Gastroscopy is an examination which belongs to the group of endoscopic methods. Endoscopy is an investigative technique that is used widely today. It allows examination of hollow organs and cavities of the body. Gastroscopy can be characterized as endoscopy of the upper part of digestive system, oesophagus, stomach and upper part of small intestine. It is a common intervention that does not carry itself a significant risk and it is important curative and diagnostic method.
Indications for gastroscopy
Indication means such circumstances which require application of certain therapeutic or diagnostic procedure. Gastroscopy covers a number of such circumstances. Gastroscopy is indicated in patients with digestive disorders, pain in the stomach, repeated vomiting or vomiting of blood. Likewise, it is necessary to perform gastroscopy in patients with blood in the stool, and in which was expelled source of bleeding from the colon by colonoscopy. Furthermore, to gastroscopic examination are sent patients with lack of appetite, weight loss, pain while swallowing, frequent heartburn and belching or the occurrence of gastric cancer in family. Since the pernicious anaemia develops due to chronic inflammation of the stomach is this disease also an indication for gastroscopy. An important indicator is also so-called gastroesophageal reflux, i.e. the return of food from stomach into the oesophagus and oral cavity. The mucosa of oesophagus is irritated by stomach's acid contents and this may lead to transformations in its structure which causes cancer of the oesophagus. Gastroscopy can be performed only if the patient signed informed consent.
Principle of gastroscopy
Gastroscopy is an examination in which through the mouth is flexible hose-type device, so-called fiberscope, inserted to the pharynx, oesophagus, stomach, and possibly into the upper part of small intestine called the duodenum. Flexibility is an important factor for easier handling of the device. The end of device is fitted with light and camera that is used to take an image that is transmitted to the screen which is during the examination constantly viewed by physician. On the other side of the device is control panel through which the doctor operates with unit and rotates it as needed. In order to see the entire wall of stomach, it is necessary to blow gas into the organ which causes its expansion and thus improved clarity. It is possible to insert additional tools by which we are able to take samples for histological examination. Gastroscopy has important diagnostic significance. Essential is also the therapeutic use of this intervention which is used to stop bleeding, e.g. bleeding from peptic ulcer.
Preparing the patient for gastroscopy
Patients undergoing gastroscopic examination must be properly prepared. Gastroscopy is performed only on an empty stomach as residue of food could hinder the assessment of changes in the lining of digestive tract. Therefore, it is recommended, prior to surgery, to not eat, drink, smoke and consume alcoholic beverages. Just before the examination, the local anaesthesia is applied to numb the mouth and upper throat of the patient and partially prevent whooping reflex. But this mean that swallowing reflex will be also phased out and it is not recommended to eat or drink after examination as it could cause asphyxiation. Sometimes is sedative given to the patient through vein, i.e. drug that attenuates and calms the patient. In this case, the patient has to stay in waiting room for some time and has a driving ban for 24 hours. Gastroscopy in young children is performed only under general anaesthesia.
Complications of gastroscopy
Gastroscopy is considered as the safe method of investigation. However, it is not possible to exclude the presence of some complications. The most common complication is an allergic reaction to medications given within preparation for examination. Therefore, it is necessary to provide information about any allergies to certain medicines. This complication occurs more likely in the elderly and sick people. Another complication is the perforation, i.e. rupture of oesophagus. This can occur in the presence of defect in lining of oesophagus or rough handling of the system. We can meet rarely with bleeding especially when taking tissue samples. If the patient failed to prepare properly, he can be endangered with aspiration of gastric contents.
Contraindications for gastroscopy
Contraindication means circumstances that prevent the implementation of diagnostic or treatment procedure. Gastroscopy is contraindicated in heart failure, shock, unconsciousness, the risk of inhalation of food debris or blood. Likewise, gastroscopy is not performed in uncooperative patients or those who refused to sign the informed consent.