All about gastroscopy

It is an examination that involves viewing the esophagus, stomach and duodenum from the inside with a flexible, optical-electronic gastroscope.

How is the examination performed?

The gastroscope is inserted through the mouth via the esophagus, into the stomach and duodenum. The patient must be fasted for at least eight hours. The technique of gastroscopic examination is based on the fact that light from halogen bulbs is sent through flexible optical fibers to the inside of the examined organ, while on the monitor screen the image transmitted from the microcamera located at the tip of the gastroscope is visible.

This allows the doctor to see the inside of the stomach and duodenum in detail with good lighting and magnification on the monitor. At the same time, the corresponding channels in the gastroscope make it possible to aspirate liquid contents that obstruct visibility, blow in air and rinse the tip.

The gastroscope includes a biopsy channel running along the entire apparatus, which is 2-4 mm in diameter. A laser probe can be inserted through the channel, as well as various instruments, such as forceps or loops.

What can be seen during gastroscopy?

During gastroscopy, the esophagus, stomach and duodenal bulb are evaluated. Their mucous membranes can be carefully examined, and it can be assessed whether there are any pathological changes in the nature of ulcers, erosions or cancerous lesions.

At the same time, it is possible to diagnose a possible hernia of the esophageal hiatus and control the work of the examined organs by evaluating the peristaltic wave. Using the gastroscope, it is possible to simultaneously perform such procedures as taking sections for further histopathological diagnosis.

During gastroscopy, a so-called trauma test is also performed for the presence of Helicobacter pylori (HP) bacteria, which causes inflammation or ulcers of the stomach or duodenum.

What else is possible with gastroscopy?

Gastroscopy also makes it possible to remove polyps and is used to stop upper gastrointestinal bleeding. Sometimes, it also makes it possible to remove foreign bodies from the gastrointestinal tract.

Foreign bodies are found and extracted, such as a bone stuck in the esophageal wall, seeds, or swallowed objects such as coins, rings, etc. Gastroscopy can also be used to remove surgical threads remaining after gastric surgery. Gastroscopy also makes it possible to reach the duodenum (the next section of the digestive tract after the stomach).

Who can perform such an examination?

Gastroscopy can be performed at most specialty clinics and hospitals. It is performed by internists (gastroenterologists) and surgeons. Everyone can have a gastroscopy, regardless of gender and age (if there are no contraindications to the test).

It can be repeated as many times as necessary. If a lesion of the nature of an erosion or ulcer is found, it is necessary to take a so-called biopsy, i.e. a tissue slice for histopathological examination, besides, a follow-up gastroscopy examination after a period of drug therapy should always be performed.

Does this examination hurt?

The gastroscopic examination is painless and takes a short time, about 5-10 minutes. A possibly unpleasant moment may be the insertion of the gastroscope into the esophagus. Patients sometimes whoop and have a vomiting reflex. This depends largely on the sensitivity and attitude of the person being examined.

Alleviating the vomiting reflex is sometimes helped by concentration and calm, deep breathing. A proper breathing rhythm makes the examination easier for the patient to bear and allows the doctor to examine the gastrointestinal tract more thoroughly.

What are the contraindications to gastroscopy?

Although it is a low-impact, brief and safe examination, there are, however, contraindications to gastroscopy, which are somewhat due to the possibility of complications.

Absolute contraindications include fresh myocardial infarction, acute coronary insufficiency, respiratory and circulatory failure, severe arrhythmias and the clinical picture of an “acute abdomen.”

When is gastroscopy performed and what are the indications for such an examination?

Gastroscopy is performed in patients who remain at least 8 hours without eating! The indication for the test is any abnormality of the upper gastrointestinal tract.

Most often, the examination is performed due to complaints of epigastric pain, weight loss, persistent vomiting, swallowing disorders, heartburn or suspected upper gastrointestinal bleeding.

During the examination, we can take sections for histopathological examination, which accurately determines the type of condition! The examination also serves to evaluate and control conservative and surgical treatment.

Modern video gastroscopes, which we have at the Video-Gastroscopy Laboratory at KCM, are much “leaner” than old-generation gastroscopes and are generally tolerated by patients without problems.