Is endoscopy reliable?

[CBB]

A close friend has been experiencing difficult bowel movement for about two years during which he has gone for endoscopy for two years. In both instances he was told that he was cleared of any signs of cancer. Yet, he still experiences pencil-shaped stools and believes that the colour of his stool has gone darker than usual. He has also been experiencing constant stomach discomfort like bloatness and pain in the area of his stomach. Both his father and grandfather died of stomach cancer. What should he do now???

[Wilson]

Endoscopy is very reliable if the problem is in the areas the scope can reach. But a colonoscopy only covers the colon, and an upper scope covers to just past the duodenum (first part of the small intestine). If your friend has a problem anywhere along the 23 feet or so of his small intestine that can't be viewed by scope, obviously endoscopy cannot be counted on. For that a small bowel series (X-ray)is the best way to go, to my knowledge. But if he's worried about stomach cancer, gastroscopy is the very best way to detect it, and likewise colonoscopy for colon problems.

If your friend's symptoms have been going on for 2 years without progressing too much, it could very well be Irritable bowel Syndrome, especially with the ribbonlike stools. But you don't want him to take the chance of being wrong and missing a serious diagnosis. If he's had BOTH ends scoped twice, and a small bowel series recently, then he should be fairly confident there is no tumor. If he hasn't had all that, or if his doctors refuse to test again, I would probably seek a new doctor and get worked up one more time.