All About Gastroscopy
After a careful medical assessment, your
doctor has recommended that you should have a gastroscopy
examination, a non-surgical technique that can aid in diagnosing
problems of the upper digestive system. Based on the results of this
exam, your doctor can then suggest the best course of treatment for
your problem. More accurate than a barium x-ray and much simpler
than exploratory surgery, gastroscopy is a safe and highly effective
most patients are a bit apprehensive about the idea of "swallowing a
scope." However, with the help of modern medical instruments and
sedation, patients usually tolerate this test with ease. After the
test is completed, most patients are pleasantly surprised by how
easy it was. We have written this information to answer any
questions that you may have about gastroscopy. If you have
additional questions or concerns after reading it, please feel free
to consult your doctor.
the upper digestive tract are quite common in our stressful society.
Various factors such as diet, environment, and heredity contribute
to these conditions. Gastroscopy is often useful in diagnosing and
treating problems such as:
- Abdominal pain
- Bleeding from the digestive tract
- Cancers of the stomach or esophagus
- Chronic heartburn and indigestion
- Diagnosis and removal of stomach polyps
- Dilatation of esophageal strictures
- Gastritis, or stomach inflammation
- Hiatal hernia
- Removal of swallowed objects
- Trouble swallowing
- Treatment of the "Ulcer Bacteria"
- Ulcers of the esophagus
- Ulcers of the stomach and ulcers of the duodenum
- Unexplained chest pain
Gastroscopy is a medical term that has two parts: gastro
for "stomach," and scopy for "looking." Gastroscopy, then, is a
diagnostic test that enables the doctor to look inside your stomach.
The instrument used to perform this simple test is the gastroscope;
a long, thin, flexible fiberoptic tube. Within the end of this
remarkable device is a miniaturized color TV camera with a wide
angle lens. By passing this "scope" into your stomach, your doctor
can directly examine the lining of your upper digestive system on a
television monitor. The technical name for this test is
Esophago-Gastro-Duodenoscopy. To simplify things the shortened form
of the name GASTROSCOPY is usually used, or the initials EGD. The
examination is quick and painless. There is no incision.
As part of your
evaluation, your family doctor may have already ordered a barium
x-ray of your upper digestive system - an UPPER GI SERIES. This
x-ray exam may have been helpful in directing attention to an area
of possible abnormality. But x-rays often do not fully reveal what
is wrong. In fact, it is believed that the standard Upper GI x-ray
may miss up to 30% of peptic ulcers.
gastroscopy permits a much more accurate view of your upper
digestive system. Rather than studying an indirect x-ray "shadow
picture" of your stomach, gastroscopy allows your doctor to directly
view your upper digestive tract in "living color" and to examine the
lining in remarkable detail. Thus, it is much more accurate.
HOW CAN YOU HELP?
cooperation is essential for a successful examination. There are
certain things that you can do before the test to help:
must be empty during gastroscopy so that your doctor's view is not
blocked by particles of food. If your test is scheduled in the
morning, you must not eat or drink anything after midnight the night
before the test. You may gargle and brush your teeth in the morning.
If your test is scheduled in the afternoon, you may have
only liquids - such as juice, coffee, tea, broth - for breakfast.
Then begin fasting. You should not eat or drink anything for at
least 6 hours before the exam.
continue to take any important medications that your personal
physician has prescribed - even on the morning of the test. Simply
take them with a small sip of water at least two hours before your
appointment. This allows time for the tablets to dissolve
completely. You should not take any antacids on the day of the test.
If you are a diabetic on insulin, call for special instructions. Do
not use tobacco within two hours of your test since this tends to
affect the natural color of your stomach lining.
You will have to change into a patient gown before the
examination. If this test is being done on an outpatient basis, you
should wear loose, comfortable, casual clothing that is easily
removed and folded. Avoid girdles, pantyhose, or tight-fitting
garments. Please leave your jewlery, valuables, and high heels at
To minimize any
discomfort, you will receive a sedative injection before the
examination. As this medication will make you drowsy for several
hours, you cannot safely drive a car for the remainder of the day.
Therefore, if this test is being done on an outpatient basis, a
family member or friend must accompany you to the office in order to
drive you home. If possible, you should choose someone with whom the
doctor can freely discuss the results of your test. We request that
your companion remain in the office during the test. You should plan
to arrive fifteen minutes before your appointment and to stay
approximately two hours.
Of course, if
this test is being done on a hospital inpatient basis, a driver will
not be needed. After the examination, you will simply return to your
hospital bed to sleep off the remainder of the medication.
If you have any
questions about this test, do not hesitate to ask the GI Assistant,
nurse, or doctor. To signify that you completely understand what
this test involves, you will be asked to sign a written consent
form, or "permit," before the test begins.
Before the test
begins, you will be asked to remove any dentures or eyeglasses.
Contact lenses need not be removed.
To make this
examination more comfortable, the GI Assistant will then spray the
back of your throat with a liquid anesthetic. This may taste
slightly bitter and will produce a numbness in your mouth and
throat. This effect will last approximately one half hour. Then you
will be positioned comfortably on your left side on the padded
examination table. A small painless oximeter probe will be placed on
your fingertip to monitor your pulse rate and breathing function
during the exam.
your comfort during the examination, you will then be given an
intravenous injection of Demerol, a pain killer, combined with
Versed, a mild tranquilizer. If you are allergic to either of these
medications, please inform your doctor. These medications will make
you drowsy and relaxed. You will not be deep asleep like a general
anesthetic, but your doctor will give you sufficient medication to
induce a pleasant "twilight sleep." In this manner, you should feel
no discomfort during the test. Upon awakening, you will probably
have little recollection of the procedure, itself. Once you are very
relaxed, the doctor will gently insert the flexible gastroscope.
Since this scope does not enter your "windpipe," it will not
interfere with your ability to breathe. The most frequent fear
expressed by patients is that they will be unable to swallow the
scope because of gagging. Fortunately, the medications given prior
to the procedure usually prevent this from happening. Even the most
apprehensive patients tolerate the procedure quite well.
small mouthpiece will then be placed between your teeth enabling you
to relax your jaws. To better see the lining of your upper digestive
tract, your stomach is then gently filled with a small quantity of
air. While this air may cause the sensation of abdominal fullness,
it should not be painful. Your doctor can now begin to inspect the
lining of your esophagus, stomach, and duodenum, an exam that takes
about fifteen minutes.
gastroscopy reveals any abnormal condition such as an ulcer, your
doctor may photograph it. This picture provides a permanent record
for your medical chart and also enables your other doctors to see
what is wrong. If necessary, a videotape of the procedure may be
recorded for later review.
evaluate areas of abnormality, your doctor may take a biopsy. This
procedure is performed painlessly with a miniature forceps. After
passing the forceps through a hollow channel inside the gastroscope,
your doctor simply snips off a tiny sample of tissue for laboratory
analysis. If a small growth called a polyp is found, it can often be
removed for analysis. This is done by using a thin wire-loop snare
which cuts off the polyp and then cauterizes the base using electric
heat. This is also painless.
Be assured that
your doctor's decision to take a biopsy does not necessarily mean
that cancer is suspected. Biopsies of the digestive tract are
routinely taken to investigate other problems such as inflammation
If you have
difficulty swallowing and the doctor finds a narrowed area in your
esophagus, it may be possible to dilate this "stricture" during this
exam with a small balloon dilator.
After an outpatient gastroscopy, you will rest awhile in
the office recovery room. Your companion will be asked to sit with
you while the effects of the sedation wear off. Initially you may
feel slightly bloated from the air that was placed in your stomach
during the examination. This feeling will gradually subside. Once
you are more alert, the doctor will meet with you to discuss the
test's findings as well as any recommended treatment. If a biopsy
was obtained, the doctor will contact you with the results when they
You will then
be able to return home with your companion's assistance. Since you
will still be somewhat drowsy and uncoordinated, you will be taken
in a wheelchair to your car by the office personnel.
the effects of the sedatives may take up to 24 hours to wear off
completely, you should plan to go directly home - not to a
restaurant. Have a light meal, and rest for several hours. After the
sedation has completely worn off, you may resume your normal diet.
However, you will not be able to go to work, drive your car, or
operate any dangerous machinery for the remainder of the day. You
may experience a mild sore throat after gastroscopy. If this occurs,
anesthetic throat lozenges, such as Cepacol or Sucrets, are helpful.
IS THIS TEST DANGEROUS ?
medical procedure involves some degree of risk, the frequency of
complications during gastroscopy is extremely low. With the modern
flexible fiberoptic instruments now available, gastroscopy has
become a safe and simple method of examining the upper digestive
tract. When performed by a physician who is specially trained and
experienced in this procedure, the benefits of gastroscopy far
exceed its risks.
Your doctor is
a GASTROENTEROLOGIST. In addition to standard medical training, he
has received special instruction in diseases of the digestive system
and has been thoroughly trained in the safe and proper operation of
the gastroscope. The combination of this experience and your
cooperation should make this test as safe and simple as possible.
However, as with all medical procedures, complications can sometimes
The main risks are perforation, or a tear, of the
stomach or esophagus lining and bleeding. Although perforation
generally requires surgery, certain cases may be treated with
antibiotics and intravenous fluids. Bleeding may occur at the site
of a biopsy or polyp removal. Typically minor in degree, such
bleeding may simply stop on its own or be controlled by
cauterization. Seldom does surgery become necessary. Fortunately,
both perforation and bleeding are extremely rare during gastroscopy.
Other minor risks include drug reactions and complications related
to other diseases you may have. Consequently, you should inform your
doctor of all allergic tendencies and medical problems.
Occasionally, the site of the sedative injection may become inflamed
and tender for a short time. This is usually not serious and warm
compresses for a few days are usually helpful. While any of these
complications may possibly occur, it is well to remember that each
of them occurs quite infrequently. Your doctor can further discuss
the above risks with you with regard to your particular need for
Due to the
recent extensive coverage of AIDS in the media, some individuals
have been concerned that they might contract AIDS through this
examination. Be assured that this is not the case. All our
instruments are extensively cleaned and undergo high level
disinfection between each case. Only techniques known to kill all
disease-causing bacteria and viruses including the AIDS virus are
employed in this process.
gastroscopy is a valuable tool for the diagnosis and treatment of
diseases of the upper digestive tract. Abnormalities suspected by
X-ray can be confirmed and studied in detail during this procedure.
Even when X-rays are normal, the cause of such symptoms as abdominal
pain and internal bleeding can often be determined by gastroscopy.
This technique is useful in the diagnosis and follow-up of patients
with peptic ulcers and also allows dilatation of esophageal
strictures. Gastroscopy is an extremely safe and worthwhile
procedure that is very well tolerated. If you have any questions or
concerns regarding this procedure, do not hesitate to consult your