Gastroscopy

What it is

A thin flexible camera is passed through the mouth down the oesophagus, into the stomach and the first part of the small intestine, giving a direct view of the lining and allowing biopsies and treatment. It takes 5-15 minutes with throat spray or light sedation.

Why it is done

• Difficulty or pain on swallowing, persistent indigestion, especially over 55 or with weight loss
• Vomiting blood or black stools (urgent, to find and treat the bleeding point)
• Unexplained iron-deficiency anaemia
• Diagnosing coeliac disease, H. pylori, Barrett oesophagus; surveillance of ulcers and Barrett
• Treatment: stretching strictures, removing polyps, banding varices, placing feeding tubes and stents

Before the procedure

• Nothing to eat for 6 hours and clear fluids only until 2 hours before
• Stop acid-suppressing tablets for two weeks if testing for H. pylori or ulcers is the aim
• Blood thinners managed; a driver if sedated

Step by step

1. Lying on the left side with a mouthguard; throat spray numbs the gullet, or sedation is given through a cannula
2. The scope is swallowed over the back of the tongue and advanced under direct vision
3. Air inflates the stomach for a clear view; the oesophagus, stomach and duodenum are inspected in turn
4. Biopsies are taken painlessly with forceps through the scope; polyps removed, bleeding treated with clips, injections or heat
5. The scope is withdrawn; the whole procedure is recorded

Afterwards

• Sore throat and bloating for a day
• Eat and drink once the throat spray has worn off (about an hour)
• No driving, alcohol or important decisions for 24 hours after sedation
• Biopsy results in one to two weeks

Recovery

Normal activities the same day (next day after sedation).