Gastroscopy – indications, preparation for examination and anesthesia. Does gastroscopy hurt?

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Gastroscopy is a method of examining the initial section of the gastrointestinal tract that helps the doctor check the condition of the esophagus, stomach and duodenum. Gastroscopy involves inserting a tube into the esophagus, which records and transmits an image from inside the patient’s body.

What is gastroscopy?

Gastroscopy is an examination of the upper gastrointestinal tract (stomach, esophagus). It is one of the best diagnostic tests in which a specialist can take a piece of the mucosa to locate possible changes. Thanks to gastroscopy, we are able to detect the presence of Helicobacter pylori in the gastrointestinal tractas well as widen the narrowing of the digestive tract, remove polyps or stop internal bleeding.

The doctor in this examination uses an endoscope, which is a thin, flexible telescope. He is as thick as the little finger. The endoscope is inserted through the mouth into the esophagus and down towards the stomach and duodenum. The tip of the endoscope contains a lamp and a small video camera so that the doctor can look inside the intestine.

The endoscope also has a side channel through which various instruments can pass. The doctor can manipulate them. For example, the physician may take a small sample (biopsy) from the inner lining of the stomach with a thin “grab” tool that is guided down the side channel.

The presence of Helicobacter pylori bacteria will help to exclude, also a mail-order test, offered by the Al-Med medical center.

Gastroscopy – indications

Gastroscopy is performed when diseases of the upper gastrointestinal tract are suspected. This includes neoplasms such as:

1. esophageal cancer
2. stomach cancer,
3. gastric lymphoma.

It is also used in ulcer diseases and Barrett’s esophagus. Gastroscopy can also be used for therapeutic purposes. For example, when closing varicose veins, removing polyps or precancerous lesions, or widening causing pain and / or difficulty swallowing a narrowed esophagus (sources may be, for example, esophageal cancer or radiotherapy).

Moreover, bleeding from the upper gastrointestinal tract manifested by: vomiting with blood, tarry stools, anemia, iron deficiency are an indication for gastroscopy. The test is also performed before surgery or in the diagnosis of celiac disease.

Bacterial disease, improper diet, stress and smoking – these are just some of the possible causes of peptic ulcer disease. If you experience disturbing symptoms, start with diagnostics. The package of diagnostic tests for peptic ulcer disease can be performed in hundreds of facilities throughout the country. Make an appointment today.

Gastroscopy is recommended if there are symptoms such as:

1. repeated (recurring) indigestion;
2. recurrent heartburn;
3. upper abdominal pain;
4. repeated vomiting;
5. difficulty swallowing;
6. other symptoms likely to come from the upper intestine.

See also: The most common bacterial diseases – overview and characteristics

Gastroscopy – types

Gastroscopy is usually performed for one of three purposes: checking the cause of symptoms, confirming or ruling out a suspected disease, or treating gastrointestinal diseases.

For this reason, there are two types of gastroscopy:

1. diagnostic gastroscopy;
2. therapeutic gastroscopy.

Contraindications to gastroscopy

Contraindications to the examination are:

1. a recent heart attack;
2. unstable coronary artery disease;
3. acute heart failure;
4. decompensated respiratory failure;
5. shock;
6. peritonitis;
7. suspicion of gastrointestinal perforation.

Cardiac problems, such as, for example, arrhythmias, are considered relative contraindications for gastroscopy. When the doctor qualifies a patient with these abnormalities for upper gastrointestinal endoscopy, he / she assesses in detail the risk of complications.

Before each gastroscopy, the patient must sign a written consent for the examination.

See also: Let’s not forget about preventive examinations! When and how often should they be done?

Gastroscopy – preparation for examination

For about six hours before the gastroscopic examination, you should not eat anything, and for the last drink you can drink four hours before the procedure (the permitted liquids that can be drunk before the procedure are water, coffee without milk, tea, juices, e.g. apple, pulp-free). however, avoid broths or stocks, drinks in red or purple color, milk, cream or plant-based alternatives to dairy products, juices with pulp).

If you are taking your medication constantly, swallow it in the morning with a little water. For several hours before the gastroscopy, do not smoke or chew gum! Immediately before the examination, dentures should also be removed.

Sometimes the patient’s drug intake has to be modified, and this is the case with drugs used in the treatment of diabetes (e.g. insulin, metformin) and anticoagulants (e.g. acetylsalicylic acid, warfarin, clopidogrel).

Chronic use of drugs from the group of proton pump inhibitors may result in a false negative result of the urease test. It is recommended to discontinue the drug about 10-14 days before the examination, however, such a decision should be made by the doctor. But it is perfectly acceptable to perform gastroscopy during therapy.

Also, after the procedure, it is not recommended to eat anything for at least two hours, because irritated throat and esophagus can cause a strong feeling of pain.

If you have questions or concerns about gastroscopy, visit a gastroenterologist who will provide expert advice and discuss the details of the examination with you.

Symptoms of diseases of the upper gastrointestinal tract

What symptoms most often indicate disease of the initial section of the digestive system?

1. heartburn;
2. swallowing problems;
3. epigastric pain;
4. nausea;
5. vomiting;
6. belching;
7. feeling full, especially after eating.

If you have these symptoms, see your doctor who will refer you to gastroscopy in turn. Especially patients with the above symptoms who are 45 years of age or older should be referred for gastroscopy, especially if they are accompanied by weight loss, anemia or eating disorders.

A referral for gastroscopy may be prescribed by an internist. You can make an appointment quickly and safely at medonetmarket.pl.

Gastroscopy – the course of the examination

At the patient’s request, throat anesthesia is performed before the procedure, thanks to which the procedure is not so painful, and the gag reflex that often occurs during the procedure is milder. Usually, the anesthetic is given by injection into the vein at the back of the hand. The anesthetic may make you feel drowsy, but it will not make you completely sleepy. It is not a general anesthetic. Although it is possible to perform gastroscopy under general anesthesia, when the patient falls asleep during the procedure.

The prepared patient is asked to lie on his left side. The doctor or nurse then puts on a mouthpiece that prevents the mouth from closing when the examination is uncomfortable. Thanks to this, there is no risk that the patient will chew the cable.

The doctor will ask you to swallow the first part of the endoscope. Modern endoscopes are quite thin, but for some it can be difficult (the tube is about 1 cm in diameter). The doctor gently pushes it further down the esophagus, into the stomach and into the first part of the intestine (small intestine) known as the duodenum. The video camera at the end of the endoscope transmits the images to the screen. The operator watches the screen for abnormalities in the esophagus, stomach and duodenum. Air is passed through a channel on the endoscope into the stomach to make it easier to see the lining of the stomach. This can make the patient feel full and may also want to belch.

Gastroscopy is performed using an endoscope – a flexible tube with its own light source, thanks to which the image of the internal walls, e.g. of the esophagus, transmitted by the device, is illuminated.

Your doctor may take one or more small samples (biopsies) of part of the inner lining of your gut – depending on why the test is being done and what the specialist is seeing. Biopsy samples are sent to a lab to be examined and viewed under a microscope. The endoscope is then gently pulled out.

However, at least two hours should be allowed for the entire visit. This is to prepare, allow time for the sedative to act (if you have one), for the gastroscopy itself, and for recovery after surgery.

Infection of the patient during the examination is unlikely, because the endoscope is disinfected after each examination, and the specimens for further examination are taken using sterile instruments. The test result can be collected after about two weeks, while the Helicobacter pylori test result is known a few minutes after the gastroscopy.

Interestingly, it is possible to perform a gastroscopy through the nose. In this case, gastroscopy is more painful than in the classic version (through the throat), but sometimes it may be the only way out. Some even prefer nasal gastroscopy as it does not induce a gag reflex. This version of gastroscopy is possible thanks to the use of small, flexible endoscopic tubes and is often also called stress-free gastroscopy.

It is good to be aware that, of course, there are alternatives to gastroscopy, such as contrast radiography or computed tomography. Unfortunately, neither of them enables the collection of material for histopathological examination, which may be necessary in some cases.

See also: Contrast to research. How it works? Can anyone take it? [WE EXPLAIN]

Gastroscopy – post-treatment recommendations

Most people are ready to go home after half an hour’s rest.

If the patient has been given an anesthetic, it may take longer to be ready to go home. The anesthetic will usually make us feel completely relaxed. However, do not drive, use machines or drink alcohol for 24 hours after using the anesthetic. Due to the fact that local anesthesia of the throat was used and the risk of choking, food and fluids were not allowed for half an hour after the examination. If you develop unclear symptoms, please report them to the nurse or doctor immediately.

The patient will also need someone to accompany him home and stay with him for 24 hours until the effects have worn off completely. Most people are able to resume normal activities after 24 hours.

The doctor draws up a report and sends it to the doctor who ordered the gastroscopy. Waiting for any sample result (biopsy) can take several days, which in turn can delay the sending of the report. The doctor can also tell the patient what he saw during the procedure. However, if the patient has been given an anesthetic, he may later not remember what he was told. Therefore, the patient may want to have a relative or close friend with him who can remember what the specialist said.

See also: What to do when you choke on a bone?

Dieta po gastroskopii

After the treatment, it is best to stick to only liquids such as water, coffee without milk, tea, and pulp-free juices (e.g. apple). If the patient does not notice any gastrointestinal complaints, he or she may slowly eat easily digestible foods, such as small porridges or potatoes, soups on delicate broths, lean cooked meat, boiled eggs.

If a patient does not develop any serious symptoms after consuming easily digestible products, he can easily return to his normal diet the next day, assuming, of course, that the doctor has not recommended any other course of action.

See also: Diets after operations in the gastrointestinal tract

Gastroscopy – examination reliability

Gastroscopy is a good examination to spot any abnormalities in the upper intestine. However, it is not foolproof. For example, a gastroscopy may miss a small number of early ulcers or early cancer. Re-gastroscopy may sometimes be recommended if symptoms persist or worsen, even if previous gastroscopy has been reported as normal.

Gastroscopy – complications

Gastroscopy is a safe procedure, but as with any medical procedure, complications may occur. Complications after gastroscopy may appear during the examination itself and after its completion (sometimes even after several days). Complications rarely endanger the patient’s life.

The rarest of these is perforation of the digestive tract walls, which occurs in approximately 0,03% of patients (this can occur in any place of the anatomical narrowing of the upper digestive tract or in a place changed by the disease process).

Some patients may feel tired or sleepy for several hours after the test if they have been treated with an anesthetic. Rarely, some patients have an allergic reaction to the sedative.

In some of the examined patients, symptoms related to the respiratory and cardiovascular systems are also observed after gastroscopy. These are heart rhythm disturbances or heart failure. There are also respiratory problems and aspiration pneumonia. Bleeding may occur in some people (this occurs in 0,15% of cases), patients with a bleeding disorder and taking anticoagulants are particularly at risk, especially for high-risk surgical procedures such as polypectomy, laser coagulation, dilatation, fine needle biopsy and treatment of gastric and esophageal varicose veins.

The most common complications are complications related to anesthesia. A hematoma or phlebitis may appear at the injection site. The medications taken also have an impact on the side effects of gastroscopy (e.g. depression of the respiratory system and behavioral disturbances or lowering blood pressure, tachycardia, arrhythmias). It may also aspire into the lungs after local anesthesia.

After the examination, the patient may have a sore throat.

There is also a risk of bacteremia in diagnostic gastroscopy, but it is small (about 3-4%). This risk increases with surgical procedures such as dilation of the esophagus (45%). In most cases, it causes no symptoms, and long-term complications such as sepsis, organ abscesses and endocarditis are very rare.

If you experience any of the following symptoms within 48 hours of gastroscopy, consult your doctor immediately.

1. Abdominal pain (especially if it gets worse and is different or more intense than any “normal” indigestion or heartburn pain we may have);
2. Increased temperature (fever);
3. Breathing difficulties;
4. Vomiting blood.

A small number of patients have a heart attack or stroke during or shortly after gastroscopy. These are usually elderly people who are already in poor health. These serious complications are rare in most people who are otherwise fairly healthy.

There is a slightly increased risk of developing a chest infection or pneumonia following gastroscopy.

Note: If the examination was performed under anesthesia, driving immediately after the procedure is prohibited.

Gastroscopy can also be performed under the National Health Fund, where the procedure is reimbursed. However, it should be borne in mind that depending on the location, the dates and the waiting time may vary and may take from several to several weeks.

If you have questions about gastroscopy or need a referral, please see your doctor. At haloDoctor.pl you can arrange an online teleconsultation with an internist who will answer all your questions.

Home diagnostic test instead of gastroscopy?

It is worth mentioning that you can also buy home diagnostic tests for Helicobacter pylori in pharmacies. Two types are available:

1. Blood test for Helicobacter pylori antibodies (compare prices)

A positive result indicates the presence of antibodies from the bacteria, which can mean both a current disease and a past disease that does not require treatment.

1. A stool test for the detection of Helicobacter pylori antigen (compare prices)

If the result is positive, there is a high probability that we are currently infected with the bacterium. This test can also be used to monitor the progress of treatment.

It is important to follow the instructions for use carefully when running the tests. The results should be discussed with your doctor who will decide if gastroscopy is necessary.

Gastroscopy and pregnancy

Gastroscopy can be performed in pregnant women and it is most often recommended in cases of gastrointestinal bleeding (the procedure is also performed in the diagnosis of the same diseases as in other patients).

Contraindications to the gastroscopy procedure in pregnancy include:

1. placental separation;
2. birth;
3. rupture of the fetal bladder;
4. eclampsia.