If you’re experiencing unusual but non-specific symptoms like bloating, heartburn or tummy pain, it can be hard to pinpoint a cause without further investigation.

Your doctor can help you work out what’s going on. Here are 4 of the main methods for diagnosing digestive conditions.

You can also speak to a gastroenterologist to find out which test is most suitable for your needs.

1. Gastroscopy

What is it?

A gastroscopy checks your food pipe, stomach and upper part of the small intestine for abnormalities. This minimally invasive procedure uses a thin, flexible camera, which is inserted through your mouth into your stomach and duodenum, to diagnose problems and take tissue samples.

What does it detect?

Your doctor may recommend a gastroscopy to:

• Investigate the cause of unexplained symptoms, such as abdominal pain, vomiting, heartburn, bloating, anaemia or unexplained weight loss
• Check for ulcers, cancer and precancerous growths or conditions

Who is it for?

Anyone with unexplained stomach symptoms or persistent heartburn may need a gastroscopy. Your doctor may also suggest the procedure if you’ve swallowed a foreign object by accident, or if you have small non-cancerous or cancerous growths that need removing from your stomach.

What can you expect during the procedure?

Your doctor may use a mild sedative to relax you before inserting the thin camera down your throat, down to your stomach and duodenum. You’ll be lying on your side during the procedure, which lasts about 15 minutes.

Any special preparations required?

You’ll need an empty stomach for the procedure, so you shouldn’t eat anything for up to 8 hours before or drink anything for up to 3 hours before. Speak to your doctor in advance if you’re taking blood thinners or medication for diabetes.

2. Colonoscopy

What is it?

A colonoscopy checks your lower intestine for any abnormality or disease. During the procedure, your doctor will gently guide a thin, lighted camera through your rectum into your colon to check your lower intestine.

What does it detect?

Your doctor may recommend a colonoscopy to:

• Investigate the cause of abdominal pain, bleeding, anaemia, unexplained weight loss, unexplained constipation or diarrhoea, or a change of your bowel habits
• Check for colorectal cancer or precancerous growths

Who is it for?

Anyone with unexplained lower intestinal symptoms may need a colonoscopy to rule out anything serious. However, if you’re over the age of 50, you should make sure to go for regular screening even if you don’t have any symptoms, as the risk of colorectal cancer increases with age.

What can you expect during the procedure?

You’ll be lying on your side for the procedure, with your knees up close to your chest. You’ll usually be given a mild sedative to help relax your body, though you may not be fully asleep.

After the camera is inserted, your doctor will gently inflate the intestine so they can get a clear view. Your doctor may also take a few tissue samples to test them for abnormal cells.

In total, you should expect the colonoscopy to last between 40 minutes and an hour.

Any special preparations required?

Your doctor will give you clear instructions to follow before your colonoscopy. For up to 72 hours before, you may need to consume a fully liquid diet (eg. pulp-free juice, sports drinks and broth). You may also need to take a laxative or use an enema during this time to flush out the waste in your intestines.

3. Capsule endoscopy

What is it?

A capsule endoscopy is a groundbreaking procedure that may be recommended by your doctor if your small bowel needs to be evaluated. You’ll swallow a small pill (the ‘capsule’) with a tiny camera inside, which takes images of your digestive system as it passes through.

What does it detect?

Your doctor may recommend a capsule endoscopy to:

• Investigate the cause of unexplained symptoms, such as anaemia, bleeding or pain
• Check for small bowel ulcers, bleeding causes or inflammatory bowel disease

Who is it for?

You may need a capsule endoscopy if you require and evaluation of the small intestines.

What can you expect during the procedure?

You won’t feel any pain while the capsule passes through your system. But you will be hooked up to a ‘sensor belt’, which tracks the progress of your capsule and records the corresponding images. You will need to wear this under your clothing for around 8 hours.

Any special preparations required?

Avoid eating or drinking anything for up to 8 hours before your test as well as in the 2 hours after swallowing the capsule. Sometimes, bowel prep (in the form of laxatives) may be advised by your doctor prior to the capsule endoscopy test.

4. Endoscopic ultrasound

What is it?

Endoscopic ultrasound uses ultrasound waves to take pictures of your internal organs. Much like an endoscopy, the ultrasound device will be guided into your body on the tip of a thin, flexible camera to investigate any problems.

What does it detect?

Your doctor may recommend an endoscopic ultrasound to:

• Study abnormalities or lumps, and take tissue samples using a fine needle
• Evaluate and more accurately stage certain cancers, eg. oesophagus, lung, pancreas, stomach or colorectal cancer

Who is it for?

As the ultrasound device takes pictures of organs you usually wouldn’t see with a traditional endoscopy (eg. your lungs, pancreas, liver or gall bladder), it’s not a first-line tool to diagnosis common stomach or intestine conditions. Your doctor may suggest this procedure:

• If they suspect other conditions like pancreatitis and bile duct stones
• For staging of certain cancers
• For evaluation of abnormal growths and access to tissue

What can you expect during the procedure?

Depending on your suspected condition, the camera may need to be inserted through your mouth to the stomach and duodenum, or up your rectum and into your lower intestine. Your doctor will give you a sedative for the 30 – 90-minute procedure.

Any special preparations required?

You should avoid eating or drinking anything for up to 8 hours in advance. You may also need to take a laxative or use an enema to clear out your bowels before the procedure. Speak to your doctor if you’re taking blood thinners or medication for diabetes.

If you’d like to scope out your stomach health, make an appointment with a specialist!

Article reviewed by Dr Tan Hui Hui, gastroenterologist at Mount Elizabeth Hospital

References

Capsule Endoscopy. (n.d.). Retrieved 12 June 2018 from https://www.mountelizabeth.com.sg/specialties/medical-specialties/stomach-digestive/capsule-endoscopy

Endoscopic Ultrasound. (n.d.). Retrieved 12 June 2018 from https://www.webmd.com/digestive-disorders/endoscopic-ultrasound

Gastroscopy. (2015, June 22). Retrieved 12 June 2018 from https://www.nhs.uk/conditions/gastroscopy/what-happens/

Gastroscopy. (n.d.). Retrieved 12 June 2018 from https://www.mountelizabeth.com.sg/specialties/medical-specialties/stomach-digestive/gastroscopy

Information for Patients About Capsule Endoscopy. (n.d.). Retrieved 12 June 2018 from http://www.wales.nhs.uk/sitesplus/documents/866/Capsule%20Endoscopy.pdf

Krans, B. (2016, January 4). Colonoscopy. Retrieved 12 June 2018 from https://www.healthline.com/health/colonoscopy