Gastroscopy

The gastroscope is inserted through the mouth, oesophagus, and stomach into the duodenum. The lining is visually examined, and small samples (biopsies) are taken for further tests.

A gastroscopy enables a diagnosis based on which specific treatment can be given. If a bleeding site is identified, treatment can stop the bleeding, or if a polyp is found, it can be removed without a major operation. 

Other treatments can be given through the endoscope when necessary.

Who is Suitable for Gastroscopy?

Gastroscopy is suitable for individuals who experience symptoms related to digestive health, including

• Abdominal pain or discomfort,
• Difficulty swallowing,
• Persistent heartburn or acid reflux,
• Nausea or vomiting, and
• Unexplained weight loss.

Gastroscopy is also recommended for people with a family history of digestive diseases or individuals diagnosed with digestive conditions such as Crohn's disease, ulcers, or celiac disease.

What are the Benefits of Gastroscopy?

Gastroscopy is a vital diagnostic procedure that provides numerous benefits, including.

• Accurate diagnosis: Gastroscopy is an effective way to diagnose digestive conditions, including inflammation, ulcers, tumours, and blockages. The procedure lets the doctor view the digestive organs and obtain tissue samples for laboratory testing, enabling an accurate diagnosis.
• Early detection: Gastroscopy can detect digestive conditions early, allowing for timely treatment and management.
• Minimal discomfort: Gastroscopy is a minimally invasive procedure performed under sedation, reducing discomfort or pain.
• Safety: Gastroscopy is a safe procedure with a low risk of complications. However, as with any medical procedure, there is a slight risk of bleeding, infection, or perforation.

What are the Types of Gastroscopy?

There are two types of gastroscopy: diagnostic and therapeutic.

Diagnostic gastroscopy is used to diagnose digestive conditions. The doctor will use the endoscope to examine the digestive organs, take tissue samples for laboratory testing, and remove any polyps or growths.

Therapeutic gastroscopy is used to treat digestive conditions. The doctor will use the endoscope to remove tumours, stop bleeding, or widen narrow passages.

Alternative Options to Gastroscopy

Gastroscopy is a standard diagnostic procedure for investigating various upper gastrointestinal tract issues, including acid reflux, peptic ulcers, and esophageal cancer. However, in some cases, alternative diagnostic procedures may be appropriate. These alternative options may include:

• Barium swallow X-ray: This diagnostic test involves drinking a liquid containing barium, highlighting the digestive tract on an X-ray image. It is used to diagnose conditions such as esophageal strictures and tumours.
• CT scan: A CT scan is an imaging test that uses X-rays and computer technology to produce detailed body images. It is used to diagnose conditions such as tumours and blockages in the digestive tract.
• Magnetic resonance imaging (MRI): MRI is a non-invasive imaging test that uses a magnetic field and radio waves to produce body images. It is used to diagnose conditions such as tumours and inflammation in the digestive tract.

While these alternative options suit some patients, gastroscopy remains the gold standard for diagnosing upper gastrointestinal tract issues.

Preparation Before Gastroscopy Procedure

• You will be asked to fast for a specified period before the procedure.
• You will be given sedation or anaesthesia to help them relax and minimise any discomfort.
• Your doctor will explain the procedure's risks and benefits and answer any questions.

Medications Before the Procedure

You will be informed when to stop eating and drinking or take your usual medicine, depending on the time of day your procedure has been scheduled.

Most medicines can be taken, as usual. However, if you are unsure, please speak to your doctor.

• Omit your diabetes tablets on the morning of the test. If you take insulin, take half your usual dose. Three days before the test, you must stop taking SGLT2 inhibitors (medications ending with—ozin). The nurses will check your blood sugar when you arrive at the hospital.
• Anticoagulants (blood thinners), such as warfarin (Coumadin), apixaban, etc., must be stopped for 3 to 5 days. You must discuss this with your doctor as you may need injections during this period.
• Antiplatelet agents such as aspirin and clopidogrel (Plavix) must stop for one week. If you have stents in your heart, DO NOT stop the medicine without your cardiologist’s permission. If necessary, aspirin can be continued up to the day of the test.
• Most other drugs (for high blood pressure, cholesterol, depression, reflux, etc.) can be taken up to 2 hours before coming to the hospital with some water.

What Happens During a Gastroscopy?

• You will be positioned on your side or back with your head tilted forward. A mouthguard will be placed in your mouth to protect your teeth and the endoscope from damage.
• The doctor will then insert the endoscope through your mouth and throat. The endoscope allows the doctor to visualise the digestive organs on a monitor. The doctor will instruct you to swallow the endoscope as it passes down your throat.
• The doctor will use the endoscope to examine the lining of your oesophagus, stomach, and duodenum. The camera on the endoscope will transmit images of the digestive organs to a monitor. The doctor will carefully inspect the organs for abnormalities like inflammation, ulcers, or tumours.
• If the doctor sees any suspicious areas, they may take tissue samples for laboratory testing. The doctor will use specialised tools passed through the endoscope to remove a small tissue sample, which will be sent to a laboratory for analysis.
• Once the examination is complete, the doctor will carefully remove the endoscope from your mouth. The entire procedure usually takes between 15 to 30 minutes, depending on the findings and the need for tissue sampling.

What Happens After the Gastroscopy?

After the procedure, you will be taken to a recovery area, where you will be monitored until the sedative wears off. 

You will be advised not to drive or operate heavy machinery for the rest of the day. 

After the procedure, you may experience mild discomfort, bloating, or sore throat, but these symptoms should resolve within a few hours.

Gastroscopy Procedure Aftercare Instructions

Although gastroscopy is a relatively safe and quick procedure, following the appropriate aftercare instructions is essential to ensure a smooth recovery. 

Rest and Hydration:

After the procedure, it is essential to rest for several hours until the sedative's or anaesthesia's effects have worn off. You should avoid driving or operating heavy machinery during this time. 

Drink plenty of clear liquids, such as water, to help hydrate your body and prevent dehydration. Avoid drinking alcohol or caffeinated beverages, which can cause dehydration.

Diet

Your doctor will provide specific dietary instructions based on your individual needs. Generally, it is advisable to start with small amounts of clear liquids, such as water, apple juice, or broth, and gradually progress to more substantial foods as tolerated. Avoid spicy or fatty foods, which can irritate the digestive tract.

Medications

Your doctor may prescribe medications to help manage discomfort or pain after the procedure. Follow your doctor's instructions carefully, and do not take over-the-counter medications without consulting your doctor first. Avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen, which can increase the risk of bleeding.

Physical Activity

Avoid strenuous physical activity, heavy lifting, or intense exercise for at least 24 hours after the procedure. Light activities like walking or gentle stretching are encouraged to help prevent blood clots and promote circulation.

Follow-Up Care

Your doctor will discuss the results of the procedure and any necessary follow-up care. Attending all scheduled appointments and following your doctor's instructions carefully is essential to ensure the best possible outcome.

Watch for Warning Signs

Although complications are rare, warning signs that may indicate a problem after the procedure must be monitored. These may include severe abdominal pain, difficulty breathing, chest pain, fever, or chills. If you experience any of these symptoms, seek medical attention immediately.

Risk and Complications of Gastroscopy

While gastroscopy is generally safe, there is a slight risk of complications, including bleeding, infection, and perforation of the digestive organs. You may also experience adverse reactions to sedation or anaesthesia. However, these risks are relatively rare and can be minimised by following your doctor's instructions before and after the procedure.

What if Gastroscopy is Delayed?

If gastroscopy is delayed, you may experience prolonged symptoms and delayed diagnosis and treatment of digestive conditions. In some cases, alternative diagnostic procedures may be appropriate. It is essential to discuss any concerns with your doctor and follow their recommendations for the best course of action.