Gastroscopy – more properly referred to as esophagogastroduodenoscopy (EGD) – refers to the endoscopy of the esophagus, stomach, and upper part of the duodenum (duodenum) using an endoscope. This is a thin, flexible, tube-shaped instrument with an integrated light source. Gastroscopy is used for early detection of pathological changes in the upper gastrointestinal (GI) tract and is recommended for various indications.
Indications (areas of application)
- Anemia (anemia)
- Installation of a PEG (percutaneous endoscopic gastrostomy) – endoscopically created artificial access from the outside through the abdominal wall into the stomach.
- Chronic diarrhea (diarrhea)
- Dysphagia (dysphagia)
- Foreign body removal
- Gastroesophageal reflux disease (synonyms: GERD, gastroesophageal reflux disease; gastroesophageal reflux disease (GERD); gastroesophageal reflux disease (reflux disease); gastroesophageal reflux; reflux esophagitis; reflux disease; Reflux esophagitis; peptic esophagitis) – inflammatory disease of the esophagus (esophagitis) caused by the pathological reflux (reflux) of acid gastric juice and other gastric contents.
- Inappetence (loss of appetite)
- Malabsorption (disorder of food utilization).
- Upper gastrointestinal bleeding (GIB) – bleeding from the upper gastrointestinal tract.
- Polypectomy (removal of polyps).
- Refractory upper abdominal symptoms such as stomach pain or but nausea (nausea)/vomiting (recurrent vomiting).
- Suspicious (suspicious) radiological findings.
- Unclear weight loss
- Changes in the esophageal mucosa such as Barrett’s esophagus (conversion of squamous to cylindrical epithelium) (Barrett’s esophagus: for metaplasia lengths of 3 cm or more, 3-year interval control endoscopies are appropriate)
- Suspicion of malignant (malignant) tumors.
Before the examination
No major preparation is needed for esophageal and gastric endoscopy. However, the patient should not have eaten anything twelve hours beforehand and should not have drunk anything six hours beforehand. Clear, noncarbonated water may be drunk up to a maximum of two hours before gastroscopy. If the patient is anticoagulated (receiving anticoagulant medication) due to atrial fibrillation (VHF), clopidogrel (platelet aggregation inhibitor) and phenprocoumon (coumarin derivative) should be paused. In contrast, acetylsalicylic acid (ASA) and nonsteroidal anti-inflammatory drugs (NSAIDs) do not appear to increase the risk of bleeding.
The procedure
Gastroscopy is as much a diagnostic procedure as it is a treatment procedure. Special endoscopes with light, optical, and working channels are used so that a good overview of the esophagus, stomach, and upper small intestine can be obtained. The tip of these flexible tubes can be angled in all directions so that almost all areas can be viewed. An important advantage of this method is that the examiner can immediately take samples from suspicious areas, which are then examined in more detail by a pathologist. The examination is usually performed on an outpatient basis. To reduce the gag reflex when inserting the instrument, you will be given a local anesthetic (agent for local anesthesia). If desired, the examination can also be performed lying down under analgesia (painless twilight sleep). Gastroscopy offers you a good opportunity for early detection of pathological changes in the upper gastrointestinal tract. It offers you effective diagnostics and, if necessary, therapy.
Possible complications
- Injury or perforation (piercing) of the wall of the esophagus (food pipe), stomach, or duodenum (duodenum), as well as injury to the larynx with subsequent peritonitis (inflammation of the peritoneum)
- Injuries to the walls of the stomach and intestines, which lead to peritonitis (inflammation of the peritoneum) only after a few days.
- More severe bleeding (eg, after tissue removal).
- Hypersensitivity or allergies (e.g., anesthetics/anesthetics, medications, etc.) may temporarily cause the following symptoms: Swelling, rash, itching, sneezing, watery eyes, dizziness or vomiting.
- After gastroscopy, swallowing difficulties, sore throat, mild hoarseness or flatulence may occur. These complaints usually disappear after a few hours by themselves.
- Tooth damage from the endoscope or teething ring is rare.
- Infections followed by severe life-threatening complications concerning heart, circulation, respiration, etc., are very rare (3 patients have severe infections per 1,000 examinations). Similarly, permanent damage (eg, paralysis) and life-threatening complications (eg, sepsis / blood poisoning) after infections are very rare.
