Heartburn and Indigestion

Dyspepsia is the medical terminology used to describe the above symptoms. Although it is a common problem in the general population, most people do not seek medical attention. Investigation with an OGD is recommended when there are associated 'alarm' features of unintentional weight loss, difficulty swallowing (dysphagia), and gastrointestinal bleeding as manifested by vomiting blood (haematemesis) or passing black tarry faeces (melaena).

Abdominal Pain and/or Change of Bowel Pattern

Irritable Bowel Syndrome is frequently diagnosed for the above symptoms. It is important to look out for any atypical features in the symptoms that might suggest an alternative diagnosis. The differential diagnoses of coeliac disease, inflammatory bowel disease, and bowel cancer requires an endoscopy examination with biopsy.


The majority of people with gallstones do not experience any symptoms. In about 20% of cases, gallstones become symptomatic (cause pain), and may lead to complications. These include acute and chronic inflammation of gallbladder (cholecystitis). Gallstone(s) jammed in the bile duct can cause infection (cholangitis), jaundice and acute inflammation of pancreas (pancreatitis). This is managed with an ERCP, followed by a cholecystectomy. The gallstone management benefits from a multi-speciality team approach involving gastrointestinal surgeons, radiologists and gastroenterologists.


Iron deficiency anaemia is a common referral to the gastroenterology outpatient clinic. This may be secondary to dietary cause or heavy period (menorrhagia) in women. It may indicate a malabsorption disorder such as coeliac disease or occult gastrointestinal blood loss from gastric or colonic neoplasia. The suggested investigations include a blood test for coeliac serology, an OGD with duodenal biopsies and a colonoscopy. Small bowel contrast imaging examination has a low yield. In some cases, a video capsule endoscopy and/or small bowel endoscopy (enteroscopy) may be helpful.

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