After a Gastroscopy (OGDS): Common Findings and the Medicines Doctors Prescribe

A gastroscopy, also called OGDS or upper endoscopy, uses a thin camera to look at the food pipe (oesophagus), stomach and first part of the small intestine. Afterwards you usually go home with a report and a prescription. This guide explains the common findings and why each medicine is given.

Good to know: if you had sedation, don’t drive or sign important documents for 24 hours. A mild sore throat and bloating from the air used are normal. Biopsy results usually take 1 to 2 weeks.

Common findings and usual treatment

Gastritis or duodenitis

Inflammation of the lining. Often treated with a PPI such as esomeprazole or pantoprazole for 4 to 8 weeks. If a biopsy or CLO test shows H. pylori, it is treated with a course of antibiotics.

Reflux oesophagitis

Inflammation of the food pipe caused by acid, graded A (mild) to D (severe). Usually treated with a PPI for 8 weeks. Vonoprazan (Vocinti) is often chosen for more severe grades because it heals the lining faster in studies. Some people then need a lower maintenance dose.

Stomach or duodenal ulcer

Healed with a PPI or vonoprazan for 4 to 8 weeks, plus treating the cause. A stomach ulcer usually needs a repeat scope to confirm healing. See stomach ulcer.

H. pylori positive

A 14-day combination of antibiotics with a PPI or vonoprazan, then a breath or stool test at least 4 weeks later to confirm cure. See H. pylori treatment.

Normal scope, but still symptoms

This is common and often called functional dyspepsia. Treatment may include a trial of acid suppression, a prokinetic such as itopride (Ganaton) for bloating and early fullness, simethicone for trapped wind, and changes to meals and stress.

Hiatus hernia, polyps or Barrett’s oesophagus

A hiatus hernia is managed like reflux. Polyps and Barrett’s oesophagus are followed up based on the biopsy, sometimes with repeat scopes.

Reading your prescription

• PPIs (esomeprazole, pantoprazole, rabeprazole, omeprazole): once a day, 30 to 60 minutes before breakfast.
• P-CAB (vonoprazan): once a day, with or without food, or twice a day within an H. pylori course.
• Prokinetic (itopride, domperidone): before meals.
• Alginate or antacid (Gaviscon): after meals and at bedtime, for breakthrough symptoms.
• Antispasmodic with simethicone (alverine and simethicone): for cramps and bloating.

Tips

• Finish the course the doctor set, and go back for the follow-up or repeat test.
• After long-term acid-reducing medicine, don’t stop suddenly. Symptoms can rebound for a few weeks, so ask the doctor how to step down.
• Bring your OGDS report to any follow-up so the doctor can see the findings.

Get help urgently if you have

• vomiting blood or material that looks like coffee grounds
• black, sticky stools
• difficulty or pain when swallowing, or food sticking
• weight loss without trying, or persistent vomiting
• severe or sudden tummy pain, or feeling faint