When it comes to gastroscopy many people feel afraid, and in outpatient clinics we often encounter people who have a fear of gastroscopy, but why do doctors still uneasily advise you to have a gastroscopy? Let’s talk about why gastroscopy is necessary, and who needs it? He refused to be examined because he was afraid or didn’t know what to do with it. Wang had been suffering from acid reflux and belching for many years, and had recurrent upper abdominal pain for six months. This year, he came to the city’s tertiary care hospital, and after seeing a doctor, he suggested that Wang have a gastroscopy. The old Wang listened to the gastroscopy reluctantly, feeling that gastroscopy is very scary, listening to others said very painful, unwilling to do. Wang asked the doctor, “Do we have to do a gastroscopy, can we just do a different kind of test or prescribe some medicine? In gastroenterology clinics, we often encounter patients like Wang who give up or refuse gastroscopy because they are afraid of the test or don’t know why they need to do it. If they are suffering from stomach pain or bleeding, then most of them would be willing to cure the disease and undergo gastroscopy, but for people with less obvious or mild symptoms, they are not so happy to accept it. However, China is a country with a high incidence of stomach cancer, which occurs in middle-aged and elderly people, and there is no specific symptom of early stage stomach cancer, so one of the purposes for doctors to persuade Lao Wang to have gastroscopy is to exclude whether his symptoms are caused by stomach cancer. Gastroscopy is the best way to detect early gastric cancer. China is a country with high incidence of gastric cancer, more than half of the new gastric cancers in the world are in China, compared with Korea and Japan, our rate of early gastric cancer is very low, and most patients are already in the middle and late stage when they are found, so the treatment effect is greatly reduced. This is mainly because of the popularity of gastroscopy in Japan. The early manifestation of gastric cancer is very secretive, the first one may only be a little change in the color of gastric mucosa, and the current technology such as CT and ultrasound cannot capture such a small change, while gastroscopy combined with visual observation and pathological analysis can make accurate judgment on early gastric cancer and precancerous lesions. That is why in gastroenterology, doctors will recommend gastroscopy to those who are old and have not had gastroscopy according to their medical history, and gastroscopy can rule out or detect gastric cancer at an early stage. Advantages of gastroscopy The advantage of gastroscopy is that it can directly reflect the smallest changes of gastric mucosa. Compared with CT and color ultrasound, which we are familiar with, the diagnostic ability of gastric mucosa is limited: for example, CT is very weak in diagnosing early gastric cancer, because early gastric cancer only has changes of gastric mucosa under gastroscopy, which is almost indistinguishable on CT or color ultrasound, and the mass can only be seen on CT after the tumor has developed to middle or late stage, formed a large mass or formed lymph node metastasis. Gastroscopy is the first choice for examining gastric diseases because lesions in the stomach are usually the most frequent and first to occur in the gastric mucosa. Gastroscopy is performed with the aid of a thin, flexible tube that is inserted into the stomach and passed through a mirror-like probe at the bottom to look directly inside the stomach. Gastroscopy can directly observe the real situation of the examined area, and can also diagnose most “stomach diseases” in one go by performing pathological biopsy and cytological examination on the suspected lesions, and the biopsy tissue can be diagnosed pathologically under the microscope. People with high risk of stomach cancer need gastroscopy more than the general population 1. People with family history of tumor. Those who have relatives with digestive system tumor or other tumors in two or three generations will have a higher chance of getting stomach cancer. 2.People who have chronic gastric diseases such as gastric ulcer, chronic atrophic gastritis, chronic gastritis, Helicobacter pylori infection, etc. People who have these diseases should actively treat them to prevent disease progression and go to hospital for regular review. 3, long-term smoking, drinking alcohol, especially love to eat hot food, pickled and barbecued food, high salt food and other bad habits, these habits can cause more serious damage to the stomach, should be timely adjustment of lifestyle habits, and should not refuse the doctor’s gastroscopy recommendations. It is recommended that people over 45-50 years old should have a gastroscopy, and those who have no positive findings or no high-risk factors for 3-5 years can generally not be re-examined; those who have gastroscopy and found to have chronic atrophic gastritis with intestinal epithelial hyperplasia or heterogeneous hyperplasia and other risk factors for gastric cancer should be re-examined in combination with doctors’ recommendations. There will always be people who find gastroscopy unpleasant, but it is still necessary to accept the doctor’s recommendation for gastroscopy as opposed to the regret brought by avoidance.