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If you have the misfortune to develop mysterious pain in your lower esophagus or stomach, your doctor might order an endoscopy to take a closer look. Depending on the severity of your symptoms, thats probably a good idea -- but before you go for the test, I want to alert you to new information about some problems with this very common procedure. Its not that its horribly dangerous, but rather because it appears that few doctors are taking the time to really educate their patients on what to expect after the endoscopy is done.
Endoscopy... and Then What?
An endoscopy, used by gastroenterologists to get to the root of digestive problems or pin down the cause of pain in the gastrointestinal tract, involves inserting a flexible tube with a tiny light and camera through the throat and down to the esophagus and upper stomach. The widely dreaded colonoscopy that is used to screen for colon cancer is another example of an endoscopic procedure, though obviously coming from the other end. No one considers these procedures fun... but most patients go home afterward and put it behind them (as expected) without much thought. However, a new study shows that two to three times as many endoscopy and colonoscopy patients as was previously thought end up in emergency rooms in the day or so after the procedure.
I spoke with Daniel A. Leffler, MD, gastroenterologist and study author, who said that it is important to realize that some discomfort is actually normal and expectable after an endoscopic procedure -- these are invasive procedures, after all. Typical aftereffects include bloating, nausea, sore throat -- virtually all of which will clear up within a day or two and are no cause for alarm, Dr. Leffler said. Whats most important, he said, is that doctors should tell patients about the difference between discomfort that they may experience that isnt worrisome and those more urgent symptoms, including bleeding and fever, that require immediate medical attention.
The new research from Harvards Beth Israel Deaconess Medical Center examined electronic records tracking the reasons why patients visited several different hospital emergency rooms. This data can be more easily analyzed than paper records, so it brought to light the higher number of people experiencing post-endoscopic procedure problems. All in all, compared with the 0.05% complication rate that was previously considered the norm, the study revealed that 1.07% of patients whod had upper endoscopies and just under 1% of colonoscopy patients landed in the emergency room. The most common complaints were abdominal pain (47%), GI tract bleeding (12%) and chest pain (11%).
What to Expect
If your doctor advises you to have an endoscopic procedure, Dr. Leffler says to ask about your doctors overall safety history, including rates of serious complications (such as perforation of the colon). While this information may have been difficult to come by in the not-so-distant past, doctors are under more pressure today to track such data and make it available to patients, Dr. Leffler said. "A group that does not collect safety data or whose results are worse than average would be concerning," he added, noting also that "the more patients who request this sort of data, the more easily available it will become."
Source(s):
Daniel A. Leffler, MD, director of clinical research, department of gastroenterology, Beth Israel Deaconess Medical Center , Boston .
Endoscopy... and Then What?
An endoscopy, used by gastroenterologists to get to the root of digestive problems or pin down the cause of pain in the gastrointestinal tract, involves inserting a flexible tube with a tiny light and camera through the throat and down to the esophagus and upper stomach. The widely dreaded colonoscopy that is used to screen for colon cancer is another example of an endoscopic procedure, though obviously coming from the other end. No one considers these procedures fun... but most patients go home afterward and put it behind them (as expected) without much thought. However, a new study shows that two to three times as many endoscopy and colonoscopy patients as was previously thought end up in emergency rooms in the day or so after the procedure.
I spoke with Daniel A. Leffler, MD, gastroenterologist and study author, who said that it is important to realize that some discomfort is actually normal and expectable after an endoscopic procedure -- these are invasive procedures, after all. Typical aftereffects include bloating, nausea, sore throat -- virtually all of which will clear up within a day or two and are no cause for alarm, Dr. Leffler said. Whats most important, he said, is that doctors should tell patients about the difference between discomfort that they may experience that isnt worrisome and those more urgent symptoms, including bleeding and fever, that require immediate medical attention.
The new research from Harvards Beth Israel Deaconess Medical Center examined electronic records tracking the reasons why patients visited several different hospital emergency rooms. This data can be more easily analyzed than paper records, so it brought to light the higher number of people experiencing post-endoscopic procedure problems. All in all, compared with the 0.05% complication rate that was previously considered the norm, the study revealed that 1.07% of patients whod had upper endoscopies and just under 1% of colonoscopy patients landed in the emergency room. The most common complaints were abdominal pain (47%), GI tract bleeding (12%) and chest pain (11%).
What to Expect
If your doctor advises you to have an endoscopic procedure, Dr. Leffler says to ask about your doctors overall safety history, including rates of serious complications (such as perforation of the colon). While this information may have been difficult to come by in the not-so-distant past, doctors are under more pressure today to track such data and make it available to patients, Dr. Leffler said. "A group that does not collect safety data or whose results are worse than average would be concerning," he added, noting also that "the more patients who request this sort of data, the more easily available it will become."
Source(s):
Daniel A. Leffler, MD, director of clinical research, department of gastroenterology, Beth Israel Deaconess Medical Center , Boston .
