Endoscopy vs. Colonoscopy: What's the Difference?

Did you know that over your entire lifetime, the risk of developing colon cancer is one in 23 for men and one in 25 for women?¹ In fact, colorectal cancer is the second most common cause of death for cancer patients in men and women combined.² That's why getting a colonoscopy or an endoscopy is so important.

While both of these tests allow your doctor to look at your intestinal tract, they each visualize very different parts of it. Your doctor will determine which test is right for you. Here, we look at the similarities and differences between these potentially life-saving tests and why you might need one or both of them.

Endoscopy vs. Colonoscopy

An endoscopy and a colonoscopy both examine your digestive tract, but each type of test looks at a different area of it. An endoscopy, also called an upper endoscopy, will examine the esophagus, stomach and small intestines while a colonoscopy looks at your large intestine, colon and rectum.³

What Is an Endoscopy?

An endoscopy lets your gastroenterologist examine your upper digestive tract using a small camera that takes high-quality images.³ This invasive procedure is typically performed under deep or light anesthesia and your doctor may take biopsies of any areas of concern during your endoscopy.⁴ The procedure typically lasts 10 to 30 minutes.⁵

How does an endoscopy work?

An endoscopy is performed by a doctor using a thin, flexible tube with a light and camera at the end called a gastroscope. The physician inserts the gastroscope into your mouth and guides it down your throat into your esophagus, stomach and then the part of your small intestine known as the duodenum.⁴

What does an endoscopy show?

The endoscopy will show your doctor if there are any precancerous polyps present within your digestive system. During the procedure, your doctor can remove these polyps. It can also show the doctor if there are any other signs of disease present.⁴

What if a bravo capsule is inserted?

For those experiencing symptoms of acid reflux, your doctor may insert a Bravo capsule during your endoscopy. The doctor places the capsule on the wall of your esophagus to monitor the amount of acid reflux that occurs over 48 hours. This information is then transmitted to a receiver that you wear on your waistband or belt. During this time, you will also keep track of your symptoms, including things like heartburn and belching, in a diary.⁶

After 48 hours, you will return the receiver unit to your doctor along with the diary. There is no need to have the capsule removed as it will fall off naturally and pass through your digestive system where you will eliminate it through a bowel movement.⁶

What Is a Colonoscopy?

A colonoscopy allows your gastroenterologist to examine your lower digestive tract using a small camera that takes high-quality images. This invasive procedure is typically performed under deep or light anesthesia and your doctor may take biopsies of any areas of concern during your colonoscopy.⁴ A colonoscopy typically takes around 45 to 60 minutes.³

How does a colonoscopy work?

A colonoscopy is performed by a doctor using a thin, flexible tube with a light and camera at the end called a colonoscope. The physician inserts the gastroscope into your rectum while you lay on your side and guides it through your large intestine and into your colon.⁴

What does a colonoscopy show?

The colonoscopy will show your doctor if there are any precancerous polyps present within your lower digestive system. A colonoscopy can detect up to 95% of cancerous polyps and growths.⁴

During a colonoscopy, your doctor can remove any polyps found.⁷ The procedure can also show the doctor if there are any other signs of disease present.⁸

Which Procedure Should You Have?

Whether you have an endoscopy, a colonoscopy, or both, depends on what your doctor recommends. Endoscopy is typically recommended for those who are suffering from symptoms such as:⁴

• Nausea
• Vomiting
• Abdominal pain
• Trouble swallowing
• Gastrointestinal bleeding
• Acid reflux⁶

Your doctor will use the test to determine the cause of these symptoms. This test might also be recommended if you have Crohn's disease to examine the progress of the disease.⁹

A colonoscopy is typically recommended for those who:⁴

• Are over 45 years old
• Have a personal or family history of colorectal cancer or polyps
• Have had adenomatous polyps or have a family history of them
• Suffer from inflammatory bowel diseases including ulcerative colitis and Crohn's disease
• Experience frequent constipation or diarrhea¹
• Have abdominal bleeding
• Are of African American descent
• Suffer from Lynch syndrome

Safety of Endoscopy and Colonoscopy

Both of these procedures are considered relatively safe but they are not without some risk, even if it is slight.¹⁰ Complications after endoscopy or colonoscopy include pancreatitis,¹¹ a perforated intestine, perforation at a biopsy site, severe bleeding, injury to the bowel wall, infection and an adverse reaction to the anesthesia.¹ Discuss these risks with your doctor to determine if either of these procedures is right for you.

Can I Have an Endoscopy and a Colonoscopy at the Same Time?

Yes, your doctor may recommend having these procedures done on the same day. This means that you won't have to go through anesthesia more than once and any blood tests before your procedures won't need to be repeated.¹²

Your doctor may also recommend having both tests done to definitively diagnose a condition such as Crohn's disease or ulcerative colitis. While ulcerative colitis affects only the large intestine, Crohn's disease can affect the small intestine and other parts of the digestive tract. Having both tests is therefore helpful in determining which condition could be affecting you.⁹

Before an endoscopy procedure, your doctor may tell you not to eat or drink for anywhere from six to eight hours. Unlike a colonoscopy, there is no bowel prep for this procedure.⁵

Before a colonoscopy procedure, your doctor may tell you not to eat the day before. You will also need to avoid liquids that aren't clear during this time and you must avoid red or purple liquids. No milk products are allowed.¹³

Typically, you'll be able to drink things like:¹³

• Water
• Orange and lemon-lime Gatorade
• Sprite
• Chicken, beef or vegetable broth
• Ginger ale
• Apple juice
• Tea or coffee with no milk

In addition, you'll need to do a bowel prep, which involves taking laxatives or a laxative solution at various intervals the day before the procedure and the day of the procedure.⁴ Many doctors will prescribe one package of Dulcolax tablets and two 10-oz. bottles of magnesium citrate, which must not be red, as your prep.¹³

The day before the colonoscopy you will take four Dulcolax tablets with an 8-oz. glass of water and the first bottle of magnesium citrate with an eight ounce glass of water in the evening. On the day of the procedure, five hours beforehand, you'll take the second bottle of magnesium citrate and an 8-oz. glass of water. After this, you shouldn't have anything else to drink.¹³

Recovery and Side Effects From Endoscopy vs. Colonoscopy

After an endoscopy, you might feel sleepy, nauseous¹ or groggy from the anesthesia.³ Getting some rest and eating bland foods for the remainder of the day should help you recover.³

Even if you feel alert, you'll need an adult to drive you home. The same is true after a colonoscopy.³

Expect some throat irritation after an endoscopy for a few days. This is normal. You may also feel bloated or gassy because air enters into the digestive tract during the procedure. This will subside naturally when you pass gas.⁴

You may also experience cramping or bloating during and after a colonoscopy because air also enters the colon during the procedure. Passing gas should relieve this in the days after the procedure. If a biopsy was performed or a polyp removed, you may have a small amount of bleeding in the rectum which should subside in a few days.¹

Note that while minor discomfort in the area of your throat after an endoscopy is normal, having chest pain, shortness of breath, trouble swallowing, fever, or vomiting could indicate a more serious complication. These symptoms require immediate medical attention.¹⁴

Costs of Endoscopy and Colonoscopy

Cost of endoscopy

The average cost of an endoscopy is $2,750. On the low end, you can expect to pay around $1,200, while on the high end it could range from $4,800 to $12,500.¹⁵

Cost of colonoscopy

The average cost of a colonoscopy is the same at $2,750. On the low end, you can expect to pay around $1,200, while on the high end it could range from $4,800 to $12,500.¹⁶

Does Health Insurance Cover an Endoscopy or Colonoscopy?

Your health insurance will likely cover your colonoscopy because it is considered a medically necessary screening test.¹⁷ The insurance will also likely cover an endoscopy if your doctor deems it medically necessary. However, you may still be responsible for additional costs such as:

• Copays
• Co-insurance
• Deductibles
• Facility fees

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Author Bio

Susan Paretts is a freelance writer with 18 years of experience covering health and wellness, pet care, and more. Her work has been published by the American Kennel Club, Bayer Animal Health, Elanco, LIVESTRONG.com, Care.com, City National Bank, The San Francisco Chronicle, Chewy, and more.