Gastroscopy

Gastroscopy is an endoscopic examination of the upper gastrointestinal tract to examine the lining of the oesophagus, stomach and duodenum.

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When should you decide to undergo a gastroscopy?

Gastroscopy allows direct examination of the lining of the oesophagus, stomach and duodenum, the taking of tissue samples (or biopsies) for microscopic examination, and the diagnosis of a wide range of diseases. Problems with the oesophagus and stomach, and occasional abdominal pain are very common among people and not every symptom means that an examination is needed. However, if the symptoms are prolonged and recurrent, we should not delay too long as this can be a serious condition that needs treatment as soon as possible.

More about examination

Gastroscopy (oesophago-gastro-duodenoscopy) is an endoscopic examination of the upper gastrointestinal tract that allows the doctor to examine the oesophagus, stomach and duodenum using a flexible instrument with a camera and light source. During the examination, the doctor may take tissue samples for further tests, such as to determine whether you have Helicobacter pylori infection (urease test) or to analyse the tissue under a microscope (histological examination). The examination usually takes a few minutes. It can also be performed under sedation.)

Course and duration of examinationn

Gastroscopy in a lying position on the left side. The throat is numbed with a local anaesthetic before the examination, which makes it easier to tolerate the examination and relieves the pharyngeal reflex during the insertion of the gastroscope through the mouth into the oesophagus. You can breathe normally through your nose or mouth during the examination. The whole procedure usually takes a few minutes, including taking tissue samples (biopsy). When examined, the patient feels no pain, just a feeling of air or bloating in your stomach, but you may also have a feeling of discomfort in your throat, a transient feeling of eructation or an urge to vomit. After the examination, you may feel slightly bloated due to the air blown into the stomach during the examination to help the mucosa become more visible.)

Preparation for the examination

You should be fasting for 6–8 hours before the gastroscopy, as your stomach must be completely empty for the examination to be carried out safely and successfully. You can drink water in sips and take any medicines you take regularly, except for diabetes medication. If you are taking anti-clotting medication, consult your doctor. Also tell your doctor if you have allergies to medicines or blood clotting disorders (e.g. haemophilia).

Frequently asked questions

Long-standing or recurrent heartburn, reflux and eructation, stomach pain, epigastrium pain.
Difficulty swallowing (dysphagia), food sticking, pain when swallowing.
Signs of gastrointestinal bleeding: vomiting blood, black stools, positive test haemorrhage in the digestive tract (if large intestine pathology is excluded).
Unintentional weight loss or unexplained digestive problems, suspected coeliac disease.
Suspected gastric, duodenal, oesophageal ulcers.
Suspected tumours of the stomach, oesophagus, duodenum.
Follow-up for changes in the gastric mucosa, regular follow-up if gastritis is accompanied by metaplasia or atrophy of the gastric mucosa.
Monitoring of oesophageal disease: In case of advanced oesophageal reflux disease, Barrett's oesophagus, eosinophilic oesophagitis.

Yes, you should be fasting before the gastroscopy, which means that you should not eat for 6–8 hours before the examination. The last meal should be light, preferably cooked, easily digestible and low in fat. You can drink water on the day of the examination, and only in sips for the last three hours. Avoid fatty and fast foods, as these can linger longer in the stomach and interfere with the examination.

Gastroscopy is mainly performed in the morning and early afternoon as it needs to be performed on an empty stomach.

The gag reflex can make the examination uncomfortable. It is more difficult for individuals with a sensitive throat and a strong gag reflex to tolerate the examination. If you prefer, you can have the examination under sedation, but this must be arranged in advance with the appointment scheduling service. It is best to arrange the sedation as soon as you schedule your appointment. You can learn more about sedation options and forms of sedation on our website.

Prepare details of known medication allergies, a detailed list of the medications you regularly take, and any previous endoscopic and histopathological findings.

Taking diabetes medication should be temporarily adjusted. On the day of the examination, when on empty stomach, you should not take your diabetes medication. If you have an insulin pump, control your blood sugar and reduce insulin accordingly. You will usually be able to eat a meal about 1 hour after the examination. Please consult your personal doctor or diabetes outpatient clinic for more detailed advice on how to adjust your treatment.

If you are taking blood-thinning medications, we can perform an endoscopic examination, but it is not always possible to take tissue samples. Therapy with Aspirin 100 does not need be interrupted except in the case of major therapeutic procedures. For anticoagulant therapy (Pradaxa, Xarelto, Eliquis, Roteas, Marevan medications), consult your doctor or an anticoagulant clinic to see if and how you can discontinue treatment. Before the test, we need to know exactly which blood-thinners you are taking and at what dose, and when you took your last pill before the test. If you are receiving Marevan and treatment has been interrupted, you will also need a fresh PT and INR, as well as an anticoagulant clinic test result.

Before the examination, you and your doctor will complete and sign a medical consent form. If you have any further questions about how the examination is carried out or what the risks might be, you can discuss these with your doctor.