Gastroscopy
Unlike colonoscopy, which is recommended in Austria from the age of 45 for colorectal cancer screening, gastroscopy is not a routine screening examination.
A gastroscopy is generally performed when there are specific symptoms, abnormal findings or a medical indication. These may include:
- Difficulty swallowing
- Heartburn and acid reflux
- Frequent or acidic belching
- Persistent upper abdominal pain
- Nausea or a feeling of fullness
- Unexplained bleeding
- Certain risk groups
- Follow-up examinations for known conditions
How is a gastroscopy performed?
For the examination, you must be fasting so that the stomach is as empty as possible.
Preparation:
- You may eat solid food up to 6 hours before the examination.
- You may drink clear liquids up to 2 hours before the examination, such as water, unsweetened tea or coffee without milk.
- After that, you must remain completely fasting.
At our practice, gastroscopy is usually performed gently under sedation (twilight sleep). This means that you will usually have little or no recollection of the examination. The procedure is therefore generally painless and usually takes around 10–15 minutes.
A thin, flexible endoscope is carefully inserted through the mouth, down the oesophagus and into the stomach and duodenum. A light source and a high-resolution camera at the tip of the endoscope allow the mucous membranes to be examined directly and in detail, making it possible to identify abnormal changes.
Through a working channel, CO₂ and water can be introduced. CO₂ is used instead of air because it is absorbed by the body and exhaled much more quickly. As a result, many patients experience less bloating after the examination.
Water can be used to rinse away mucus or food residue, allowing optimal assessment of the mucous membrane. Special instruments can also be passed through the working channel, for example to take tissue samples (biopsies) or remove small lesions and polyps.
Complications during a diagnostic gastroscopy are rare. As with any medical procedure, you will be informed in detail about the procedure and possible risks beforehand.
What conditions can be diagnosed during a gastroscopy?
1. Gastritis
Gastritis is an acute or chronic inflammation of the stomach lining. Common causes include infection with Helicobacter pylori, certain medications – particularly painkillers – as well as other factors.
Treatment depends on the underlying cause. It may include lifestyle and dietary changes, acid-suppressing medication or, in the case of a Helicobacter pylori infection, targeted antibiotic treatment
2. Reflux disease
In reflux disease, stomach acid or stomach contents repeatedly flow back into the oesophagus. Typical symptoms include heartburn, acid regurgitation or a burning sensation behind the breastbone.
Treatment depends on the symptoms and findings. It may include lifestyle modifications and acid-suppressing medication. In selected patients, surgical treatment may also be considered when medically indicated.
3. Helicobacter pylori
Helicobacter pylori is a bacterium that can colonise the stomach lining. It can cause chronic inflammation as well as gastric and duodenal ulcers and is associated with an increased risk of developing stomach cancer.
If an infection is confirmed, eradication therapy is generally recommended. This involves a combination of several antibiotics and an acid-suppressing medication. The aim is to completely eliminate the bacterium and thereby prevent associated complications and long-term consequences.
4. Hiatus hernia
A hiatus hernia occurs when part of the stomach moves through an opening in the diaphragm towards the chest
A hiatus hernia can be completely asymptomatic, but it may also contribute to symptoms such as heartburn, reflux or occasional coughing.
Treatment depends on the symptoms and the size of the hiatal hernia. In certain cases, surgical treatment may be appropriate.
5. Gastric ulcer
A gastric ulcer is a deeper lesion of the stomach lining. Possible symptoms include upper abdominal pain, nausea or a feeling of fullness. Common causes include Helicobacter pylori infection and certain medications, particularly painkillers.
Treatment depends on the underlying cause and may include acid-suppressing medication. If Helicobacter pylori infection is present, appropriate eradication therapy is required.
