Common Procedures
Common Procedures > Upper GI Endoscopy
What is it?
Upper GI (GI = gastrointestinal) endoscopy, gastroscopy, oesophagal-gastro-duodenoscopy or OGD are all different ways of saying the same thing. That is a scope to look at your oesophagus (food pipe), stomach and duodenum (the first part of the small intestine).
The scope comprises a long, soft, slim, flexible tube with a camera and a light source on the end. The thickness of the scope is about the same as that of a ballpoint pen. The scope is introduced via the mouth into the food pipe and then the stomach and duodenum. As the scope moves along, the doctor doing the scope will take pictures and may take tissue samples to check for infection or to evaluate abnormal findings. On average a scope takes about 5-10 min.
Why do I need it?
Upper GI endoscopies are done to investigate symptoms such as abdominal pain, anaemia (low blood level) or weight loss. Causes may range from benign infections of the stomach to ulcers and stomach cancer. Your doctor should explain why the procedure is necessary in your case.
How is it done?
The scope can be done either sedated or unsedated. In either case, a local anaesthetic is sprayed to numb the back of the throat and thus reduce discomfort.
In sedated scopes, a needle is first inserted into the patient’s veins. Medication is then injected via the needle to calm the patient and help him/her sleep prior to insertion of the scope. Most patients undergoing a sedated scope usually do not remember the procedure has taken place. Rarely, some patients are more difficult to sedate and may not fall asleep prior to the scope being introduced into the mouth. They, however, will usually be much calmer and will be able to continue with the procedure.
In an unsedated scope, the patient is not given any medication prior to and during the procedure and thus is fully awake. The most uncomfortable part of the procedure is when the scope is passing from the back of the throat into the food pipe. Once this step is over, the scope is much more bearable. The most important thing for patients to remember is to focus on breathing slowly as this helps reduce the sensation of gagging. The advantage of doing a scope unsedated is that you do not have to wait for the sedation to wear off and can leave the endoscopy centre almost immediately.
Will the scope be painful?
The scope should NOT be painful. Patients may have a little sore throat after the scope but usually no more than this. The scope is introduced into the food pipe by direct visualization. Tissue samples taken will also not be painful. If you have significant pain after a scope, then you should seek medical advice in case of complications.
What are the possible complications?
Scopes are very safe, common procedures. In some of the big hospitals, hundreds of endoscopies are performed every day. Patients who are comfortable and relaxed, regardless of sedation or not, usually undergo a quicker procedure with clearer endoscopic pictures and a lower chance of complications.
Complications usually come from the two areas of sedation and the procedure. Patients may suffer an allergic reaction to the sedative drugs or develop low blood pressure. Medication is usually given slowly in a stepwise fashion to minimize this happening. The complications of the scope include bleeding and perforation although these risks are rare.
Usually, they are more common where the scope is not a straightforward diagnostic procedure but one where intervention is required, like removing an early gastric cancer. The more complex procedures require substantially more planning and are done only after a diagnostic scope has identified the problem and consultation with the patient. Major complications from a diagnostic scope occur in less than 1 in 1000 cases.
What else should I know?
If you are unsure of the indication for the scope or do not want to undergo the procedure, or need more information, then you should speak to your doctor. There are alternatives to endoscopy although they may not be as accurate as the scope. If the non-invasive tests do show a lesion, then you will need to undergo a scope to properly evaluate the finding.