This procedure is sometimes called oesophagogastroduodenoscopy, but for practical purposes is usually shortened to "gastroscopy". During this procedure the endoscopist uses a long flexible tube with a camera on the end to visualize the inside of the oesophagus (food pipe), stomach and duodenum (first part of the small bowel). The images of these organs are projected on a screen that the endoscopist can inspect.
The procedure is uncomfortable. As a result, it is necessary to spray the back of the throat with local anaesthetic and give intravenous sedation to the patient to minimize this discomfort. This is not a full anaesthetic, but most patients will remember very little about the procedure afterwards.
Diagnostic indications for gastroscopy include:
- Upper abdominal pain or indigestion i.e. dyspepsia
- Upper gastro-intestinal tract bleeding
- Unexplained iron deficiency anaemia
- Chronic diarrhoea
- Swallowing difficulties i.e. dysphagia
- Unexplained loss of weight
- Persistent gastro-oesophageal reflux symptoms
- Persistent non-cardiac chest pain
- Persistent nausea or vomiting
Various therapeutic interventions can also be performed using gastroscopy:
- Dilatation of oesophageal strictures
- Resection of gastric polyps and high grade dysplastic lesions
- Ablation of vascular abnormalities using argon plasma coagulation
- Radiofrequency ablation of Barrett’s oesophagus and Gastric Antral Vascular Ectasia (GAVE)
- Oesophageal stenting
- Duodenal stenting
Whenever procedures are performed, there is a risk of complications. The risk of significant complications from gastroscopy is extremely low. Such complications include:
- Sedation-related complications e.g. over-sedation with suppression of breathing. An antidote will be given in this situation and the procedure will be abandoned.
- Perforation: This can occur either if there is an anatomical abnormaility in the oesophagus or if an intervention is performed e.g. resection of a large tumour endoscopically or ablation of a vascular lesion using argon plasma coagulation. If perforation occurs, it is considered an emergency and an operation may need to be performed.
- Bleeding: If a polyp is resected or if an ulcer is biopsied, it may cause significant bleeding. Usually this is dealt with during the gastroscopy, but bleeding can occur later and a repeat procedure may be required to stop the bleeding.