Case scenario

John, 62, regularly visits your community pharmacy. Following his referral to a gastroenterologist, he presents to purchase a bowel cleansing kit and asks for advice about his upcoming endoscopy and colonoscopy. John reports a history of difficulty swallowing certain foods and says a family member recently told him that his grandfather had bowel cancer. He is feeling anxious about the procedures and the bowel preparation.

Introduction

Endoscopy and colonoscopy are commonly performed gastrointestinal procedures that pharmacists may encounter. Patients may require counselling before and after investigations. Endoscopy refers to procedures that use an endoscope – a thin, flexible tube with a light and camera – to examine internal organs. However, in both clinical and public contexts, particularly in gastroenterology, the term endoscopy is generally used to refer specifically to oesophagoscopy, gastroscopy or duodenoscopy, which involves examining the upper gastrointestinal tract (oesophagus, stomach and duodenum). Colonoscopy is the term used specifically for the examination of the lower gastrointestinal tract (colon/bowel) and includes the entire colon, rectum and terminal ileum. Both procedures are usually performed by gastroenterologists, although colonoscopies may also be performed by colorectal surgeons.1

Learning objectives

After reading this article, pharmacists should be able to:

  • Describe endoscopy and colonoscopy procedures and their clinical indications
  • Discuss potential adverse events and post-procedure effects
  • Advise patients regarding bowel

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