Gastroscopy - This examination allows for the scanning of various internal organs through the mouth, such as the esophagus, stomach, and duodenum (upper digestive tract).
What is an endoscopy?
Endoscopy is a general term that includes several different examinations. Endoscopy is a medical procedure during which the interior of the upper or lower gastrointestinal tract is visualized using a flexible tube device equipped with a camera (endoscope). During the examination, the doctor can inspect the lining and mucosa of the esophagus, stomach, and intestines and detect conditions such as polyps, ulcers, and more. The doctor can also perform complex procedures using the endoscope, such as polyp removal, cauterization of bleeding lesions, and more. Additionally, biopsies can be taken from the gastrointestinal tract to diagnose inflammatory processes or growths. Recently, there have been significant advancements in the scope of procedures that can be performed with an endoscope, to the point of resecting extensive segments of the gastrointestinal tract, sometimes avoiding the need for traditional surgery.
Upper Gastroscopy Procedure:
The examination and treatment are performed in the Gastroenterology Institute's advanced endoscopy unit. In most cases, it is done on an outpatient basis, meaning that the patient spends 2-3 hours in the clinic and then returns home. Depending on the type of examination and the discomfort it may cause, local anesthesia spray may be administered to the throat (for upper digestive tract examinations), and sedative drugs may be given to reduce discomfort during the procedure (sedation). In special cases, the examination can be done under general anesthesia.
When is a gastroscopy performed?
Gastroscopy is used for diagnostic purposes, such as detecting conditions like esophagitis, duodenal ulcers, inflammatory bowel diseases (ulcerative colitis), pre-cancerous and cancerous growths, and identifying foreign bodies that may have been swallowed. Nowadays, gastroscopy is also used for therapeutic purposes. Therefore, the purpose of gastroscopy is both diagnostic and therapeutic. For example, it can be used to stop bleeding in a bleeding stomach ulcer by cauterization, injecting drugs to stop bleeding, or placing a metal clip (as in surgery). It can also be used for dilatation procedures, such as dilating narrowed areas with specialized balloons, inserting temporary or permanent stents, marking growths before surgery using medical ink, and more. The use of gastroscopy with an argon gas coagulator (APC) is common.
Preparation for the Procedure:
Generally, the preparation is simple, and fast for about 6 hours before the examination is required unless instructed otherwise. If you take certain medications regularly, you will need to take them at 6 a.m. with a quarter cup of water, except in the following cases:
• If you take anticoagulant drugs, you must stop taking them a week before the examination, in coordination with your family doctor or cardiologist. Regarding aspirin, if there is a risk of cerebral or heart events as a result of stopping it, the examination can be done under aspirin therapy. In such cases, it should be coordinated in advance with the gastroenterologist and the treating cardiologist or neurologist.
• If you have a history of heart valve disease or have undergone stent or pacemaker implantation, you should consult your family doctor about taking antibiotics before and after the examination.
• If you have diabetes, you should consult your family doctor about taking medications on the day of the examination.
Upper endoscopy is usually a simple procedure, but it can cause temporary blurriness, so you should have someone accompany you to the clinic. Driving is prohibited for about 8 hours after the examination.
Complications:
Complications as a result of gastroscopy are very rare. Possible complications include:
• Local irritation and soreness in the throat. Such irritation usually subsides without any special intervention within a few days.
• Sometimes there may be a feeling of discomfort during swallowing that may last for up to 48 hours.
• It is possible to have slight bleeding from the area where the biopsy was taken or where a polyp was removed. The bleeding is usually mild and stops on its own.
• Perforation of the examined gastrointestinal tract - a very rare complication that is usually detected immediately after the examination and requires immediate treatment.
If you experience signs of unexplained pain, black stools, bloody vomiting, or fever, you should seek immediate medical attention or go to the emergency department.
You can reduce the risk of complications by preparing correctly according to the doctor's instructions, such as fasting and stopping certain medications as required.
Procedure:
Upon entering the examination room in the Gastroenterology Institute, you will receive a further explanation from the doctor who will perform the examination and will be asked to sign an informed consent form. You will be provided with a gown to wear and a venous access for sedation will be inserted. If you have dentures, they should be removed before the examination. Before the procedure begins, you will be asked to lie on your left side, and the doctor or nurse will spray a numbing agent into your throat to reduce discomfort during the insertion of the endoscope. Then, you will be given a sedative injection through the venous access in your arm to minimize any discomfort during the procedure. With the effect of the sedation, the flexible endoscope will be gently inserted through your throat into your esophagus, and from there to your stomach and duodenum. The insertion of the endoscope does not interfere with your breathing.
After the Procedure:
After the examination, you will remain in the recovery unit for about an hour. You may feel bloated in the abdomen due to the air introduced during the examination, but this feeling should disappear on its own after a short time. Subsequently, as you recover, you will be provided with the examination results by the performing doctor, who will also explain the further treatment and follow-up. It is highly recommended to have a family member or someone you trust with you during the discussion with the doctor when receiving the
results.
Recovery at Home:
During the first few days after the examination, you may experience some discomfort or soreness in the throat. To alleviate this, you can drink cool liquids and take pain-relieving medications. If you take medications regularly, you can continue your usual medication regimen – it is essential to consult the doctor who examined taking blood-thinning medications.