A gastroscopy is an examination of the upper part of the gastrointestinal tract – the esophagus (gullet), stomach and duodenum (the first part of the small intestine). This is done using a flexible, tube-like telescope called an endoscope, which is about the thickness of a little finger. The endoscope is passed through the mouth and into the esophagus. The procedure may also be simply referred to as an endoscopy.

A gastroscopy is useful for finding out what is causing your symptoms, or as a check-up for certain gastrointestinal conditions. During the procedure, the doctor may take a biopsy – a sample of the lining of the gullet, stomach or duodenum – for examination in the laboratory.

Gastroscopy is routinely performed as an outpatient or day case, requiring no overnight stay in hospital. A general anesthetic is not generally required, but you may be given a sedative to help ensure that you are relaxed and comfortable.

• Anemia or gastrointestinal bleeding
• Stomach ache
• Gastroesophageal reflux
• Difficulty in swallowing
• Unexplained abdominal pain
• Polyps / tumors
• Gastric cancer screening
• Removal of swallowed objects, e.g. Fishbone

Since stomach cancer is difficult to diagnose because most people typically do not show symptoms in the earlier stages, it often goes undiagnosed until after it spreads to other parts of the body. This makes stomach cancer more difficult to treat. Risk factors may include ageing, a diet high in salty and smoked foods, diet low in fruits and vegetables, family history of stomach cancer, H. pylori infection, long-term stomach inflammation, pernicious anemia, smoking, and stomach polyps.

Gastroesophageal junction cancer is associated with having gastrointestinal reflux disease (GERD). GERD is a condition caused by frequent backflow of stomach acid into the esophagus. There is a strong correlation between a diet high in preserved foods that are smoked, pickled and salted and stomach cancer located in the main part of the stomach.

Symptoms of gastroesophageal junction cancer and stomach cancer may include fatigue, feeling bloated after eating small amounts of food, persistent heartburn, severe indigestion, persistent nausea and vomiting, stomach pain, unexplained weight loss.

In addition, the risk of gastric cancer in patients with H. pylori infection is 4 to 6 times higher than non-carriers. H. pylori is a type of bacteria that can enter your body and live in your digestive tract. Over time, they can cause ulcers in the lining of your stomach or the upper part of your small intestine. H. pylori infection may also lead to stomach cancer.

• The reason for conducting an OGD, the procedure and the possible complications will be explained by the doctor and a consent form must be signed prior to the procedure.
• Please inform the doctor if the patient is or might be pregnant.
• Please inform the doctor if the patient currently takes any drugs or medications particularly for diabetes or that could affect blood clotting, for example:
  – Aspirin products
  – Arthritis drugs
  – Antiplatelet drugs, e.g. Plavix, Persantin, Pletaal, Pradaxa
  – Blood thinners, e.g. Warfarin (anticoagulants)
  – Insulin
  – Diabetic tablets
  – Iron supplements
  – Any Chinese medicines or herbal remedies
  – OGD can be conducted as an out-patient or in-patient. Please consult your doctor for the arrangement.
  No food or drink six hours before OGD.
  Please change into a surgical gown after removing all clothing including undergarments, dentures, jewelry and contact lenses.

Procedures

• Patient has to lie on his left side and wear a small plastic mouth guard.
• Local anesthetic spray to the throat and intra-venous sedative will be administered according to doctor’s prescription.
• Doctor will pass the gastroscope into patient’s stomach through the mouth. It is normal if the patient feels bloating and abdominal distention during the procedure.
• The procedure will usually take 15 minutes.
• The procedure can be conducted without any sedation. Please consult your doctor for information.