- Direct Visualisation: The procedure provides clear, real-time images of the digestive tract lining, allowing detailed examination.
- Immediate Tissue Sampling: Biopsies can be collected during the procedure for laboratory analysis to aid in diagnosing conditions such as infections or abnormal growths.
- Treatment Capability: Certain conditions, such as bleeding ulcers or small growths, can be treated directly during the procedure.
- Minimal Recovery Time: Patients typically resume normal activities within 24 hours after undergoing the procedure.
Gastroscopy
Dr Chong Choon Seng
MBBS | MRCS | Masters in Medicine (Surgery) | FRCS (Edinburgh)
A gastroscopy is a medical procedure used to examine the upper digestive tract. It involves inserting a thin, flexible tube with a built-in camera and light (endoscope) through the mouth to visualise the oesophagus, stomach, and duodenum (the first section of the small intestine). This procedure helps detect and assess conditions such as ulcers, inflammation, infections, tumours, and bleeding. Additionally, biopsies or minor treatments, such as removing polyps or controlling bleeding, can be performed during the examination if necessary.
Indications for Gastroscopy
Gastroscopy is commonly performed for the following conditions and symptoms:
- Persistent Upper Abdominal Pain: The procedure helps identify causes of ongoing discomfort, including ulcers and inflammation.
- Difficulty Swallowing: Gastroscopy can reveal narrowing or blockages in the oesophagus that affect swallowing ability.
- Persistent Heartburn: The examination can detect signs of acid reflux damage and conditions like Barrett’s oesophagus.
- Unexplained Weight Loss: The procedure helps identify digestive conditions that may cause unintended weight reduction.
- Persistent Nausea or Vomiting: Gastroscopy can reveal structural abnormalities or conditions causing these symptoms.
- Upper Digestive Tract Bleeding: The procedure locates and assesses the source of bleeding, indicated by black stools or vomiting blood.
Benefits of Gastroscopy
Gastroscopy offers several advantages in diagnosing and treating upper digestive conditions. These include:
Procedure Preparation
Medical Evaluation
Your medical history, current medications, and allergies are reviewed to ensure safety during the procedure. Blood tests may be conducted to assess clotting function and overall health.
Medication Adjustments
Certain medications, such as blood thinners, may need to be paused temporarily. Diabetic patients are given specific instructions on adjusting medication timing. Clear guidance is provided on which medications to continue or stop.
Fasting Requirements
To ensure a clear view during the procedure, you will need to avoid food for 6–8 hours beforehand. Clear fluids may be permitted up to 2–4 hours before the procedure.
Step-by-Step Procedure
Pre-Procedure Preparation
A local anaesthetic spray numbs the throat, and sedation is administered through an IV line to ensure comfort. Vital signs are continuously monitored throughout the procedure.
Endoscope Insertion
The endoscope is gently guided through the mouth and throat, with a mouthguard in place to protect the teeth and facilitate insertion. The procedure usually takes 5–10 minutes.
Upper GI Examination
The endoscope is advanced through the oesophagus, stomach, and duodenum. Air is introduced to expand the digestive tract, improving visibility. High-quality images are captured, and tissue samples may be collected if needed.
Completion
The endoscope is carefully removed, and the patient is monitored until the effects of sedation have subsided, which typically takes 30-60 minutes.
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Post-Procedure Care and Recovery
- Immediate Recovery: Mild throat soreness, bloating, or drowsiness from sedation may occur but typically resolve within 24 hours. Rest in a comfortable environment until fully alert.
- Activity Restrictions: Avoid driving, operating machinery, or engaging in strenuous activities for 24 hours after sedation. Normal eating can usually resume once the swallowing reflex returns, often within a few hours.
- Follow-up and Results: The findings from the procedure are reviewed during a follow-up appointment. Biopsy results, if taken, are usually available within 1–2 weeks. Based on these results, further treatment or management plans are determined.
Potential Risks and Complications
While gastroscopy is generally safe, possible complications include throat soreness, minor bleeding, or infection. Rare but serious risks include perforation of the digestive tract wall, adverse reaction to sedation, or damage to teeth. Bleeding may occur at biopsy sites but typically stops without intervention. These complications occur in less than 1% of procedures.
Frequently Asked Questions
Are there alternatives to gastroscopy for diagnosing digestive issues?
Yes, alternatives include barium swallow X-rays or capsule endoscopy. However, these methods provide less detailed images and do not allow for tissue sampling or direct treatment during the examination.
Can gastroscopy detect early signs of cancer?
Yes, gastroscopy is effective in detecting early signs of oesophageal, stomach, or duodenal cancer. It allows for high-resolution imaging and the collection of biopsies, which are necessary for accurate diagnosis.
How is air removed from the digestive tract after the procedure?
Air introduced during the procedure is expelled naturally through belching or flatulence within a few hours. Mild bloating or discomfort may occur temporarily as the air dissipates.
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Dr Chong Choon Seng
MBBS (NUS)
MRCS (Edinburgh)
Masters in Medicine (Surgery)(NUS)
FRCS (Edinburgh)
Dr Chong is the former Program Director of General Surgery Residency at NUHS, and has more than 10 years of experience as a colorectal and general surgeon.
As an esteemed professional in minimally invasive surgery, Dr. Chong remains committed to achieving optimal outcomes for all surgical conditions, from piles to cancer treatment.
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38 Irrawaddy Road, #09-34
Singapore 329563
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