What is it about ?
A gastroscopy is an examination that allows you to see ‘live’ the lining of the esophagus, stomach and the first part of the duodenum. To do this, the doctor uses an endoscope. It is a thin flexible tube, the end of which is equipped with a small camera and which is introduced through the mouth. Some treatments can also be done in this way.
It is also possible to take pieces of tissue (biopsies) during this examination. These biopsies are then examined under a microscope to look for possible bacteria or malignant cells.
When is the examination indicated?
Not all stomach problems require a gastroscopy. In people under 50-55 years of age with heartburn, regurgitation or bloating, a trial treatment with antacids from the proton pump inhibitor (PPI) class is usually started. for 4 weeks. It is also the first step when complaints are caused by drugs such as anti-inflammatory drugs.
The examination is necessary for the diagnosis of diseases of the stomach and esophagus, for monitoring the effect of treatment and for certain local procedures.
For the diagnosis of a condition in:
- people under 50-55 years of age who experience stomach heaviness after a meal, a feeling of rapid fullness, or heartburn or pain (dyspepsia), in whom the breath test did not show Helicobacter pylori, and who are not relieved by the trial treatment.
- people over 50-55 years of age with persistent stomach pain such as heartburn and acid regurgitation.
- people with warning symptoms or a medical history such as vomiting blood or some black stools (melena), difficulty swallowing (dysphagia), a unexplained weight loss, a anemia of unknown origin, history of ulcers, excessive consumption of anti-inflammatory drugs, excessive consumption of alcohol and unexplained chest pain.
For the follow-up of:
- the effect of treatment for an esophageal ulcer, for some stomach ulcers and for inflammations of the esophagus.
- patients who have other underlying conditions such as damage to the digestive tract due to gluten intolerance, a stomach cancer or cancer of the esophagus.
For certain interventions, such as:
- removal of polyps and tumors.
- stopping bleeding and ligation of varicose veins.
- dilation of strictures.
- placing a probe in the stomach for artificial feeding.
How is the exam conducted?
Ideally, the examination should be performed on an empty stomach. You should therefore preferably not eat anything since the night before. A light, low-fiber meal, for example a little jam on toast white bread or a rusk, is still allowed up to 5 hours before the exam.
You will need to stop certain medications before the test. Ask your doctor for advice.
The doctor will usually anesthetize your throat locally with a spray. People who are very nervous or anxious are sometimes given an injection of midazolam, which produces (light) anesthesia for about 15 minutes.
After the exam, you can simply go home. Driving after the exam is not recommended, especially if you have received anesthesia.
It is advisable not to drink or eat anything for 2 hours after the exam. Because your throat is asleep, food and drink may pass through your windpipe without you noticing.
What can your doctor do?
A gastroscopy may show inflammation, strictures, ulcers, and tumors in the esophagus. Sometimes it shows streaked areas, covered with cells that can develop into malignant cells. This is called a Barrett’s esophagus.
The doctor may also detect a hernia in the stomach (hiatal hernia). This hernia is not necessarily accompanied by symptoms. Also in the stomach, the doctor may also see ulcers, tumors and lesions that bleed. Sometimes the lining of the stomach is pale and thinner (atrophy). This may be the case in people who have problematic alcohol use. In this case, a blood test will be performed to identify a lack of vitamin B12.
If the doctor sees bile reflux to the stomach, this is usually not a problem.
Finally, the doctor may see inflammation, ulcers, tumors or deformities of the junction between the stomach and the small intestine, at the level of the duodenum.
What can you do ?
Prepare properly for the exam. Preferably be on an empty stomach since the night before; if you have a full stomach, the doctor will not be able to see much.
To prevent stomach and esophageal diseases, choose a Healthy eating and avoid very spicy dishes. Don’t drink too much alcohol, coffee, or sparkling drinks if you are sensitive to them. Avoid foods that trigger complaints. Try to lose weight if you are overweight and stop smoking. It is also advisable to eat smaller meals and chew well. Take the time to eat.
What can your doctor do?
It all depends on the results of the exam. Inflammation is usually treated with antacids from the class of proton pump inhibitors (PPIs) (eg omeprazole). In case of bacterial infection (Helicobacter pylori), a combination of 2 antibiotics is also prescribed in addition to antacids. The combination of these 3 drugs cures 96% of infections.
If the doctor sees a suspicious lesion, he will take a biopsy. If the lesion is malignant, an intervention will usually be scheduled.
If you think of a lack of vitamin B12 or a gluten intolerance, a blood test is usually done.
A gastroscopy is usually done after treatment to check that the disease has healed.
Find out more
- Stop smoking. It’s possible – Tabacstop – Foundation against cancer
- The food pyramid – Eat Move – Health Question
- Non-steroidal anti-inflammatory drugs – CBIP – Belgian Center for Pharmacotherapeutic Information
- Proton pump inhibitors – CBIP – Belgian Center for Pharmacotherapeutic Information
Are you looking for more specialized help?
- Smoking Assistance Center (CAF®) – FARES – Respiratory Affections Fund
- Tobacco specialists – FARES – Respiratory Affections Fund
- Find a registered dietitian – Professional Union of French-speaking dieticians
- Find a nutritionist doctor – Belgian Society of Nutritionist Doctors
- Alcohol aid – Le Pélican & Le center ALFA
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