Gastroscopy

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.