Gastroscopy

Gastroscopy

What is a gastroscopy?

Gastroscopy is a procedure to examine the interior of the gullet, stomach, and duodenum. It involves using a thin, flexible fiber-optic instrument passed through the mouth, allowing the doctor to visually inspect the lining of the esophagus and stomach for any signs of damage or ulcers.

The decision to perform gastroscopy is typically made by the GP, who determines whether drug treatment alone is sufficient or if further investigation at the hospital is necessary.

The procedure is generally painless and is often conducted under light sedation as a day-case patient in a specialized endoscopy unit. Occasionally, it may be performed without sedation after discussion with the endoscopist. If sedation is used, the patient should refrain from driving or operating machinery for the remainder of the day.

Individuals experiencing stomach issues should consult a doctor, who will usually initiate treatment for symptoms without requiring extensive examination.

How is a gastroscopy performed?

After explaining the procedure, the endoscopist applies a local anesthetic spray to the back of the throat, similar to that used by dentists, to numb the area and ease discomfort. Sedation may also be administered, although the patient remains conscious and aware throughout the procedure.

The patient is positioned on their left side, and the endoscopist gently inserts the instrument into the mouth, instructing the patient to swallow it, akin to swallowing a large piece of food.

Air may be introduced into the stomach to aid examination, which could cause mild discomfort or a need to belch. This is normal.

The endoscopist meticulously examines the lining of the esophagus, stomach, and duodenum to identify any underlying issues, a process typically lasting 10 to 15 minutes.

Why is gastroscopy useful?

Gastroscopy allows the doctor to thoroughly examine the mucous membrane of the stomach, identifying irritations, wounds, or tumors. It has largely replaced X-rays in diagnostics due to its precision and safety.

Through the gastroscope, the doctor can obtain samples or photographs of the mucous membrane, aiding in diagnosis. Modern gastroscopes can display stomach areas on a TV screen for a comprehensive examination, with recordings made for future reference.

Indigestion symptoms often prompt gastroscopic examinations, which can usually be managed with medication. In some cases, ulcers, often caused by bacterial infections, may be detected and biopsied during the procedure for accurate diagnosis.

While rare, a small number of patients with indigestion may have cancer, which can be identified through biopsy during gastroscopy, leading to further investigations for appropriate treatment.

Can gastroscopy examine other body parts?

Gastroscopy can also inspect the esophageal mucous membrane on its route to the stomach, aiding in the diagnosis of diseases with symptoms resembling those of stomach ailments. This independent examination is termed oesophagoscopy.

How far can a gastroscope see?

A gastroscope can only examine the lining of the esophagus, stomach, and duodenum, detecting conditions causing symptoms in those organs but unable to identify issues like gallstones or pancreatic disease.

Are there other uses for gastroscopy?

Increasingly, gastroscopy is employed to obtain biopsies from the upper small bowel, mainly to rule out coeliac disease, although this is typically arranged at a hospital clinic.

Why not just opt for an X-ray?

While X-rays were previously used for diagnosing indigestion symptoms, gastroscopy offers increased diagnostic accuracy and the ability to perform biopsies, making it the preferred choice in many cases.

Is gastroscopy safe?

Outpatient diagnostic gastroscopy is generally very safe, with minor complications uncommon and major complications extremely rare.