Comprehensive Guide to Endoscopy and Gastroscopy in Singapore 

Understanding Endoscopy and Gastroscopy

What is Endoscopy?

Endoscopy  is a medical procedure where a flexible tube (scope) with a miniaturized camera and lighting system at the tip is skillfully advanced into a body orifice. 

It is an umbrella term that covers all types of scopes.

What is Gastroscopy?

A flexible fiberoptic tube is inserted under sedation via the mouth into the food gullet to examine the stomach and the 1st part of the small intestine (duodenum) under video guidance. Some of the following conditions may be diagnosed:

1. Gastritis - stomach lining inflammation caused by a bacterium called H. Pylori. Untreated, this may cause pain, bloating, and ulcers. There is evidence to show this may be a cancer-causing agent.
2. Gastric or Duodenal ulcers - These are defects in the lining of the stomach or intestine that, if untreated, may cause pain, perforation, or bleeding. H. Pylori causes up to 90% of ulcers.
3. Acid reflux - Laxity of the sphincter muscle of the food gullet can cause acid in the stomach to reflux into it. This can cause pain and irritation. If this is chronic, ulceration, change of the type of lining, and, ultimately, cancer can ensue.
4. Gastric cancer - This may be detected and presents as an ulcer or mass arising from the stomach lining. Biopsies can be taken to confirm the diagnosis.
   

Common complaints include upper abdominal bloating and pain before or after a meal. As an initial presentation, symptom relief with medications is a reasonable approach.

However, if symptoms persist beyond a month, especially if accompanied by the following alarm symptoms:

1. Weight loss > 10% body weight
2. Anaemia
3. Vomiting. Especially of blood-tinged content
4. Difficulty swallowing
5. Passage of dark-colored stools

These warranted prompt medical attention if patients are over 40 years of age.

Factors Affecting Endoscopy and Gastroscopy Cost in Singapore

• The range of professional fees is stipulated in the MOH Fee Guidelines. Range depends on the case complexity and seniority of the doctor. 
• The variability in costs arises from facility charges (hospitals and day surgery centers), a specialist doctor (anesthetist) providing monitored sedation, and the complexity of polyp removal that can have a bearing on consumables used and tissue analysis (pathology).
• Insurance coverage is essential. Doctors who belong to an insurance panel have an additional requisite fee schedule to adhere to so that costs would be more defined. Additionally, Medisave deductions (according to the procedure schedule) are allowable to offset costs and supplement insurance shortfalls.
  

Conclusion: Prioritising Digestive Health with Endoscopy

• Early diagnosis of gastritis and ulcers can prevent the development of complications of internal bleeding from the stomach and perforation (a defect in the stomach wall).
• Acid reflux diagnosed early can prevent symptoms from becoming chronic and malignant changes to the distal food gullet lining.
• Early gastric cancer detected through the use of modern high-definition and magnifying video scopes may be amenable to local treatment and prevent the need for surgery.