What Are The Different Types of Upper GI Endoscopy?

Gastric endoscopy or upper gastrointestinal (GI) endoscopy is a diagnostic procedure that visualizes the upper part of the gastrointestinal tract down to the duodenum. It is a minimally invasive test performed by using a long, flexible tube called an endoscope. This tube has a tiny light and camera on one end to create video images of the esophagus, stomach, and duodenum on the monitor. A gastro-surgeon can also do upper GI endoscopy for therapeutic purposes and for obtaining tissue samples or biopsies.

How is Gastric endoscopy performed?

The patient is generally given a topical anesthetic by spraying it to the throat to numb it before the procedure. Any dentures or plates worn by the patient are removed simultaneously. Some patients are given a sedative via an intravenous needle in the arm, although this is subject to the consent obtained from the patient. Following this, the patients will be asked to lie on their side with the head resting comfortably on the pillow. A mouthguard is then placed between the teeth to prevent the patient from biting the endoscope. The endoscope is then gently maneuvered into the esophagus and down the stomach and duodenum. A small camera mounted on the endoscope will send the video images of the upper GI tract to a monitor while the tube is being pushed. It allows for the close examination of the lining of the upper GI tract. Usually, the endoscope pumps air into the stomach and duodenum to make it easier to see. Sometimes, small biopsy samples are taken with the help of the endoscope itself. For this, a pincer or biopsy forceps is passed through the scope to sample 1 to 3 mm pieces of tissue. Once the procedure is completed, the air in the stomach is aspirated, and the endoscope is removed. Still, photographs are usually taken during this diagnostic test to explain the findings to the patient later on.

Why is Gastric endoscopy performed?

Gastric endoscopies are usually done for the following purposes –

Unexplained symptoms

Identifying the cause of unexplained symptoms of the following conditions –

Unexplained anemia
Persistent dyspepsia
Heartburn
Persistent vomiting for unknown reasons
Unexplained weight loss
Upper chest pain or belly pain that is not related to the heart
Dysphagia (Difficulty in swallowing)
Odynophagia (Painful swallowing)

Diagnostic purposes –

Upper gastrointestinal bleeding
Chronic acid reflux
Gastroesophageal reflux disease (GERD)
Benign or malignant tumors of the upper GI tract (via biopsy)
Blockages in the upper GI tract
Crohn’s disease of the upper GI tract
Celiac disease (via biopsy)
Infections of the upper GI tract
Esophageal varices (more prominent than normal veins in the esophagus)
Inflammation and sores of the upper GI tract

Therapeutic purposes –

Treatment of esophageal varices and control of bleeding from ulcers
Removal of polyps or outgrowths
Removal of foreign objects that patient may have ingested
Dilating or opening up narrowed areas with a small balloon that is passed via the endoscope
Tamponade of bleeding esophageal varices with a balloon
Place feeding tubes or drainage tubes

Surveillance purposes –

Surveillance of gastric ulcer or duodenal ulcer
Check the stomach and duodenum after surgery

What are the different types of gastric endoscopies?

The different types of gastric endoscopies are as follows –

Esophagoscopy – It is a type of endoscopy that is done by inserting the endoscope into the mouth to identify the cause of the abnormal throat, stomach, or intestinal symptoms. Gastroscopy (Upper GI endoscopy) – This test is used to diagnose stomach ulcers, GERD, and the treatment of bleeding ulcers, polyps, or small cancerous tumors.
Enteroscopy – This test is commonly performed to detect problems in the small intestine or stomach, such as blocked bowel passages, unexplained diarrhea or malnutrition, or a high white blood cell count.
Duodenoscopy – It is a diagnostic test that is used for seeing the duodenum and aids in the diagnosis and treatment of gallstones, pancreatitis, and tumors of the bile ducts.
Colonoscopy – This test is used to examine the large intestine to screen for colorectal cancer and find the reason for unexplained weight loss, chronic constipation, or diarrhea.

Are there any risks involved in Gastric endoscopy?

Upper GI endoscopy is commonly associated with a sore throat and bleeding at the site where the surgeon removed the tissue or polyp, although this usually stops without any treatment. Other complications that are rarely seen are perforation in the lining of the upper GI tract, aspiration pneumonia, cardiopulmonary problems, and abnormal reaction to the sedative.

FAQs:

What are preparations required from the patient? The patient is instructed not to eat or drink anything for up to 8 hours before the procedure. They should also review their medical history and all prescribed and over–the–counter medicines with the physician and stop taking them if advised to do so. The patient is often recommended to arrange for a ride home after the procedure as the sedatives need time to wear off.

How long does it take? It usually takes between 15 to 45 minutes to get an upper GI endoscopy done, depending on the test’s purpose.
Who performs it? A gastroenterologist will generally do an upper GI endoscopy in a GI clinic or hospital.
How much does it cost? It costs around INR 1000 to 3000 to get an upper GI endoscopy done in India.
When can I go home after the procedure? The patient is often asked to stay at the hospital or clinic for 1 to 2 hours after the procedure so that the sedative wears off. After this, they are allowed to go home and rest for the rest of the day. If a sedative was not used for the endoscopy, the patient could go home immediately after the test.