Gastroscopy

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Definition

What is Gastroscopy?

A gastroscopy is a procedure where a thin, flexible tube called an endoscope is used to look inside the oesophagus (gullet), stomach and first part of the small intestine (duodenum). It’s also sometimes referred to as an upper gastrointestinal endoscopy.

The endoscope has a light and a camera at one end. The camera sends images of the inside of your oesophagus, stomach and duodenum to a monitor.

The purpose of Gastroscopy is to investigate disorders of the oesophagus (gullet), stomach and the duodenum (the first part of the small bowel).

Why is Gastroscopy performed?

A gastroscopy may be advised if you have symptoms such as:

  • Repeated (recurring) indigestion.
  • Recurring heartburn.
  • Pain in the upper tummy (abdomen).
  • Repeatedly being sick (vomiting).
  • Difficulty swallowing.
  • Other symptoms thought to be coming from the upper gut.

Precaution/Warnings

What should I know before receiving Gastroscopy?

Gastroscopy is not for everyone. This procedure may not be recommended in cases of:

  • Heart attack
  • Low oxygen content of the blood
  • Low blood pressure, regardless of cause
  • Massive upper GI bleeding with low blood pressure where emergency surgery is necessary
  • Uncontrolled hypertension
  • Un co-operative patient

A gastroscopy is a very safe procedure, but like all medical procedures it does carry a risk of complications.

Possible complications that can occur include:

  • A reaction to the sedative, which can cause problems with your breathing, heart rate and blood pressure
  • Internal bleeding
  • Tearing (perforation) of the lining of your oesophagus, stomach or duodenum

It’s normal to feel bloated or have a sore throat for a day or 2 after a gastroscopy.

You should contact your GP or the endoscopy unit immediately if you develop signs of a more serious problem, such as:

  • Severe or worsening chest pain or abdominal (tummy) pain
  • Passing dark or “Tar-like” Poo
  • Persistent vomiting or vomiting blood
  • Shortness of breath
  • A high temperature of 38C or above

Process

How to prepare for Gastroscopy?

If you’re referred for a gastroscopy, you’ll be told whether you need to stop taking any of your medications beforehand.

You may need to stop taking any prescribed medicines for indigestion for up to 2 weeks before the procedure. This is because the medication can mask some of the problems that a gastroscopy could find.

If you’re taking any of the following medications, you should phone the endoscopy unit before your appointment, because special arrangements may need to be made:

  • Any medication used to treat diabetes, such as insulin or metformin
  • Any blood-thinning medication (used to prevent blood clots), such as low-dose aspirin, warfarin or clopidogrel

It’s important that your stomach is empty during a gastroscopy, so the whole area can be seen clearly. You’ll usually be asked not to eat anything for 6 to 8 hours before the procedure, and to stop drinking 2 to 3 hours before the procedure – follow the instructions given to you by the hospital.

What happens during Gastroscopy?

A gastroscopy often takes less than 15 minutes, although it may take longer if it’s being used to treat a condition. It’s usually carried out as an outpatient procedure, which means you won’t have to spend the night in hospital.

The procedure will usually be carried out by an endoscopist (a healthcare professional who specialises in performing endoscopies) and assisted by a nurse. You’ll meet the nurse before the procedure and they’ll be able to answer any questions you have and you’ll also have an opportunity to ask the endoscopist.

A local anaesthetic spray will be used to numb your throat for the procedure and you’ll be asked beforehand if you’d like to have a sedative injection. Young children may have the procedure under general anaesthetic, which means they’ll be asleep while it’s carried out.

The sedative will help you feel drowsy and relaxed during the procedure, but you’ll need to stay in hospital for a bit longer while you recover, and you’ll need someone to pick you up from the hospital and stay with you for at least 24 hours. You won’t able to work or drive during this period.

Before the procedure starts, you’ll be asked to remove any glasses, contact lenses and false teeth. You won’t usually need to get undressed, but you may be asked to wear a hospital gown over your clothes.

The local anaesthetic spray is then given and a small plastic mouth guard placed in your mouth, to hold it open and protect your teeth.

You’ll be asked to lie down on your left-hand side and the endoscopist will insert the endoscope into your throat. They’ll ask you to swallow it to help move it down into your oesophagus. This may be uncomfortable at first and you may feel sick or gag, but this should pass as the endoscope is moved further down.

Diagnosing a condition

If the gastroscopy is being used to diagnose a certain condition, air will be blown into your stomach once the endoscope is inside. This allows the endoscopist to see any unusual redness, holes, lumps, blockages or other abnormalities.

It may feel a bit uncomfortable when the air is blown into your stomach, and you may burp or feel bloated. This should start to improve once the procedure is finished.

If abnormalities are detected, a tissue sample (biopsy) can be removed and sent to a laboratory for closer examination under a microscope. You won’t feel anything while the sample is removed.

Treating bleeding varices

If you have bleeding varices (enlarged veins), the endoscopist will use the endoscope to locate the site of the bleeding.

They can then stop the bleeding by either tying the base of the varices with a small rubber band (band ligation), or injecting them with a chemical that seals the hole or tear in the blood vessel (sclerotherapy).

Treating bleeding stomach ulcers

If you have bleeding stomach ulcers, a number of techniques may be used to treat them. For example:

  • A probe may be passed through the endoscope to seal the ulcer with heat, or small clips may be used to stop the bleeding
  • Medication may be injected around the ulcer to activate the clotting process

During the procedure, you may also receive an injection of an acid-reducing medication called a proton-pump inhibitor (PPI) to stop the bleeding recurring.

Widening the oesophagus

If you have a narrowed oesophagus, the endoscopist can pass instruments down the endoscope to help stretch and widen it.

The instruments can also be used to insert a balloon or stent (a hollow plastic or metal tube) to hold the sides of your oesophagus open.

What happens after Gastroscopy?

After the procedure, you’ll be taken to the recovery area.

If you didn’t have a sedative, you can usually go home soon after the procedure is finished.

If you had a sedative, you’ll need to rest quietly for a few minutes or hours until the sedative has worn off. You’ll also need to arrange for someone to take you home and to stay with you for at least 24 hours.

Even if you feel very alert, the sedative can stay in your blood for 24 hours and you may experience further episodes of drowsiness.

Before you’re discharged, the nurse or doctor may be able to explain the results of the procedure to you. Sometimes, you may need to have an appointment with the doctor or your GP a few days or weeks later to discuss the results.

You’ll be told if you need to make any changes to your diet during the hours or days after going home.

For the first 24 hours after your procedure:

  • Do not drink alcohol.
  • Do not drive or use heavy machines.
  • Do not make important decisions or sign any legal papers.
  • Do not take any sedatives, tranquilizers, sleeping pills, or medicines

that make you drowsy.

You can return to your normal activities 24 hours after your gastroscopy.

You can start taking your regular medicines when you get home, unless your

doctor gave you different instructions. Talk to your doctor before restarting

blood thinners, anti-inflammatory or anitplatelets medicine.

If you have any questions about the Gastroscopy, please consult with your doctor to better understand your instructions.

Explanation of results

What do my results mean?

The operator writes a report and sends it to the doctor who requested the gastroscopy. The result from any sample (biopsy) may take a few days, which can delay the report being sent. The operator may also tell you what he/she saw before you leave. However, if you have had a sedative you may not remember afterwards what you were told. Therefore, you may wish to have a relative or close friend with you who may be able to remember what was said.

Depending on the laboratory and hospital, the normal range for Gastroscopy may vary. Please discuss with your doctor any questions you may have about your test results.

 

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: October 11, 2018 | Last Modified: October 11, 2018

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