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GASTROSCOPY / UPPER GI ENDOSCOPY

Gastroscopy is an examination of the oesophagus, stomach and duodenum(first part of the small bowel) using a thin flexible tube called an endoscope which has a camera attached. The inside lining can be seen on a TV screen.

Benefits

Direct visualization of the wall allowing detection of polyps/cancer, inflammation of wall(eg esophagitis, gastritis), abnormal blood vessels(esophageal varices, angiodysplasia), peptic ulcers, hiatus hernia

Biopsies can be taken for histology.

Most polyps can be removed and treated at the same time.

Before the operation

Need to fast for 6 hours before procedure(ie no food from 2am for morning procedure)
Can have plain water to drink up to 4 hours before the procedure.

Procedure

An anaesthetist will put in a drip and give sedation during the procedure. An anaesthetic spray to numb the throat may also be given.

Position – lying on left side with mouth guard, oxygen line to nose.

The gastroscope will then be passed into your mouth and down your throat into your oesophagus, stomach and halfway into your duodenum.

Risks

There are some risks which include:

Perforation(<1 in 1000): This is very rare, if so may need surgery.

Bleeding from biopsy site : usually minor. Rarely serious bleeding(<1 in 1000) - may need blood transfusion or an operation.

Anaesthetic reactions; aspiration in lung/pneumonia; sepsis/infection; complications from lung and heart disesase; heart attack/stroke; death(1 in 10000).

Rarely, pathology/polyps may be missed.

The procedure may not be completed due to problems inside the body/technical problems.

Other Investigations As Alternatives to Gastroscopy

Contrast(Barium) Meal.

Advantages: not as invasive, less risks of perforation/bleeding.

Disadvantages: poorer visualization of mucosal abnormality, exposure to radiation, biopsies
cannot be taken; rarely done these days because of availability of gastroscopy.

Discharge advice

Do NOT drive a vehicle/operate machinery/sign any legal documents/work/drink alcohol for 24 hours after (because of sedation being given).

Need to be taken home by a responsible person and have a responsible adult care for you that night/be on hand iin case of any problems.

Seek urgent medical attention if : severe abdominal pain/fever/persisting bleeding/black stools/trouble breathing/sharp pain in chest or throat/any other concerns.