Gastroscopy

What is a gastroscopy?

A gastroscopy is an investigative medical procedure that is used to examine the upper part of your digestive system, which includes your oesophagus (food pipe), stomach and the first part of your small intestine. It’s performed using a long, thin tube called an endoscope, which is a long, thin, flexible tube that has a light and camera on the end of it. It’s designed to investigate symptoms and suspected conditions affecting the upper part of your digestive system.

It’s the most commonly performed gastrointestinal procedure carried out in the UK, with between 600,000 and 700,000 performed each year.

What else is a gastroscopy known as?

You may also hear of a gastroscopy referred to as oesophagogastroduodenoscopy (OGD), gastrointestinal endoscopy, upper GI endoscopy or endoscopy.

Gastroscopy vs. Endoscopy

Many people think that a gastroscopy and endoscopy are the same thing. While they share many similarities, the term endoscopy is actually a broad word to describe any type of procedure that uses a long, thin, flexible tube with a light and camera at the end to examine the inside of your body. A gastroscopy is a specific type of endoscopy that examines the upper part of your digestive system. In contrast, a colonoscopy is where the endoscope is used to examine the colon.

What conditions can a gastroscopy diagnose or treat?

A gastroscopy can be used to diagnose a wide range of conditions, including but not limited to:

• Stomach ulcers
• Unexplained bleeding
• Narrowing of the oesophagus
• Narrowing of the duodenum
• Blockages in the oesophagus
• Swallowed foreign objects
• Barrett’s oesophagus
• Polyps in the stomach or duodenum
• Peptic ulcer
• Gastro-oesophageal reflux disease (GORD)
• Gastritis
• Coeliac disease
• Helicobacter pylori infection
• Oesophagitis
• Hiatus hernia
• Duodenal cancer
• Oesophageal cancer
• Stomach cancer.

It can also be used to perform a number of different treatments, including:

• Controlling bleeding
• Removing polyps
• Placing feeding tubes
• Applying clips or stents
• Removing foreign bodies or impacted food
• Taking biopsies
• Performing early cancer treatments.

Your doctor will be able to explain why they believe that a gastroscopy is the best diagnostic tool, or treatment tool, for you.

Can a gastroscopy detect cancer?

Yes. A gastroscopy is the primary tool used in the detection of cancers affecting your upper digestive system, such as cancer of the oesophagus or stomach. However, it will form part of a range of diagnostic tests, which will help to determine the type, stage and best treatment for your cancer.

Can a gastroscopy detect H. pylori?

Yes, a gastroscopy is also the most prevalent way of detecting H. pylori, a common bacterial infection that causes unpleasant symptoms such as burping, nausea and burning pain in your upper abdomen.

What symptoms might lead to a gastroscopy?

You may be recommended to have a gastroscopy if you are experiencing any of the following symptoms:

• Persistent indigestion (dyspepsia)
• Frequent or severe heartburn or acid reflux
• Upper abdominal pain that doesn’t go away
• Difficulty swallowing (dysphagia)
• Pain when swallowing
• Persistent nausea or vomiting
• Feeling unusually full after eating only a small amount
• Ongoing bloating with other concerning symptoms
• Unexplained loss of appetite
• Unexplained weight loss
• Persistent chest pain after heart problems have been ruled out

You may also be referred for a gastroscopy if your doctor:

• Believes you may have a stomach or duodenal ulcer
• Wants to test you for Helicobacter pylori
• Wants to monitor a pre-existing condition you have
• Needs to remove a foreign object you’ve swallowed

What would happen if these conditions were left untreated?

It depends on the condition. While some gastrointestinal conditions can cause discomfort, they are not necessarily serious. However, many could develop into something much more serious. We would always recommend speaking to your doctor about treatment for any gastrointestinal symptoms that you have.

What are the alternatives to a gastroscopy?

If you aren't a good candidate for a gastroscopy, your doctor may recommend a barium swallow instead. This tends to be less accurate than a gastroscopy and doesn't allow your doctor to take a biopsy of any concerning areas.

During a barium swallow, you'll be asked to drink a special liquid that shows up on X-rays, allowing your doctor to view your throat, oesophagus and stomach. If anything concerning is found and your doctor recommends a biopsy, this will need to be taken during a separate procedure.

Who is suitable for a gastroscopy?

You may be recommended to have a gastroscopy if you are experiencing:

• Unexplained symptoms such as weight loss, stomach pain, nausea or vomiting
• Problems swallowing or feeling like food is going to get stuck
• Chronic heartburn or indigestion that doesn’t respond to medication
• Signs of digestive bleeding, such as vomiting blood or passing tar-like bowel movements
• Anaemia (iron-deficiency).

You may also need a gastroscopy if you have been diagnosed with polyps that require removal, have a stuck item that needs to be removed, have a bleeding ulcer that requires treatment, or need a biopsy.

Can I have a gastroscopy if I am pregnant?

While some studies have shown that it can be safe to carry out a gastroscopy during pregnancy, generally, it’s widely recommended to avoid one unless it’s completely necessary.

Can I have a gastroscopy if I take blood thinners?

Yes, you can have a gastroscopy while taking blood thinners, but since your medication increases your risk of bleeding, special precautions will need to be taken during your procedure. This also means that you may be asked to reduce or stop taking your medication beforehand.

Who may not be suitable for a gastroscopy?

You may not be a good candidate for a gastroscopy if:

• You have an implantable device (special management may be required)
• You have untreated sleep apnoea, as you may have higher risks associated with your sedation
• You have an active infection
• You have a severe heart or lung disease
• You’ve recently had gastrointestinal surgery
• You have dental issues
• You’re unable to follow the preparatory steps, including fasting requirements.

How can I prepare for a gastroscopy?

Preparing for your gastroscopy can help ensure that the procedure goes as smoothly as possible and minimise your risk of complications. It’s always important to follow the guidance of your Nuffield Health medical team. Some of the ways that you may be advised to prepare could include:

• Following instructions about when to stop eating and drinking before your appointment (eating should be stopped at least six hours before your gastroscopy, while clear fluids are allowed in very small amounts up until two hours before)
• Stop taking medications as advised by your doctor. It is important you tell your doctor if you are taking any blood-thinning medications such as aspirin, clopidogrel, warfarin, edoxaban, etc.
• Wear comfortable clothing the day of your appointment
• Arrange for someone to drive you home and stay with you after your appointment.

If you have any questions about getting ready for your gastroscopy, speak to your medical team.

What happens during a gastroscopy?

A gastroscopy is a straightforward procedure, usually performed while you are sedated but not fully asleep. The sedation is given through a small tube (a cannula) placed into a vein in the back of your hand. This should ensure you aren't in any discomfort, and that you feel relaxed and only partially aware of your surroundings.

Alternatively, the procedure can be carried out using only a local anaesthetic spray to numb the back of your throat. Your doctor will discuss both options with you and help you decide which is right for you.

Once you are suitably sedated, your doctor will pass the endoscope, which is a long, thin, flexible tube with a light at the end, into your mouth and down your throat until it reaches your stomach. You may initially feel a bit nauseous or want to gag, but this should pass once the tube reaches your stomach.

A small amount of air will be pumped into your stomach to inflate the area. This will allow your doctor to see everything in your stomach clearly. During this time, you may feel bloated and gassy. If necessary, tiny tools will be passed down the endoscope to collect some tissue samples or to remove any polyps.

Once complete, the endoscope will be gently removed, and you’ll be taken to a side room for the sedation to wear off.

How long does a gastroscopy take?

The actual gastroscopy procedure usually takes up to 15 minutes to perform, but the preparation and recovery time means that you should allow at least a few hours for your appointment.

What happens after a gastroscopy?

After your gastroscopy, you’ll be monitored by your medical team until it’s time for you to go home. You may be kept with us for up to an hour before you are released, but it’s important to remember that it can take 24 hours for the sedation to completely wear off. For this reason, you must arrange for someone to drive you home after your appointment and stay with you. You won’t be able to operate any machinery, drink alcohol or make any important decisions either.

When can I return to normal activities after a gastroscopy?

Most people can get back to their usual daily activities around 24 hours after their gastroscopy procedure. However, if you have had a biopsy taken, it may be advisable to wait several days before doing any heavy physical activity. Always follow the guidance of your doctor.

How long do biopsy results take after a gastroscopy?

It can take several weeks for a biopsy to be analysed by the laboratory. However, your doctor will be able to give you a more definitive timeline about when to expect the results of your biopsy analysis.

When can I eat and drink after a gastroscopy?

It’s recommended that you wait at least an hour after your gastroscopy before eating or drinking anything, particularly if you’ve had local anaesthetic spray. Always wait for the feeling to completely return before consuming anything hot, in case you inadvertently burn your throat.

What are the benefits of a gastroscopy?

Some of the benefits of a gastroscopy include:

• Real-time visualisation of the inside of your digestive system
• Performing painless biopsies
• Performing other treatments including polyp removal, widening the oesophagus, placing a feeding tube or stopping bleeding, such as from an ulcer
• Monitoring of diagnosed issues, such as peptic ulcers.

A gastroscopy is also one of the best ways of confirming or ruling out specific digestive conditions.

What are the side effects and possible complications of a gastroscopy?

As with any medical procedure, there are some side effects and risks of complications associated with a gastroscopy. They include:

Common, usually mild side effects (often go away on their own)

• Sore throat
• Sore nose or brief nosebleed (especially if nose placement is used)
• Bloating or feeling full
• Mild stomach or throat pain
• Temporary hoarse voice or numb feeling in the mouth (from anaesthetic spray)
• Feeling like you want to be sick during the procedure.

Less common but possible complications

• Reaction to sedation
• Bleeding in your oesophagus, stomach, or intestine
• Infection after the procedure
• Fluid from the stomach going into the lungs
• Perforation (tear) in the oesophagus, stomach, or intestine
• Damage to teeth

Serious complications are rare, but seek urgent help if you have:

• Severe stomach or chest pain
• Vomiting blood or black, tar-like stool
• High temperature, feeling hot/shivery, or shortness of breath
• Persistent vomiting

How safe is a gastroscopy?

A gastroscopy is a very safe procedure, with complications being very rare. As always, your consultant will ensure that the benefits of a gastroscopy will outweigh any risks.

How much does a gastroscopy cost at Nuffield Health?

Click here and select your local Nuffield Health hospital to find the guide prices for a gastroscopy. Please note that we can only provide a guide price until your referral has been reviewed by one of our radiography professionals.