What are the alternatives to a gastroscopy (OGD)?

The entire gastroscopy procedure is generally very quick. It takes around 5-15 minutes to examine your entire upper gut to help a doctor give you a diagnosis of your gastrointestinal symptoms. While the procedure isn’t at all painful, some people find it rather uncomfortable to swallow a tiny camera attached to the end of a thin wire. So, are there any alternatives and do they work as well?

Dr Laith Al-Rubaiy, a one of our top consultant gastroenterologists from the GI Doctors group in London, explains what a gastroscopy is, what the procedure involves and if there are any other ways to diagnose your bothersome symptoms.

What is a gastroscopy?

Gastroscopy is an examination of the upper gut that consists of the oesophagus (gullet), the stomach and duodenum (part of the small intestine joining the stomach). The procedure involves passing a narrow flexible instrument with a light and a camera on the end through the mouth, into the gullet and then into the stomach and duodenum to examine the lining. Sometimes it is helpful to take a biopsy, which is a sample of the lining.

A small instrument called forceps passes through the gastroscope to ‘pinch’ out a tiny bit of the lining (about the size of a pinhead). This is then sent to a laboratory for analysis.

When would someone require a gastroscopy?

We recommend a gastroscopy when you display symptoms such as difficulty swallowing or persistent stomach pain. This procedure aims to find out the cause of these symptoms and to diagnose problems such as:

• ulcers
• inflammation
• infection
• the presence of helicobacter pylori (bacteria that can cause ulcers, gastritis and gastric cancer)
• coeliac disease (inability to digest gluten)
• cancer (e.g. stomach and oesophageal)

It can also be used to check a previously diagnosed gastrointestinal condition. A similar procedure to a gastroscopy can be used to both diagnose and treat certain symptoms, but this is slightly different and is known as a therapeutic gastroscopy.

Who is suitable for the procedure and who isn’t?

A gastroscopy is a safe procedure and a very good way to investigate your symptoms. However, sometimes it is not safe to have an endoscopy; for example, if you have severe breathing problems, unstable vital signs, unable to lie flat for long periods or you have problems with the digestive tract, then it can make a gastroscopy very difficult to be done.

We have to discuss the suitability of the procedure with each patient. If a gastroscopy is not suitable, we may suggest an alternative investigation.

Are there any alternatives to a gastroscopy?

In some cases, depending on individual factors, there may be alternatives to a gastroscopy. These include:

• A barium meal
• CT scan

A barium meal involves drinking barium liquid, which coats the inside of your oesophagus and stomach, and then having an X-ray. As X-rays can’t go through barium, the outline of your stomach shows up on the X-ray image.

However, you may still need a gastroscopy if any abnormalities are found as samples or biopsies of the gut or polyps cannot be removed during a barium test. Generally, a barium swallow involves radiation and may be less accurate at detecting problems than a gastroscopy.

If you are concerned about anything mentioned in this article, go to Dr Laith Al-Rubaiy’s Top Doctors profile and book an appointment with him.