These 2 procedures are commonly performed together as a single examination and is often referred to as an endosocopy. Oesophagoscopy is the examination of the oesophagus, i.e., the tube that connects the back of the tongue and throat to the stomach. Gastroscopy is the examination of the stomach and usually involves the examination of the first portion of the small bowel (duodenum). The examination is usually performed using a flexible tube (endoscope). The endoscope has a light at its tip and images of the lining of the oesophagus, stomach and duodenum are conveyed to a viewing port or TV monitor.

Common indications for this examination include:

• Difficulty or pain on swallowing,
• heartburn,
• vomiting blood (haematemesis),
• anorexia,
• weight loss,
• unexplained anaemia and
• upper abdominal pain including suspected ulcer disease.

Technique and Preparation
The oesophagus, stomach and duodenum should be examined when empty. Therefore no food or oral fluids are given over the preceding 8 hours. A full explanation of the procedure should already have taken place and a consent form signed. Loose fitting jewellery and false teeth are removed prior to the examination. Most examinations are done in a dedicated endoscopy suite as a day case (admission in the morning and discharge by the end of the afternoon). The patient changes into a surgical gown in the endoscopy suite; anaesthetic spray is applied to the back of the throat. The patient is then asked to lie on their side. A short acting sedative is usually administered via a canula in a vein in the back of the hand. Once appropriate sedation has been achieved the endoscope is gently introduced into the mouth and slowly advanced from the back of the throat into the oesophagus and then into the stomach and duodenum. If required, small tissue samples may be taken from abnormal areas by using a small pair of forceps. This is called a biopsy. At the end of the procedure, which usually takes between 10 - 20 minutes, the endoscope is removed. The patient continues lying on their side or in a semi-prone position and returns to an area for observation and recovery. When the patient is alert and normal sensation has returned to the throat, fluids and light food may be taken if the examination has been straightforward.

Discomfort, After Effects and Risks
With adequate sedation and local anaesthetic to the back of the throat, there is relatively little discomfort during this procedure. Some retching may occur after the procedure, and patients will be initially drowsy until the sedation wears off. Small amounts of blood may be brought up if there has been mild damage to the lining of the oesophagus or stomach. There is a small risk of more significant injury to the lining of the oesophagus or stomach (perforation) and therefore regular observation of blood pressure, pulse and temperature are taken after the procedure. If sedation has been administered the patient will need to be accompanied home by a responsible adult. The patient should avoid driving or operating machinery over the next 24 hours.