Who needs a gastroscopy? How often should it be done?

As a gastrointestinal surgeon, we often feel saddened that many people do not have regular medical checkups, especially gastroscopy. Many friends have long had symptoms of stomach discomfort, but are reluctant to go to the doctor, reluctant to do gastroscopy, until the emergence of very serious symptoms, it is often too late. What kind of people need gastroscopy? How often do you need a gastroscopy? Let’s talk about this today.

There are three types of people who need regular gastroscopy

The first group, patients with symptoms

Patients with frequent stomach pain, epigastric pain, epigastric fullness, nausea, acid reflux, belching, unexplained weight loss, loss of appetite, black stool, vomiting blood, heartburn, pain behind the sternum, bitterness in the mouth, difficulty in swallowing, etc. need to see a doctor, who, after evaluating your condition, will decide whether you need a gastroscopy to see if there is inflammation, polyps, ulcers, or even cancer inside the stomach.

The second category, patients with abnormal physical examination

Many people attend regular physical examinations every year, and if the physical examination reveals some abnormal indicators that suggest the possibility of gastric disease, further examination is needed. For example, anemia, H. pylori infection, positive fecal occult blood test, tumor markers CEA, CA-199, CA-724, and changes in serum pepsinogen concentration are found during the physical examination. If these abnormalities are found during the physical examination, gastroscopy may be needed, and a doctor needs to make a comprehensive assessment to determine whether gastroscopy is needed.

The third category, high-risk group of gastric cancer

Even if you do not have any symptoms or discomfort, you may be a high-risk group for stomach cancer and need regular medical checkups. People who meet any of the following criteria are at high risk of stomach cancer: (1) from areas with high incidence of stomach cancer; (2) people with Helicobacter pylori infection; (3) people who have suffered from precancerous diseases of the stomach, such as chronic atrophic gastritis, gastric polyps, previous gastric surgery, hypertrophic gastritis, etc.; (4) people with first-degree relatives suffering from stomach cancer; (5) people with unhealthy (5) people who have some unhealthy living and eating habits, such as long-term high-salt diet, long-term consumption of pickled food, smoking and heavy alcohol consumption.

For people who are at high risk of stomach cancer, they should receive gastroscopy from the age of 40.

How often should gastroscopy be done?

After all, gastroscopy is an invasive operation and patients need to suffer certain pain. For most people, gastroscopy is not necessary every six months or every year.

How often a gastroscopy needs to be done depends on the results of the first gastroscopy.

(1) If the result of the first examination is chronic superficial gastritis, it does not matter, if there is no discomfort, you can not need to repeat the gastroscopy. If there is discomfort, the gastroscopy needs to be repeated in a timely manner.

(2) Mild atrophic gastritis, without enterosis or gastric mucosal epithelial heterotypes, can be reviewed once every 1 to 2 years.

(3) moderately severe atrophic gastritis, with or without intestinal epithelial metaplasia, with annual gastroscopy.

(4) Moderate atypical hyperplasia, if present, needs to be reviewed once every 6 months to 1 year.

(5) Severe atypical hyperplasia, not excluding precancerous lesions or early gastric cancer, needs to be treated immediately by removing the suspected lesion, deciding the next treatment plan according to the pathology, and being reviewed regularly.

(6) Patients with gastric ulcer need to receive treatment, and after treatment, they should be reviewed at least once for gastroscopy.

(7) Patients with postoperative gastric cancer must have a gastroscopy review within one year, and the next review will be decided according to the gastroscopy and biopsy.

Source: Dr. Zeng, Department of General Surgery