What is a gastroscopy?
Gastroscopy, also known as upper endoscopy, is a medical procedure that allows doctors to examine the upper digestive tract. During the procedure, a thin, flexible tube with a camera and light attached to it, called an endoscope, is inserted into your mouth and passed down your throat to your stomach and the first part of your small intestine. The camera on the endoscope transmits images to a screen to allow diagnoses, guide sampling, or allow treatment.
Why is gastroscopy an important option?
Gastroscopy is a safe and important diagnostic tool that can help doctors identify problems in the upper digestive tract. Gastroscopy can also allow minimally invasive treatment of a broad range of conditions.
Is gastroscopy safe?
Gastroscopy is generally considered a safe procedure with few risks. Serious complications are rare. However, there is a small risk of bleeding, perforation, infection, or issues related to anaesthesia. Dilatation procedures (for narrowing of the gut tube, most often in the oesophagus) is generally performed in increments of around 3mm per procedure. Sticking to this approach is very effective at reducing the risk of perforation
When is gastroscopy performed?
Gastroscopy is usually performed to evaluate symptoms of indigestion, abdominal pain, nausea, vomiting, or difficulty swallowing. It may be indicated for diarrhoea or malabsorption, especially if coeliac disease is suspected. Sometimes gastroscopy is performed to treat conditions such as bleeding ulcers or to remove a foreign body. Patients with risk factors for stomach cancer or Barrett’s oesophagus should be screened for these conditions using gastroscopy.
It is important to investigate symptoms like swallowing difficulty as they may indicate underlying conditions that may require urgent treatment.
Barrett’s Oesophagus
Barrett’s oesophagus is a condition where the lining of the oesophagus changes and becomes more like the lining of the intestine. It is associated with an increase risk of oesophageal cancer, and identifying and managing the problem may reduce this risk.
Screening should be offered in patients with a family history of Barrett’s or oesophageal cancer, or in patients with a history of long-standing or recurrent heartburn/reflux and one or more additional risk factors (male, age 50, body mass index over 30, or smoking).
Screening gastroscopy for gastric cancer can be considered from age 40-80 in patients with a family history of the condition, from high risk areas (i.e. North East Asia), or with conditions associated with the disease (gastric intestinal metaplasia).
It should also be discussed in certain genetic conditions that increase risk (FAP, Lynch/HNPCC). There may be benefit for screening in other conditions (i.e. pernicious anaemia, prior partial gastrectomy for benign conditions).
How do I prep for a gastroscopy?
Before the procedure, you will need to fast for six hours (with the exception of small amounts of water and black tea/coffee without milk or other additives until two hours prior). You may also need to stop taking certain medications, particularly blood thinners and diabetic medications. Your current medications should be provided to the doctor before the procedure. Your doctor may give you personalised instructions on how to prepare for the procedure.
What should I expect?
Gastroscopy is usually performed on an outpatient basis which means that you can go home on the same day as the procedure. The procedure typically takes between 15 and 30 minutes. You will be given a sedative to help you relax and minimise discomfort during the procedure, which means that you need someone to take you home and cannot drive or make important decisions in the 24 hours after the procedure. You may feel bloated or have a sore throat after the procedure but these symptoms should go away within a few hours.
