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A gastroscopy, also called an upper gastrointestinal endoscopy, is the insertion of a small flexible camera system, called an endoscope, into the intestine to examine the oesophagus and the stomach. We take a look at the procedure and the conditions that it is used to diagnose.
Sometimes biopsies may be done, which involves taking small tissue samples and sent away for analysis. The biopsies taken are very small and the procedure is painless.
A gastroscopy can also be used to treat some digestive-related problems, such as stopping internal bleeding found in the stomach and oesophagus, widening a narrowed oesophagus which causes pain and discomfort, removing foreign objects, cancerous tumours and non-cancerous growths, and providing nutrients through a feeding tube for patients who have difficulty eating.
They will lie on their side and the doctor, or the endoscopist with the help of some nursing staff, will insert the tube through the mouth and oesophagus and into the stomach. The patient may be asked to swallow to help the tube pass through quicker. The stomach will be inflated with air in order to make it easier for the doctor to conduct the examine the lining of the stomach, oesophagus and duodenum. The procedure will take only a few minutes to complete.
Patients who take certain medication, such as antacids, drugs for treating diabetes, and blood-thinning drugs, including low-dose aspirin or clopidogrel, may be advised to stop for up to two weeks before the operation or given special arrangements. This is because these medications can interfere with the main aim of the gastroscopy to identify problems.
A key risk is damage to the teeth, but precautions are taken to avoid this. The patient can also vomit and breath in the stomach contents, but again if the patient follows the instructions issued by the doctor and it is not an emergency, this is very rare.
As the patient will be sedated, there are a number of possible risks associated with this, including infection, nausea, a burning sensation near the site of the injection, an irregular heartbeat, and breathing difficulties. There is also the risk the endoscope will perforate the upper gut, but this again is very rare in a non-emergency setting.
If the patient was given a sedative, they will be transferred to the recovery unit to rest. Once the sedation has worn off, which is usually within an hour, the patient can go home. But the effects of sedation may still remain so the patient will not be able to drive, drink alcohol, operate machinery, cook or sign legal documents for around 24 hours afterwards. The patient should be able to return to work the next day.
Due to the effects of sedation, patients should arrange for someone to pick them up from hospital and remain with them for the rest of the day or night if possible or advised by the doctor. If the patient is not able to arrange for someone to be with them at home, they should be near a telephone in case of an emergency.
However, this test involves radiation and the image will be less accurate than what an endoscope camera can provide, and patients are likely to still require a gastroscopy if any abnormalities are found. Furthermore, a barium test cannot enable doctors to take biopsy samples. Other tests may include a CT scan, MRI scan or ultrasound scan. However, whilst these tests will be carried out on patients, none can provide an accurate diagnosis as an endoscopy.