Endoscopy provides a live close-up vіеw оf thе dіgеѕtіvе trасt and may be used for diagnostic or therapeutic purposes. An upper GI endoscopy or oesophagogastroduodenoscopy (OGD) examines thе oesophagus, ѕtоmасh, аnd thе first раrt оf the small іntеѕtіnе known as the duodenum. Conditions that affect the mucosal lining of the upper digestive tract such as ulcers, polyps, nodules, vascular disorders, tumours and cancers may be accurately diagnosed. The scope is preferred to a scan because of the ability to visualise these conditions directly. A therapeutic scope refers to a procedure that is performed to remove a blockage such as a foreign body or food particle in the intestinal tract or to arrest internal bleeding that occurs. Below are some conditions that require upper endoscopy.

Gastroscopy

HEARTBURN AND ACID REFLUX

Hеаrtburn іѕ оnе оf thе commonest symptom amongst patients seeking medical help. It affects the young and old, both male and female. Heartburn may be accompanied by acid brash which is the sour taste of gastric contents regurgitating up into the mouth. Factors that predispose to acid reflux and heartburn include:

  • Pregnancy
  • Hiatal hernia (when the stomach bulges up into the chest)
  • Gastroesophogeal reflux disease (GERD)
  • Lifestyle and eating habits (eg. Large meals close to bedtime)
  • Obesity

Certain foods and drinks can trigger heartburn for some people. Examples include:

  • Citrus fruits
  • High-fat foods
  • Tomatoes
  • Alcohol
  • Citrus juices
  • Caffeinated beverages
  • Carbonated beverages

BARRETT’S OESOPHAGUS

This condition is diagnosed when the flat, uniformly pink appearance of the oesophagus is replaced with thickened, red lining (mucosal change). This is caused by acidity of the gastric contents leading to chemical change in the mucosal lining. Barrett’s oesohagus is associated with an increased risk of oespohageal cancer and therefore requires regular checkups with careful visualization and extensive biopsies of the oesophagus to check for precancerous cells (dysplasia).

Barrett’s oesophagus is not usually associated with any symptoms and is diagnosed endoscopically and
histologically.

NEUROMUSCULAR DISORDERS OF THE OESOPHAGUS

These are rare chronic disorders affecting the motility of the oesophagus and results in patients having trouble swallowing and chest pain. Examples of neuromuscular disorders include achalasia and diffuse oesophageal spasm. An endoscopy is often performed in the first instance to rule out more common conditions which affect the oesophageal lining or lumen.

GASTRITIS

Gastritis is a general term for a group of conditions with one thing in common: inflammation of the lining of the stomach. The inflammation of gastritis is most often the result of infection with the same bacterium that causes most stomach ulcers. Factors that contribute to gastritis and ulcers include:

  • Chronic alcohol use
  • Certain pain killers (non-steroid anti-inflammatory drugs or NSAIDs)
  • Long term steroid use
  • Blood thinning medications (eg. aspirin, clopidogrel, warfarin)
  • Helicobacter pylori infection

Gastritis may occur suddenly (acute gastritis) or appear slowly over time (chronic gastritis). The pain from acute gastritis can be very severe, often resulting in hospitalisation for treatment. In some cases, gastritis can lead to ulcers and an increased risk of stomach cancer. For most people, however, gastritis isn’t serious and improves quickly with treatment.

During the endoscopy procedure, your doctor will obtain some biopsy samples of the stomach lining. This ensures a histological diagnosis of gastritis and is important to discern if a pre-cancerous or cancerous component co-exists. It also helps to determine the presence of Helicobacter pylori, a bacterium commonly residing in the stomach which causes gastritis and ulcers and may lead to gastric cancer if left untreated in the long term.

GASTRIC ULCERS

When gastric ulcers are detected during endoscopy, it is important to obtain multiple tissue biopsies to determine whether cancer is present. Once this is ruled out, your doctor will put you on medications (proton pump inhibitors or PPI) to enable the ulcer to heal up. You will be required to have periodic endoscopies to ensure that the ulcer has healed completely.

UPPER G.I CANCER

OGD can detect pre-cancers or cancers in the oesophagus, stomach and rarely, the duodenum. The symptoms vary depending on the location of cancer.

In the oesophagus, cancer most commonly results in:

  • Difficulty swallowing
  • Regurgitation of undigested food
  • Vomiting of fresh blood

In the stomach, cancer may result in:

  • Persistent upper abdominal pain
  • Vomiting of fresh or stale blood (coffee ground material)
  • Passage of black stools (malaena)
  • Vomiting of undigested food

Generalised symptoms that are common to both types of cancer include:

  • Unexplained severe weight loss
  • Severe fatigue due to iron-deficiency anaemia

Aside from diagnosing a cancerous growth within the digestive tract, your doctor will perform a biopsy to determine the histology. This is achieved by passing a forceps along the tubing to take a tissue sample. Histology may reveal different types of cancer within the digestive tract. These include

  • Adenocarcinoma
  • Squamous cell carcinoma
  • Lymphoma
  • Other rare histology types

Differentiating the various histology is important as the prognosis and treatment is different for each of them.

SCHEDULING AN UPPDER ENDOSCOPY

If you are experiencing symptoms such as heartburn or acid reflux, upper abdominal pain, repeated vomiting, or unexplained weight loss, call our clinic to schedule a consultation today.

An endoscopy can be arranged within the same day as it does not require special preparations other than fasting at least six hours from the last meal. It is a day surgical procedure so that MediShield insurance reimbursement can be facilitated.

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