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Gastroscopy

Dr Thng Yongxian

Hepatopancreatobiliary & General Surgeon
MBBS • MMed • MRCS (IRE) • FRCSED • FAMS

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What Is Gastroscopy?

Gastroscopy, also known as upper endoscopy, is a diagnostic procedure that views the upper part of the gastrointestinal tract, including the oesophagus, stomach, and duodenum. This procedure uses a thin, flexible tube equipped with a light and camera, called a gastroscope, inserted through the mouth and down the throat.

 

Gastroscopy is used to diagnose conditions such as stomach ulcers, gastritis, and celiac disease and to identify causes of abdominal pain, persistent nausea, or dysphagia (difficulty swallowing). It can also be used to treat certain conditions, such as bleeding ulcers or removing swallowed objects.

Indications for Gastroscopy

Gastroscopy is recommended for various diagnostic and therapeutic reasons. Here are the primary indications for undergoing this procedure:

Diagnostic Assessment

Gastroscopy is often performed to investigate symptoms such as persistent upper abdominal pain, nausea, vomiting, difficulty swallowing (dysphagia), or bleeding in the digestive tract. It helps diagnose conditions like gastritis, peptic ulcers, and celiac disease.

Surveillance

Patients with a history of gastrointestinal diseases, such as Barrett’s oesophagus or early-stage gastric cancer, may undergo regular gastroscopies to monitor their condition and assess the effectiveness of treatments.

Therapeutic Procedures

Gastroscopy treats certain conditions directly, such as removing foreign objects, cauterising bleeding vessels, and performing polypectomy (removal of polyps).

Preoperative Evaluation

It may be used to obtain visual confirmation and biopsy before surgeries for known gastrointestinal conditions.

Preparing for a Gastroscopy

To ensure a successful gastroscopy, follow these preparation steps:

Fasting

  • Avoid eating or drinking for at least 6 to 8 hours before the procedure to clear the stomach.

Medication Adjustments

  • Discuss all medications, as some may need to be paused or adjusted for the procedure.

Pre-Procedure Instructions

  • Follow specific instructions regarding timing and what to bring.

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The Gastroscopy Procedure

Gastroscopy is a precise, structured procedure that examines the upper gastrointestinal tract. The following describes a typical gastroscopy procedure:

Arrival and Preparation

Upon arrival at the clinic or hospital, patients complete any final paperwork and are prepared for the procedure, which includes changing into a hospital gown.

Sedation

A sedation is administered to help the patient relax and minimise discomfort during the procedure. Some patients might receive a local anaesthetic sprayed into the throat to numb the area.

Insertion of the Gastroscope

The gastroscope is gently inserted through the mouth and advances down the oesophagus into the stomach and duodenum. The camera at the tip of the gastroscope transmits video to a monitor, allowing examination of the lining of these organs.

Examination and Intervention

The mucosal lining is inspected, and interventions are performed if needed, such as taking biopsies, removing polyps, or treating bleeding sources. This is done using tiny instruments passing through the gastroscope.

Withdrawal of the Gastroscope

Once the examination and any necessary treatments are complete, the gastroscope is carefully withdrawn. This part of the procedure usually causes no discomfort.

Recovery and Aftercare

After a gastroscopy, attention to recovery and aftercare ensures a smooth transition back to normal activities. Here’s what patients can typically expect:

  • Post-Procedure Monitoring:
    Immediately following the procedure, patients are monitored in a recovery area until the effects of the sedation wear off. This usually takes about an hour.
  • Diet and Hydration:
    Patients are often encouraged to start with sips of water and gradually progress to more solid foods as they feel comfortable. It’s important to avoid alcohol for at least 24 hours after receiving sedation.
  • Throat Discomfort:
    Some throat soreness or discomfort is common after a gastroscopy due to the insertion of the gastroscope. Lozenges and warm drinks can help soothe the throat.
  • Activity Level:
    Patients should plan to rest for the remainder of the day following the procedure. Normal activities can typically be resumed the next day unless advised otherwise.
  • Observing Symptoms:
    Watch for signs of complications such as severe abdominal pain, fever, difficult or painful swallowing, or bleeding (including vomiting blood or blood in the stool). These symptoms require immediate medical attention.

Dr Thng Yongxian

Senior Consultant

HEPATOPANCREATOBILIARY & GENERAL SURGEON

MBBS (SG) • MMed (Surg) • MRCS (Ire) • FRCSEd (Gen) • FAMS (Surg)

Dr Thng Yongxian is a dual fellowship-trained Hepatopancreatobiliary & General Surgeon who has performed over 6000 surgical procedures.

  • Bachelor of Medicine & Bachelor of Surgery
  • National University of Singapore
  • Membership of the Royal College of Surgeons, Ireland
  • Master of Medicine, General Surgery, Singapore
  • Fellow of the Royal College of Surgeons, Edinburgh
  • Fellow of the Academy of Medicine, Singapore

He pursued his subspecialty training in Hepatopancreatobiliary surgery first in the Department of Hepatopancreatobiliary Surgery, Singapore General Hospital. Following this, he completed a clinical fellowship in Minimally Invasive Hepatopancreatobiliary Surgery at Seoul National University Hospital in Bundang, South Korea.


Dr Thng set up and pioneered the Minimally invasive surgery program for his hospital in complex liver and pancreas cases. His surgeries were featured on live national television. His surgical videos have also been presented at international surgical conferences. He also pioneered the use of capsule colonoscopy for colorectal screening.


Dr Thng has served on various committees at hospital, cluster and ministry level. Dr Thng served as a member of the Ministry of Health (MOH) Laparoscopic cholecystectomy Clinician workgroup for value-driven care (VDC).

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Nexus Surgical @ Mt. Alvernia

Nexus Surgical @ Mt. Elizabeth Orchard

Nexus Surgical @ Mt. Elizabeth Novena

Nexus Surgical @ Parkway East

Nexus Surgical @ Gleneagles Medical Centre

Nexus Surgical @ Mt. Alvernia

Nexus Surgical @ Mt. Elizabeth Orchard

Nexus Surgical @ Mt. Elizabeth Novena

Nexus Surgical @ Parkway East

Nexus Surgical @ Gleneagles Medical Centre

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