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Gastroenterology is the medical specialty that focuses on the digestive system, encompassing the gastrointestinal (GI) tract, liver, pancreas, and gallbladder.

Gastroenterologists are specialists in diagnosing and treating a wide range of digestive disorders, from common conditions like acid reflux to complex diseases such as inflammatory bowel disease and liver cirrhosis.

To do this, they employ various procedures to examine and treat the GI system.

In this guide, we will explore these gastroenterology procedures in detail, shedding light on their purposes, how they are performed, and their significance in the field of digestive health.

Introduction to Gastroenterology Procedures


Gastroenterology procedures are invaluable tools that gastroenterologists use to diagnose, treat, and manage a wide array of gastrointestinal and hepatobiliary conditions.

These procedures provide a direct view of the internal structures of the digestive system, enabling accurate diagnosis and, in many cases, therapeutic interventions.

Diagnostic procedures are primarily used to assess the condition of the GI tract and adjacent organs, while therapeutic procedures involve the treatment of various digestive disorders.

Let’s delve into these procedures in detail, starting with diagnostic methods.


Diagnostic Procedures


  • Upper Endoscopy (Esophagogastroduodenoscopy or EGD)
  • Colonoscopy
  • Flexible Sigmoidoscopy
  • Capsule Endoscopy
  • Endoscopic Ultrasound (EUS)
  • Imaging and Radiological Tests

Therapeutic Procedures


  • Polypectomy
  • Endoscopic Mucosal Resection (EMR)
  • Endoscopic Submucosal Dissection (ESD)
  • Esophageal Dilation
  • Gastrostomy and Jejunostomy Tubes


Advanced Gastroenterology Procedures


  • Endoscopic Retrograde Cholangiopancreatography (ERCP)
  • Percutaneous Endoscopic Gastrostomy (PEG)
  • Liver Biopsy


Diagnostic Procedures


Upper Endoscopy (Esophagogastroduodenoscopy or EGD)

Purpose: Upper endoscopy is a procedure that allows the gastroenterologist to examine the lining of the esophagus, stomach, and the upper part of the small intestine (duodenum). It is used to diagnose conditions like acid reflux, ulcers, gastritis, and Barrett’s esophagus.

Procedure: A thin, flexible tube with a light and camera at the tip is inserted through the mouth and guided down the throat. This provides real-time images of the upper GI tract, allowing the doctor to examine the tissues and take biopsies if necessary.




Purpose: Colonoscopy is used to examine the large intestine (colon) and rectum. It is an essential tool for colorectal cancer screening and the diagnosis of conditions like inflammatory bowel disease and colorectal polyps.

Procedure: A long, flexible tube (colonoscope) with a camera is inserted through the rectum. It allows the doctor to visualize the colon’s inner lining and detect abnormalities. During the procedure, the gastroenterologist can also remove polyps or take biopsies.


Flexible Sigmoidoscopy

Purpose: This procedure focuses on examining the sigmoid colon, the last portion of the colon before the rectum. It is primarily used for colorectal cancer screening and the evaluation of lower GI tract symptoms.

Procedure: A flexible sigmoidoscope is inserted through the rectum to examine the sigmoid colon. It offers a limited view of the lower part of the colon, making it a valuable screening tool for certain conditions.


Capsule Endoscopy

Purpose: Capsule endoscopy is a non-invasive method for imaging the small intestine. It is particularly useful for diagnosing conditions like Crohn’s disease and obscure gastrointestinal bleeding.

Procedure: Patients swallow a small, pill-sized capsule with a camera inside.

As the capsule moves through the digestive system, it captures images, which are transmitted to a receiver worn on the body. The images are later reviewed by the gastroenterologist.


Endoscopic Ultrasound (EUS)

Purpose: EUS combines endoscopy and ultrasound to obtain detailed images of the digestive tract and nearby structures. It is often used for staging cancer and evaluating the pancreas and bile ducts.

Procedure: A thin, flexible tube is equipped with an ultrasound transducer and inserted through the mouth or rectum, depending on the area to be examined. EUS provides high-resolution images that help in diagnosing and staging diseases.


Imaging and Radiological Tests

In addition to endoscopic procedures, gastroenterologists also use various imaging and radiological tests to diagnose digestive and liver conditions:

  • Computed Tomography (CT) Scan: A non-invasive imaging technique used to assess the abdominal organs and surrounding structures.
  • Magnetic Resonance Imaging (MRI): MRI provides detailed images of the abdomen and is especially useful for evaluating the liver and bile ducts.
  • Ultrasound: Ultrasound is employed to visualize the liver, gallbladder, and blood vessels.
  • X-rays: X-ray studies with contrast agents, such as a barium swallow or enema, can reveal structural abnormalities in the GI tract.


Therapeutic Procedures


In addition to diagnosis, gastroenterologists perform a range of therapeutic procedures to manage and treat various gastrointestinal conditions:


Purpose: Polyps are growths on the inner lining of the colon, and some can potentially develop into cancer. A polypectomy is performed during a colonoscopy to remove these polyps.

Procedure: A wire loop or snare is inserted through the colonoscope, allowing the gastroenterologist to remove polyps by cutting them from the colon wall.


Esophageal Dilation

Purpose: Esophageal dilation is performed to widen a narrowed or constricted esophagus, often due to conditions like strictures or Schatzki rings.

Procedure: A dilating device, such as a balloon or bougie, is used to gently stretch the esophagus, relieving symptoms like difficulty swallowing.


Gastrostomy and Jejunostomy Tubes

Purpose: Gastrostomy and jejunostomy tubes are placed in the stomach or jejunum (part of the small intestine) to provide enteral nutrition to patients who cannot eat or drink normally.

Procedure: A tube is inserted through the skin and into the stomach or jejunum to deliver liquid nutrition directly into the digestive tract.


Advanced Gastroenterology Procedures


Endoscopic Retrograde Cholangiopancreatography (ERCP)

Purpose: ERCP is a procedure to examine the bile ducts, pancreatic duct, and gallbladder. It is used for diagnosing and treating conditions like gallstones, pancreatitis, and bile duct obstructions.

Procedure: A flexible endoscope is passed through the mouth into the duodenum.

A contrast dye is injected into the ducts, and X-rays are taken to visualize any blockages or abnormalities. Therapeutic interventions, such as stone removal, can be performed during ERCP.


Percutaneous Endoscopic Gastrostomy (PEG)

Purpose: PEG is a method for placing a feeding tube directly into the stomach for long-term nutritional support, commonly used in individuals who cannot eat or drink normally.

Procedure: A tube is inserted through the abdominal wall and into the stomach, allowing for the administration of nutrition and medications.


Liver Biopsy

Purpose: A liver biopsy is performed to obtain a small sample of liver tissue for examination, aiding in the diagnosis and staging of liver diseases.

Procedure: A needle is inserted through the skin into the liver, and a small tissue sample is collected for analysis.

Conclusion: The Evolving Landscape of Gastroenterology Procedures


Gastroenterology procedures have revolutionized the diagnosis and treatment of gastrointestinal and hepatobiliary conditions.

They provide gastroenterologists with the tools to not only understand the inner workings of the digestive system but also to intervene and treat various disorders effectively.

As technology and research continue to advance, the field of gastroenterology will only become more precise, patient-friendly, and outcomes-focused.

This evolution offers hope to individuals dealing with digestive diseases, as it promises more accurate diagnoses, less invasive treatments, and improved overall care.

For individuals with gastrointestinal symptoms or those at risk of digestive conditions, seeking the expertise of a gastroenterologist and considering these procedures, when necessary, can lead to better outcomes and a higher quality of life.

Gastroenterology procedures are not just medical tools; they are pathways to understanding, treatment, and digestive well-being.




Contact Dr. Deetlefs


Dr Eduan prides himself on his ability to help his patients to the best of his ability by embracing good listening skills, effective communication, compassion and knowledge and skill honed during years of private gastroenterology practice.

If you would like to book an appointment with a gastrointestinal (GI) specialist or would simply like more information on a particular GI topic, don’t hesitate to use our online booking form or call Dr. Deetlefs at 021 551 867.


The information on this website is to provide general guidance. In no way does any of the information provided reflect definitive medical advice and self-diagnoses should not be made based on information obtained online. It is important to consult a Gastroenterologist or medical doctor regarding ANY and ALL symptoms or signs including, but not limited to: abdominal pain, haemorrhoids or anal / rectal bleeding as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today and schedule a consultation.

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© Dr. Eduan Deetlefs, Registered Gastroenterologist, GI Doc Cape Town

Our website information is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a doctor about your specific condition. Only a trained physician can determine an accurate diagnosis and proper treatment.