Gastroscopy

Understanding Gastroscopy
Your physician has determined that gastroscopy is necessary for further evaluation or treatment of your condition. This information has been prepared to help you understand the procedure. It includes answers to questions patients ask most frequently. Please read it carefully. If you have additional questions, please feel free to discuss them with the endoscopy nurse or your physician before the examination begins.

What is a Gastroscopy?
Gastroscopy is a procedure that enables your physician to examine the lining of the upper GastroIntestinal tract for abnormalities by inserting a flexible tube that is about the thickness of your finger into the mouth and advancing it slowly into the stomach and first part of the small intestine.

What preparation is required?
The stomach must be completely clean for the procedure to be accurate and complete. Your physician will give you detailed instructions regarding the dietary restrictions to be followed. Most commonly this is only for you not to eat or drink for 6 hours before the procedure.

What about my current medications?
Most medications may be continued as usual, but some medications can interfere with the examination. It is therefore best to inform your physician of your current medications as well as any allergies to medications several days prior to the examination. Aspirin products, arthritis medications, anticoagulants (blood thinners), insulin, and iron products are examples of medications whose use should be discussed with your physician prior to the examination. You should alert your doctor if you require antibiotics prior to undergoing dental procedures, since you may need antibiotics prior to gastroscopy as well.

What can be expected during Gastroscopy?
Gastroscopy is usually well tolerated and rarely causes much pain. There is often a feeling of pressure, bloating, or cramping at times during the procedure. Your doctor may give you medication through a vein to help you relax and better tolerate any discomfort from the procedure. You will be lying on your side or on your back while the gastroscope is slowly advanced. As the gastroscope is slowly withdrawn, the lining is again carefully examined. The procedure usually takes 5 to 15 minutes.

What if the Gastroscopy shows something abnormal?
If your doctor thinks an area needs to be evaluated in greater detail, a forceps instrument is passed through the gastroscope to obtain a biopsy (a sample of the stomach lining). This specimen is submitted to the pathology laboratory for analysis. If gastroscopy is being performed to identify sites of bleeding, the areas of bleeding may be controlled through the gastroscope by injecting certain medications or by coagulation (sealing off bleeding vessels with heat treatment). None of these additional procedures typically produce pain. Remember, the biopsies are taken for many reasons and do not necessarily mean that cancer is suspected.

What happens after a Gastroscopy?
After gastroscopy, your physician will explain the results to you. If you have been given medications during the procedure, someone must accompany you home from the procedure because of the sedation used during the examination. Even if you feel alert after the procedure, your judgment and reflexes may be impaired by the sedation for the rest of the day, making it unsafe for you to drive or operate any machinery.
You may have some cramping or bloating because of the air introduced during the examination. This should disappear quickly with passage of flatus (gas). Generally, you should be able to eat after leaving the endoscopy, but your doctor may restrict your diet and activities, a detailed sheet of instructions will be given to you on discharge.

What are the possible complications of Gastroscopy?
Gastroscopy is generally safe when performed by physicians who have been specially trained and are experienced in these endoscopic procedures.
One possible complication is a perforation or tear through the intestinal wall that could require surgery. Bleeding may occur from the site of biopsy or polypectomy. It is usually minor and stops on its own or can be controlled through the gastroscope. Rarely, blood transfusions or surgery may be required. Other potential risks include a reaction to the sedatives used and complications from heart or lung disease. Localized irritation of the vein where medications were injected may rarely cause a tender lump lasting for several weeks, but this will go away eventually. Applying hot packs or hot moist towels may help relieve discomfort.
Although complications after gastroscopy are uncommon, it is important for you to recognize early signs of any possible complication. Contact your physician who performed the gastroscopy if you notice any of the following symptoms: difficulty swallowing, hoarseness, severe chest or abdominal pain, fever and chills, or bleeding.

To the Patient
Because education is an important part of comprehensive medical care, you have been provided with this information to prepare you for this procedure. If you have questions about your need for gastroscopy, alternative tests, the cost of the procedure, methods of billing, or insurance coverage, do not hesitate to speak to your doctor or your doctor's office staff. Most endoscopists are highly trained specialists and welcome your questions regarding their credentials and training. If you have questions that have not been answered, please discuss them with the endoscopy nurse or your physician before the examination begins.