Upper GI Endoscopy

Upper GI endoscopy is also commonly referred to as gastroscopy. It is an endoscopic examination of  the digestive tract, which allows us to examine esophagus, stomach and duodenum. Therefore, its full name is esophagogastroduodenoscopy. The procedure carries only little risk, but it is valuable in diagnosis of many diseases of the upper gastrointestinal tract.

Principle

The examiner inserts a thin, flexible tube of the endoscope into the patient's mouth and carefully introduces it into the pharynx, esophagus and deeper to stomach and finally the duodenum. The endoscope is equipped by a video camera and a light source. The camera projects the image of mucosa to a screen where the examiner sees it. The visualization may be further improved by chromoendoscopic methods.

 

In addition, the endoscope has a working canal, which allows to use a small forceps to take a sample of any suspicious lesion. Such sample can be sent for histological examination.

Special various tools may be used to remove any polyps and to destroy sources of acute bleeding (peptic ulcer, esophageal varices, etc.).

 

Gastroscopy

 

Preparation

The patient should not eat, drink fluids or smoke about 6 hours before the procedure, because the stomach should be absolutely empty. Before the procedure starts, the oral cavity and pharynx of the patient is sprayed by a local anesthetic to dampen the gag reflex. However, this is the reason why the patient should not eat or drink for about 30 minutes after upper GI endoscopy, because the anaesthetized throat can easily cause aspiration of food or fluids. Intravenous tranquilizer may be also used, but when this has been administered, the patient should not drive a motor vehicle for the rest of the day.

Indications

Upper GI endoscopy is very valuable for diagnostics (and in some cases for treatment) of many diseases of the upper gastrointestinal tract including gastroesophageal reflux, achalasia, esophageal cancer, esophageal varices, stomach inflammation, stomach cancer, peptic ulcers and others. In addition, the endoscope can be used for extraction of various swallowed objects (mainly in children or psychiatric patients).

Disadvantages

The procedure is very safe and painless, but it also carries certain risks and other disadvantages. May people do not tolerate the insertion due to gag reflex. The examination can irritate local mucosa, especially when the patient gags and tries to vomit. The most serious, but very rare complication, is rupture of the esophageal wall caused by the endoscopic device. It usually happens in esophagus, which is affected by some pathological process, or in Zenker's diverticulum. This is a life-threatening condition that must be usually solved by surgeons.

Advantages

The examination is great in diagnosis and therapy of the majority of common esophageal, stomach and duodenal diseases. It is painless, does not expose patient to radiation and allows taking histological samples.