Impact of nonsurgical, invasive endoscopy of the diagnosis and therapy of gastrointestinal diseases.

In the last 2 decades, endoscopy has become the most reliable means of diagnosing gut disorders. With the aid of magnifying endoscopy and staining methods, gastrointestinal cancers and malignant diseases can be detected in the early stages. Endoscopic ultrasonography is currently indicated for staging digestive cancers, assessing submucosal tumors, and diagnosing biliary and pancreatic diseases. During the past decade, endoscopy evolved from a solely diagnostic tool to a therapeutic modality. Endoscopic heater probes, bipolar electrocoagulation, and laser therapy are all of effective for achieving immediate hemostasis and preventing rebleeding in actively bleeding lesions. Various ligation methods and endoscopic injection sclerotherapy safely achieve high rates of hemostasis. Endoscopic mucosal resection allows curative treatment of gastrointestinal cancer in the mucosal layer, and removal of precancerous lesions. Endoscopic balloon dilators have been developed for dilating gut stenoses. Various endoprostheses are used for palliation of malignant stenoses. Endoscopic sphincterotomy, balloon dilation, lithotripsy, and endoprosthesis placement are alternatives for biliary tract and pancreatic disease therapy. Endoscopic photodynamic therapy is useful in palliation of esophageal cancer or in ablation of dysplastic lesions in Barrett's esophagus. With advances in modern biotechnology, endoscopy continues to show value in treating or preventing diseases, with less discomfort and lower cost than other methods.