Gastroscopy is a diagnostic imaging procedure to detect diseases of the stomach. With the help of a gastroscope, the inside of the stomach can be examined and, if necessary, tissue samples can be taken (biopsy) or minor procedures performed. For the examining physician, this not only offers the possibility of recognizing different diseases (diagnosis) but also of treating them in the same procedure.
Indication of a gastroscopy
Reasons for a gastroscopy is always recommended when problems or pain occur in the area of the esophagus, stomach or duodenum, which is directly adjacent to the stomach. The entire upper digestive tract can be examined with a gastroscopy. It serves to confirm or exclude an inflammation of the mucous membrane of the stomach (gastritis) and is also performed if ulcers or sacs in the stomach or duodenum are suspected.
Further indications are, for example, recurrent severe heartburn, frequent nausea with vomiting, pain or problems swallowing, blood in the stool or in vomit, but also generalized anemia (lack of blood) or unclear weight loss, which can always have a cause in the upper digestive tract. The examination method used in gastroscopy is well proven and for experienced doctors a daily routine. Specialized medical specialists (gastroenterologists) perform them in most cases on an outpatient basis, so that a hospital stay is not necessary.
The patient arrives at the scheduled examination appointment and is then allowed to go home after a short rest period. Depending on the type of anesthesia or the anesthetic procedure, the patient must be picked up, is not allowed to drive a car on that day and should not operate machinery. Before the examination begins, a local anaesthetic is applied to the throat to make the following a little more comfortable.
The procedure itself is somewhat unpleasant, but completely painless. For this reason, the local anesthesia mentioned above is sufficient in principle. However, if desired, a short sedative injection is also possible, which will make the patient no longer notice the procedure.
A gastroscopy is performed with a special endoscope, the so-called gastroscope. This is a plastic tube less than one centimeter in diameter with several channels in which various things are placed. This gastroscope is advanced by the examiner through the oesophagus, past the larynx and into the stomach.
Meanwhile, the patient lies on his left side and has a teething ring between his teeth to prevent reflex biting and damage to the gastroscope. One channel of the gastroscope houses a mini-camera, whose images are displayed on an external screen, so that the exact position and condition of the mucosa can be assessed at any time. Another channel carries glass fibers with light to illuminate the interior.
It is also possible to inject or aspirate liquid or air through the gastroscope or to insert instruments. With the help of the air connection, as soon as the gastroscope is deep enough in the stomach, the examining doctor lets an air-gas mixture flow into the stomach so that it expands and the mucosa can be seen more easily. Other instruments are particularly important when switching from purely diagnostic gastroscopy as an examination method to therapeutic gastroscopy with treatment intention.
Superficial tissue changes (both benign and malignant) can be removed or biopsied immediately. The sample obtained in this way is then used to classify and determine the change and thus to decide on the further procedure. Special rubber clips or bands can also be used to stop bleeding immediately.
In some cases, targeted injections of anticoagulant medication are sufficient. At the end of the examination, the gastroenterologist pulls out the approximately one meter long gastroscope on the same path through the esophagus. A good preparation by the patient is essential for a good gastroscopy.
To be able to assess the area to be examined well, it must be free of food and liquids. Therefore, the patient should not eat or drink for at least 6 hours before a gastroscopy. If it is unavoidable to drink a little, clear water should be chosen.In contrast, a complete colon cleansing as in a colonoscopy is not necessary. Patients who occasionally (e.g. acetylsalicylic acid for pain) or regularly take blood-clotting medication should always let the examining physician know and discuss the further procedure with him. It may be necessary to discontinue these medications a few days before the gastroscopy in order not to endanger the course of the examination and to reduce the risk of complications.
