Dr Thomas Lee
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GASTROENTEROLOGY PROCEDURES
A Gastroscopy — also known as upper endoscopy or upper gastrointestinal endoscopy – is a procedure to diagnose and treat conditions that affect the upper digestive tract, including the oesophagus, stomach, and beginning of the small intestine. A thin, flexible tube with a small camera attached is inserted into your mouth and down your food pipe (oesophagus), then into your stomach and the first part of the small intestine (duodenum).
A gastroscopy can determine the cause of symptoms such as persistent stomach ache, difficulty swallowing, heartburn and acid reflux, and nausea and vomiting. Gastroscopies are generally painless and a simple, low-risk, and effective way to diagnose and treat digestive problems.
Investigate symptoms
A gastroscopy is an effective way to determine the cause of digestive problems, such as difficulty swallowing, persistent stomach ache, indigestion, and severe bleeding, including vomiting blood. The gastroscope enables the physician to visually examine the digestive tract without surgery.
Diagnosis
Gastroscopies are performed to diagnose stomach ulcers or gastro-oesophageal reflux disease (GORD), which causes heartburn and acid reflux, as well as coeliac disease, stomach cancer and oesophageal cancer. During the procedure, the physician can take tissue samples (biopsies) of anything unusual they see and can remove polyps. Accurate diagnosis is critical to appropriately and effectively treating gut conditions and diseases.
Treatment
Gastroscopy can be performed to treat bleeding ulcers, remove a blockage in the oesophagus (dilatation), remove non-cancerous growths and tumours, or remove a foreign body. In some cases, a gastroscopy can help doctors guide a feeding tube into the stomach when a person cannot eat in the usual way.
Step 1 – Preparation
Dr Lee will provide specific details and eating, drinking, any current medications, allergies or other medical conditions before your procedure. As a general guide, you need to have an empty stomach so the physician can see clearly, and so you don’t vomit. This typically means not eating or drinking for up to 8 hours before your procedure.
Step 2 – Procedure
A gastroscopy is often a short procedure of 15 minutes to half an hour. It is normally painless, but some patients experience some discomfort. First, a local anaesthetic spray will be used to numb your throat, and you may have the option of receiving a sedative injection. Next, you will be asked to lie on your side, and the physician will insert the gastroscope into your mouth, and you will be asked to swallow to help it pass down your throat. Any feeling of sickness or gagging should pass as soon as the scope moves down the oesophagus.
Step 3 – Recovery
Recovery is typically quick. If you have had a sedative, you will need to rest until it wears off, which can be up to a few hours. You will need to arrange for someone to drive you home, and for at least 24 hours, you should avoid alcohol and driving. Dr Lee will advise on any specific recovery details, including when you can eat and drink and your follow-up consultation.
The main alternatives are
1) Barium swallow where x-ray of your chest and upper abdomen are taken as you swallow Barium liquid. This is used to look for any structural abnormality of the food pipe such as a stricture as well as assessing the co-ordination between the oesophageal muscles and nerves.
2) A 24hour pH study and/or oesophageal manometry. This involves having a thin plastic tube passed down your nostrils into the lower oesophagus. It has an electronic sensors attached to measure your pH as well as how well the muscles contract. The tube may stay in your oesophagus for 24 hour.
The results will depend on the reason for your procedure. Some results, such as investigating an ulcer, may be available immediately. Tissue samples (biopsies) may need a few days before Dr Lee receives lab test results. Dr Lee will discuss with you how long it will take to get test results and arrange another appointment to discuss your diagnosis, treatment options and answer any questions you have. For Dr Lee, it is important that you are fully informed and given time to think about and understand your diagnosis and treatment before going ahead. You will be given a hard copy of the gastroscopy report to take home with for your record.
A gastroscopy is a very safe procedure, and the risks of serious complications are small. Though rare, some of the possible complications of a gastroscopy include:
A gastroscopy can be performed only by a credentialed clinician who meets the requirements of an accepted certification and recertification process. Gastroenterologists perform colonoscopies because of their expertise and qualifications in treating diseases and conditions related to the digestive system and intestines. Gastroenterologists, including Dr Lee, are members of the Gastroenterological Society of Australia (GESA), promoting the highest standards in research, education, patient care and clinical practice. You will need a referral from a doctor to see a gastroenterologist.
Many people approach their doctor when they have ongoing symptoms such as:
To fully investigate what’s causing these issues, your GP will need to refer you to a gastroenterologist. A gastroscopy is a safe and effective way to see inside your digestive tract to identify and sometimes treat the causes of your symptoms.
For new and ongoing patients, make a booking to speak to Dr Lee about understanding, managing, and treating your gut health issues.
