What is Gastroscopy (Gastric Endoscopy)?

Gastroscopy, or stomach examination, helps to confirm or rule out the presence of medical conditions such as gastritis or peptic ulcers. In this procedure, an instrument called a gastroscope is used to examine the inside of the esophagus, stomach and part of the intestine.

A gastroscopy test is performed by a gastroenterologist. The procedure uses a long, flexible tube with a small camera and light at the end. This tube is called a gastroscope or endoscope.

The gastroscope is a flexible tube with a small light and a video camera attached to the end. Images from the video camera are sent to a screen. The tube can be used to take tissue samples by inserting tools such as small pliers. It can also be used to suck in air and fluids.

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Why is Gastroscopy done?

Gastroscopy can be performed to check what is causing complaints in the digestive tract, to treat certain conditions or to check for cancer. However, gastroscopy is not only a diagnostic procedure. Some diseases can be treated during the procedure or treatment can be scheduled for another session if deemed necessary.

The procedure is performed with an endoscope inserted through your mouth. The test is typically performed when patients experience symptoms such as heartburn, abdominal pain and bloating. Gastroscopy is also the most effective screening method for stomach cancer. Gastroscopy is recommended for patients with the following conditions

  • Chronic or recurrent heartburn, nausea or vomiting
  • Prolonged nausea
  • Abdominal pain
  • Difficulty swallowing
  • Black stools or blood in the stool
  • Weight loss for no apparent reason
  • Suspected peptic ulcer
  • Suspicion of esophageal or stomach cancer
  • Control after gastric surgery

Examples of procedures for which treatment is performed during gastroscopy include:

  • Removal of polyps in the stomach
  • Stopping bleeding by intervening in bleeding lesions
  • Removal of superficial tumors or early stage cancers (endoscopic mucosal resection – EMR or ESD)
  • Dilatation of stenosis in the esophagus, gastric outflow tract or intestines (dilatation procedures)
  • Stent insertion
  • Ligation of varicose veins in the esophagus (band ligation)
  • Removal of foreign bodies in the esophagus or stomach
  • Gastric botox, gastric balloon and endoscopic stomach reduction procedures

Gastroscopy Procedure

In general, there is no need for an intensive preparation process before the gastroscopy procedure. At least 8 hours of fasting (no liquid and water consumption) is sufficient for the procedure to be performed. Only some blood thinners may need to be discontinued before the procedure.

On the day of the procedure, a consent form is signed in the endoscopy unit, the patient is registered and the patient is taken to the preparation room. In the preparation room, the patient is hospitalized and prepared for the procedure. The relevant nurse asks the patient whether he/she has a chronic disease, the medications he/she is taking, the last time he/she took which medication, the last time he/she ate and drank, and whether he/she has any allergies. The patient is then given anesthesia and taken to the procedure room with the patient bed.

An endoscopy nurse, anesthesia team and gastroenterologist are present in the procedure room. Before the procedure begins, there is a preparation period of about 1-2 minutes. During this time, the patient’s blood pressure, pulse rate, respiratory rate and oxygen level in the blood are measured with a small device like a clothespin attached to the fingertip. A plastic nasal mask is inserted into the nostrils to ensure continuous oxygen intake during the procedure. Before the procedure, a spray is sprayed into the mouth and throat to numb the throat. This spray numbs the tongue, mouth and throat and makes the procedure easier to perform. Then a disposable plastic mouthpiece with a hole in the center is placed in the patient’s mouth between the front teeth through which the endoscopy tool will pass. Finally, the anesthesia team administers intravenous medication and the patient falls asleep after about 10 to 20 seconds.

Once the anesthesia takes effect, the procedure begins. Gastroscopy is a procedure that takes about 5 minutes. During this procedure, the patient’s throat, esophagus, stomach and approximately the first 20-30 cm of the small intestine are examined. After the procedure is over, the endoscopy tool, nose mask and mouthpiece are removed. The patient is again taken to the rest room with his/her bed. Within a few minutes, the effect of the anesthesia drugs wears off and the patient begins to wake up. After about 15-20 minutes of rest in the resting room, the patient is expected to fully wake up and the intravenous line is removed and the patient is discharged when he/she feels well.

After Gastroscopy Procedure

After the gastroscopy, the effect of the anesthesia drugs wears off and the patient begins to recover. Pulse rate, blood oxygen level and blood pressure are checked. The patient is then informed about the procedure and discharged.

The difficulty in swallowing caused by the effect of the spray sprayed to numb the throat before the procedure lasts for about 30-60 minutes after gastroscopy. For this reason, liquid and food consumption is started one hour after the procedure. In routine endoscopic procedures, a biopsy sample is taken from the stomach. For this reason, it is recommended to prefer light and soft foods and not to consume very hot foods and drinks on the first day after the procedure. In cases that may be more risky in terms of bleeding, such as removal of polyps or masses during the procedure, the liquid diet may be extended for a few more days. If there are any medications (especially blood thinners) that have been suspended due to gastroscopy, the patient will be informed about when they will be resumed.

It is important not to drive for a few hours after the procedure due to anesthesia and not to do things that require attention. At the end of these few hours, the patient can return to his/her daily work on the same day.

Risks of Gastroscopy

Gastroscopy is a very easy and comfortable procedure. Routine endoscopic procedures are very safe and the risk is very low, especially when performed by competent hands.

Especially in cases where endoscopic intervention is required (such as polyp or mass removal, stent placement, expansion procedures), risks such as bleeding may rarely be encountered. Such unwanted events (complications) can be easily managed in procedures performed by competent people.

Frequently Asked Questions About Gastroscopy

Gastroscopy can be life-saving by providing early diagnosis and, in some cases, treatment. To give an example of this, both gastroscopy and colonoscopy screening are performed in people with anemia or iron deficiency or positive fecal occult blood test in the tests performed when the patient has no complaints yet. In these scans, early stage tumors and cancers are detected in a considerable number of people and can be treated endoscopically.

Gastroscopy is frequently performed for complaints such as pain, burning, souring, scraping sensation in the stomach, bad breath, bloating, indigestion, loss of appetite, burning in the chest, bitter water in the mouth, difficulty swallowing, painful swallowing, feeling of food stuck in the throat or chest, anemia, vitamin deficiencies, nausea, vomiting, hoarseness. It is also performed for complaints such as blood coming from the mouth (it may be red or in the form of coffee grounds), blood coming from the rectum or black colored stools (it should be noted that black colored stools may be a sign of stomach bleeding), involuntary weight loss.

In people with a family history of stomach cancer, gastroscopy should be performed for control purposes regardless of the complaint, and if a bacterium called helicobacter pylori is detected in the stomach, it should be treated appropriately.

Gastroscopy should not be performed on people who have consumed liquid or solid food or drunk water in the last 8 hours. The incomplete emptying of the stomach poses a risk as it may cause stomach contents to escape into the throat and lungs during the procedure. Therefore, food and beverage consumption should be stopped at least 8 hours before the procedure. In addition, since the use of certain blood thinners may increase the risk of bleeding, gastroscopy should be planned with the knowledge of the relevant doctor. In addition, due to the risk of anesthesia in patients with serious heart and lung diseases, kidney and liver failure and in elderly patients, the procedure should be decided by the doctor and anesthesiologist together. Routine gastroscopic procedures should be avoided in pregnant women unless absolutely necessary.

Since the procedure is performed under anesthesia, the patient does not feel any pain or gagging during the procedure. The patient does not even remember the procedure after the anesthesia wears off.

People with chronic diseases can also undergo gastroscopy; however, the medications used for anesthesia preparation must be checked by a doctor. In some cases, medication changes or dose changes may be required. For this reason, the person should discuss this situation with his/her doctor before the procedure.

There is no routine time for repeat gastroscopy. Each patient and disease has a specific follow-up period. For example, gastritis or duodenal ulcers usually do not require a routine follow-up endoscopy, but gastric ulcers may require a follow-up gastroscopy after treatment (1-2 months). This is because of the rare risk of stomach cancers starting as stomach ulcers.

Anesthesia is given during the procedure and there are no complaints such as pain, nausea, gagging or inability to breathe.

It is not necessary to have a companion with the person undergoing the procedure; however, since anesthesia is given, no work requiring attention and no driving should be done for a few hours after the procedure. For this reason, it is recommended that the patient does not drive himself/herself to the procedure.

If no intervention was performed during the procedure, food can usually be consumed one hour after the procedure. Biopsies are often taken during the gastroscopy procedure. Therefore, on the first day after the procedure, it is recommended to consume liquid foods such as soups; yogurt, pudding and puree-like soft and low-fat foods. If an intervention is performed during the procedure, the doctor will inform the patient about what needs to be done.

Pathology results are usually available within 7-10 days.

The procedure itself does not prevent breastfeeding; however, due to the risk of the anesthesia drugs administered for the procedure passing into the milk, it is recommended to express milk for about 4-6 hours after gastroscopy and discard it before giving it to the baby. To prevent the baby from starving, the mother can express and store breast milk before the procedure and give it to her baby during the hours when she cannot breastfeed.