Q. What is the role of endoscopy in diagnosing melena?
Doctor Answer is medically reviewed by SecondMedic medical review team.
Endoscopy plays a crucial role in diagnosing the cause of melena. It is one of the primary methods used by healthcare professionals to investigate and identify the source of gastrointestinal bleeding when melena is present. Here's how endoscopy is used in diagnosing melena:
1. Upper Endoscopy (Esophagogastroduodenoscopy, EGD): This procedure involves the insertion of a flexible, lighted tube with a camera (endoscope) through the mouth and into the esophagus, stomach, and duodenum. It allows for direct visualization of the upper gastrointestinal tract, including the lining of the esophagus, stomach, and the first part of the small intestine (duodenum).
- Ulcers: EGD can identify peptic ulcers and assess their size and location.
- Varices: It can detect esophageal varices and assess their severity.
- Inflammation: EGD can reveal signs of inflammation, such as gastritis or esophagitis.
- Tumors: EGD can identify tumors or growths in the upper GI tract, including stomach cancer.
- Tears or lesions: Mallory-Weiss tears or other lesions in the esophagus or stomach lining can be visualized and assessed.
2. Colonoscopy: While melena typically indicates upper gastrointestinal bleeding, it's essential to rule out lower gastrointestinal bleeding as well. Colonoscopy is a procedure that involves the insertion of an endoscope through the rectum to visualize the colon and rectum. It can identify bleeding sources in the lower gastrointestinal tract, such as diverticulosis, polyps, or colorectal cancers.
3. Capsule Endoscopy: In some cases, when upper endoscopy and colonoscopy do not reveal the source of bleeding, capsule endoscopy may be used. This involves swallowing a small, disposable capsule with a camera that transmits images as it passes through the entire digestive system. It can help identify bleeding sources in the small intestine.
Endoscopy allows for direct visualization of the gastrointestinal tract and often provides a definitive diagnosis for the cause of melena. Once the source of bleeding is identified, healthcare professionals can determine the most appropriate treatment plan, which may include medical management, endoscopic therapy, or surgery, depending on the underlying condition. It's important for individuals with melena to undergo endoscopic evaluation as part of the diagnostic process to ensure the proper management of their condition.