2.8 Gastroscopy

During gastroscopy the doctor can clearly view the inside of the oesophagus, stomach and duodenum (first portion of the small intestine) and take tissue biopsies (samples) if necessary. The stomach should be completely empty when performing this examination. The physician guides a thin, tubular instrument (endoscope) through the patient’s mouth and into the stomach. Air is pumped carefully into the stomach so that the stomach wall structures can expand and any disease-mediated changes can be seen more easily. At the end of the endoscope is a mini-camera enabling the doctor to inspect carefully the inside of the stomach and intestines. Using special working channels integrated into the endoscope, he can introduce small instruments into the stomach and take tissue samples. Thanks to the use of modern instruments with a soft tube and tiny camera as light source, this examination is scarcely unpleasant. But if the patient is anxious about undergoing gastroscopy he/she can take a mild sedative or, if desired, an anaesthetic so that as a rule the procedure is relaxed and painfree.
Gastroscopy is used primarily to investigate for the presence of hiatal hernias. It enables the doctor to distinguish between a sliding hernia with reflux of gastric acid into the oesophagus (reflux disease) and a paraesophageal hernia where a portion of the stomach is pushed up into the chest cavity. [For information on the various types of hiatal hernia, please see “What types of hernias are there?”.] An exact diagnosis is urgently needed here to decide on optimal surgical treatment.