UPPER GASTROINTESTINAL ENDOSCOPY

An upper gastrointestinal endoscopy is done to investigate symptoms such as upper abdominal pain, swallowing difficulties, heartburn, anaemia, vomiting, nausea, weight loss, early satiety and gastrointestinal bleeding and is vital for diagnosing diseases of the oesophagus, stomach, and duodenum. The doctor inserts a flexible, narrow tubular video camera via the mouth and throat into the oesophagus, stomach and duodenum to examine the inner lining of the upper GI tract and take biopsies for testing for various diseases.

Gastroesophageal reflux disease (GERD) occurs when the lower oesophageal sphincter weakens and allows gastric acid to reflux into and injure the distal oesophageal epithelium, resulting in heartburn.

Gastritis is the term that describes inflammation of the gastric mucosa. Helicobacter pylori, a bacteria that have adapted to living in the acidic stomach, is the most common cause of gastritis. Other causes are ingested chemicals, especially medications like aspirin and non-steroidal anti-inflammatory drugs that damage the mucosa. Gastritis can cause ulceration, which can lead to chronic pain, or perforation or severe bleeding that can be life-threatening.

Coeliac disease is a very rare disease caused by an allergic reaction to gluten, a protein found in wheat. It results in malabsorption due to damage to the mucosa of the small intestine. Sticking to a gluten-free diet assists people with coeliac disease who experience persistent long-term digestive problems. It is diagnosed by upper gastrointestinal endoscopy, biopsies for histology of duodenal mucosa and blood tests for specific antibodies.

How an upper GI endoscopy is performed

In preparation for an upper GI endoscopy, patients will not eat or drink fluids at least eight hours before the procedure. Dr Stapleton will review the patient’s medical history, previous surgeries completed, allergies, vitamins and supplements before performing the upper endoscopy. A local anaesthetic spray numbs the patient’s throat and some intravenous drugs are administered to sedate the patient for the short duration of the investigation.

The doctor inserts the endoscope into the oesophagus, down into the stomach and duodenum. During the procedure, the surgeon pumps air into the stomach and duodenum to distend it to allow a thorough examination. The camera projects images to the monitor in the endoscopy room.

After an upper gastrointestinal endoscopy

The patient will experience slight grogginess after the upper GI endoscopy and should not drive a vehicle, operate dangerous equipment, sign important documents or engage on social media for at least 6 hours after the sedation. The patient will wake up within 15-30 minutes when they will be given coffee or tea and a snack, after which he or she will be allowed to go home, escorted by a family member or friend.

DR GRAHAM STAPLETON

Dr Graham Stapleton is registered with the Health Professions Council of South Africa as a General Surgeon.

He specialises in liver and pancreatic surgery, with particular emphasis on removal of tumours of the liver and pancreas as well as other gastrointestinal cancers. He also supervises palliative treatments such as endoscopic and percutaneous stenting of obstructed bile ducts for those patients whose cancers are advanced and not resectable.

+27 (0) 21-6716181

+27 (0)82-569-4427

1406 Netcare Christian Barnard Memorial Hospital
Cnr DF Malan Street & Rua Bartholemeu Dias Plain
Foreshore, Cape Town, 8001