to accurately diagnose. However, remember
that despite the safety and harmlessness of magnetic tomography, this
examination has its contraindications.

If you have any questions,
ask our specialist!

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MRI or CT of the intestine – which is more effective?

It is unambiguously difficult to answer this question: it all depends on the
pathology to be identified. We recommend that you do not
undergo an examination of your own choice, it threatens you
loss of money for an ineffective examination in your case.
Sign up for a doctor’s consultation! Competent specialist is a must
will help you find the best diagnostic method!

Sign up for an MRI of the intestine at the Diagnostic
center of Elena Malysheva near Baumanskaya metro station (see map)
by phone: 8 (495) 127-03-71 or leave a request on the website.

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