These summaries were prepared by Dr Felicity Goodyear-Smith, Goodfellow Unit, Department
of General Practice & Primary Health Care, University of Auckland. Thanks for
the material provided by Ms Sarah Marshall, Charge Nurse Manager, Department of
Gastroenterology & Hepatology, A+, Auckland.
Gastroscopy
About Gastroscopy
Endoscopic examination of the upper bowel: oesophagoscopy and gastroscopy -
Procedure Details
Description of procedure
Fibreoptic gastroscopy examination allows an accurate internal inspection of the
upper bowel from oesophagus, through the stomach, to the duodenum. While early gastroscopes
merely carried a light source, these days the instrument usually contains a videocamera
allowing inspection of the bowel via a video monitor or even transmitted using communication
technology to a distant location. The gastroscope allows for other instruments to
be passed through it to carry out certain procedures for better diagnosis or treatment.
In particular, it allows for painless biopsy for diagnostic or treatment purposes,
and removal of polyps using electrocautery. Balloon dilators can also be introduced
via the endoscope. Conditions that might be diagnosed by use of the gastroscope
include oesophageal strictures, hiatus hernia, oesophagitis or gastritis, gastric
polyps, ulcers of the oesophagus, stomach or duodenum, coeliac disease and carcinomas
of the upper GI tract. Gastroscopy can also be used to treat a number of conditions.
Examples include dilatation of oesophageal strictures, removal of swallowed objects,
removal of gastric polyps, cautery to actively bleeding lesions.
Advantages of gastroscopy:
- Safe and highly effective diagnostic technique
- More accurate than barium meal
- Simpler than exploratory surgery
- Ability to take biopsies
Disadvantages of gastroscopy:
- Complications rarely occur. Possible complications include bowel perforation or
haemorrhage, which might require surgical repair or blood transfusion respectively
- Risk of perforation or haemorrhage is increased when polyps are removed via the
endocsope
- The procedure requires a hospital stay (usually on an out-patient basis)
- Sedation is required, with a small risk of adverse reactions to medications used
- There is a degree of patient discomfort
- There is a very small risk of contracting hepatitis, the AIDS virus or disease-causing
bacteria and viruses, should there be inadequate cleaning and disinfection of the
instrument after each use
Reasons patients might be referred for gastroscopy:
- Difficult or painful swallowing
- Persistent nausea and vomiting
- Unexplained cheat pain
- Dyspepsia
- Pain in the stomach or abdomen
- Haemoptesis or melaena
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Images from Gastrosocopy
Click on these images for an enlarged view - opens in a separate window which you
will need to close.
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Patient Information
This patient information is
available as a PDF file from which you may print copies - you will need
an acrobat reader.
Information for the patient on endoscopy of the upper GI tract
In order to diagnose and treat you, an examination called gastroscopy has been
requested. Endoscopy is a special technique for looking inside the body. Endoscopy
of the upper gastrointestinal tract (called oesophagosocopy and gastroscopy) allows
inspection of the lining of the oesophagus, stomach and duodenum (the beginning
of the small intestine). The gastroscope is a long, thin, flexible tube with a tiny
video camera and light on the end which can be guided down into the oesophagus,
stomach and duodenum, giving a detailed view of the lining onto a video monitor.
The gastroenterologist is able to inspect the lining of your upper bowel to see
if there is any inflammation, ulcers or other problems. If necessary, biopsies (tiny
samples of tissue) are taken. These can be viewed under the microscope to assist
with a medical diagnosis. The whole examination is painless, including the taking
of biopsies.
Preparation
Please keep your appointment if at all possible. Because of the preparation required
for the investigation, your appointment may not be used by someone else if you cancel
just before your scheduled time or if you fail to attend.
Your stomach needs to be empty so the doctor can see clearly. You will be asked
to have nothing to eat or drink for at least 4 hours before the gastroscopy.
What the procedure involves
Before the procedure the doctor or nurse may spray inside your mouth with local
anaesthetic to numb your throat. A small injection of sedating medication may be
given to make you feel relaxed. You will not be completely asleep but if you have
had sedation, you may forget what has happened.
You will be asked to lie on your left side. The doctor will pass the gastroscope
into your mouth and ask you to swallow to help the tube pass over the back of your
throat. Using the lens at the end of this tube, the doctor will look closely at
the lining of your oesophagus. You will be able to breathe normally during this
procedure, which usually takes a few minutes only. During the procedure, you should
feel no pain.
Once the gastroscopy is finished you will be wheeled on your bed into the waiting
area for a short period of recovery. The nurse will check your blood pressure and
heart rate. Once you are fully awake you will be able to go home.
You are not able to drive or operate machinery for 8 hours after the procedure,
so please have transport organised to get you home.
Elderly patients undergoing gastroscopy are advised to have a support person who
transports them home and stays with them for several hours.
You should be able to eat and drink normally following discharge.
Risks and Potential Complications:
- Gastroscopy is a safe procedure and complications are very rare. Major complications
occur once in every 7000 procedures. If you wish to discuss risks further with the
doctor, please ask.
- You may experience a sore throat for a day or two.
- Please note that any crown or bridging work may be at risk during the gastroscopy
if your reaction is such that you clench or grind your teeth. Otherwise, your teeth
are not at risk during this procedure.
- Perforation (making a hole in the bowel) or major bleeding from the bowel is extremely
rare but if it occurs, may require an operation. When polyps are removed during
the examination there is a slightly higher risk of perforation or bleeding. In the
unlikely event of haemorrhage occurring, a blood transfusion may be necessary.
- There is a very small risk of adverse reaction to one of the drugs used in the procedure.
For this reason, please let your doctor know all the medicines you are taking and
any allergies you have to drugs or other substances.
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