Procedure
BUILD NOTE: this page was drafted for the refresh and has NOT yet been read by Dr Chen. Clinical content, and the medical-review byline above, must be confirmed by him before the domain cutover.
Dr Chen may recommend a gastroscopy if you have:
Gastroscopy is usually done because of a symptom, but it may also be considered for people with no symptoms who are at higher risk of gastric cancer.
In Singapore the risk of gastric cancer is intermediate, so not everyone will be recommended for screening.5 Screening is offered by risk profile rather than by age alone.
Screening is generally considered for people aged 50 or above who have three or more of the following risk factors:5
Gastric cancer is often found late, with more than two-thirds of cases diagnosed at stage 3 or 4.5 Screening aims to find it earlier in people at higher risk.
Meeting the threshold does not mean you need a gastroscopy, and not meeting it does not rule one out. Dr Chen will advise based on your own risk.
The stomach needs to be empty so the lining can be seen clearly, which means fasting for at least six hours beforehand.1 You will usually also be asked to stop clear fluids a couple of hours before your appointment. Tell the clinic about any medication you take, particularly blood thinners or diabetes medication, as timing may need to be adjusted.
BUILD NOTE: exact fasting window and medication instructions to be confirmed by Dr Chen.
A gastroscopy examines the lining of the oesophagus, the stomach and the duodenum, which is the first segment of the small intestine.1 It is a day procedure. A local anaesthetic spray numbs the throat first, followed by light sedation to help you relax.1 A thin flexible camera is then passed through the mouth. Small tissue samples, or biopsies, can be taken painlessly, and a test for Helicobacter pylori is often done at the same time.
The examination usually takes about 10 minutes.1 It takes longer where treatment or biopsies are needed, and you should allow a few hours at the day-surgery centre once preparation, sedation and recovery are factored in.
H. pylori is a bacterium that colonises the stomach lining, and it is a major risk factor for both peptic ulcer disease and stomach cancer. Prevalence in Singapore rises with age, from 3% in children below 5 to 71% in adults over 65, with up to 31% of Singaporeans infected.2
Where it is found, treatment is a course of several medications over seven to 14 days, typically a proton pump inhibitor and antibiotics. Eradication then needs to be confirmed by a further test.2
Most gastroscopies do not find cancer. They usually find one of a handful of common, treatable conditions.
Where premalignant change is suspected, samples are taken from at least five specific points around the stomach.5 Together they indicate how widespread the change is, which sets how often the gastroscopy should be repeated.
You rest in the recovery area until the sedation wears off. A mild sore throat is common and usually settles within a few days, and you may feel bloated as air passes.1
Because of the sedation, do not drive or operate machinery until the next day.1 Please arrange for someone to accompany you home, and put off anything with significant consequences, such as signing a legal document, while the sedation wears off. You can eat normally the same day and return to your usual activities the following day.1
If the examination shows no abnormality and your symptoms settle, there is usually no need to repeat it. Where premalignant change is found, the biopsies are staged by how widespread the change is, and that determines how often the gastroscopy is repeated.
The staging system used is called OLGIM. It grades how widespread the cell change is across the stomach lining. The recommended intervals are:5
| OLGIM stage | No additional risk factors | With two or more risk factors |
|---|---|---|
| Stage I | No routine surveillance | Every 3 years |
| Stage II | Every 5 years | Every 3 years |
| Stage III to IV | Every 3 years | Every 2 years |
Different intervals apply for claim purposes, including intestinal metaplasia every 1 to 3 years, dysplasia every 6 to 12 months, Barrett’s oesophagus every 3 to 5 years when shorter than 3cm and every 2 to 3 years when longer, and confirmation of ulcer healing within 8 weeks.4 These are claim rules rather than clinical guidelines. Dr Chen will provide the interval that applies to your result.
What you pay depends on whether the procedure is diagnostic only or includes treatment such as a biopsy or removal of tissue, and on your insurance cover. MediSave can be used for approved day surgery, meaning a procedure on MOH’s Table of Surgical Procedures where you are admitted and discharged the same day.3 An Integrated Shield plan may cover part of the cost.
MediShield Life does not cover tests done purely for screening, which includes general health screening packages and check-ups.4 A procedure done to investigate symptoms is treated differently. We will give you a clear, personalised estimate, including what you can claim, before you decide.
See how our fees and claims work →
Gastroscopy is a routine procedure and complications are uncommon. The recognised risks are bleeding from a biopsy site, a tear in the lining, and stomach contents entering the airway.1 A reaction to the sedation is also possible. Dr Chen will discuss these with you in the context of your own health before you begin treatment.
Afterwards, contact a doctor immediately if you develop severe chest or abdominal pain, fever, or bleeding.1
A gastroscopy is usually performed under sedation, so most patients are drowsy or asleep and remember little of the procedure. A local anaesthetic throat spray may be used as well. Dr Chen will discuss the options with you beforehand.
The examination usually takes about 10 minutes,1 and longer where biopsies or treatment are needed. With preparation, sedation and recovery, set aside a few hours at the day-surgery centre.
Yes. Where both are indicated they are often performed during the same session under one episode of sedation, which means one preparation, one recovery and one day of downtime. Dr Chen will advise whether this is appropriate for you.
MediSave can be used for approved day surgery, meaning a procedure on MOH’s Table of Surgical Procedures where you are admitted and discharged the same day,3 and an Integrated Shield plan may cover part of the cost. Contact us to confirm your eligibility.
Usually not, unless your risk profile warrants it. Screening is considered from age 50 in people with three or more of these risk factors: Chinese ethnicity, male sex, a history of H. pylori infection, heavy smoking, a first-degree family history of gastric cancer, or pernicious anaemia.5
Most often gastritis, a peptic ulcer, reflux changes, or nothing abnormal at all. H. pylori is a major risk factor for both peptic ulcer disease and stomach cancer.2 A normal result is a useful outcome when symptoms have gone on for months.
If the examination shows no abnormality and symptoms settle, usually not at all. Where premalignant change is found, the interval is set by OLGIM stage, ranging from no routine surveillance for stage I without risk factors, to every 2 years for stage III or IV with two or more risk factors.5 Dr Chen will provide the interval that applies to your result.
Because premalignant change in the stomach lining is often not visible to the eye. One or two samples are taken from each of at least five set locations around the stomach.5 Taking them allows the extent of the change to be staged, not just recorded as inflammation.
BUILD NOTE: every figure on this page carries a numbered citation. All four sources were fetched and checked on 22 September 2026. The NUH Helicobacter pylori page shows no review date, so treat its prevalence figures as dating from the 2016 study it cites. Re-check each source at medical review.
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