Gastroscopy - an irreplaceable method in the diagnosis of stomach diseases

Author: Assoc. Prof. Dimo Kurktschiev

Modern diagnostics and treatment of diseases of the esophagus, stomach and duodenum is unthinkable without gastroscopy. Modern devices allow for quick and safe investigation. The unpleasant feelings for patients are minimized.

What is a gastroscopy?

Endoscopic stomach examination (gastroscopy) is a medical procedure in which the esophagus, stomach and duodenum can be seen from inside. A flexible tube (gastroscope) is being inserted through the mouth, and due to its special technique of flexible fiber glass, it is possible to achieve a direct image of the area under investigation. The advantage of this procedure is that it can be used not only for diagnostics but also for treatment.

How does gastroscopy work?

Gastroscopy is performed with the so-called gastroscope, a special form of endoscope. It consists of the mentioned above fiber glass optics which are wrapped with a flexible tube of artificial material. The apparatus has an additional small tube (work channel), through which a medication can be injected or a washing liquid can be sprayed, and special devices can be inserted for obtaining biopsiеs, performing haemostasis, etc. Modern gastroscopes have a video system that allows the surveyed images to be viewed directly on a monitor. Contemporary devices have a tube diameter of less than one centimeter. They can be managed externally very well and introduced smoothly into the esophagus, stomach and duodenum

Taking tissue samples (biopsies), as well as gastroscopy in general, performed by an experienced endoscopist and modern equipment, are totally or almost painless. The procedure itself lasts most often for about 5-15 minutes.

When do you need gastroscopy?

The following symptoms indicate the necessity of gastroscopy:
- recurrent stomach pain
- difficulty in swallowing with uncertain origin (dysphagia)
- burning sensation behind the sternum
- prolonged nausea, retching or vomiting
- unexpected weight loss
- blood vomiting
- tarry black stools
- anemia

In addition, gastroscopy is used to control the treatment effect, for example in stomach ulcers, stomach bleeding as well as post stomach operations.

Special procedures and treatments are also possible through gastroscopy:
- endoscopic control of gastrointestinal bleeding;
- removal of polyps in the stomach and duodenum;
- treatment of stenosis (esophageal dilation);
- removal of ingested foreign bodies

How to prepare for gastroscopy?

Gastroscopy is performed on an empty stomach, therefore patients are instructed not to eat and drink at least 6 hours before the investigation.

Is anesthesia necessary for gastroscopy and what type?

At the discretion of the doctor, gastroscopy can be performed without any anesthesia, with the advantage that the patient can drive a car after the procedure. Patients with a moderate to high level of fear and anxiety about the gastroscopy are advised to have a short acting sedative. Diazepam is the most commonly used sedative, which is injected intravenously. In this case, the patients do not have any unpleasant sensations or memories of the gastroscopy, but they have to be aware that at least a few hours afterwards, they cannot drive a car.

What happens during a gastroscopy?

Prior to procedure, the patient will have a local anaesthetic throat spray for reducing the sensitivity of the throat. He or she will be asked to lay down on his/her left side. The doctor will insert the device through the mouth in the esophagus and will then advance it into the stomach and duodenum. By introducing air, the stomach is expanded and enables better investigation. Depending on the disease, tissue samples can be taken or therapeutic procedures can be performed.