Question 1

Gastroscopy (upper GI endoscopy)

Accepted Answer

Gastroscopy uses a flexible camera to examine the oesophagus, stomach, and first part of the small intestine. Diagnostic gastroscopy is used to investigate symptoms such as persistent heartburn, upper abdominal pain, difficulty swallowing, vomiting, anaemia, and bleeding, with tissue samples (biopsies) taken where needed. Therapeutic gastroscopy includes procedures to control bleeding, such as variceal band ligation, sclerotherapy, electrocoagulation, and argon plasma coagulation. It also includes the removal of polyps and placement of stents to relieve blockages in the oesophagus, stomach outlet, or duodenum.

Question 2

Colonoscopy

Accepted Answer

Colonoscopy uses a flexible camera to examine the lining of the large intestine, from the rectum through the colon. Diagnostic colonoscopy is used to investigate bleeding, changes in bowel habits, anaemia, and inflammatory bowel disease. It is also used for colorectal cancer screening and surveillance, with tissue samples (biopsies) taken where needed. Therapeutic colonoscopy includes the removal of polyps (polypectomy), control of bleeding, and placement of stents in the colon.

Question 3

Pulmonary Endoscopy

Accepted Answer

AKUH offers comprehensive diagnostic and therapeutic pulmonary endoscopic procedures performed by internationally trained interventional pulmonologists. Our speciali s ed services include: Diagnostic Airway Evaluation: Flexible bronchoscopy , including bronchoalveolar lavage (BAL), bronchial brushings, and endobronchial or transbronchial lung biopsies , to investigate respiratory conditions. Lymph Node Evaluation and Lung Cancer Staging : Endobronchial u ltrasound with t ransbronchial n eedle a spiration (EBUS-TBNA) to examine and obtain samples from lymph nodes in the chest, including those used in lung cancer staging. Complex Airway Interventions: Rigid bronchoscopy, airway stenting, balloon dilatation, and treatments such as laser therapy , a rgon p lasma c oagulation ( APC ), and cryotherapy for malignant and benign airway obstructions. Foreign Body Removal and Bleeding Control : Removal of foreign bodies from the airways and procedures to control airway bleeding (haemo sta sis). Pleural Disease Assessment: Medical pleuroscopy (thoracoscopy) for the evaluation and management of unexplained fluid accumulation around the lungs and other pleural conditions.

Question 4

Other Diagnostic Procedures

Accepted Answer

Our services also include biopsies, cytology, microbiological sampling and related investigations to help diagnose a range of conditions.

Question 5

Emergency Endoscopy

Accepted Answer

Urgent endoscopic procedures are available 24 hours a day, seven days a week, for clinically indicated emergencies.

Question 6

Therapeutic ERCP

Accepted Answer

Endoscopic retrograde cholangiopancreatography (ERCP) combines endoscopy with X-ray imaging to examine and treat conditions affecting the bile ducts and pancreatic duct. During the procedure, a flexible endoscope is passed through the mouth into the first part of the small intestine. Specialised instruments are then used to reach the ducts without the need for surgical incision. ERCP is performed under sedation or anaesthesia, with fasting required beforehand. At AKUH, ERCP is used mainly for treatment, including: Bile duct stones: Removal of stones blocking the common bile duct. Bile duct strictures: Treatment of narrowed bile ducts, including the placement of stents to relieve blockages caused by conditions such as tumours. Bile leaks: Treatment of bile leaks, including those that occur after gallbladder or other surgery, through procedures such as stent placement. As with other endoscopic procedures, ERCP carries a small risk of complications, including pancreatitis (inflammation of the pancreas), bleeding, infection, and perforation (a tear in the digestive tract or duct). Your doctor will explain the potential risks and benefits before the procedure.

Question 7

Endoscopic Ultrasound (EUS)

Accepted Answer

Endoscopic ultrasound combines endoscopy with ultrasound imaging. An endoscope fitted with a small ultrasound probe at its tip is passed through the mouth or rectum to produce detailed images of the wall of the digestive tract and of nearby organs and structures, such as the pancreas, bile ducts, gallbladder, and lymph nodes. Because the probe sits close to these structures, EUS can provide detailed images that may not be seen through external imaging alone. AKUH offers both diagnostic and therapeutic EUS, performed by internationally trained doctors. Diagnostic EUS: Used to evaluate pancreatic and bile duct conditions, gallstone disease and abnormalities identified on other scans. It can also help assess and stage tumours of the oesophagus, stomach, pancreas, and rectum. EUS-guided needle sampling, including fine-needle aspiration or biopsy, may be used to collect samples from masses, cysts, and lymph nodes. Therapeutic EUS: Provides minimally invasive treatment where clinically indicated, including drainage of pancreatic fluid collections and obstructed bile ducts when standard ERCP is not possible. EUS is usually performed under sedation. You will receive preparation instructions, including guidance on fasting, before your procedure. Your doctor will explain whether EUS is suitable for you.

Question 8

Your Experience

Accepted Answer

Undergoing an endoscopic procedure can feel unfamiliar or worrying. Our team supports patients and their families throughout the process. Preparation: You will receive clear instructions on fasting, bowel preparation, and medication adjustments before your procedure. Comfort and safety: Sedation options, continuous monitoring, and minimally invasive techniques help support your comfort and safety. Recovery: Most patients resume normal activities within hours. You will receive instructions on after-care and when you can resume your usual activities.

Question 9

Safety and Possible Complications

Accepted Answer

Endoscopic procedures are generally safe, but complications can occur. The risks depend on the type of endoscopy and any additional procedures performed. Possible complications include bleeding, infection, reactions to sedation or anaesthesia, and injury to the area being examined. Your doctor will explain the relevant risks and benefits before your procedure and answer any questions you may have.

Question 10

Booking and Referral

Accepted Answer

Whether you need a referral or a specialist consultation depends on your clinical condition. Please contact AKUH for guidance on clinic appointments and the appropriate referral pathway. Location Endoscopy Unit, D2 Ward, 2nd Floor, Main Hospital Building, The Aga Khan University Hospital, Stadium Road, Karachi. For appointments, procedure-related information, and preparation instructions, please contact: For clinic appointments, call +92 111-911-911 Endoscopy Unit: + 92 21 3486 1422 for procedure-related information and preparation instructions.

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