The principles of decontamination in gastrointestinal endoscopy

Modern endoscopes can be used to examine the whole of the gastrointestinal (GI) tract. During these examinations, biopsies may be taken, or treatment provided via working channels in the endoscope. Demand for GI endoscopy is increasing because of the National Bowel Cancer Screening Programme and a rise in dyspepsia. Endoscopes are complex and expensive, so are reused. To prevent cross-infection and cross contamination, endoscopes need to be adequately decontaminated between patients; there are specific concerns around transmission of variant Creuztfeldt-Jakob disease. Endoscopes are sensitive to heat and cannot be autoclaved, so other methods of decontamination are needed. This article looks at endoscope decontamination processes, and the systems and management that need to be in place.