Sievering Clinic

Competence Centre for Minimally Invasive Medical Services

Diagnosis

Gastroscopy

A gastroscopy is a test where a specialist physician looks into the upper part of your gut (the upper gastrointestinal tract). The upper gut consists of the oesophagus (gullet), stomach and duodenum. The operator uses an endoscope to look inside your gut; therefore, the test is sometimes called an endoscopy.

An endoscope is a thin, flexible, telescope. It is about as thick as a little finger. The endoscope is passed through the mouth, into the oesophagus and down towards the stomach and duodenum.

The tip of the endoscope contains a light and a tiny video camera so the operator can see inside your gut.

The endoscope also has a ‘side channel’ called working channel through which various instruments can be passed. These can be manipulated by the physician. For example, the operator may take a small sample (biopsy) from the inside lining of the stomach by using a thin ‘grabbing’ instrument which is passed down the working channel.

Who needs a gastroscopy?

A gastroscopy may be advised if you have symptoms such as:

The sort of conditions which can be confirmed (or ruled out) include:

  • Recurring indigestion
  • Recurring heartburn
  • Pains in the upper abdomen
  • Repeated vomiting
  • Difficulty swallowing
  • Other symptoms thought to be coming from the upper gut
  • Esophagitis (inflammation of the oesophagus)
  • The physician will see areas of redness on the lining of the oesophagus.
  • Duodenal or stomach ulcer
  • An ulcer looks like a small, red crater on the inside lining of the duodenum or stomach.
  • Duodenitis (inflammation of the duodenum)
  • Gastritis (inflammation of the stomach)
  • Cancer of the stomach or oesophagus
  • Various other rare conditions
Is gastroscopy reliable?

Gastroscopy is a good test for seeing abnormalities in the upper gut. However, it is not fool proof. For example, gastroscopy may not detect a small number of cases of early ulcers or early cancer. Sometimes a repeat gastroscopy may be advised if symptoms persist or get worse, even if a previous gastroscopy was reported as normal.

Why can’t I just have an X-ray?

This is a good point. Barium meals were used for many years for the diagnosis of indigestion symptoms. However, the small disadvantages of gastroscopy – special units, day-case admission and the need for sedation – are far outweighed by the increased accuracy of diagnosis and the ability to take biopsies at gastroscopy. As a result there is relatively very few indication for barium meals and they are seldom performed nowadays.