Gastroscopy – Diagnosing Stomach Ulcers

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An imaging device is the most important tool in the clinician’s arsenal to view the anatomical structures. Out of the many imaging devices that uses a plethora of techniques; those that employ normal vision to view structures in their normal physiological phase are the most useful. One such device is a thin flexible tube called an endoscope with its own lens and a light source connected to a video monitor to display crisp real time pictures of internal structures. Endoscope aids in checking symptoms and diagnosing, treating conditions. It is also helpful in surgical management to treat or palliate conditions. Its use during follow up is one of the few direct methods of confirming the non recurrence of an illness.

Gastroscopy is a procedure where an endoscope is used to examine the lining of the upper part of the gastrointestinal tract including the esophagus (gullet), stomach and the first part of the small intestine (duodenum). This is also referred as upper GI endoscopy or esophagogastroduodenoscopy (OGD). It’s an excellent test in identifying and treating the cause of bleeding from the upper gastrointestinal tract. It is more accurate than X-rays or barium tests for detecting inflammation, ulcers and tumors of the esophagus, stomach and duodenum.

Gastroscopy used to check symptoms or confirm diagnosis is called diagnostic gastroscopy and gastroscopy to treat a condition is called therapeutic gastroscopy. It may be recommended when there are symptoms that suggest a problem in the stomach, esophagus or the first part of the small intestine (duodenum).

Problems that are often investigated using Gastroscopy are:

  • Abdominal pain
  • Heartburn
  • Pain or difficulty when swallowing (dyspepsia)
  • Anemia caused by persistent internal bleeding
  • Vomiting blood or passing dark or tar like stools

Gastroscopy may also be used to confirm or rule out, suspected conditions such as:

  • Stomach ulcers or peptic ulcers
  • Gastroesophageal reflux disease (GERD)
  • Coeliac disease
  • Barrett’s esophagus
  • Portal hypertension
  • Stomach cancer and esophageal cancer

Besides aiding in the examination of the upper gastrointestinal tract, gastroscopy is also used in removing small samples of tissue for biopsy. Gastroscopy can also be used to treat problems affecting the esophagus, stomach and duodenum.

  • Stop stomach or esophageal bleeding caused by stomach ulcers or enlarged veins
  • Widen a narrowed esophagus that’s causing pain or swallowing difficulty
  • Remove malignant tumors, polyps or foreign objects
  • Provide nutrients by way of a feeding tube

Diagnosing stomach ulcers

Based on the symptoms, a gastroenterologist may suspect you’ve an ulcer and will want to know if you’re taking any non-steroidal anti inflammatory drugs. You may also be tested for Helicobacter Pylori (H. Pylori) infection or may be advised gastroscopy.

Gastroscopy is carried out in a fully equipped theater, where a thin tube called an endoscope is passed into your mouth down your stomach and the first section of the small intestine. A mild sedative injection will be administered to you or your throat sprayed with a local anesthetic to make the passing down of the endoscope more comfortable. Air will be blown into the stomach once the endoscope is inside allowing the gastroenterologist to see any unusual redness, holes, lumps, blockages or other abnormalities. You may burp or feel bloated when the air is blown into your stomach, but it gets better once the procedure is finished.

The images taken by the camera and relayed to the monitor will confirm or rule out a stomach ulcer. A small tissue sample may also be collected to test for any H. Pylori infection. If a stomach ulcer is confirmed then the treatment depends on what caused it. With treatment most ulcers will heal in a month or two. You may have to repeat gastroscopy after four to six week to check that the ulcer is healed.

Preparing for gastroscopy

The safest way to take he test is on an empty stomach. Eat or drink nothing six hours prior to the gastroscopy examination. It is very important to tell the doctor at least 5 days in advance about any medications you take. You might even have to stop certain medications like iron tablets, blood thinning drugs. Discuss any allergies to medications or any medical conditions such as heart or lung conditions with the gastroenterologist performing the gastroscopy.

Gastroscopy risks

It is normal to feel bloated or have a sore throat for a day or two after a gastroscopy. It is a safe procedure and risks of any serious complications are small. Where it is used to diagnose a condition, the risk of complications is 1 in 1000. Some of the possible complications of Gastroscopy include:

  • Adverse effects from sedation
  • Bleeding
  • Perforation (tearing)

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