What is Gastroscopy?
Gastroscopy is a procedure used to examine the esophagus (swallowing tube), stomach and duodenum (first part of small intestines). An endoscope is a thin, flexible telescope that is about as thick as a little finger. The endoscope is passed through the mouth into the esophagus and down towards the stomach and duodenum. The tip of the endoscope contains a light and a tiny video camera so the doctor can see inside your gut.
The endoscope also has a “side channel” down which various instruments can pass. These can be manipulated by the doctor to take a small sample (biopsy) from the inside lining of the stomach by using a thin “grabbing” instrument which is passed down the side channel.
Why do I Need to Have a Gastroscopy?
Gastroscopy (EGD) is a commonly performed routine test. This test may be advised if you have symptoms such as recurring indigestion, recurring heartburn, pains in the upper abdomen, repeated vomiting, difficulty swallowing, or other symptoms thought to be coming from the upper gut. The sort of conditions which can be confirmed (or ruled out) include:
- Esophagitis (inflammation of the esophagus).
- Duodenal or stomach ulcer.
- Duodenitis (inflammation of the duodenum).
- Gastritis (inflammation of the stomach).
- Cancer of the stomach or oesophagus.
- Various other rare conditions.
What Happens During a Gastroscopy?
When you arrive at the endoscopy unit, you will be registered and asked to sign the consent form. The test can be done without sedation, but most people prefer to have sedation during the procedure. A topical anesthetic agent will be used to numb the throat and reduce gagging. You will be drowsy but conscious during the gastroscopy. The drowsiness can last for up to a couple of hours. If you have sedation, you must have a responsible adult to drive you home or accompany you in a taxi. We do not allow you to go home by public transport or to take a taxi on your own. You cannot drive, operate dangerous machinery or go back to work until the next day. You should avoid making important decisions or drinking alcohol during this period.
The gastroscope is passed through the mouth. A mouthguard is used to protect your teeth. Dentures should be removed. While gastroscopy can be uncomfortable, it is not usually painful. Some people experience a desire to cough or gag when the scope is passed into the esophagus.
During the procedure, small samples (biopsies) may be taken. These will be sent to the laboratory for examination by the pathologist. The testing may include looking for a bacteria known as Helicobacter pylori which are associated with an increased risk of ulcers.
After the procedure, you will be allowed to drink and eat soft foods once the sedation and freezing have worn off. Resume your usual diet the next day. While a gastroscopy only takes about 5 minutes to perform, you will be in the recovery area for about 30-45 minutes while the sedation wears off. We will let you know the results of the test before you go home.
How do I Prepare?
- Avoid all food for 8 hours before the examination. You can have water or apple juice only, up to 4 hours before the test.
- STOP ALL LIQUIDS 4 HOURS BEFORE YOUR TEST. You must have a completely empty stomach prior to your test as even small amounts of food/liquid may result in delay or cancellation and increase the risk of aspiration pneumonia that could result in death.
- Stop Aspirin (ASA,Entrophen), Vitamin E 7 days before
- Stop taking Coumadin (Warfarin) 5 days before
- Stop Ticlopidine (Ticlid), Clopidogrel (Plavix), Aggrenox, Pradaxa (Dabigatran Etexilate) 3 days before
- Stop Xarelto (Rivaroxaban), Eliquis (Apixabon) 2 days before
What are the Risks of Gastroscopy?
In the hands of an experienced endoscopist, the risks are very low. They include the following:
- Aspiration (inhalation of liquid into the lungs)
- Injury to the esophagus
- Sore throat
Gastroscopy is a very common, safe procedure. While there are certain risks associated with this procedure, they are outweighed in most instances by the advantages of establishing the correct diagnosis.
What symptoms can be expected after a gastroscopy?
The effects of the sedation can last for the rest of the day, leaving you feeling drowsy. During this time, you should avoid alcohol. You might have a sore throat, especially if there was a lot of gagging during the gastroscopy. This normally resolves in a day or two. You can use lozenges for this. Most people feel a bit bloated from the introduced air. If you have severe pain or any other worrying symptoms, you should contact either the doctor who did the gastroscopy or your family doctor or go to the emergency department at the nearest hospital.