Upper GI Endoscopy (Gastroscopy)

Acidity that antacids no longer touch. A burning feeling behind the breastbone after every meal. Food that seems to stick on the way down, black stools, or weight falling off without trying. Each of these points to the upper part of the digestive tract, and the quickest way to find out what's happening there is to look.

Upper GI endoscopy (also called gastroscopy or OGD) does exactly that. A flexible tube a little thinner than your little finger, with a light and camera at its tip, is passed through your mouth into the food pipe (oesophagus), the stomach and the first part of the small intestine (duodenum). Through the same tube, the gastroenterologist can take tiny tissue samples (biopsies), test for the stomach infection H. pylori, stop a bleeding ulcer or remove a small polyp.

Most people find it easier than they feared. It takes 10 to 20 minutes, and with sedation many remember little of it. A normal result is useful too. It rules out ulcers, cancer and other structural problems, and lets your doctor treat reflux or indigestion with more confidence.

At Prakash Hospital, upper GI endoscopy is done in the endoscopy suite of our gastroenterology department, using high-definition video endoscopes, with sedation and monitoring. We recommend it only when there's a clear clinical reason, and the same team can treat much of what it finds, including banding of varices from liver disease and removal of swallowed objects.

An endoscopy is usually suggested when symptoms don't settle with first-line treatment, or when warning signs need looking into straight away.

Your gastroenterologist usually explains what they saw soon after the test, once you're awake enough to take it in, and gives you a written report, often with photographs. It describes each part of the upper gut in turn: the food pipe, the stomach and the duodenum.

Common findings include inflammation of the food pipe from reflux (oesophagitis), a hiatus hernia, gastritis, and ulcers in the stomach or duodenum. H. pylori can be detected with a rapid test on a biopsy. Most of these are treated with medicines: acid-reducing tablets, and usually a two-week combination of antibiotics if H. pylori is found.

Biopsy results take several days to about a week. They confirm conditions such as coeliac disease or Barrett's oesophagus (a change in the lining after years of reflux), and they rule cancer in or out. If anything needs a repeat look, such as checking that a stomach ulcer has healed, you'll be told when to come back.