What are the alternatives to a gastroscopy (OGD)?

Written by: Professor Laith Al-Rubaiy
Published: | Updated: 25/05/2020
Edited by: Cameron Gibson-Watt

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 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.

Professor Laith Al-Rubaiy

By Professor Laith Al-Rubaiy
Gastroenterology

Dr Laith Al-Rubaiy is an award-winning consultant gastroenterologist and hepatologist who is part of the GI Doctors group in London. He specialises in alcoholic liver disease, acid reflux, irritable bowel syndrome, inflammatory bowel disease, endoscopy, colonoscopy and diverticular bowel disease.

After finishing medical school with "distinction", Dr Al-Rubaiy won two highly-competitive scholarships to complete his postgraduate medical studies at the State University of New York and then at King’s College London. He was then awarded a prestigious fellowship to pursue his clinical academic training in Wales, which lead to his accreditation in hepatology, gastroenterology and general medicine. Part of his advanced hepatology training was at the Royal Free Hospital in London.

Dr Al-Rubaiy was awarded his PhD from Swansea University School of Medicine. He has received 12 grants and two highly-competitive scholarships throughout his medical career. He was awarded the " Young Gastroenterologist of the Year" by the British Society of Gastroenterology (BSG) in 2017.

He is a reviewer for a number of international journals and has authored several peer-reviewed publications. Dr Al-Rubaiy is an elected committee member for the British Society of Gastroenterology.


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