Gastroscopy involves the insertion of a fibreoptic gastroscope through the mouth into the oesophagus,
stomach and duodenum (first part of the small intestine). It is a non-invasive procedure that is safe and
done under sedation.
Gastroscopy may be indicated if you have a history of epigastric pain or bloating, or gastro-oesophageal
reflux, or there is a family history of gastric or oesophageal cancer.
Figure 1. Fibreoptic gastroscope passed into the oseophagus, stomach and duodenum while the
patient is under sedation.

Oesophagitis may result from gastro-oesophageal reflux disease (GORD) where the acidic gastric contents
reflux into the the distal oesophagus. It is common in those with a hiatus hernia. The diagnosis is made
during gastroscopy with red patches (erythema) or even ulceration of the mucosal lining of the oesophagus,
with biopsies confirming oesophagitis on histopatholoy.
Oesophagitis is treated by taking a medication that lowers the acid. The most effective medication is a proton-pump inhibitor, which include pantoprazole (Somac®) rabeprazole (Pariet®) ompeprazole (Losec®) or esomeprazole (Nexium®). Peristent oesophagitis can lead to dysplasia, and even cancer, which can be excluded on biopsy. WHAT IS GASTRITIS?
Gastritis may result from imbalance between acid and mucous secretion, but can also result from infection
with the bacterial organism Helicobactor Pylori. During gastroscopy the appearance of the mucosa lining
your stomach can be inspected for any evidence of gastritis, that typically results in red patches (erythema)
and occasionally ulceration. Biopsies can be taken, which are painless, and sent for histopathology
analysis to determine if there is active gastritis, and if it is associated with Helicobactor Pylori infection. If
Helicobactor Pylori is identified, it can be treated in patients without pencillin allergy by a two week course
of amoxicillin, clarithramycin and esomeprazole (Nexium HP7®). Persisent gastritis or helicobactor infection
can lead to a chronic gastric ulcer, or even cancer, and these can be excluded on biopsy during your
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Coeliac disease is an auto-immune disorder of the small intestine that occurs in genetically predisposed
people of all ages, from infancy onwards. It results in antibodies against gliadin (a gluten) found in wheat.
This leads to sloughing of the mucosal villi of the small intestine. Diarrhoea and bloating can often be the
only symptoms. The diagnosis can be made at gastroscopy by taking a biopsy of the small intestine while
the patient is under sedation. It is a painless procedure. Once the diagnosis is confirmed, a gluten-free diet
can eliminate symptoms.
Lactose intolerance is the inability to digest lactose, a sugar found in milk. It is due to a deficiency of the
enzyme lactase. It is very common in adulthood, either due to a genetic deficiency in the production of
lactase (primary lactase deficiency) or can be a transient condition that results after a recent episode of
gastroenteritis. Lactose intolerance can result in abdominal bloating, pain and diarrhoea 30 minutes to 2
hours after consuming diary products. An intestinal biopsy can confirm lactase deficiency.
Lactase levels vary from one patient to the next, and vary over time, therefore lactose intolerance is not
usually an absolute condition. Since lactose intolerance poses no further threat to a person’s health, the
condition is managed simply by minimising the symptoms. Therefore management involves the avoidance
of diary products, substituting them for plant-based milks (e.g. soy milk, rice milk, or oat milk).
Gastroscopy is performed as a day procedure. Unless you are also having a colonoscopy, no bowel
preparation is required prior to your gastroscopy. You must be fasted for 6 hours (no oral food or liquids)
prior to your gastroscopy.
Gastroscopy is quick, easy and safe. You will be sedated during the procedure. You may be asked to bite
on a mouth guard prior to the insertion of the gastroscope. If biopsies are taken, they will be painless.
You will need 1-2 hours to recover after your gastroscopy before being allowed to leave the hospital. You
will need someone to pick you up from hospital following your procedure, as it is unsafe for you to travel
alone or drive a vehicle. Results of your biopsy should be available within 1 week of you procedure.
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