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Upper GI Endoscopy: who should have it, when and why?

By Dr. Siddiq Mohamed Osman Elmalik, Consultant Gastroenterologist at Al-Ahli Hospital / Qatar

Abdominal pain is one of the commonest presentations in emergency department visits. It has many potential underlying causes, ranging from benign, self-limited conditions to life-threatening surgical emergencies. 

The gastroscope is a plastic tube where on top of it, there is a camera which is inserted through the mouth after sedating the patient to the esophagus, stomach and duodenum.  All the patient needs to do before to prepare for the endoscopy is fasting for 8 hours from food and even water.  There is no need to admit the patient to the hospital.  The gastroscopy is done as a day case where they will stay in the Endoscopy Unit for 4 to 5 hours.

Who Should Have It?

Those patients above the age of 50.  They should have done it directly if there is evidence of recent onset of dyspepsia, reflux or abdominal pain.

Those who are less than 50 years old should have the endoscopy if they present with one of the following symptoms:

  • a. Upper and lower GI bleeding.
  • b. Persistent vomiting.
  • c. Dysphagia.
  • d. Anemia.
  • e. Unintentional weight loss.
  • f. Abdominal mass.

Why Do We Do It?

  • To check for gastroesophageal reflux, if it is only acid or bile.
  • To assess the degree of esophagitis.
  • To check if there is hiatal hernia or not.
  • To assess the stomach and check for Helicobacter pylori.
  • To assess the duodenum and take biopsies to rule out inflammation, parasitic infestations, or Celiac disease.

When the equipment and facilities are available and there is good expertise, the OGD is the ideal test for Upper GI diseases, non-cardiac chest pain and recurrent unexplained ENT problems.

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