What is Gastroscopy?

Gastroscopy, also known as “Upper endoscopy”, is a medical procedure performed using a thin, flexible scope equipped with a camera. This allows doctors to examine the upper part of the digestive system, including the esophagus, stomach, and duodenum (the first part of the small intestine).

This procedure is typically safe and quick and is used to diagnose a wide range of health issues and, at times, even treat them during the procedure. (1)

Indications

An upper gastrointestinal endoscopy is recommended for various diagnostic and therapeutic purposes. The most common reasons include: (2)

1. Unexplained Symptoms:

• Persistent abdominal pain.
• Acid reflux that does not respond to treatment.
• Difficulty swallowing; food or liquids feel stuck in the throat.
• Iron-deficiency anemia without any visible bleeding or known cause.

2. Diagnosing Certain Conditions:

• Gastroesophageal reflux disease (GERD).
• Celiac disease.
• Upper gastrointestinal cancers or Barrett’s esophagus (a condition that alters the lining of the esophagus).
• Clarifying abnormal findings from imaging tests.

3. Therapeutic Purposes:

• Stopping bleeding, such as that caused by ulcers.
• Removing polyps or other abnormal growths.
• Dilating strictures in the esophagus using specialized balloons or dilation tubes.
• Extracting foreign objects accidentally swallowed.
• Monitoring recovery, progression, or recurrence of prior issues like tumors, growths, or ulcers.

How to Prepare

The medical team will provide specific instructions based on your individual case, to help you prepare for the gastroscopy. These generally include: (3)

1. Fasting: Avoid eating any food for at least 8 hours and drinking liquids for 4 hours before the procedure, depending on your doctor's specific instructions.
2. Medication Adjustments: You can usually continue taking your regular medications, but certain drugs, like blood thinners, may be paused temporarily as per your doctor’s guidance.

Inform your doctor about all medications and supplements, especially those for chronic conditions like diabetes or heart disease, to receive proper guidance.

How is the Procedure Performed?

A gastroscopy typically takes 10 to 20 minutes and follows these steps: (4)

• Preparation:
  • A sedative is usually administered through an IV line to help you relax.
  • A throat spray or numbing solution may be used to minimize discomfort.

• The Procedure:
  • You will lie on your side while the doctor gently inserts the scope through your mouth into your esophagus, stomach, and duodenum.
  • The scope releases air to expand the area for better visibility.
  • The camera sends high-resolution images to a monitor for the doctor to observe.

• Additional Actions:
  • Your doctor may take tissue samples, stop bleeding, or address issues like esophageal narrowing during the procedure.

Recovery and Side Effects

After the procedure, you’ll be monitored until the sedative wears off, typically within an hour. You may experience temporary side effects such as: (4)

• Bloating: Because of the air introduced during the procedure.
• Mild throat irritation: This usually resolves quickly.
• Fatigue or difficulty concentrating: Common after sedatives.

It is advisable not to drive on the day of the procedure. Most people can eat and resume normal activities shortly after.

Safety and Risks

Gastroscopy is a generally safe procedure, that has been widely used in the medical field for many years. Complications are rare but may include: (4)

• Perforation of the Digestive Tract Wall:
  • Small perforations— though exceedingly rare—may heal on their own, but larger ones often require surgical repair.

• Bleeding:
  • This is more likely if a polyp is removed or a biopsy is taken.

• Allergic Reactions or Side Effects to Medications:
  • These are rare and carefully managed by the medical team.
  • These risks are carefully managed by the medical team.

Receive a safe and comfortable gastroscopy experience in our gastroenterology department, equipped with the latest diagnostic endoscopes, enabling our doctors to perform procedures at the highest international standards.

References

1. NIDDK - Upper GI Endoscopy 
2. UpToDate - Patient education: Upper endoscopy (Beyond the Basics) 
3. Mayo Clinic - Upper endoscopy
4. Gastro.org Upper GI endoscopy