Gastroscopy

What is a gastroscopy?

A gastroscopy, also known as an upper gastrointestinal (GI) endoscopy, or oesophago-gastroduodenoscopy (OGD), is a procedure used to examine the inside of the oesophagus, stomach, and the first part of the small intestine (duodenum). This is done using a thin, flexible tube called an endoscope, which has a camera at the end to capture images. A gastroscopy can help diagnose and sometimes treat conditions affecting the upper digestive tract.

When is a gastroscopy recommended?

Gastroscopy is performed to investigate symptoms related to the digestive system and can also be used to monitor or treat certain conditions. Common reasons for undergoing a gastroscopy include:

• Unexplained abdominal pain
• Persistent heartburn or acid reflux
• Difficulty swallowing (dysphagia)
• Unexplained weight loss
• Vomiting blood or passing dark stools (indicating internal bleeding
• Anaemia due to low iron levels

A gastroscopy can also be used to take tissue samples (biopsies) for further analysis or to treat conditions such as bleeding ulcers or abnormal tissue growths (polyps).

Preparing for a gastroscopy

Before the procedure, patients will be advised to fast for at least six to eight hours. This ensures the stomach is empty, allowing a clearer view during the examination. it is important that these instructions are strictly adhered to. Patients should inform their doctor if they are diabetic or taking any medication that might thin the blood (including aspirin) as blood thinners may need to be stopped before the procedure. Patients will be asked to sign a consent form after discussing the procedure, its risks, and the benefits with the doctor.

What does the procedure involve?

A gastroscopy is usually performed as an outpatient procedure, meaning the patient can go home the same day. It typically takes around 20 minutes to complete. Before the procedure begins, the throat may be numbed with a local anaesthetic spray. For patients who choose to have sedation, a small needle or canula is passed into a vein in the back of the hand, at the start of the procedure to allow the administration of the sedative drug. While lying on their side, the endoscope is gently passed through the mouth, down the oesophagus, and into the stomach and duodenum. The endoscope contains a small camera that transmits images to a monitor, allowing the doctor to closely examine the upper digestive tract. If necessary, small instruments can be passed through the endoscope to take biopsies or perform certain treatments, such as removing polyps or stopping bleeding ulcers. The procedure is generally not painful, although some patients may experience mild discomfort, such as bloating or the urge to gag.

What are the potential risks and complications?

Gastroscopy is a safe and routine procedure, but as with all medical procedures, there are potential risks. These include:

• Sore throat – most common and temporary.
• Bleeding – this is rare but may occur if a biopsy is taken or a treatment is performed, though this usually stops on its own.
• Perforation (tear in the oesophagus or stomach) – this is rare are but may require further treatment or surgery.
• Reaction to sedation – mild reactions are more common, such as feeling drowsy or sick, but serious reactions are rare.

Patients should contact their doctor if they experience severe abdominal pain, heavy bleeding, or difficulty swallowing after the procedure.

After the procedure

Following the gastroscopy, patients will be monitored for a short period while the effects of any sedative wear off. It is advised not to drive or operate machinery for at least 24 hours after receiving sedation, so patients should arrange transport home. Most people can eat and drink normally after the procedure, but it is best to start with light meals. It is normal to experience a sore throat, mild bloating, or wind for a few hours after the procedure. These symptoms usually subside quickly. The doctor will explain the findings of the gastroscopy, any tissue samples taken will take a few days to be processed by a pathologist. The doctor will normally share the results of any biopsies at a follow-up consultation. If any treatment was performed during the procedure, such as removing a polyp, specific aftercare instructions will be provided.