Gastroscopy

Next review due March 2024

A gastroscopy is a test to look inside your oesophagus (the tube that carries food from your mouth to your stomach), your stomach and the first part of your small bowel (duodenum). You may have a gastroscopy to help find what’s causing your symptoms. You can also have certain treatments during a gastroscopy.

What is a gastroscopy?

A gastroscopy is a type of endoscopy. This means the procedure is carried out using a narrow, flexible tube called an endoscope. This has a light at the end and a camera to allow your doctor to see images of your insides on a screen. You can find out more about what’s involved in our section below: What happens during a gastroscopy?

Other names for a gastroscopy are ‘upper gastrointestinal endoscopy’ and ‘oesophago-gastro-duodenoscopy (OGD)’.

Your doctor may recommend you have a gastroscopy to find out why you’re having certain symptoms. These include:

• indigestion that doesn’t go away with treatment or that returns when you stop treatment; you may have acid reflux or discomfort in your upper tummy
• difficulty when you swallow (food sticking in your oesophagus) or pain when you swallow
• pain in your chest or upper tummy
• being sick (vomiting) repeatedly
• vomiting blood or having very dark tar-like blood in your poo

A gastroscopy helps your doctor to confirm or rule out suspected medical conditions. These include:

• peptic ulcers (in your oesophagus, stomach or first part of your small intestine)
• coeliac disease
• Barrett’s oesophagus
• cancer of the oesophagus
• stomach cancer

Your doctor may take small samples of tissue (a biopsy) during the gastroscopy.

Your doctor can also use a gastroscopy to carry out certain treatments, such as:

• stopping bleeding
• removing small growths
• removing objects which have got stuck in your throat
• widening your oesophagus if it has become narrowed

For more information on this, see our FAQ below: Can my doctor treat my condition during a gastroscopy?

Preparing for a gastroscopy

A gastroscopy is usually done as a day-case procedure in hospital. This means that you’ll be an outpatient and you won't need to stay overnight. Before your gastroscopy, you’ll be given information about what’s involved. This will tell you anything you need to do to prepare for your gastroscopy. It’s important that you follow any advice you’re given. If you don’t, it may not be possible to have the procedure.

Before coming to hospital

The information you get will tell you if you need to stop any regular medicines you’re taking. Some indigestion medicines (called proton pump inhibitors) can mask problems in your oesophagus or stomach. If you take these, you may need to stop them for one or two weeks before your gastroscopy. Your doctor will let you know if they want you to stop taking any indigestion medicines before your procedure.

You must let the hospital team know if you’re taking medicines to thin your blood. These include aspirin, clopidogrel and warfarin. Your doctor will tell you if you should stop taking them for a while. This will depend on which medicine you take and what the gastroscopy will involve. If you continue to take medicines that should be stopped, you may still be able to have a gastroscopy. But you probably won’t be able to have a biopsy or a treatment procedure.

You should arrange for someone to take you home and, if possible, stay with you for 24 hours afterwards.

On the day

Your stomach must be empty during your gastroscopy. This means you shouldn’t eat or drink for four to six hours beforehand. It’s important to follow the advice your hospital gives you.

Tell your doctor about any medicines you’re taking. This includes prescribed medicines and those you buy over the counter.

Your doctor will talk to you about what will happen before, during and after your procedure. They’ll ask if you want to have a local anaesthetic or sedation or both. The local anaesthetic is a spray that numbs your throat area. The sedative will make you drowsy and more relaxed. It’s given as an injection at the start of the procedure.

Ask your doctor to explain the pros and cons of having sedation or local anaesthesia. For instance, you may be more comfortable with a sedative. But if you choose this, you’ll need to have someone to take you home and keep an eye on you afterwards. If you choose to have the local anaesthetic spray, it may feel a little more uncomfortable at the time. But you won’t be drowsy afterwards.

You’ll have the chance to ask questions so that you understand what will happen. Once you understand the procedure and if you agree to have it, your doctor will ask you to sign a consent form.

What happens during a gastroscopy?

A gastroscopy usually takes only five to 10 minutes, though it might take longer. But you should expect to be in the hospital for a few hours. Your gastroscopy will be done by a doctor or a specialist nurse.

You may be asked to take off your shirt or top and put on a hospital gown. If you have any false teeth or you wear glasses, you’ll need to remove them. You can leave contact lenses in.

If you’re having a local anaesthetic, your doctor or specialist nurse will spray the back of your throat. If you're having a sedative, this will be given through a fine tube into a vein in your arm. Your heart rate and oxygen levels will be checked using a sensor attached to your finger.

You’ll be asked to lie on your left side. Your doctor or specialist nurse will place a guard into your mouth to protect your teeth. They’ll then pass the gastroscope through the opening of the guard into your mouth. You’ll be asked to swallow to let the gastroscope pass into your oesophagus and down towards your stomach. This may be uncomfortable for a few seconds, and it’s usual to gag once or twice. The discomfort usually passes quickly.

As the gastroscope passes down, your doctor or specialist nurse watches images on a nearby screen. They will be able to see the lining of your oesophagus, stomach and duodenum. They may put some air down the gastroscope to inflate your stomach, so they can see better.

If needed, your doctor or specialist nurse can pass special forceps down the gastroscope to take a biopsy (a small sample of tissue). They will then send the samples to a laboratory for testing.

You can have some treatments through the gastroscope. For more information, see our FAQ below: Can my doctor treat my condition during a gastroscopy?

What to expect after a gastroscopy

If you had a sedative, you’ll need to rest in a recovery area until the effects of the sedative have passed. You’ll be able to go home when you feel ready, usually after about an hour. You will need someone to drive you home.

If you had a local anaesthetic throat spray, you won’t be able to eat or drink until it wears off. This usually takes around an hour. After that you can eat normally.

Before you leave the hospital, you’ll be given advice about your recovery. This will include what to do if you have any problems. It’s OK to ask questions if you have any concerns.

Your doctor or specialist nurse may explain the findings of your gastroscopy to you before you leave. You may find it best to have a friend or family member there to listen too. For example if you had a sedative, because it can affect your memory.

Ask your doctor or specialist nurse how and when you’ll get your results. You may get a date for a follow-up appointment to discuss the findings in more detail. Your results will be sent in a letter to your GP and you should get a copy of this letter. It can take up to two weeks to get results from a biopsy, if one was taken during your gastroscopy.

Recovering from a gastroscopy

After your gastroscopy, you may have a slight sore throat. This can last for one or two days. You can eat and drink as normal from about an hour after your gastroscopy.

If you’ve had a sedative, you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours. It’s best to have a friend or relative stay with you for the first 24 hours, while you rest.

Most people have no problems after a gastroscopy. You should seek medical attention immediately if you:

• cough up or vomit blood (which may look like coffee grounds)
• have blood in your poo or black tar-like poo
• have severe pain in your tummy or pain that gets worse
• have a raised temperature
• have problems breathing

If you have any of these symptoms, tell the doctor you see that you have recently had a gastroscopy.

What are the alternatives to a gastroscopy?

The alternative to a gastroscopy is a test called a barium swallow and meal. For this test, you drink a special liquid which coats the inside of your oesophagus and stomach and shows up on X-rays.

A barium swallow and meal gives less information than a gastroscopy and may miss problems. And it doesn’t let your doctor take a sample of any abnormal tissue they might see. If you have a gastroscopy, your doctor can take a biopsy if necessary.

You can ask your doctor whether a barium swallow and meal would be an option for you.

What are the risks of having a gastroscopy?

As with every procedure, there are some risks when having a gastroscopy.

Side-effects

After having a gastroscopy, you may feel bloated and have some tummy discomfort for an hour or two. And you may have a sore throat for a few days. This is normal.

Complications

Complications are problems that happen during or after a procedure. Very few people have complications from a gastroscopy.

When complications do happen, they may include the following.

• Difficulty breathing or heart problems caused by a reaction to the sedative. This is the most likely complication. Your doctor can treat these issues with medicines.
• Bleeding from where a biopsy is taken or a small growth removed. This may stop on its own. On very rare occasions, you may need an operation to stop the bleeding.
• Damage or tears to your throat, oesophagus, stomach or duodenum. This is rare, but if it happens, you may need an operation to repair the damage.

Complications are more likely if you’re having a treatment during your gastroscopy.

You can ask your doctor how these risks might apply to you.