Therapeutic Endoscopy at Cheltenham Hospital

Therapeutic endoscopy is when a doctor uses an endoscope, a thin, flexible tube with a camera, not just to look inside your body but to treat a problem at the same time. It covers a range of techniques used to stop bleeding, remove growths, widen narrowed passages and more.

Why might I need therapeutic endoscopy?

You might be offered therapeutic endoscopy if a problem is found during a routine look inside your body, or if you're already known to have a condition that needs treating this way.

You may need it if you have:

• bleeding inside your gut, such as from an ulcer
• polyps (small growths) found during a colonoscopy
• a narrowed section (stricture) of your gullet or gut
• something stuck in your food pipe
• swollen veins (varices) that are bleeding or at risk of bleeding
• difficulty swallowing or eating that means you need a feeding tube fitted directly into your stomach.

Often, what starts out as a procedure to look and diagnose can become a treatment in the same sitting, once your doctor sees what needs to be done.

What are the benefits of therapeutic endoscopy?

Because treatment happens through the endoscope, it can often be done in the same session as the procedure that found the problem, without you needing to come back separately or have surgery.

For bleeding, treating it this way has been shown to significantly reduce deaths from the condition. It also avoids the need for surgery in many cases, tends to cost less, and is generally well tolerated.

Removing polyps during a colonoscopy is a widely used technique, and doing so can lower the chance of colon cancer developing later on.

Are there different types of therapeutic endoscopy?

The technique used depends on what needs treating:

• For bleeding: Injecting medicine, applying heat, or using a gas treatment (argon plasma) to seal the bleeding point
• For narrowed passages: Stretching them with a balloon, or fitting a stent to hold them open
• For polyps: Snaring or removing them during the same procedure they're found in
• For swollen veins (varices): Fitting small bands around them, or injecting them to seal them off – this is usually done as an outpatient and may need one or two sessions to fully clear them
• For feeding difficulties: Fitting a tube directly into the stomach without the need for a surgical cut
• For something stuck in the food pipe: Removing it using instruments passed through the endoscope.

What happens during therapeutic endoscopy?

The exact steps depend on what's being treated and which part of your body is involved, so it's worth asking your care team what to expect for your specific procedure.

In general, your endoscopist first looks at the area using the camera on the endoscope. If they find something that needs treating there and then, they pass small instruments down a channel inside the endoscope to carry out the treatment, such as sealing a bleeding point, fitting a stent, or removing a polyp, without needing to make any cuts in your skin.

What are the risks or side effects?

Treatments used to control bleeding carry a small risk of causing a hole in the gut wall (perforation) or inflammation inside the abdomen (peritonitis), though this is uncommon.

Risks vary depending on which technique is used and which part of your body is being treated, so it's important to discuss the specific risks of your procedure with your doctor.