What is gastroscopy?
Gastroscopy is a diagnostic test during which a flexible tube is inserted through the mouth and studies the surface (mucosa) of the esophagus, stomach and the first part of the small intestine.
What is the preparation for the procedure?
To perform a correct and safe examination it is necessary to have an empty stomach, so you should avoid taking food or drinks (including water) in the 4-5 hours before the exam.
It is possible to take home morning therapy such as antihypertensive drugs.
Antiplatelet drugs, such as aspirin, can also be taken unless the examination is performed to remove large lesions.
It is however advisable to inform the doctor in advance about any drugs taken at home. It is also essential to inform your doctor about any allergies (drugs, food, environmental) and medical conditions such as heart disease or lung diseases.
Why is gastroscopy accomplished?
This test is performed to investigate certain symptoms, such as burning and stomach pain, nausea, difficulty swallowing.
During the procedure it is possible to perform biopsies that consist of the collection of mucosa samples and are performed for the search for infections (for example Helicobacter Pylori), inflammation, for the diagnosis of intolerances such as celiac disease or more generally for the histological study of lesions located on the mucosal surface of the organ. Biopsies do not cause pain.
Therapeutic procedures such as polyp removal may also be performed during gastroscopy.
What happens during the procedure?
Before the examination it is necessary to remove any dental prostheses.
After having ascertained that there are no allergies to anesthetics, the nurse sprays a local anesthetic spray into the throat. The examination can be performed in sedation, ie through the introduction into the vein of sedative drugs by the anesthesiologist present in the examination. During the procedure the patient remains lying on the left side. The endoscope is introduced into the digestive tract and does not interfere with breathing. The duration of the exam is variable, generally takes 5-10 minutes.
What happens after the procedure?
The patient is kept under control until the effects of any sedative injected disappear. After around 30 minutes it will be possible to introduce food, unless the doctor provides different instructions. The patient should be taken home and will not have to drive or make important decisions until the next day, as the faculty of judgment and reflexes may be slowed down due to the sedative drug administered.
What are the possible complications of gastroscopy?
Although they are possible, complications for this test are rare (less than 0.05%). Perforation has a maximum frequency of 0.03% and is generally linked to the presence of particular anatomical conditions (esophageal stenosis, Zenker's diverticulum, neoplasms). Bleeding may occur at the point of biopsy or removal of a polyp, but it is often an irrelevant phenomenon, generally controllable by endoscopy, which can only require surgical intervention or a blood transfusion only in very rare cases.
Some patients may present cardiac respiratory complications related to the use of sedatives, or complications due to cardiac or pulmonary diseases that will be managed by the operators present and in particular by the anesthesiologist. Death is an extremely rare event in endoscopic procedures.
Dr. Vincenzo Matarese