How are Biopsies Taken During an Endoscopy?

During an endoscopy, gastroenterologists use special tools to examine the inner lining of the upper gastrointestinal tract and collect tissue samples or biopsies for laboratory testing. As gastroenterologists advance through the upper gastrointestinal (GI) system, they can investigate and gather information from visualizations of ulcers, inflammation, and precancerous growths. Collecting biopsies and other tissue samples of these observations can help doctors confirm any instances of cancer or precancerous conditions and deliver accurate results and diagnoses to patients.

Here, we will explore the practical aspects of minimally invasive endoscopic procedures, emphasizing the importance of obtaining and analyzing tissue samples (biopsies) and carefully examining the potential risks and benefits of this crucial step.

Understanding the Endoscopic Process

Endoscopies are a minimally invasive procedure involving the insertion of a long, flexible tube equipped with a tiny camera and light through the mouth and into the upper GI system. Gastroenterologists feed the tube down through the esophagus, stomach, and small intestine, using the camera to gather visual images of the conditions of your GI tract and intestinal linings. As gastroenterologists examine the GI tract, abnormalities such as polyps, ulcers, and inflammation are documented and analyzed, and biopsies are collected and removed from the body for laboratory analysis. 

While visual inspection and analysis can provide valuable information to gastroenterologists and provide context clues toward diagnoses, further investigation from laboratories is often required to reach a definitive conclusion and deliver accurate diagnoses on specific conditions such as:

• Infection
• Cancer
• Inflammation or Irritation
• Celiac Disease
• Precancerous Conditions or Growths

Collecting Biopsies During an Endoscopy

Biopsies are commonly performed during endoscopy. During your endoscopy, the gastroenterologist will identify an area for sampling before using specialized tools for collection and removal. Special tools such as forceps or brushes are passed through channels within the endoscope and carefully guided to the targeted area. These tools perform different functions depending on the location of the target area and the depth of the sample:

Forceps Biopsy: The most common method for biopsy removal is the use of forceps to grasp and remove a small piece of tissue from the target area. 

Needle Biopsy: This technique is used to obtain samples from deeper layers of tissue in the organ walls. Thin needles are inserted into the target areas and manipulated to acquire a sample of tissue.

Brush Cytology:  This technique uses an endoscopic brush to gently brush and collect the surface layer of cells from the lining of the gastrointestinal tract. Rather than sampling, a single point this technique allows for a large area of tissue to be sampled reducing the chance of a missed cancer or precancerous lesion.

The entire biopsy process is usually quick and minimally invasive, taking place during an endoscopy, colonoscopy, or other procedure after the detection of cancer or other chronic GI issues. While the procedure is not entirely free of complications or side effects, biopsy collection in endoscopy is extremely safe, with complications occurring in less than 1% of procedures.

The Importance of Biopsy Collection and Testing

Once samples are collected, certified lab technicians will send them to a laboratory for further review under a microscope. The results of biopsies are crucial for determining further treatment decisions and diagnosing instances of cancer or chronic disease. If cancer is diagnosed, biopsy results can help doctors determine the stage and grade of the tumor, providing context for treatment plans and medications. 

Aside from cancer diagnosis, biopsies can also help doctors diagnose chronic conditions, such as celiac disease or other inflammatory illnesses. Following diagnosis, your doctors may refer you to a specialist to determine the causes of inflammation and to guide you in choosing appropriate treatment options. Inflammation in the GI system can be caused by various issues such as poor gut health, allergens, or other inflammatory diseases such as Crohn’s disease. Endoscopy and biopsy collection remain extremely important procedures, giving patients the answers they need to address symptoms, illnesses, or pain that they may be experiencing. 

Risks and Complications of Biopsies

Biopsies are crucial for diagnosing abnormalities within the GI system. Gastroenterologists utilize advanced techniques and modern practices to ensure patient safety and a smooth procedure. However, as with any medical procedure, there's an inherent risk, though minimal. While generally safe and minimally invasive, potential complications of biopsy collection may include:

Bleeding: As tissue samples are removed from the body, minor bleeding from the biopsy site is a common occurrence and usually stops on its own.

Infection: While extremely low, the risk of infection at the biopsy site remains a possibility. Infection can occur when the body's immune system is compromised, hindering the healing process at the biopsy site. Additionally, inadequate sterilization of surgical instruments can increase the risk of infection.

Perforation: In rare cases, the endoscope may puncture the wall of the organ being examined, leaving a hole. In the event of perforation, immediate surgical intervention is required to repair the hole and prevent further complications or pain. 

The risks and complications associated with endoscopic procedures, including biopsy collection, are generally minimal, contributing to a high overall success rate.

Dr. Ernest Castro, M.D. — Accurate Results and Diagnoses

Biopsies are an essential component of endoscopic procedures, providing valuable insights and information to gastroenterologists for accurate and thorough diagnosis. While few risks are associated with biopsies, the benefits of undergoing an endoscopy and biopsy collection typically outweigh the potential complications. Biopsy collection allows doctors to get a better idea of your general health profile, diagnosing instances of cancer or precancerous conditions, celiac disease, ulcers, or other GI issues.

Dr. Ernest Castro prioritizes comprehensive, personalized, and efficient healthcare, striving to restore a focus on traditional values in medicine while delivering the highest quality of patient care. As Denver’s premier gastroenterologist, Dr. Castro and his medical team take ownership of patient care, guiding patients through each step of their gastrointestinal care. Using advanced technology and techniques, Dr. Castro maintains an adenoma detection rate greater than the national average with exemplary safety records. To request an appointment or to get more information on scheduling, visit our website or call us at (720) 782-6188. 

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