Gastroscopy, or gastroscopy, is a medical procedure used to examine and/or perform procedures on the upper digestive tract. This includes the esophagus, stomach, and duodenum. It was developed in the 19th century by surgeon Johann Mikulicz-Radecki.
Function and goals of gastroscopy
Schematic diagram of oral gastroscopy. Click to enlarge. The goal of a gastroscopy is usually to determine the causes of discomfort or pain within the stomach area and the mucous membranes of the adjacent esophagus and duodenum. This is done with a special endoscope, which is inserted through the patient’s mouth or, optionally, nose. In the past, the doctor looked directly through the tube of the endoscope into the patient’s stomach, but today the image taken by the endoscope is usually displayed on a monitor. Once the causes of the stomach complaints have been clarified, the gastroscopy technique can also be used to perform surgery directly. This may involve ulcers, mucosal problems, bleeding or narrowing in the esophagus, for example. Foreign bodies and tissue can then be removed or extracted by means of the endoscope.
Application
Because gastroscopy is both a time-consuming and uncomfortable procedure for the patient, it should not be considered for every type of abdominal pain or nausea. However, it is useful in cases of persistent or recurrent pain in the upper abdomen, heartburn or diarrhea without a visible background, and suspected gastric ulcers. Swallowing disorders, persistent loss of appetite, vomiting of blood and unwanted weight loss are also included. Depending on the medical diagnosis that follows, regular check-ups may be necessary. Gastroscopy can be life-saving if sudden bleeding from the anterior digestive tract or esophagus occurs – for example, due to varicose veins in the esophagus – and the mirror examination finds causes. However, if there are complaints in the lower abdomen and intestines, a colonoscopy must be performed. Patients who have a gastroscopy performed on them must not eat anything for six hours before the start of the procedure, as the food slurry in the stomach makes it largely impossible to detect symptoms of the disease. Patients are usually given medication beforehand – primarily sedatives, as the insertion of the tube through the mouth into the stomach is perceived as very unpleasant – and are briefly anesthetized. This is usually supplemented by anesthetics in the mouth and throat to reduce the gag reflex.
Side effects and risks
Schematic diagram of nasal gastroscopy. Click to enlarge. Gastroscopy is considered largely safe, and major complications are exceptional. However, patients with weaker circulation and blood pressure may respond to the medications with circulatory problems. Also, theoretically, respiratory arrest can occur, which can be counteracted with the addition of oxygen or even ventilation. However, the occurrence of such respiratory arrest can be more or less completely prevented by close and conscientious monitoring. In addition, patients who ingest food or drink before the anesthesia wears off may inhale it into their lungs, causing pneumonia. It can also happen that so-called perforations, i.e. small punctures in cavities such as the stomach or lungs, can occur during treatment with the endoscope. A gastric perforation of this type can result in dangerous inflammation of the abdominal cavity. Nevertheless, the risk is extremely low and should not be a reason not to have a necessary gastroscopy. Long-term complaints after a gastroscopy usually do not occur even if one of the above-mentioned cases does not occur.
