What is a gastroscopy?

A gastroscopy is a procedure used to inspect the oesophagus (food pipe or gullet), stomach and duodenum (first section of the small bowel). It is performed using a long flexible tube (gastroscope) that has a light and camera on the end. Gastroscopy is used to both diagnose and on occasion treat conditions of the oesophagus, stomach and duodenum. During the procedure the gastroenterologist may take biopsies, which can then be inspected under a microscope by an expert pathologist.

What is the reason for having a gastroscopy?

Gastroscopy is used in diagnosing patients who are experiencing upper abdominal pain, heartburn/reflux, gastrointestinal bleeding, iron deficiency, unexplained nausea, vomiting or loss of weight. It is also used for the diagnosis and monitoring of coeliac disease and Barrett’s oesophagus.

Are there alternatives to gastroscopy?

Gastroscopy is the best way to visualise the inside of the upper gastrointestinal tract and is the main way for the gastroenterologist to take tissue samples. There are some other tests which can assist in assessing the anatomy and function of the upper gastrointestinal tract and abdomen including:

• CT scan: This is an imaging technique that will inspect the whole abdomen and look at the organs of interest.
• Ultrasound: This is commonly used to investigate the liver, gallbladder, abdominal vessels and more recently small intestine.
• Manometry: This is used in patients having swallowing difficulties and will assess the changing pressures and movements of the oesophagus.
• Barium swallow: This involves taking a series of consecutive X-rays after the patient has swallowed some contrast (dye). It can provide some information about the structure and function of the oesophagus.

What preparation is required prior to the procedure?

You will need to fast for 6 hours prior to the procedure. This will ensure your stomach is empty and able to be fully visualized. While this generally means  nothing to eat or drink during this period, there will be some instances where you will be advised to take some of your important medications with a small sip of water.  Please read the instructions carefully.

Preparation instructions

• Morning procedure Preperation sheet
• Afternoon procedure Preperation sheet

What are the risks of gastroscopy?

Gastroscopy is generally a very safe and well tolerated procedure.
Major complications are extremely rare, but can include:

• Upper abdominal perforation: Approximate rate of 1 in 10000. This involves a hole in the stomach or oesophagus and can sometimes be repaired at the time of the procedure or may require surgery.
• Bleeding: Approximate rate of 1:500 This can occur from a biopsy or polyp removal. It will generally resolve spontaneously but very rarely may require hospitalization.
• Damage to teeth: Approximate rate of less than 1:500 (Please advise the gastroenterologist and anaesthetist if you have had any recent dental work including crowns or dental implants).
• Aspiration: This is stomach fluid refluxing into the airways or lungs and is estimated to occur in 1% of cases. It is one of the major reasons for needing to be properly fasted.  If aspiration occurs you may require antibiotics or hospital admission.

What do I do with my usual medications?

If you are taking any blood thinners including warfarin, clopidogrel (Isocover, Plavix), rivaroxaban (Xarelto), apixaban (Eliquis), dabigatran (Pradaxa) or ticagrelor (Brilinta) please let the staff at Yarra gastroenterology know at least 7 days prior to the procedure. It is also important to inform us if you are taking diabetic medications (including insulin) as the doses will need to be adjusted prior to the procedure.

Most regular medications can be taken with a sip of water early in the morning prior to the procedure.

What do I bring to the procedure?

Please bring a copy of your doctor’s referral, private health fund details and medicare card. Wear loose fitting clothing. You will be asked to change into a gown prior to the procedure. Please leave any valuables or jewelry at home.

What can I expect at the hospital before the procedure?

You will be met by both the anaesthetist and gastroenterologist prior to the procedure and will be asked some basic questions regarding your health and medications.

What happens during the procedure?

Your comfort and wellbeing will be monitored throughout. You will be lying on your side for the procedure and the anaesthetist will place a small cannula  in the back of your hand through which  a sedative will given. The gastroscope will be inserted through your mouth and then all the way through the oesophagus, stomach and into the beginning of the small intestine (duodenum). These areas will be thoroughly inspected and if necessary biopsies will be taken.  This whole process takes between 10-15 minutes.

What happens afterwards?

You will be monitored until you are awake and alert. The gastroenterologist will speak to you to explain the results. You will be given a light snack and water to drink. You may be slightly drowsy for a number of hours following the procedure due to the sedation. You will be able to leave approximately 1-2 hours after the procedure and will require a friend or family member to collect you. You are advised to not drive until the following day and also not operate heavy machinery for 24 hours. You can take your regular medicines following the procedure unless otherwise notified.