Sometimes doctors recommend gastroscopy during outpatient visits, and many patients ask, “When do I need a gastroscopy? Does it hurt to have a gastroscopy? Can other tests be used instead of gastroscopy? Here is a brief answer to several questions about gastroscopy: What are the conditions that require gastroscopy? Have symptoms of functional dyspepsia, such as epigastric pain, epigastric distention, early satiety, burning sensation in epigastrium, and other upper gastrointestinal symptoms, such as dysphagia, painful swallowing, vomiting, reflux, heartburn, loss of appetite, wasting, etc. Family history of gastric cancer or esophageal cancer, etc. What are the conditions in which gastroscopy cannot be performed? Severe heart, lung and brain diseases that cannot tolerate gastroscopy; suspected shock or gastrointestinal perforation; patients with acute inflammation of the gastrointestinal tract, especially corrosive gastritis; patients with obvious aortic aneurysm; those who suffer from mental illness and cannot cooperate with endoscopy. Does it hurt to have gastroscopy? Many patients worry that gastroscopy will be painful and ask for painless gastroscopy. In fact, gastroscopy is not painful and may be accompanied by nausea and vomiting. Can other tests be used instead of gastroscopy? Sometimes patients ask if they can skip gastroscopy and if there are other tests that can be done instead of gastroscopy. If a lesion of the esophagus, stomach or duodenum is suspected, a barium meal of the upper gastrointestinal tract can be considered if the gastroscopy is not tolerated. However, if the barium meal is considered a lesion, gastroscopy is still needed for further clarification or to take a pathological biopsy, etc. What preparations do patients need to make before gastroscopy? Do not eat 6 hours before the examination. Some patients eat too greasy dinner, which will affect the gastroscopy examination the next morning. A surface anesthetic for the pharynx will usually be applied 3 minutes before the examination to reduce the discomfort in the pharynx during the examination. What is the gastroscopy procedure? Gastroscopy is performed with a 1.0 cm diameter endoscope that is inserted through the mouth into the patient’s esophagus, stomach, and duodenum in sequence. If necessary, a mucosal biopsy or H. pylori testing can be performed through the biopsy channel of the gastroscope. The examination takes about 5-10 minutes, and may take about 10-20 minutes if a pathological biopsy is taken. If treatment such as polypectomy is required, the time may be extended accordingly. How does the patient cooperate during the examination? Generally, the patient is placed in the left lateral position with legs slightly bent. When the gastroscope is inserted into the pharynx, the whole body should be relaxed and the swallowing action should be done slightly so that the gastroscope can pass smoothly through the pharynx into the esophagus. There will be nausea when passing through the entrance of the esophagus, so pay attention to inhale deeply through the nose and try not to make breathing movements or sounds with the mouth. If there is saliva, it should come out naturally and should not be swallowed. If you feel nausea and other discomfort and find it difficult to tolerate the examination, you can gesture to the examining doctor and do not grab the gastroscope, let alone bite it with your teeth. What should I pay attention to after the examination? Do not drink or eat for 1 hour after the examination. When the effect of surface anesthesia wears off, drink a small amount of water and eat only if there is no choking or coughing. Some people may experience a temporary sore throat or foreign body sensation, which usually recovers gradually in 1-2 days.