Discovering Gastrointestinal Disorders Through Gastroscopy

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Gastrointestinal disorders affect the gastrointestinal (GI) tract – from the mouth to the anus. Many factors can upset your gastrointestinal tract, such as eating a low-fibre diet, physical inactivity, changes in your routine (e.g., travelling), and excessive consumption of dairy products. You might also experience unexplained symptoms like:

  • Persistent heartburn – If you experience heartburn more than twice a week, your oesophagus might be inflamed. Over time, the acid from your stomach can further damage your oesophagus and lead to complications.
  • Bleeding – Signs of bleeding in the digestive tract include bright red blood in vomitus, vomitus that look like coffee grounds, black or tarry stool, and dark blood mixed with stool.
  • Nausea and vomiting – Nausea and vomiting can indicate an infection, food poisoning, motion sickness, appendicitis, migraine, or brain injury. They can sometimes be symptoms of a more severe disease like kidney or liver disorder, heart attack, central nervous system disorder, brain tumour, or cancer.
  • Abdominal pain – Most digestive symptoms may include abdominal pain. Abdominal pain could signal an ulcer, irritable bowel syndrome (IBS), or other more serious disorders.
  • Difficulty in swallowing – Dysphagia is the medical term for having difficulty swallowing. It could be a sign of gastroesophageal reflux disease (GERD), abnormal growth of tissues in the oesophagus, or diseases affecting the muscle and nerve functions.
  • Bloating – This could be a sign of irritable bowel syndrome (IBS) or food intolerance.

Such symptoms may imply the presence of gastrointestinal diseases. Examples of gastrointestinal diseases include, but are not limited to:

Gastroscopy For Diagnosis

Gastroscopy is a procedure in which a doctor uses an endoscope (a flexible tube with a mounted camera). It is also known as an upper endoscopy. Gastroenterologists, surgeons, or other trained doctors perform the procedure to see the lining of your upper gastrointestinal tract. Gastroscopy is also the most effective screening tool for stomach cancer.

Before the procedure, you will be required to fast for 6 hours to ensure that your stomach is empty for the doctor to get a complete view. Additionally, you must inform your doctor if you are on blood thinners or diabetic medications. Closely follow the instructions given to you during the pre-procedure counselling.

An outline of the whole procedure is as follows:

  1. You will likely get a sedative or medicine through an intravenous (IV) needle in your arm to help you stay relaxed. You may also be given a fluid medicine to gargle or an anaesthetic spray to numb your throat, preventing you from gagging.
  2. The nurse will monitor your vital signs before you are asked to lie on your side.
  3. The doctor will carefully pass the endoscope down your oesophagus into your stomach and duodenum (the first part of the small intestine).
  4. The small camera attached to the endoscope will send a video image to a monitor, allowing close examination of your digestive inner lining.
  5. The endoscope also pumps air into your stomach and duodenum to distend the organs so that a clearer view is obtained.
  6. The doctor may extract tissue samples during the gastroscopy for testing. This procedure is called a biopsy. Biopsies are needed to diagnose conditions such as cancer and gastritis.

The whole procedure usually takes at least 10 minutes to complete. In some cases, it may take about 30 minutes before the examination is completed.

What To Do After Gastroscopy

A brief endoscopy summary report and self-care instructions will be given to you before you are discharged.

You may be discharged shortly if your gastroscopy is done under local anaesthesia. If you received sedation through injection, you may be observed in the recovery area for at least an hour until the sedative wears off.

Have someone accompany you home to ensure your safety. You may return for an outpatient review if a follow-up visit is deemed necessary by the doctor.

Risks of Gastroscopy

This endoscopic procedure is considered a safe screening method. The risks of complications are low but may include:

  • Bleeding from where the doctor took the tissue samples or removed the polyp
  • A hole in the lining of your upper GI tract
  • Breathing or heart problems as an abnormal reaction to the sedative

Bleeding caused by gastroscopy is often minor and stops without treatment. Severe complications like the presence of a hole in the lining of the GI tract are uncommon. Seek medical attention immediately if you experience any of these symptoms after the endoscopic procedure.

  • Chest pain
  • Breathing problems
  • Swallowing problems or throat pain that is getting worse
  • Vomiting, specifically if it is bloody or looks like coffee grounds
  • Abdominal pain which is getting worse
  • Tar-coloured stool
  • Fever

Conclusion

Gastroscopy is a diagnostic tool for digestive diseases and is also used to detect early signs of ulcers and cancer. Arrange a consultation with the doctor if you are experiencing recurring throat, abdominal, or stomach pain to receive the necessary medical attention.

References

  • https://my.clevelandclinic.org/health/articles/7040-gastrointestinal-diseases#:~:text=Constipation%2C%20irritable%20bowel%20syndrome%20(IBS,Not%20getting%20enough%20exercise.
  • https://www.niddk.nih.gov/health-information/diagnostic-tests/upper-gi-endoscopy#:~:text=Doctors%20use%20upper%20GI%20endoscopy%20to%20help%20diagnose%20and%20treat,and%20upper%20intestine%20or%20duodenum.&text=Upper%20GI%20endoscopy%20can%20be,ulcers
  • https://www.gleneagles.com.sg/facilities-services/centre-excellence/digestive-gut-health/upper-digestive-disorders
  • https://www.rafflesmedicalgroup.com/services/specialist-centres/surgery/packages/gastroscopy-screening/
  • https://www.healthhub.sg/a-z/diseases-and-conditions/654/gastroscopy-video
  • https://medlineplus.gov/gastrointestinalbleeding.html

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Upper Gastrointestinal, Weight Loss & General Surgeon
Dr. Lim Khong Hee graduated from the National University of Singapore in 1992. He obtained his postgraduate degree in 1998 and was a Clinical Fellow (HMDP) in Upper Gastrointestinal and Laparoscopic Surgery at the renowned Princess Alexandra Hospital (Brisbane) in 2002.
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