A gastroscopy (or upper gastrointestinal endoscopy) is a procedure to look inside your gullet (oesophagus), stomach and the first part of your small intestine (duodenum). Using an instrument called an endoscope, the doctor is able to carry out a thorough investigation of this area and diagnose a range of conditions that may be causing symptoms.
A gastroscopy uses a thin, flexible tube called an endoscope to investigate symptoms of the upper GI tract (gullet, stomach and small intestine) and treat certain conditions. The endoscope has a light and camera at one end, which transmits images back to a monitor, enabling the doctor to get a detailed picture of what is going on inside.
The procedure can be done with a local anaesthetic to numb your throat or a sedative to help you to relax. The endoscope will be gently placed in the back of your mouth by the doctor who will ask you to swallow the first part of the tube. This will then be guided down your oesophagus and into your stomach and duodenum. The procedure can feel a little uncomfortable but should not be painful.
While a gastroscopy is a safe, accurate and routine procedure it carries a small risk of complications, including damage to the lining of your oesophagus, stomach or small intestine. Your doctor will discuss any potential risks with you in detail before the procedure.
A gastroscopy is used to investigate your upper gastrointestinal tract symptoms and confirm a suspected diagnosis. It may also be used to take a biopsy (small tissue sample), which is sent away to the laboratory for analysis, and to treat certain problems. If you are unable to eat normally, a gastroscopy can be used to place a feeding tube into your stomach.
You might be offered a gastroscopy to investigate the cause of your upper gastrointestinal tract symptoms.
Diagnostic gastroscopies may be used to investigate symptoms such as:
- Problems swallowing (dysphagia).
- Recurrent indigestion or heartburn.
- Persistent sickness or feeling sick.
- Abdominal pain.
- Vomiting blood or passing dark, tarry stools.
- Anaemia due to suspected internal bleeding.
It is also used to confirm or rule out conditions such as:
- Hiatus hernia
- Gastro-oesophageal reflux disease (GORD)
- Barrett’s oesophagus
- Peptic (stomach) ulcers
- Oesophageal and stomach cancer
- Portal hypertension
- Coeliac disease
Gastroscopies may also be used to:
- Widen a narrowed oesophagus caused by GORD, oesophageal cancer or radiotherapy.
- Remove tumours, polyps or foreign objects.
- Stop bleeding caused by a peptic ulcer or enlarged veins.
Prior to the procedure you may need to stop taking prescribed medication for indigestion because these can affect the result. Your doctor will also advise you what to do if you are diabetic or taking blood-thinning medication.
You will need to stop eating for six hours before the procedure and stop drinking three hours beforehand. This is because your stomach needs to be empty for the doctor to be able to get a clear view.
You will be offered a local anaesthetic spray to numb your throat and/or a sedative to help you relax. Occasionally, the procedure needs to be done under general anaesthetic. You will be asked to lie on your left side and a plastic mouth guard will be placed in your mouth to hold it open.
The endoscope will be inserted through your mouth into your throat and the doctor will ask you to swallow it. This may feel uncomfortable at first and you may gag but this feeling should reduce as the endoscope moves further down your gullet.
Air will be blown into your stomach to give the doctor a clear view. This may make you feel bloated or burp, but this will be short-lived and should improve once the gastroscopy has been completed. A biopsy may be taken using tiny surgical instruments inserted through the tube. You won’t feel the biopsies being taken.
Certain conditions, such as bleeding stomach ulcers, enlarged veins or a narrowed oesophagus may be treated during the procedure.
If you had a sedative, you will need to wait for the effects to wear off before leaving the clinic. You will need someone to ensure you get home safely and stay with you for 24 hours as the sedative can cause drowsiness. You shouldn’t drive or go back to work until the effects have fully worn off.
Your throat may feel sore after a gastroscopy and you may feel bloated. This normally wears off after a day or so but seek medical help if you develop chest or abdominal pains, shortness of breath or if you are vomiting blood or passing dark tarry stool.
Natalie has been a consultant gastroenterologist since 2016 and in addition to her private practice she currently holds a post at Imperial College Healthcare NHS Trust, with a specialist interest in gastroenterology and…
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Consultant Gastroenterologist & HPB Physician