Gastroscopy—gentle and completely painless

Gastroscopy—don’t worry, you won’t feel anything!

Upper abdominal and stomach pain or complaints in the area of ​​the esophagus are very common. In most cases, a gastroscopy (gastroscopy) is necessary for clarification in addition to an exact survey of the course of the disease. The examination is carried out under sedation with a sleeping pill. So don't worry, you won't feel anything and you will wake up when it's all over!

An empty stomach is a prerequisite for the examination and for a precise assessment. In the gastroscopy, the duodenum (duodenum), stomach and esophagus can be assessed. It is also possible to take tissue samples (biopsies). This represents the decisive advantage compared to a gastric x-ray. The sample is then examined by the pathologist under the microscope and a result is available after several days. This gives you the option of microscopically supporting the diagnosis, which is already described macroscopically during the examination. In addition to gastritis, ulcers and tumors, there are a number of other pathologies that can be diagnosed with gastroscopy. The determination of Helicobakter pylori, a stomach germ that is common and can cause a number of diseases, is a central part of the investigation. If the germ is present and especially if a typical pathology is diagnosed at the same time, antibiotic treatment for 7 days is important to eliminate the helicobacter. With regard to reflux disease (GERD), the main focus is on the transition from the stomach to the esophagus. If there is a diaphragmatic hernia (hiatal hernia), the size and whether it is fixed or sliding is described. An incompetent occlusion system between the stomach and esophagus with or without a diaphragmatic hernia results in visible (GERD—gastroesophageal reflux disease) or invisible (NERD—non-erosive reflux disease) damage due to the backflow of aggressive substances (stomach acid and /or bile), even against gravity . Even if the mucous membrane is macroscopically normal, biopsies are taken from this area, as cell changes (Barrett's) are already present in up to 17%. The Barrett's mucous membrane is a precancerous stage and increases the incidence of later esohagus carcinoma (esophageal cancer) many times over. If cell changes are already visible, after applying vinegar or indigo carmine to enhance the contrast, biopsies are taken from several levels below and above the mucosal border (multilevel biopsies) in order to obtain the most accurate assessment possible. The reflux disease itself can be located in the lower part of the esophagus, but it can also extend far up into the neck area. Adjacent organs such as the lungs, the entire ear, nose and throat area and the oral cavity may even be affected. With clinical suspicion or with typical "transverse grooves" in the esophagus, numerous biopsies are also taken in the middle and upper area in order to exclude so-called eosinophilic esophagitis. Treatment for eosinophilic esophagitis is different from reflux-associated inflammation of the esophagus and is administered according to a specific dietary protocol. Naturally, however, both diseases—eosinophilic esophagitis and reflux disease - can be present at the same time. With a few exceptions, eosinophilic esophagitis is treated as a matter of urgency. Usually, the special diet and the administration of PPIs also lead to a significant improvement in the reflux-associated symptoms, but not in the reflux.

Information on gastroscopy:

  • No specific preparation necessary
  • Please stay sober for at least 6 hours, you can drink clear water until shortly before the examination
  • You can take important medication, such as blood pressure medication Take with a few sips of water up to 2 hours before the gastroscopy. Please note, however, that the absorption of the active ingredient may be incomplete and thus the effect of the drug is inadequate
  • If you want sedation, you must not drive a vehicle afterwards!
  • Please bring any relevant previous findings with you to the examination
  • You do not have to discontinue any coagulation medication for a routine gastroscopy or take any laboratory results with you.

Impedance measurement

The impedance measurement is one of the most modern methods for a quantitative clarification of the reflux disease and is clearly superior to conventional pH metry in terms of information content.