Coeliac disease is a condition in which the lining of the small intestine becomes damaged when it is exposed to even small amounts of gluten – a protein found in wheat, barley, rye and oats.
As a result, affected patients absorb food and nutrients poorly. This can result in bowel symptoms and deficiencies of vitamins, minerals and other nutrients.
Coeliac disease is diagnosed by a gastroscopy. During the gastroscopy if your specialist suspects coeliac disease, tiny samples (biopsies) are taken from your small bowel and sent to the lab for analysis to confirm if you have the disease.
Coeliac disease is successfully treated by removing all foods containing gluten from the diet. This is called a gluten-free diet. Following a gluten-free diet after the diagnosis of coeliac disease should allow an improvement in symptoms and restoration of health.
Gastro-Oesophageal Reflux Disease (GORD)
Reflux is due to stomach acid rising up to the oesophagus where it can cause pain in your chest (sometimes called heartburn) and inflammation that your specialist can see when you have a gastroscopy.
Heartburn is very common. Almost everyone has it at some time. It is a feeling of discomfort or burning or even pain felt rising up from the lower chest to the neck. Some people call it indigestion. Doctors call it gastro-oesophageal reflux disease, or reflux or GORD for short.
Occasionally reflux is associated with food or fluid coming into the mouth. This is called regurgitation. If reflux symptoms occur regularly, for example a few days a week or even every day, they may be distressing and need treatment.
Helicobacter pylori is a bacterium (germ) that can infect the human stomach. Its significance for human disease was first recognised in 1983 by a doctor from Western Australia called Barry Marshall.
Helicobacter lives in the lining of the stomach, and the chemicals it produces causes inflammation of the stomach lining. This can cause pain or indigestion, and sometimes stomach ulcers. Helicobacter means you are slightly more likely to get stomach cancer, although stomach cancer is still uncommon in Australia.
Infection appears to be life long unless treated with medications to eradicate it.
Helicobacter can be detected during a gastroscopy, usually by taking tiny samples (biopsies) from your stomach and sending them to the lab. Your doctor will advise treatment.
Oesophageal Stricture and Dilatation
An oesophageal stricture is a narrowing of the oesophagus, usually caused by acid reflux causing scarring but sometimes caused by an “allergic oesophagus” (also called eosionphilic oesophagitis or EoE) and uncommonly caused by oesophageal cancer.
A stricture usually presents with a feeling of food sticking or with problems swallowing. Problems with swallowing are not always caused by oesophageal stricture, although if you have this symptom you should see a doctor urgently.
Some problems swallowing are caused by oesophageal dysmotility, which is a disorder of the swallowing movement of your oesophagus. This is detected either at gastroscopy or with a special x-ray called a barium swallow.
Oesophageal dilatation is a procedure where a balloon is placed in the middle of the oesohpageal stricture or narrowing and then inflated to stretch the oesophagus and help you swallow. After the procedure the balloon is removed. This is done during a gastroscopy.
Stomach and Duodenal Ulcers (also called peptic ulcers)
A stomach or gastric ulcer is a break in the tissue lining in the stomach.
The term “peptic ulcer” refers to those that occur in either the stomach or the first part of the small intestine that leads out of the stomach, called the duodenum. It was once thought that stress, smoking and diet were the principal causes of ulcers. However, the Helicobacter pylori bug is now known to be responsible for most of them. Some ulcers are caused by taking anti-inflammatory drugs (also called Non-Steroidal Anti-Inflammatories or NSAIDs) such as ibuprofen, nurofen, or aspirin.
Treatment for stomach ulcers includes the use of antibiotics to eradicate the Helicobacter infection, avoidance of NSAIDs if necessary and acid-suppressing drugs.
Ulcers often don’t produce any symptoms. If present, they can include:
- abdominal pain just below the ribcage
- loss of appetite
- weight loss
- bright or altered blood present in vomit or bowel motions
- symptoms of anaemia, such as light-headedness shock due to blood loss – a medical emergency.
Stomach Cancer and Oesophageal Cancer
These are cancers that are detected with a gastroscopy. Neither are common in the Australian population, but if you have any of the following symptoms you will need a gastroscopy to rule them out:
- Weight loss or loss of appetite
- Problems with swallowing or a sensation of food sticking
- Abdominal pain (tummy pain) or discomfort
- A sense of fullness in the upper abdomen after eating a small meal
- Heartburn or indigestion
- Nausea or vomiting (particularly if the vomit has blood in it)
Barrett’s oesophagus is where the lining of the lower part of the oesophagus changes probably from damage caused by acid reflux.
This is seen during endoscopy. If you have Barrett’s oesophagus you are slightly more likely to develop oesophageal cancer, so you will likely need regular endoscopies to try to pick that up early.
Liver Disease, Cirrhosis, Portal Hypertension
Liver disease, which if severe can be called cirrhosis. This can be detected during gastroscopy. Portal hypertension is the name for some of the signs of liver disease that can be seen during a gastroscopy.