A gastroscopy or upper GI endoscopy or OGD is an examination of the oesophagus (gullet), stomach and duodenum (first part of small intestine). A gastroscopy, which is a flexible lighted instrument that projects a video image onto an external monitor, is inserted through the mouth and carefully maneuvered by the surgeon. This allows him to visualize the lumen (internal view) of the upper digestive system and in turn allows him to evaluate for any abnormalities such as polyps, cancerous growths or other changes to the mucosal lining. When these are detected, the surgeon can remove the polyp or sample the tissue for a detailed histological examination.
A gastroscopy is indicated to evaluate symptoms of persistent or unexplained upper abdominal pain, nausea, vomiting, difficulty swallowing, heartburn or significant weight loss. Patients with iron deficiency anemia are also generally investigated by gastroscopy. Another common indication is suspicion of bleeding within the upper digestive system as evidenced by vomiting blood or digested blood (coffee-ground substance) or passing black, tarry stool. When the source of bleeding is found, immediate therapeutic measures to stop the bleeding is effective 90% of the time.
Gastric cancer is more prevalent amongst Asians than in the west. A gastroscopy is useful for detecting early cancer where treatment may be offered to achieve a curative result. Where polyps or suspicious areas are seen in the mucosal lining of the digestive tract, biopsies are taken for tissue samples for a detailed histological examination.
A very common cause for stomach ulcer or inflammation of the stomach and duodenum within our population is Helicobacter pylori infection. During a gastroscopy, the doctor can sample the tissue for a simple and quick diagnostic test known as CLO test. If positive, a two-week course of oral medication known as triple therapy given by the doctor is effective in eradicating the infection.
Minimal preparation other than an empty stomach is required. You should be fasted for at least 6 hours prior to the procedure. You can consume your usual medications with small sips of water but certain medications such as blood-thinning medication may need to be stopped. It is important to inform your surgeon beforehand.
Just before the procedure, an IV cannula will be inserted for administration of sedation. You will be given a small amount of liquid to drink which removes the bubbles within the stomach. You will be placed on your side during the procedure and a mouth guard placed in your mouth to prevent biting down on the scope. Sedatives will be given to help you relax and remain comfortable. You may or may not fall completely asleep during the colonoscopy, but most patients will not be able to remember the procedure. Some monitoring devices will be attached to your body during the examination. The whole procedure should take 5 to 10 minutes during which you may experience abdominal bloating from the air that is introduced to assist in the endoscopy evaluation. Most patients may experience some gagging as the scope is inserted into the back of the throat but this is a normal and transient reflex.
When the procedure is completed, you will be transferred back to the recovery ward where monitoring continues while you recover from the sedation. When you are fully awake and comfortable, you will be given a drink and some food. It is strongly recommended that you have someone to accompany you home after the procedure.
Gastroscopy is a very common day surgery procedure and major complications are rare.
Should these occur, it is important to contact your surgeon urgently so that follow-up measures may be undertaken expediently.
A gastroscopy in Singapore can range anywhere from $500 to $3,500, depending on the doctor’s professional fee, hospital facility fee and other miscellaneous fees.
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