Gastroscopy (OGD)

Gastroscopy is used to investigate certain digestive symptoms before diagnosing oesophageal, stomach and duodenal diseases. It is also a vital tool for preventing serious complications, including cancer.

When Is a Gastroscopy Needed?

A gastroscopy is often recommended for patients who experience persistent digestive symptoms or have risk factors for stomach and oesophageal cancer. It is both a diagnostic and preventive tool. During the procedure, doctors can detect precancerous areas and remove them, significantly reducing the risk of cancer.

What Symptoms Require a Gastroscopy?

You may be advised to have a gastroscopy if you experience certain warning signs, including:

• Upper abdominal pain or discomfort – persistent or unexplained pain in the upper stomach area.
• Persistent or recurrent nausea and vomiting – frequent digestive upset that does not respond to standard treatment.
• Reflux symptoms – such as heartburn, acidic taste, or irritation in the throat.
• Difficulty swallowing – feeling like food is stuck in the throat or chest.
• Blood in vomit or black stools – signs of bleeding in the upper digestive tract.
• Unexplained weight loss – sudden or significant weight loss without dietary changes.
• Iron deficiency anaemia – low iron levels that cannot be explained by diet alone.

Early identification of these symptoms is crucial. Gastroscopy helps doctors diagnose underlying conditions, guide treatment, and prevent serious complications, including cancer. For patients at high risk, it can detect precancerous areas that can be removed during the procedure to prevent them from becoming cancerous.

You should fast for at least 6 hours prior to your gastroscopy. You may drink clear fluids up to 2 hours before the procedure. Prolonged fasting may be needed if your doctor suspects that your stomach is not completely emptied. 

In general, most medications can be continued before the procedure with the exception of diabetic  medications and blood thinners. Diabetic medications should be omitted during the fasting. You should check with your doctor if your blood thinner needs to be ceased prior to the procedure.

You will be given medication to make you sleepy. Therefore, you must not drive, work or make any important decision after the procedure. A Medical Certificate will be issued and you should rest at home for the rest of the day.

A nurse will conduct final checks, and bring you into the procedure room where an intravenous line will be inserted.

A throat spray will be administered to attenuate the discomfort of the procedure. A plastic mouth piece will be placed between your teeth for dental protection. You will be positioned to lie on your left. Sedation will then be administered. After you have fallen asleep, the procedure will begin. It is likely that you will not remember any parts of the procedure. You will be breathing on your own and monitored closely during the procedure. Once the procedure has completed, you will gradually wake up.

You will be cared for in a recovery room. You will be monitored until you have regained consciousness from the anaesthesia. The nurses will give you food and drink after post-procedure assessments. You should arrange for a family member to take discharge instructions and take you home. You should only resume going to work and/or drive the following day. It is common to have mild sore throat, abdominal discomfort or bloating after a gastroscopy. This usually goes away after 24 hours.

Your doctor will fix an appointment to explain the gastroscopy procedure and findings, including the results of any biopsies taken. He will then discuss the appropriate management plan.

Gastroscopy is a very safe examination. Complications are rare and overall occur in less than 0.1% of cases. These are often due to disease factors. Such complications include tearing of the wall, bleeding and anaesthetic adverse reactions. Unfortunately, emergency surgery or urgent hospitalisation may be required. The risk may be higher in complex cases or those involving interventions. Your doctor will advise you on the complications, precautions, and on what to do should these events occur.

Quality of gastroscopy is imperative and depends heavily on the specialist. A good specialist will have good photo-documentation of landmarks, and comprehensive report writing using international nomenclature. The specialist will customise the gastroscopy according to the symptoms or disease. In cancer screening, the specialist should be able to perform a risk assessment using international standards, and detect precancerous areas. A good quality control program will help assure patients that their gastroscopy meets the required international standards.

A gastroscopy is a hospital procedure, and is covered under most hospitalisation plans. It is also Medisave deductible. Many companies’ health benefits and private health insurances cover the cost of gastroscopy, which may extend to the private sector. The Ministry of Health provides fee benchmarks and publishes the average fees in each hospital. Before any endoscopic procedure, a detailed financial counselling is done to help patients understand the cost breakdown. Patients should check with their insurance provider and do their own research before seeing a specialist.