Gastroscopy

What it is

Gastroscopy (full name: esophagogastroduodenoscopy) is an examination of the esophagus, stomach and duodenum with a thin, flexible tube that has a camera and a light at its tip. The doctor sees the lining on a screen and, when needed, takes a biopsy or treats some lesions.

Why it is done

Gastroscopy may be recommended for:

• difficulty or pain when swallowing
• signs of bleeding or iron-deficiency anemia
• repeated vomiting or unexplained weight loss
• persistent upper abdominal complaints that do not improve with treatment
• follow-up of some conditions, such as Barrett's esophagus or some stomach ulcers

Not every case of heartburn or stomach pain requires an immediate gastroscopy. The doctor decides according to age, alarm signs and response to treatment.

Preparation

• The stomach must be empty. Usually at least 6 hours without eating are required; clear liquids (water) are allowed until 2 hours before the exam. Follow the written instructions given by the unit, as they may vary.
• Tell the doctor about allergies, pregnancy, diabetes, heart or lung disease and all your medication.
• Do not stop blood thinners (anticoagulants), antiplatelet drugs or diabetes medication on your own. The plan for them is made together with the doctor.
• If you are going to have sedation, arrange for someone to accompany you home.

How it is performed

• The throat is numbed with a local anesthetic spray, with or without intravenous sedation (relaxation). Sedation is not compulsory; it is chosen together with the doctor.
• You lie on your left side and a small mouthguard is placed between your teeth.
• The diagnostic exam usually takes 5–15 minutes. Including preparation and recovery, the time spent in the unit is longer.
• You may feel a gag reflex, bloating or discomfort. A biopsy does not feel like pain.

After the exam

• After the throat anesthetic: do not eat or drink until normal swallowing sensation returns (usually about an hour).
• After sedation: for 24 hours do not drive, operate machinery, drink alcohol or make important decisions.
• Mild bloating and a sore throat go away within a day.
• Biopsy results usually come after a few days, up to two weeks.

Risks

Gastroscopy is a safe exam. Complications are rare: bleeding (especially after treating lesions), perforation or reactions to sedation. The doctor explains them to you before you give your consent.