Gastroscopy is used to examine the organs of the upper digestive tract: the oesophagus, stomach and duodenum (it's the first and shortest segment of the small intestine).
I perform gastroscopy for 3 groups of patients:
- Patients with symptoms that may be due to disorders of the upper digestive tract.
I use gastroscopy to examine the internal lining of the oesophagus, stomach and duodenum for disorders. I may also obtain tissue biopsies to allow further examination of cellular structures under a microscope by a pathologist. This allows me to make an accurate diagnosis and recommend the appropriate treatment.
The top 10 symptoms that I perform gastroscopy for include: upper abdominal discomfort or pain, ‘gastric symptoms’, ‘reflux symptoms’, heartburn, chest pain, bloating, belching, nausea and ‘indigestion’.
- Patients with increased risk of oesophageal and gastric cancer.
In these patients, I use gastroscopy to identify precancerous and cancerous changes. I will incorporate image enhanced endoscopy in the gastroscopy as the early changes may be difficult to see with routine gastroscopy.
Accurate detection of precancerous changes allows me to determine the patient’s cancer risk in the future, and to plan monitoring of these areas so that they may be removed before developing into cancer. Precancerous areas and even early cancers can be removed endoscopically with good results and safety, avoiding the need for surgery.
- Patients who need endoscopic treatments, in order to avoid surgery.
Emergencies such as internal bleeding and swallowed foreign body can be effectively treated through gastroscopy, and this can be life-saving.
Other examples of treatment I have performed through gastroscopy include: removal of precancerous areas and early cancers, bypassing or opening up of blocked passages, and insertion of feeding tubes for nutrition.
These procedures are usually performed by advanced endoscopists, and doctors like me undergo years of additional focused and sub-specialized training in endoscopy after we have become specialists.