Gastroscopy

Description of procedure

Oesophago-gastro-duodenoscopy, or gastroscopy as it is often shortened to, is an examination of the upper GI tract performed by passing a flexible camera/telescope through the mouth. It allows examination of the oesophagus (gullet, stomach and duodenum (first segment of small bowel). Biopsies can be taken to help identify any abnormality  Gastroscopy is the gold standard for examining the upper gut.

Gastroscopy is performed in an endoscopy unit. You will be asked to lie on your left hand side whilst the procedure is performed. There will be doctors and nurses present during the procedure who will be able to explain to you exactly what is happening.

Indications for gastroscopy

Gastroscopy is usually performed for any symptoms which might relate to the upper GI tract.

Common indications would be persistent reflux (heart burn) or dyspepsia (indigestion), upper abdominal pain, weight loss, to exclude Coeliac disease or to investigate possible bleeding from the upper GI tract.

Will it hurt?

As the camera passes over the back of the throat it inevitably causes a degree of coughing and possibly retching. Once past this point the procedure becomes easier. Gastroscopy is considered by most patients a little uncomfortable but it is relatively brief, usually taking only 5 – 10 minutes.

Sedation

Gastroscopy is usually performed with a sedative injection. This is not a general anaesthetic. You will be awake but may be drowsy and may not remember the procedure clearly afterwards. Throat
spray is also given to numb the back of the throat to make passing of the scope easier. After sedation you will require a period of recovery in the hospital of usually approximately one hour. You will need someone to escort you home and you should not drive, operate heavy machinery or drink for the next 24 hours. Given the procedure is relatively brief some patients chose to have it performed without sedation. The advantage of this is that they are able to leave the department almost immediately afterwards and can drive themselves home.

Preparation

The patient is required to be nil by mouth for six hours prior to performing gastroscopy. This ensures the stomach is empty so that good views can be obtained.  You may eat and drink normally once the sedation has worn off.

Risks

Gastroscopy is a very safe procedure. Common side effects include a sore throat for 24 hours and abdominal bloating which may last for a few hours after the procedure. There is also a very low risk (less than 1:1000) of causing internal bleeding (haemorrhage) or a tear in the stomach (perforation). These risks are extremely low but in theory if a perforation were to occur surgery might be required to repair it and therefore it is standard practice throughout the UK to inform patients of this risk.

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