A B C D E F G H I J K L M N O P R S T U V W

GASTROSCOPY

Why is a Gastroscopy performed ?

Some disorders of the gullet and stomach can be treated without proof of the cause. However, in many cases it is essential to be quite certain what condition is being treated. Endoscopy can reduce the need for other, less convenient and less exact tests. Dyspepsia (indigestion) is the major condition justifying endoscopy. This assists the accurate diagnosis of peptic ulcers, gastritis, inflammation of the gullet and other forms of so-called non-ulcer dyspepsia . The procedure may also be helpful in finding the cause of difficulty in swallowing, especially if there appears to be some obstruction to the flow of food. In some instances, bleeding is occurring from the gullet because of varicose (bulging) veins within the lower gullet and upper stomach. This can be diagnosed and treated through endoscopic equipment. Finally, anaemia is a common problem and bleeding in the stomach and neighbouring areas of the gut are a common cause. Endoscopy enables an accurate diagnosis to be made. In many instances, endoscopy needs to be repeated after treatment of an underlying condition, just to make sure that the initial problem has been corrected.

Preparations needed for a Gastroscopy

One day off work is needed, and some additional time off is necessary following treatment if varicose veins of the gullet (varices) have been injected. It is essential that the nurse or doctor involved with the endoscopy is aware of any allergies or bad reactions to drugs. No food or drink should be taken from midnight of the night before. Arrangements need to be made for you to be both taken to and collected from the hospital. It is wise not to drive or to operate any machinery for 24 hours or so after endoscopy.

What Happens during a Gastroscopy

Some doctors may spray a local anaesthetic on the back of your throat to reduce any discomfort. Sometimes a tablet is given to suck, and this will also numb the area of the mouth and throat. A mild anaesthetic is given which will produce slight sleepiness only and create less awareness of the surroundings. A plastic mouthpiece is usually put gently in place between the teeth to keep the mouth slightly open and make it easier for the doctor to pass the tube. The endoscope is a long flexible tube (usually smaller in diameter than the little finger). This is placed in the mouth in such a way that it can be easily swallowed. The doctor will be able to view the gullet, the stomach and the first bend of the small intestine (the duodenum). Sometimes a biopsy (a sample of the lining) is taken and this can be analysed in the laboratory under the microscope. A small piece of tissue can be quite painlessly removed through the endoscope using tiny forceps. This provides no discomfort after the procedure.

Possible Complications during a Gastroscopy

Upper GI endoscopy is relatively free of problems. Occasionally, there may be a sore throat following the test. Although there may be a little internal bleeding after tissue samples are taken, only rarely is there any vomiting of blood afterwards. Following injection of any veins, however, there may be some bleeding and then patients need to stay in hospital for a night after the endoscopy. If treatment has been carried out for an obstructed gullet, there is a small risk of perforating the gullet. Accordingly, after such a procedure, you would normally be kept in hospital overnight.

After a Gastroscopy

After the procedure, there may be some pain in the throat and a little blood may be coughed or vomited. It is generally possible to return to work after an ordinary (investigative) endoscopy after 24 hours. Some form of follow-up is always necessary, and the doctor will wish to discuss with you these findings and provide treatment. As indicated above, a repeat endoscopy is sometimes needed to check that any abnormality has returned to normal. The time at which the doctor arranges this varies, depending on the doctor's individual practice. The follow-up may alternatively be done by your GP, when he has the endoscopist's report.

If a Gastroscopy is not performed

This depends on the cause. If an important cause of dyspepsia or obstructed gullet is missed (e.g. a tumour), the opportunity for early treatment may be missed. An obstructed gullet may get worse, so that no food can be taken, and fluids only with difficulty. Unchecked, bulging veins in the gullet may bleed to such a point that they may be life-threatening.