Dr Kieron Lim
Senior Consultant Gastroenterologist
MBBS (University of London), MRCP (UK), FRCP (Edinburgh), FAMS (Gastroenterology)
A gastroscopy, also known as an upper endoscopy, is a medical procedure that allows for the direct, real-time visualisation of the upper digestive tract, including the oesophagus, stomach, and the first part of the small intestine (duodenum). This procedure uses a gastroscope, a thin, flexible tube with a light and camera at the end, to examine and diagnose conditions affecting the upper gastrointestinal (GI) tract.
A gastroscopy has several advantages:
A gastroscopy can detect conditions such as gastritis, ulcers, and early-stage cancers, allowing for timely intervention.
By providing a clear view of the upper digestive tract, a gastroscopy enables doctors to diagnose conditions that may not be detectable through imaging tests alone.
A gastroscopy can help confirm the presence of Helicobacter pylori, a bacteria linked to ulcers and stomach cancer.
Unexplained symptoms such as persistent heartburn, difficulty swallowing, and unexplained weight loss can be investigated with a gastroscopy.
A unique advantage of a gastroscopy is the ability to take tissue samples (biopsy) for further analysis and perform treatments, such as stopping internal bleeding or removing small growths.
A gastroscopy is a valuable diagnostic tool for identifying various upper gastrointestinal conditions, including:
Gastritis and Stomach Ulcers
Inflammation of the stomach lining (gastritis) and stomach ulcers can be identified through gastroscopy.
Gastroesophageal Reflux Disease (GERD)
Chronic acid reflux can cause damage to the oesophagus, which a gastroscopy can help assess.
Barrett’s Oesophagus
This condition, caused by prolonged acid reflux, increases the risk of oesophageal cancer and can be detected during a gastroscopy.
Oesophageal and Stomach Cancer
Early signs of cancer in the oesophagus or stomach can be detected, improving the chances of effective treatment.
Hiatal Hernia
A gastroscopy can identify the presence of a hiatal hernia, where part of the stomach pushes through the diaphragm.
Unexplained Upper GI Bleeding
If a patient experiences vomiting blood or black stools, a gastroscopy can help determine the source of bleeding.
A gastroscopy may be recommended for individuals with the following risk factors or symptoms:
Persistent Digestive Symptoms
People experiencing chronic heartburn, indigestion, nausea, or difficulty swallowing may require a gastroscopy to identify the cause.
Unexplained Weight Loss
Significant, unintentional weight loss can be a sign of a serious condition requiring further investigation.
Family History of GI Cancer
Those with a family history of stomach or oesophageal cancer may benefit from early screening.
Suspected H. pylori Infection
A gastroscopy can help confirm and diagnose an H. pylori infection, which is associated with ulcers and stomach cancer.
Proper preparation ensures accurate results and a smooth procedure. Key steps include:
Fasting
Patients are typically required to fast for at least 6 to 8 hours before the procedure to ensure a clear view of the digestive tract.
Medication Adjustment
Certain medications, such as blood thinners, may need to be paused before the procedure.
Sedation Arrangements
Since sedation is often used, patients should arrange for someone to accompany them home afterward.
A gastroscopy is a quick outpatient procedure, typically lasting 10-20 minutes. Here’s what to expect:
Sedation or Local Anaesthesia
Patients may receive sedation or have their throat numbed with a local anaesthetic spray to minimise discomfort.
Insertion of the Gastroscope
The doctor will gently insert the gastroscope through the mouth and into the oesophagus, stomach, and duodenum.
Examination and Biopsy
The camera transmits images to a monitor, allowing the doctor to examine the lining of the upper GI tract. Tissue samples may be taken if necessary.
After the procedure, patients will be monitored until the sedation wears off. Here’s what to expect:
Post-Procedure Sensations
Mild throat irritation or bloating due to the air introduced during the procedure is common and usually resolves quickly.
Dietary Recommendations
Patients can typically resume eating and drinking after the procedure unless advised otherwise by their doctor.
Resuming Activities
If sedation was used, patients should rest for the remainder of the day and avoid driving or operating heavy machinery.
Follow-up and Interpretation of Results
Initial findings may be discussed immediately after the procedure. However, if biopsies were taken, results may take a few days. Depending on the findings, follow-up tests or treatments may be recommended.
Frequently Asked Questions (FAQs)
Meet Our Specialist
Dr Kieron Lim
MBBS, University of LondonMember, Royal College of Physicians (UK)Fellow, Academy of Medicine (Gastroenterology) SingaporeFellow, Royal College of Physicians (Edinburgh)
Dr Kieron Lim is a senior consultant specialising in Gastroenterology and Hepatology, providing comprehensive care for patients with gastrointestinal conditions in Singapore. His expertise extends to disorders affecting the oesophagus, stomach, colon, liver, pancreas, and gallbladder. Through his experience, Dr Lim enhances patient outcomes by facilitating early detection and timely medical interventions.