Gastrointestinal Endoscopy Unit
The Gastrointestinal Endoscopy Unit provides a comprehensive range of diagnostic endoscopic procedures, including:
- Upper Gastrointestinal Endoscopy (Gastroscopy / Esophagogastroduodenoscopy – EGD), with or without tissue biopsy sampling.
- Colonoscopy to the cecum, with optional intubation of the terminal ileum when clinically indicated, with or without tissue biopsy sampling.
- Limited Colonoscopy (Left-sided Colonoscopy / Flexible Sigmoidoscopy) to the splenic flexure, with or without tissue biopsy sampling.
- Rapid urease testing (CLO test) for the prompt and reliable detection of Helicobacter pylori infection during upper gastrointestinal endoscopy.
The Gastrointestinal Endoscopy Unit is equipped with state-of-the-art high-definition endoscopic systems, incorporating advanced image-enhancement and virtual chromoendoscopy technologies. This enables the acquisition of high-quality endoscopic images and supports accurate diagnostic assessment. Endoscopic reports are accompanied by comprehensive photographic documentation.
The Unit is further equipped with a modern automated endoscope reprocessing and high-level disinfection system, ensuring full compliance with international standards for infection prevention and patient safety.
The expertise and extensive clinical experience of our gastroenterologists, together with our highly trained endoscopy nursing staff, ensure that all procedures are performed with the highest standards of safety, comfort, and patient-centered care in a welcoming and professional environment.
The Gastrointestinal Endoscopy Unit is certified according to ISO 9001:2015 Quality Management System standards.
About Colonoscopy
Colonoscopy is a safe and highly effective diagnostic procedure that enables direct visualization of the inner lining of the large intestine (colon) and, when clinically indicated, the terminal ileum, which is the final segment of the small intestine. It is considered the gold standard examination for the evaluation of colorectal symptoms, the investigation of gastrointestinal disorders, and the prevention and early detection of colorectal neoplasia.
During the procedure, the gastroenterologist may obtain targeted or systematic tissue samples (biopsies) for histopathological evaluation when clinically indicated.
The examination is performed using a colonoscope, a flexible, narrow endoscope approximately the width of a finger, equipped with a high-definition imaging system that allows detailed assessment of the colonic and ileal mucosa.
Bowel Preparation
Successful colonoscopy depends on adequate bowel cleansing, which is essential for optimal visualization of the colonic mucosa and accurate detection of abnormalities, including polyps, inflammatory lesions, and early neoplastic changes.
Detailed instructions regarding bowel preparation are provided separately and should be carefully reviewed and followed precisely as directed. Inadequate bowel preparation may reduce the diagnostic accuracy of the examination and, in some cases, necessitate repetition of the procedure.
Medications and Medical Conditions
Prior to the examination, patients should inform their physician and the endoscopist if they are receiving:
- Antiplatelet therapy (e.g., aspirin Aspirin®, Salospir®, clopidogrel Plavix®, or combination antiplatelet agents such as aspirin/clopidogrel Duoplavin®).
- Anticoagulant therapy (e.g., acenocoumarol Sintrom®, warfarin Coumadin®, Panwarfin®, apixaban Eliquis®, rivaroxaban Xarelto®, dabigatran Pradaxa®, or other direct oral anticoagulants [DOACs]).
- Medications for diabetes mellitus, including insulin and oral antidiabetic agents.
- Iron supplements, which may interfere with bowel preparation and visualization of the colonic mucosa.
Depending on the indication for colonoscopy and the patient's individual thromboembolic and bleeding risk profile, temporary discontinuation, dose adjustment, or alternative management of these medications may be required. Patients should follow the specific instructions provided by their treating physician prior to the procedure.
Important: Patients should not discontinue antiplatelet agents, anticoagulants, antidiabetic medications, or any other prescribed treatment without first consulting their physician.
During the Procedure
Upon arrival at the Gastrointestinal Endoscopy Unit, patients are welcomed into a comfortable and professional environment and are positioned on an examination couch. An intravenous cannula is inserted to facilitate the administration of medications and intravenous fluids when required.
Colonoscopy is routinely performed under intravenous conscious sedation (moderate sedation), administered and monitored by appropriately trained healthcare professionals. Sedation helps patients remain relaxed and comfortable throughout the procedure, significantly reducing anxiety and procedural discomfort while facilitating a safe and effective examination.
The colonoscope is gently advanced through the rectum and navigated throughout the colon, reaching the cecum and, when clinically indicated, the terminal ileum. High-definition imaging allows meticulous examination of the intestinal mucosa, while biopsies may be obtained when necessary.
Throughout the procedure, patients are continuously monitored according to established standards of endoscopic practice and patient safety, including monitoring of oxygen saturation, heart rate, and blood pressure.
After the Procedure
Following completion of the examination, patients remain in the recovery area until the effects of sedation have sufficiently worn off. The endoscopist will discuss the preliminary findings and provide a detailed endoscopy report, including photographic documentation of the examination.
If biopsies have been obtained, histopathological results are typically available within a few days and will be reviewed with the patient during a follow-up consultation.
Quality and Patient-Centred Care
Our Gastrointestinal Endoscopy Unit combines advanced endoscopic technology with evidence-based clinical practice to provide the highest standards of diagnostic accuracy, patient safety, and comfort.
All procedures are performed by experienced gastroenterologists, supported by specialized endoscopy nursing staff and modern endoscope reprocessing systems that comply with internationally recognized quality and infection-control standards.
Our physicians and endoscopy team remain available to provide further information, answer questions, and ensure that each patient is fully informed and supported throughout every stage of the procedure.
About Gastroscopy
Gastroscopy, also referred to as Upper Gastrointestinal Endoscopy or Esophagogastroduodenoscopy (EGD), is a safe and minimally invasive procedure that allows direct visualization of the esophagus, stomach, and duodenum. It is an essential diagnostic tool for the evaluation of upper gastrointestinal symptoms and the detection of a wide range of gastrointestinal disorders.
During the examination, targeted or systematic mucosal biopsies may be obtained when clinically indicated for histopathological assessment. In addition, Helicobacter pylori infection can be accurately detected through a Rapid Urease Test (CLO Test) and, when appropriate, by histological examination of gastric biopsy specimens.
Preparation for the Examination
Adequate preparation is essential to ensure optimal visualization and procedural safety.
Patients should:
- Refrain from consuming solid food for at least eight (8) hours before the procedure.
- Avoid all liquids for at least four (4) hours prior to the examination, unless otherwise instructed by their physician or the Endoscopy Unit.
- Follow any additional preparation instructions provided by their treating physician.
Medications and Medical Conditions
Prior to the procedure, patients should inform their physician and the endoscopist if they are receiving:
- Antiplatelet therapy (e.g., aspirin, clopidogrel, dual antiplatelet therapy).
- Anticoagulant therapy (e.g., warfarin, apixaban, rivaroxaban, dabigatran, or other direct oral anticoagulants).
- Medication for diabetes mellitus, including insulin and oral antidiabetic agents.
Depending on the indication for endoscopy and the patient's individual thromboembolic and bleeding risk profile, temporary discontinuation, dose adjustment, or alternative management of these medications may be required in accordance with current international clinical practice guidelines and the recommendations of the treating physician.
During the Procedure
Upon arrival at the Gastrointestinal Endoscopy Unit, patients are welcomed into a comfortable and professional environment and are positioned on an examination couch. An intravenous cannula is inserted to facilitate the administration of medications and intravenous fluids when required.
Gastroscopy is routinely performed under intravenous conscious sedation (moderate sedation), administered by appropriately trained healthcare professionals. Sedation helps patients remain relaxed and comfortable throughout the procedure, significantly reducing anxiety and procedural discomfort while maintaining cardiorespiratory stability.
A flexible high-definition endoscope is gently advanced through the mouth into the upper gastrointestinal tract, allowing detailed examination of the mucosal lining of the esophagus, stomach, and duodenum. The procedure is generally well tolerated and typically requires only a few minutes to complete.
Throughout the examination, patients are continuously monitored according to established standards of endoscopic practice and patient safety, including monitoring of oxygen saturation, heart rate, and blood pressure.
After the Procedure
Following completion of the examination, patients remain in the recovery area until the effects of sedation have sufficiently worn off. The endoscopist will discuss the initial findings, and a detailed endoscopic report, including photographic documentation, will be provided.
If biopsies have been obtained, histopathological results are typically available within a few days and will be reviewed with the patient during follow-up consultation.
Quality and Safety Standards
All procedures are performed using state-of-the-art high-definition endoscopic equipment and are supported by rigorous infection prevention and endoscope reprocessing protocols that comply with internationally recognized quality and safety standards.
The Gastrointestinal Endoscopy Unit is staffed by experienced gastroenterologists and specialized endoscopy nurses, ensuring the highest standards of clinical excellence, patient comfort, and individualized care.
About Flexible Sigmoidoscopy (Limited Colonoscopy)
Flexible sigmoidoscopy, also referred to as limited colonoscopy, is a minimally invasive endoscopic procedure that allows examination of the distal portion of the large intestine, including the rectum, sigmoid colon, and descending colon up to the splenic flexure.
The procedure is commonly performed for the evaluation of lower gastrointestinal symptoms, rectal bleeding, changes in bowel habits, inflammatory bowel disease, and other conditions affecting the distal colon. When clinically indicated, targeted mucosal biopsies may be obtained for histopathological assessment.
Bowel Preparation
Adequate bowel preparation is essential to ensure optimal visualization of the colonic mucosa and maximize the diagnostic accuracy of the examination.
Preparation is typically achieved using rectal cleansing enemas (e.g., sodium phosphate enema preparations such as Fleet® Enema), according to the instructions provided by the Endoscopy Unit.
Preparation Instructions
For morning appointments:
- One cleansing enema should be administered on the evening before the examination.
- A second cleansing enema should be administered approximately 2–3 hours prior to the procedure.
For afternoon appointments:
- The first cleansing enema should be administered on the morning of the examination.
- The second cleansing enema should be administered approximately 2–3 hours before the procedure.
Patients should carefully follow the preparation instructions provided by their physician or the Endoscopy Unit, as inadequate bowel cleansing may compromise visualization and reduce the diagnostic yield of the examination.
During the Procedure
Upon arrival at the Gastrointestinal Endoscopy Unit, patients are comfortably positioned on an examination couch. An intravenous cannula may be inserted to facilitate the administration of medications when required.
Flexible sigmoidoscopy is typically performed under intravenous conscious sedation (moderate sedation), allowing patients to remain relaxed and comfortable throughout the procedure while minimizing procedural discomfort and anxiety.
A flexible high-definition endoscope is gently introduced through the rectum and advanced to the splenic flexure, enabling detailed examination of the distal colonic mucosa. If clinically indicated, biopsies may be obtained during the examination without causing significant discomfort.
Throughout the procedure, patients are continuously monitored according to established standards of endoscopic practice and patient safety.
After the Procedure
Following completion of the examination, patients remain under observation until recovery from sedation is achieved. The endoscopist will discuss the preliminary findings and provide a detailed endoscopic report, including photographic documentation when appropriate.
If biopsies have been obtained, histopathological results will be reviewed with the patient during follow-up consultation.
Quality and Patient Safety
Flexible sigmoidoscopy is performed using state-of-the-art high-definition endoscopic equipment and evidence-based clinical protocols. Our experienced gastroenterologists and specialized endoscopy nursing staff are committed to providing the highest standards of diagnostic accuracy, patient safety, comfort, and individualized care throughout every stage of the procedure.
Patient Preparation for Colonoscopy and Upper Gastrointestinal Endoscopy