Three endoscopic procedures for study of the gastrointestinal tract, esophagoscopy, gastroscopy, and proctoscopy, are used unhesitatingly by the internist specializing in gastroenterology when indicated. The clinician is well aware of the limitations and values of esophagoscopy and proctoscopy, but gastroscopy being the newest procedure has but recently been established as a valuable diagnostic aid. Bockus1 states, “unquestionably the flexible gastroscope is opening up new diagnostic channels. The method has already justified itself in the study of some patients with a suspicion of stomach disease . . . gastroscopy should be called upon in any case in which the diagnosis remains obscure after the application of roentgenography and other diagnostic aids. Every gastro-enterologic clinic should be equipped with a flexible gastroscope and its personnel should include someone trained in its use.”
It is agreed that gastroscopy is an office procedure. The examination need not be made formidable to the patient by using an operating room or an elaborate set-up. The examination is best performed in a gastro-enterologic clinic, where results can be correlated by the gastroenterologist with those of other common gastroenterologic tests.
The examination is done in the morning on a fasting stomach. In general, the technic is that advanced by Schindler2 with minor modifications according to the needs or desires of the examiner (figure).
I have found it advantageous to reduce the preparatory time to a minimum to prevent the patient from becoming unduly anxious. Whereas preparation used to take nearly an hour, I now complete the entire examination. . .