A gastroscopy is used when there is persistent discomfort in the esophagus, stomach, and duodenum. Through the examination, the physician can detect conditions such as stomach or duodenal ulcers, infections with Helicobacter pylori, or bleeding in the upper digestive tract. The gastroscopy can be performed either with or without anesthesia – usually a local anesthetic of the throat is sufficient. Learn more about the preparation, procedure and duration of a gastroscopy here.
When is a gastroscopy performed?
A gastroscopy is useful whenever there is persistent discomfort in the esophagus, stomach or duodenum. These include frequent heartburn, dysphagia or chronic cough. Likewise, a gastroscopy may be useful for pain in the upper abdomen, constant flatulence, persistent nausea, blood in the stool or unexplained weight loss. A gastroscopy can clarify whether, for example, the following diseases or injuries are present:
- Gastritis
- Ulcers in the stomach or duodenum
- Outpouchings (diverticula)
- Varicose veins in the esophagus
- Infection with Helicobacter pylori
- Internal bleeding in the upper digestive tract.
Preparation for gastroscopy: refrain from food.
Extra preparation for a gastroscopy you do not actually need. The only important thing for the examination is that the upper digestive tract is free of food. Therefore, you should appear for the examination fasting. This means that you should not eat or drink anything for eight hours before the examination. If you are very thirsty, you can take some clear water. If you are taking blood-thinning medication (anticoagulants), you should consult with your doctor before the examination. Ask him or her if and when it is best to stop the medication to avoid internal bleeding.
Gastroscopy procedure
Today, a gastroscopy is usually performed as an outpatient procedure in a hospital or gastroenterologist’s office. An inpatient stay in the hospital is rarely necessary. In most cases, the examination does not take long; it is usually completed after only a few minutes. A so-called gastroscope is used for the examination. This is a flexible plastic tube that is about one meter long and less than one centimeter in diameter. To prevent you from biting on the tube, you will be given a teething ring to place between your teeth. Among other things, the tube is equipped with a light and a mini camera. This allows the doctor to carefully examine the esophagus, stomach and duodenum from the inside. The images taken by the mini-camera are transmitted to a monitor. The doctor can also carefully introduce air into the digestive tract through the gastroscope. This causes it to dilate slightly, making it easier to see changes.
Detect and treat disease
The plastic tube allows the doctor to aspirate fluids such as blood or saliva. This ensures that he can always get the best possible picture of the region being examined. In addition, he can also insert small instruments such as forceps or snares to take a tissue sample (biopsy). During the gastroscopy, however, the doctor can not only detect possible diseases, but also initiate initial treatment steps. For example, minor tissue changes can be removed or bleeding can be stopped. This can be done either by injecting an anti-bleeding agent or by attaching rubber bands or metal clips. That some conditions can be treated directly is a major advantage of gastroscopy over other treatments.
Risks and side effects
Problems rarely occur during a gastroscopy. Only when the gastroscope is inserted do patients often experience a choking sensation. In some cases, the plastic tube may also cause injury and inadequate breathing. To prevent breathing problems, the patient’s pulse and oxygen saturation are monitored during and after the examination. If the teeth are loose, the insertion of the gastroscope may cause damage to the dentition. In very rare cases, serious complications such as cardiac arrhythmias or pneumonia can also occur.
With or without anesthesia?
A gastroscopy is somewhat unpleasant, but usually does not cause pain. That is why local anesthesia is sufficient for the examination: before the gastroscope is inserted into the esophagus, the throat is lightly anesthetized with a spray. In addition, patients can receive a short-acting anesthetic – if they wish – so that they are unaware of the examination itself. Such anesthesia is not a general anesthesia. Patients are only given a sedative such as diazepam. After the anesthesia, however, you should have an escort pick you up at the hospital. Until the next day, you are not allowed to participate in road traffic or perform any dangerous activities. You are also not allowed to make important decisions immediately after anesthesia.
After the gastroscopy
After gastroscopy, you are often left with an uncomfortable feeling in your throat caused by the insertion of the gastroscope. Typical symptoms include hoarseness and a scratchy feeling in the throat. As long as you notice a numb feeling in the esophagus (about two to three hours after the examination), you should not eat or drink anything. Otherwise, you run the risk of choking.
