Definition & Overview
Gastroscopy is a diagnostic procedure commonly used to identify problems with the upper digestive system, which includes the stomach, esophagus, and duodenum (small intestine). The procedure is also referred to as an upper gastrointestinal endoscopy.
In a gastroscopy, the doctor uses an instrument called an endoscope or gastroscope to view the condition of the upper digestive system. An endoscope consists of a thin tube with a camera and light source at the tip. This is inserted into the mouth, down the throat, and towards the esophagus. Since the device has a camera, everything that it passes by will be shown on a monitor.
Endoscopes can also be used to perform surgical procedures. Miniature surgical instruments can be passed through the tube. The surgeon performs the procedure while watching the monitor closely.
Who should undergo and expected results
Gastroscopy is performed to diagnose and treat upper digestive system disorders, such as bleeding ulcers, blocked esophagus, or remove early-stage cancerous or non-cancerous polyps, or to perform a biopsy.
Patients who have recurrent abdominal pains, anemia, unexplained weight loss, heartburn, or acid reflux will usually be asked to undergo a gastroscopy. The procedure will also be recommended if the doctor suspects cancerous or non-cancerous growths in the upper digestive system.
A gastroscopy helps the doctor diagnose your condition accurately, so you can expect a more accurate form of treatment. If the procedure is used as a treatment, such as to repair a bleeding ulcer or remove polyps, then you can expect a remarkable improvement in your condition.
In some cases, the procedure will also be used to stretch or widen a narrowed portion of the esophagus.
How the procedure works
The thought of having something shoved down your throat can be quite disconcerting. However, in reality, the procedure itself is remarkably painless. The doctor will provide a numbing agent for your throat so you won't feel any pain.
You will need to swallow the first part of the endoscope and this will cause you to gag. Everybody gags, but it will soon pass and you'll no longer feel the instrument being directed down to your esophagus. Another trick is to take slow deep breaths as you're swallowing. The airway is not blocked during the procedure so you won't have any difficulty breathing. It's important to keep calm throughout the procedure. The doctor may give you a sedative to help you relax, but not put you to sleep.
The entire procedure takes around 15 minutes, but the actual time that the scope is inside your body will only be around 4 minutes.
Air will also be introduced inside your body to open up your stomach so the doctor can examine the tissue or perform a biopsy. Most of the air will be removed after the procedure, but not all of it. You can expect to belch or pass gas as the remaining air finds its way out.
Once the gastroscopy is completed, you can return to your normal activities. However, if you received sedation prior to the procedure, you'll be asked to refrain from driving or drinking any alcohol for at least 12 hours.
Possible risks and complications
Gastroscopy is a low-risk procedure. In fact, only 1 in every 1000 patients who undergo a gastroscopy will experience any type of complication.
Nevertheless, any type of medical procedure does have risks and gastroscopy is not an exception. The most common complications include bleeding, perforation, and adverse reaction to sedation.
Although everybody wants procedures such as these to go perfectly well, it just isn't possible. There have been cases wherein the endoscope hit a blood vessel causing bleeding. These cases may be rare, but they have happened.
If a sedative is used to help you relax, there is a possibility of an adverse reaction to the sedative. The anesthesiologist and doctor will do everything in their capacity to prevent this from happening, but the risk is still there.
The endoscope may also cause a perforation in the tissue of your esophagus, chest, or abdomen. If this happens, you'll experience neck pain, abdominal pain, breathing difficulties, and high temperature. If the perforation is mild, it will be left to heal on its own without any medical intervention. However, you may be given antibiotics to prevent any infections.
- Pasricha PJ. Gastrointestinal endoscopy. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 136.
- Zurad EG. Esophagogastroduodenoscopy. In: Pfenninger JL, Fowler GC, eds. Pfenninger & Fowler's Procedures for Primary Care. 3rd ed. Philadelphia, Pa: Elsevier Mosby; 2010:chap 101.