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Esophago/gastro/duodenoscopy


Medical editor Trond Warloe MD
Surgeon
Oslo University Hospital

General

Esaphago-gastroduodenoscopy (also called upper gastrointestinal scopy) is an examination of the esophagus, stomach, and duodenum.  The examination is carried out by means of a gastroscope, which is a flexible tube equipped with a camera on the end, a light system, and one or two work canals. The mucosa can be inspected and the images are transferred to a monitor.  

During a scopy, the following can also be carried out:

  • biopsy
  • polyp removal
  • treatment for bleeding
  • injection of medication
  • laser treatment of lesions 
  • dilatation of the esophagus

The examination is simple and is carried out at most hospitals. It is important the stomach is empty before the exam.

Indications

  • Diagnose changes in the mucosa (soreness, inflammation, benign or malignant tumors)
  • Monitor a sore in the stomach/duodenum
  • Find source and treat acute bleeding in the upper gastrointestinal tract. 

Goal

  • Diagnose and possibly definitive treatment

Equipment

  • Gastroscope with equipment for biopsy and treatment.

  • Preparation

    Before the examination:

    • Anamnesis:
      • With known valve defect, endocarditis prophylaxis should be considered. 
      • Diabetes requiring insulin should be treated according to guidelines. 
      • Anticoagulation or antiphlogistic drugs should be stopped 5 days before the examination.
    • The stomach should be empty.
    • The patient should fast, starting 6 hours before the examination. Clear fluids are allowed up to 2 hours before the examination.
    • Daily medications can be taken the same day with a sip of water.

    The day of the examination:

    • Premedication with local anesthetic in the pharynx.
    • Possibly general anesthesia.

    Implementation

    • The gastroscope is inserted in through the mouth, down the esophagus and further down to the stomach and duodenum. How far the scope is inserted depends on which organs are inspected or which organ is suspect of tumor growth.
    • Air is blown in to clear the esophagus/stomach and get a better view during insertion of the scope.
    • The mucosa is inspected for abnormalities.
    • Perform necessary procedure.

    The examination usually lasts around 10-30 minutes.


    Follow-up

    Vomiting, pressure, and bloating are normal discomforts during/after the exam.

    The patient should be observed for:

    • bleeding if a biopsy is taken or polyps are removed
    • vomiting blood, black and tar-like stool, or intense stomach pain. If the patient has returned home, the patient is recommended to contact the hospital immediately.

    The patient may eat/drink 1 hour (at the earliest) after the exam due to the local anesthetic in the throat. For an outpatient exam, the patient may return home after 1-2 hours.

    Tissue sample results are available after 1-4 weeks. Further follow-up and treatment should be scheduled, if necessary.


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