A stomach endoscopy is a common diagnostic procedure allowing doctors to examine the upper part of the digestive tract. This examination helps investigate symptoms such as persistent heartburn, difficulty swallowing, or unexplained weight loss. It provides a direct view of the esophagus, stomach, and the initial section of the small intestine, known as the duodenum.
Understanding Stomach Endoscopy
A stomach endoscopy, also known as an esophagogastroduodenoscopy (EGD), involves using a long, flexible tube called an endoscope, which has a tiny light and video camera at its tip for real-time visualization of the upper digestive tract. The procedure involves administering a sedative to help the patient relax; general anesthesia is not typically required, and many individuals may even fall asleep. A mouth guard is placed to protect the teeth and prevent biting the tube.
The endoscope is gently guided through the mouth, down the throat, through the esophagus, into the stomach, and then into the duodenum. During this process, the doctor carefully observes the lining of these organs, looking for any visible lesions, inflammation, ulcers, polyps, or areas of discoloration. The endoscope can also inflate the digestive tract with gentle air pressure, allowing for a clearer view and easier movement of the tube. This direct visualization provides insights that other imaging tests cannot.
Identifying Concerning Findings
During a stomach endoscopy, certain visual abnormalities can raise suspicion for cancer, though these are considered potential signs rather than definitive diagnoses. Physicians look for specific changes in the stomach lining, such as ulcers that do not heal despite medical treatment, distinct masses or tumors, or areas where the stomach wall appears thickened or unusually rigid.
Other concerning observations can involve abnormal blood vessels or significant changes in the color or texture of the stomach lining. For example, some endoscopes use narrow band imaging (NBI) technology, which changes the wavelength of light to highlight subtle abnormalities more clearly. When such findings are observed, a biopsy becomes the next important step. This involves taking small tissue samples from suspicious areas through the endoscope for microscopic examination.
Confirming a Cancer Diagnosis
Following an abnormal endoscopy with concerning visual findings, the biopsy samples are sent to a pathology laboratory. In the lab, a pathologist, who specializes in diagnosing diseases by examining tissues, microscopically examines the collected tissue. This examination determines if cancer cells are present in the samples. A positive pathology report confirms the presence of malignant cells, indicating a diagnosis of stomach cancer.
Once a stomach cancer diagnosis is confirmed, further tests are performed to determine the extent of the cancer, a process known as staging. This often involves additional imaging tests, such as computed tomography (CT) scans or positron emission tomography (PET) scans, to assess if the cancer has spread to other parts of the body. The staging information is important for guiding treatment decisions. A multidisciplinary team, including oncologists, surgeons, and radiation therapists, often reviews the case to determine the most appropriate course of action.
Other Causes of Abnormal Findings
Not all abnormal findings during an endoscopy indicate cancer. Many common, non-cancerous conditions can cause similar visual changes in the stomach lining. Gastritis, which is inflammation of the stomach lining, is a frequent finding that can cause redness and irritation. Peptic ulcers, which are open sores in the stomach or duodenum, are also common and are not cancerous.
Benign polyps, which are small growths on the lining of the stomach, can also be observed and are non-malignant. Other conditions such as a hiatal hernia, where part of the stomach pushes up through the diaphragm, or esophagitis, inflammation of the esophagus, can also present with abnormal appearances during an endoscopy. Only a biopsy and subsequent pathology examination can definitively differentiate between these benign conditions and malignant ones. Follow-up discussions with a healthcare provider are important to understand the specific findings and next steps.