Thanks for the D2D. Unlike colonoscopy, ‘routine’ gastroscopy for general screening is not proven. I typically advise 2 groups of people to go for ‘screening’ gastroscopy.
1. Patients with symptoms that may be due to disorders of the upper digestive tract, as the gastroscopy may be able to diagnose a problem to allow treatment and prevent it from getting worse.
I use gastroscopy to examine the internal lining of the oesophagus, stomach, and duodenum (it's the first and shortest segment of the small intestine), and may obtain tissue biopsies to allow further examination of cellular structures under a microscope by a pathologist.
This allows me to make an accurate diagnosis and recommend the appropriate treatment.
The top 10 symptoms that I perform gastroscopy for include: upper abdominal discomfort or pain, ‘gastric symptoms’, ‘reflux symptoms’, heartburn, chest pain, bloating, belching, nausea, and ‘indigestion’.
2. Patients with increased risk of oesophageal and gastric cancer. This includes patients with certain chronic symptoms or digestive disorders, and patients with family history.
Most general practitioners will be able to advise if a person is at increased risk. In these patients, I use gastroscopy to identify precancerous and cancerous changes. I will incorporate image enhanced endoscopy as the early changes may be difficult to see with routine gastroscopy.
Accurate detection of precancerous changes allows me to determine the patient’s cancer risk in the future, and to plan monitoring of these areas so that they may be removed before developing into cancer.
Precancerous areas and even early cancers can be removed endoscopically with good results and safety, avoiding the need for surgery.
