Gastroscopy (exams)

Content

Introduction

Introduction

Gastroscopy, also called esophagus-gastro-duodenoscopy (EGDS), or endoscopy of the upper gastrointestinal tract, is a medical procedure that involves the use of a long flexible tube with a small video camera at the end, the endoscope, to see the internal surface of the organ to be investigated. Esophagus, stomach and duodenum, taken together, form the so-called upper gastrointestinal tract.

Gastroscopy can be done, often after light sedation, by a specialist in gastroenterology or a surgeon.

Your doctor prescribes it if you have bleeding or have some complaints (symptoms) for a long time, such as heartburn or pain, nausea and vomiting, difficulty swallowing (swallowing), weight loss without other causes evident.

Gastroscopy is able to identify several diseases:

  • gastroesophageal reflux
  • gastric and duodenal ulcers
  • esophageal, gastric and duodenal tumors
  • gastroesophageal inflammation
  • precancerous anomalies
  • celiac disease

In other cases, it can help to ascertain (diagnose) the causes of other diseases such as, for example, anemia.

In addition, it allows you to take small fragments of tissue from the esophagus, stomach or duodenum (biopsies) and submit them to a histological examination that will allow you to ascertain (diagnose) the presence, or not, of certain diseases such as gastritis, tumors and celiac disease. .

Surgery (operative endoscopy) may also be performed during the examination, such as, for example, stopping excessive bleeding from the esophagus, stomach and duodenum, removal of polyps, dilation of narrowings formed in the esophagus and removal of objects or food stuck in the upper gastrointestinal tract.

The test

The test

Gastroscopy usually takes less than 15 minutes to complete. It may take longer if surgery is needed to stop bleeding, resolve narrowing of the upper gastrointestinal tract, or remove small tumors or objects.

Usually, it is performed on an outpatient basis, it is not necessary to spend the night in the hospital and you can go home about two hours after the end of the exam.

Preparationto the exam
The doctor who performs the gastroscopy usually informs the person who will have to undergo the examination of the need to stop taking any medications a few days beforehand.

In particular, you should tell your doctor if you are being treated with:

  • diabetes medications such as, for example, insulin or metformin
  • antiplatelet or anticoagulant medicines such as, for example, aspirin, warfarin or clopidogrel

Since it is important that the esophagus, stomach or duodenum be empty in order to visualize well, it is necessary to eat nothing in the six or eight hours before the exam and stop drinking two or three hours beforehand.

Performing gastroscopy
Immediately before starting the exam, the person undergoing the exam is sprayed with a local anesthetic in the mouth to reduce throat sensitivity and make the procedure less annoying. If the person is too anxious, sedation may be necessary which, while keeping them awake will reduce awareness of what is happening. In children, esophagus-gastro-duodenoscopy is usually performed under general anesthesia.

The examination begins with the insertion of the endoscope in the mouth. Then the doctor will ask you to swallow the first part of the tube and guide the endoscope down into the esophagus, stomach and duodenum. Gastroscopy is not painful, but it can be unpleasant or annoying.

After gastroscopy
At the end of the investigation, if sedatives have not been administered, it is usually possible to go home immediately. the effect of the medications will not be over. In this case, it is important to be accompanied home by a family member or friend. Also, as you may experience sleepiness in the 24 hours following the examination, it is not advisable to drive, work or drinking alcohol during this period.

Risks
Gastroscopy is a fairly safe investigation but, like all medical procedures, although rarely it can cause some complications:

  • unwanted reactions (adverse) to the sedative consisting of mild breathing problems
  • heart rate disturbances and blood pressure
  • bleeding from the esophagus, stomach or duodenum
  • infections of the gastrointestinal tract
  • perforations of the esophagus, stomach or duodenum

Some disorders (symptoms) may indicate the onset of a complication:

  • fever
  • chest pain
  • shortness of breath
  • feces of a reddish color, black or very dark
  • difficulty swallowing
  • continuous abdominal pain
  • He retched with the presence of blood

If these disorders appear immediately, or shortly after, having performed a gastroscopy, it is necessary to contact the doctor immediately or, if this is not possible, to go to the emergency room.

Results

Results

Gastroscopy is useful for ascertaining (diagnosing) a disease or for treating it (operative endoscopy).

It can be done to find the cause of some ailments, such as bleeding or heartburn or weight loss, that go on for a long time. In these cases, the exam can identify:

  • gastritis, stomach inflammation
  • ulcers, in the stomach or duodenum, often caused by inflammation
  • gastroesophageal reflux, a condition in which the acid present in the stomach flows back up towards the esophagus
  • tumors

After having ascertained the causes, the doctor will suggest the most appropriate therapy.

Treatment of bleeding varices
If a person suffers from varicose veins (dilated veins) bleeding in the esophagus, gastroscopy can identify the site of the bleeding and stop it.

This can be done by:

  • ligation of the varices with a small rubber band to stop blood flow from the vein
  • sclerotherapy, injection of a chemical that closes the hole or lesion responsible for bleeding into the dilated vessel

Treatment of bleeding gastric or duodenal ulcers
If there are ulcers in the stomach or duodenum, gastroscopy allows them to be identified and, possibly, to stop the bleeding with different techniques:

  • generating heat, through a probe passed through the endoscope, to heal the ulcer
  • inserting small clips (similar to very small paper clips)
  • injecting a drug, around the ulcer, which activates coagulation

Dilation of a narrowing of the esophagus
If there is a narrowing in the esophagus it is possible to dilate it by inserting a balloon, also called stent (a small plastic bag), through the gastroscope tube.

Bibliography

Bibliography

NHS. Gastroscopy (English)

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