An esophagoscopy is a procedure that allows your doctor to examine the inside of your esophagus using a long thin instrument called an endoscope. The endoscope contains a light and a camera that transmits pictures of the inside of your esophagus to a video screen.
Esophagoscopy can help diagnose and treat diseases and disorders of the esophagus, such as esophageal cancer, Barrett’s esophagus, and objects stuck in the esophagus.
The esophagus is a muscular tube located in the upper gastrointestinal tract that connects your mouth to your stomach.
An esophagoscopy can help your doctor diagnose unexplained symptoms you may be having, such as difficulty swallowing, upper abdominal pain, vomiting blood, or regurgitation.
An esophagoscopy can also show certain structures of the throat and larynx (voice box).
Esophagoscopy is a minimally invasive procedure that can often be performed in an outpatient setting. The procedure does not require an incision and generally has a quick recovery and a very low risk of complications.
Esophagoscopy is only one method used to treat and diagnose conditions of the esophagus. Ask your doctor or healthcare provider about all of your options to understand which option is best for you.
Esophagoscopy is routinely performed in an outpatient setting, although inpatient and emergency room management of gastrointestinal diseases often require urgent inpatient upper endoscopy including but not limited to esophagoscopy.
Moreover, certain conditions require routine esophageal endoscopic surveillance and therapeutics. In such cases, a procedure may be limited to esophageal exploration alone. The indications for esophagoscopy are as follows:
- Food bolus or foreign object impaction
- Evaluation and management of gastroesophageal reflux disease (GERD) including noncardiac chest pain.
- Screening and surveillance of Barrett esophagus
- Treatment and surveillance of esophageal varices
- Evaluation and management of dysphagia, including dilation of esophageal strictures
- Evaluation and management of odynophagia
- Evaluation and management of esophageal cancer including placement of esophageal stents
- Evaluation of the esophagus after abnormal imaging studies
Esophagoscopy is considered a safe procedure with a complication risk of approximately 1 per 1000 procedures.[1, 2] Absolute contraindications include the following:
- Hemodynamic instability
- Failure to obtain consent
- Possibility of perforation
Relative contraindications to esophagoscopy include the following:
- Anticoagulation in the appropriate setting (ie, esophageal dilation)
- Head and neck surgery
- Pharyngeal diverticulum
- History of procedure intolerance
Types of esophagoscopy
The types of esophagoscopy include:
- Flexible esophagoscopy is performed by inserting a thin, flexible endoscope through the mouth and down the throat into the esophagus.
- Transnasal flexible esophagoscopy is performed by inserting a thin, flexible endoscope through the nose and down the throat into esophagus.
- Rigid esophagoscopy is performed by inserting a rigid endoscope through the mouth and down the throat into the esophagus.
Why is an esophagoscopy performed?
Your doctor may recommend an esophagoscopy to diagnose and possibly treat a variety of diseases and conditions of the esophagus, and sometimes the throat and larynx (voice box). These include:
- Acid reflux, gastroesophageal reflux disease (GERD), hiatal hernia, laryngopharyngeal reflux, or heartburn
- Barrett’s esophagus, which is damage to the esophagus caused by stomach acid
- Cancer, tumor, or mass of neck, throat, airway, or esophagus
- Chronic cough or hoarseness due to such conditions as acid reflux or GERD
- Difficulty swallowing (dysphagia), painful swallowing (odynophagia) and esophageal motility disorders, such as hypertensive lower esophageal sphincter, or difficulty feeding and regurgitation in infants
- Esophageal varices, which are swollen veins in the esophagus that can bleed
- Foreign body evaluation and removal
- Globus sensation, which is a feeling of a lump in the throat
- Narrowing or compression of the esophagus due to such conditions as scar tissue or a muscle disorder
- Trauma to the esophagus, such as a tear or injury from violent and repeated coughing or vomiting
- Vomiting blood from such conditions as a bleeding ulcer in the upper gastrointestinal tract or veins in the esophagus