Overview of a gastroscopy?
Gastroscopy is an exam of the first part of your esophagus, stomach, and small intestine. The exam is performed by a doctor or a specialized nurse (endoscopist). They use a long, flexible tube that holds a small camera and a light at the end. This tube is called a gastroscope or endoscope.
You may also hear this test called an oesophagal gastric duodenoscopy (OGD).
Why you might have a gastroscopy
You may have a gastroscopy to find out what is causing your symptoms:
- Abnormal bleeding
- Low iron levels (iron deficiency anaemia)
- Hard to swallow
If you have Barrett’s esophagus, you will have regular gastroscopies to check for changes in the cells lining your esophagus.
During the exam, your endoscopist will take samples (biopsies) from any abnormally visible areas. They send the samples to the lab to see them under the microscope.
How is gastroscopy done?
Preparing for your exam
You may have blood tests beforehand to check your blood levels and blood clotting.
Tell your doctor if you are taking medications to thin the blood, such as warfarin.
Your doctor may tell you to stop taking these or other medications for a time before your gastroscopy.
You cannot eat 6 hours before the test, but you can sip water 2 hours before. Your doctor or nurse will give you written instructions on this before your appointment.
Talk to your doctor if not eating could be a problem for you. For example, if you have diabetes.
Most people have a gastroscopy as an outpatient, which means you go home the same day. The test takes up to 15 minutes. But expect to be in the hospital for several hours.
First, you meet with your nurse, who will ask about your medical history and any allergies you may have. They can monitor your blood pressure and heart rate.
Your nurse or endoscopist will explain the procedure to you and ask you to sign a consent form. This is a good time to ask yourself questions.
Some endoscopy units may ask you to change into a hospital gown, but you can usually perform the test in your own clothing.
You usually stay awake when you are tested, but you can also choose medicine to help you relax. These make you sleepy.
If you have dentures or wear glasses, you should remove them for examination. Your nurse will place a plastic shield over your mouth to protect your teeth from the gastroscope.
Having the test awake
Your endoscopist will spray the back of your throat with a local anaesthetic to make it easier for you to numb and swallow the tube. It can make you cough, make your eyes water, and can be bitter. Then you lie on your left side.
It may take a few minutes for your throat to clear. Your endoscopist inserts the gastroscope into your mouth and down your throat into your esophagus. The tube is slightly larger than the pen and should be uncomfortable but not painful.
They will ask you to swallow as the tube goes down. They can see images from the gastroscope on the TV screen. They can put small amounts of air into the tube to help them see your esophagus, stomach, and duodenum. You may feel like burping.
Your endoscopist will take samples (biopsies) through the gastroscope of any abnormal areas. It is not painful.
At the end of the test, your endoscopist will gently remove the gastroscope.
Having the test while drowsy
You lie on the bed.
Your nurse inserts a small plastic tube (a cannula) into a vein in your hand. They then inject the sedative into the cannula. It will take a few minutes for you to relax more, which will make you sleepy. You can still follow the instructions of your endoscopist and nurse. They give you oxygen through a small plastic tube with tips inside your nostrils. They also place a clip on your finger to monitor your oxygen levels and heart rate. Next, your endoscopist will insert the gastroscope into your throat.
After your gastroscopy
Your nurse or endoscopist will talk to you about how the test was done, whether they are taking biopsies, and when to expect the results.
You may feel some bloating and discomfort for a few hours after your gastroscopy.
If you are not intoxicated, you can go home shortly after the test. You cannot eat or drink until you have applied a local anaesthetic spray. This can take up to an hour.
If you are intoxicated, you will be in the endoscopy unit for an hour or two to recover. You may not remember much (if you have any) about the test. You need a friend or family member to drive you home.
24 hours after intoxication, you should not:
- Drinking alcohol
- Operate heavy machinery
- Sign any important documents
Possible risks of gastroscopy
This test is a very safe procedure, but your nurse will tell you whom to contact if you have any problems after the test. Your doctor will negate the benefits of having a gastroscopy.
Some of the risks include:
If you have a biopsy, you may have a small amount of bleeding. It usually stops on its own. If not, you will have to go to the hospital to stop the bleeding.
This is normal and lasts for a few days after the endoscopy. See a hospital if you have severe pain in your throat, chest, or abdomen (abdomen).
The risk of injury after the biopsy is very low. If you have a fever, hot or cold or chills, or feel generally unwell, you should contact your GP.
Damage to teeth
There is a small chance that the gastroscope will damage your teeth during the test. The mouth guard helps prevent this from happening.
There is a small risk of breathing in the saliva (secretions) that you normally swallow because your throat is numb or you fall asleep from poisoning. Your nurse protects your airways by inhaling secretions during the procedure.
Reaction to poisoning
Occasionally, narcotics can cause problems with your breathing, heart rate, and blood pressure. The risks are higher in the elderly and those with lung or heart problems. Your nurse will monitor you closely for any problems during the test, so they can be treated quickly.
Tear or hole (punctured)
The gastroscope has a very low risk of causing tears in the lining of the esophagus, stomach, or duodenum. You may need surgery to repair this.