When is a gastroscopy needed?

Stomach problems rarely begin with a single, clear complaint. Initially, it might be a feeling of heaviness after eating, early satiety, acid reflux, morning sickness, or pain, easily attributed to diet and stress. People change their diet, buy heartburn medications, tolerate the heaviness, and hope it's temporary. At this point, a request for a gastroscopy at the SM-Clinic in Podolsk is usually driven by a desire to finally understand the cause of the complaints.

Gastroscopy allows the doctor to examine the esophagus, stomach, and the first part of the duodenum. A thin, flexible endoscope allows the doctor to see inflammation, erosions, ulcers, signs of bleeding, polyps, stenosis, and other changes. If necessary, samples are taken for analysis during the procedure.

The main value of the procedure is its accuracy. Tests, ultrasound, and pain descriptions are helpful, but they don't reveal the mucosa from the inside. Therefore, if symptoms are persistent or worrisome, the doctor may recommend an endoscopic examination rather than another change in medication.

What complaints may lead to an examination?

The most common cause is pain or discomfort in the upper abdomen. It can occur on an empty stomach, after eating, at night, or after drinking coffee, alcohol, spicy foods, or medications. The nature of the pain cannot reliably differentiate gastritis from an ulcer, reflux, or other cause.

Heartburn and acid reflux require attention if they occur frequently, interfere with sleep, recur after stopping medications, or are accompanied by pain. It's important for a doctor to determine whether the esophagus is affected, whether there is inflammation, erosion, or reflux complications.

Nausea, repeated vomiting, a feeling of fullness after a small meal, loss of appetite, and early satiety are other reasons to seek medical attention. These symptoms can be functional, but are sometimes associated with inflammation, obstruction, ulcers, or mucosal changes.

Disturbing signs

There are situations when a gastroscopy is needed not as a routine examination, but as part of a more urgent diagnostic process. These include symptoms that may indicate bleeding, ulceration, esophageal stenosis, or another condition requiring prompt treatment.

These symptoms include vomiting blood, black, tarry stools, increasing weakness, pallor, unexplained weight loss, persistent vomiting, and difficulty swallowing. Anemia is assessed separately if it is detected by tests and has no clear cause.

If you experience these symptoms, it's best not to self-medicate. Painkillers, heartburn medications, and folk remedies may temporarily improve the sensation but not address the underlying cause. They can sometimes increase the risk of complications.

You should see a doctor as soon as possible if you experience the following symptoms:
• vomiting with blood or dark clots appears;
• the stool became black, sticky, with a sharp unusual odor;
• pain in the upper abdomen intensifies, wakes you up at night, or is combined with vomiting;
• food gets stuck, swallowing becomes painful or difficult;
• weight is reduced without intentional dietary restrictions;
• weakness and dizziness appeared along with stomach complaints.

When an examination is scheduled

A routine gastroscopy is appropriate if symptoms persist for a long time or return after treatment. For example, a person may take heartburn medications, experience temporary relief, but then the symptoms recur. In this situation, the doctor needs to see the mucosa, not just rely on a description.

The examination may be prescribed if peptic ulcer disease, chronic gastritis, esophagitis, reflux complications, polyps, or changes following stomach surgery are suspected. Sometimes the procedure is necessary to monitor an existing condition.

Gastroscopy may also be necessary before certain treatments. If long-term use of medications that affect the gastric mucosa is planned, or the cause of anemia needs to be clarified, the doctor will compare the patient's symptoms, test results, and physical examination.

What does a gastroscopy show?

During the examination, the doctor evaluates the color, texture, and integrity of the mucosa. Redness, swelling, erosions, ulcers, scars, blood, reflux, narrowing, and polyp-like formations are visible. This helps distinguish superficial changes from those that require further investigation.

If necessary, a biopsy—a small tissue sample—is taken for laboratory testing. This doesn't necessarily mean the doctor suspects a dangerous process. A biopsy helps clarify the nature of the inflammation, examine specific areas of the mucosa, and assess changes that cannot be discerned by appearance alone.

Sometimes, gastroscopy is used for therapeutic purposes: stopping minor bleeding, removing some polyps, and widening narrowed areas as needed. But more often, the procedure is used for diagnostic purposes, to avoid blindly treating pain, heartburn, or nausea.

After the examination, the report may describe:
• condition of the esophagus, stomach and duodenum;
• presence of inflammation, erosions, ulcers, scars or polyps;
• signs of bleeding or traces of previous injury;
• areas from which material was taken for analysis;
• recommendations for further examinations or follow-up consultation.

How to prepare and what is important to remember

Typically, you should fast for several hours before a gastroscopy, and only drink as directed by your doctor or clinic. The exact timeframe depends on the duration of the procedure, the type of anesthesia, and the patient's condition. Any history of diabetes, pregnancy, heart disease, allergies, or blood thinning medications will be discussed in advance.

The day before, avoid overloading your stomach with heavy foods and alcohol. On the day of the examination, it's important to keep any medications you're taking regularly. Your doctor may continue some medications, while temporarily adjusting others, especially if a biopsy is planned or there's a risk of bleeding.

The procedure itself usually takes a short time, but the sensations vary depending on sensitivity, anxiety, and the method of administration. A sore throat, belching, and moderate discomfort are possible. If severe pain, blood, fever, repeated vomiting, or weakness occur after the examination, medical attention is needed.

Gastroscopy is a way to identify the cause of complaints, clarify the diagnosis, and choose treatment without guesswork. This reduces unnecessary medications, repeated attempts, and anxiety around food.