Upper GI Endoscopy (Gastroscopy)

Procedure

What upper GI endoscopy is

Upper GI endoscopy — also called gastroscopy or OGD (oesophagogastroduodenoscopy) — is a procedure in which a thin, flexible tube with a camera and light at its tip is passed through the mouth to examine the food pipe (oesophagus), the stomach and the first part of the small intestine (duodenum).

The camera projects a magnified view onto a monitor, allowing the endoscopist to identify ulcers, inflammation, polyps, tumours, varices and sites of bleeding directly. Because instruments can be passed through the tube, endoscopy is not only diagnostic: biopsies, polyp removal, bleeding control and dilatation of narrowed segments can all be performed in the same session.

Why it may be advised

• Persistent acidity and reflux
• Upper abdominal pain
• Difficulty or pain on swallowing
• Food sticking or impaction
• Persistent nausea or vomiting
• Vomiting blood or black stools
• Iron-deficiency anaemia
• Unexplained weight loss
• Suspected ulcer or H. pylori
• Variceal screening in liver disease

How the procedure is performed

Most upper GI endoscopies at GastroCare Hospital are performed under intravenous sedation, which means you are relaxed or lightly asleep and usually remember little of the procedure. The procedure itself typically takes between five and fifteen minutes, longer if treatment is required.

1. You are reviewed by the endoscopist, and the reason for the procedure and its risks are explained before you give consent.
2. An intravenous line is placed, and monitoring for oxygen saturation, pulse and blood pressure is attached.
3. Sedation is given, and a throat spray may be used to numb the back of the throat.
4. The endoscope is passed through the mouth. It does not interfere with breathing.
5. The lining is examined systematically, and photographs are recorded.
6. Biopsies or treatment are performed if needed — this is painless.
7. The scope is removed, and you are transferred to the recovery area to wake up.

Preparing for the procedure

• Fasting: nothing to eat for about 6–8 hours before. Clear water is usually allowed up to about 2 hours before, unless told otherwise.
• Medicines: tell us about blood thinners, insulin, diabetes tablets, heart medicines and any allergy. Specific instructions will be given.
• Escort: because of sedation, you must be accompanied by a responsible adult and must not drive or travel alone afterwards.
• Timing: plan to spend roughly two to three hours at the hospital including preparation and recovery.

After the procedure

You will rest in the recovery area until the sedation wears off — usually 30–60 minutes. A mild sore throat, mild bloating from the air used during the procedure, and drowsiness are common and settle quickly. You can usually eat and drink normally once you are fully awake, unless told otherwise. The findings are explained to you before you leave, and you receive a written report. If a biopsy was taken, the result usually takes a few days and will be discussed at a follow-up visit.

Risks

• Sore throat and mild bloating — very common, temporary.
• Reaction to sedation — altered blood pressure or breathing, managed by the monitoring team.
• Bleeding after a biopsy or polyp removal — usually minor and self-limiting.
• Perforation of the gut wall — uncommon, may require further treatment.
• Aspiration of stomach contents into the lungs — uncommon, reduced by proper fasting.

Your endoscopist will discuss the risks relevant to your particular situation, including any that are higher because of your other medical conditions.