Gastroscopy

A gastroscopy is an examination of the upper digestive tract using an endoscope. An endoscope is a thin, flexible tube containing a camera. It is operated by a doctor and enters the body through the mouth.

Why is it performed?

A gastroscopy is performed to investigate a number of symptoms in the upper digestive tract, such as stomach or chest pain, heartburn, nausea and vomiting.

The procedure

The patient is told not to eat for at least 4-6 hours before the procedure, and not to drink for one hour before. Most patients tolerate the procedure with only local anaesthetic spray applied to the throat. However, patients are offered sedation and the very anxious/agitated patient may even need a general anaesthetic. Consent is obtained before the procedure. The risks are bleeding and perforation but this risk is incredibly low. The risk is increased when a biopsy or other intervention is performed.

The patient lies on his/her left side with the head resting comfortably on a pillow. A bite guard is placed between the teeth to prevent the patient from biting on the endoscope. The endoscope is then passed over the tongue and into the throat. This is the most uncomfortable stage for the patient as it can feel like choking. Quick and gentle manipulation under vision guides the endoscope into the oesophagus. The endoscope is gradually advanced down the oesophagus making note of any pathology. The endoscope is quickly passed through the stomach and through the pylorus to examine the first and second parts of the duodenum. Once this has been completed, the endoscope is withdrawn into the stomach and a more thorough examination is performed. Still photographs can be made during the procedure and later shown to the patient to help explain any findings.

At its most basic, the endoscope is used to inspect the internal anatomy of the digestive tract. Sometimes inspection alone is sufficient, and a biopsy may be taken. Small biopsies can be made with a pincer which is passed through the scope and allows sampling of 1 to 3 mm pieces of tissue. The lining of the stomach heals readily.

Gastroscopy Diagram