What Is a Stomach Biopsy?

Updated on 2024-03-26 10:38:27 0 0

By Rachael Zimlich, BSN, RN

Medically reviewed by Steffini Stalos, DO

A stomach biopsy allows your healthcare provider to examine your stomach tissues under a microscope. This can help your provider diagnose conditions that affect your stomach and digestive tract.

An invasive test called a gastric biopsy is done if your healthcare provider suspects a specific condition. Tissue samples are taken with tiny tools at the end of a long tube that is inserted down your throat during a procedure called an endoscopy.

This article will explore what to expect during an endoscopy with biopsy, why your provider takes tissue samples from your stomach, and what to expect after the biopsy.

Why Is a Stomach Biopsy Performed?

Some digestive disorders can be challenging to diagnose with a blood test, physical exam, or even an endoscopy, so your healthcare provider may want to perform a stomach biopsy.

During an endoscopic exam, your provider may see areas of concern that require a closer look. If this is the case, the endoscopic tools are used to remove a small piece of tissue that can be tested and examined under a microscope.

Some symptoms that may lead to an upper endoscopy with biopsy include:12

Heartburn
Difficulty swallowing
Stomach pains
Nausea
Vomiting
Anemia
Weight loss
Blood in your stool or vomit

Upper vs. Lower Gastrointestinal (GI) Disease

You may hear a gastrointestinal specialist talk about upper GI disease and lower GI disease. Depending on the condition, it can be difficult to determine if your problem is in the upper or lower digestive tract based on your symptoms alone.3

The GI tract is divided as follows:

The upper digestive tract includes your mouth, esophagus, stomach, and duodenum (the upper part of the small intestine).
The lower digestive tract consists of the remainder of your small intestine to your large intestine, including the colon and rectum.

Your provider may do separate procedures (upper endoscopy for the upper GI tract and colonoscopy for the lower GI tract) to look at each area to determine the cause of illness.

The Stomach Biopsy Procedure

Stomach biopsies are usually done during an upper upper endoscopy. This procedure uses a long, thin tube inserted into the mouth. As the endoscope is advanced down the throat into the stomach, a healthcare provider can see the structure and tissues in the digestive tract.

Endoscopy Prep: How to Prepare for a Stomach Biopsy

Before you are scheduled for an endoscopy, your provider should review the reason for the procedure and the risks involved. You may not be a candidate for an endoscopy if:4

You are medically unstable.
The risks of the procedure outweigh any possible benefit.
You have a tear in your upper digestive tract.

Once your healthcare provider confirms you can safely have the procedure and gives consent, you will be scheduled for an appointment. In some cases, an endoscopy may be done immediately, especially if you are already in the hospital.

If an upper endoscopy is scheduled, your healthcare provider will ask you not to eat or drink for six to 12 hours before the procedure. Small sips of water are OK, but you should avoid drinking large amounts or taking medications. Your provider may also review your regular medications and let you know which you can and can't take before the procedure.1

What to Expect During a Stomach Biopsy

When it's time for your endoscopy, you will be asked to change into a hospital gown and have a tube called a peripheral intravenous (IV) catheter inserted into your arm to administer fluids and medications.

Most endoscopies are performed with the patient being put under conscious sedation, a form of anesthesia in which you remain awake but are sedated enough to feel relaxed. You will also have a local anesthetic applied in your mouth to make it numb and reduce your gag reflex. You will be positioned on your left side for the procedure, and you will not be able to swallow your saliva or talk.5

You should not feel much during the procedure, aside from the movement and pressure of the endoscope. Your healthcare provider will advance the endoscope into your digestive tract using a light and camera to find areas of concern. Tools at the end of the endoscope will be used to collect small samples for further examination.15

When the endoscopy and biopsy are complete, the tube will be removed. Your heart rate, breathing, and other vital signs will be monitored during and after the procedure. Observation time following the procedure will vary, but the endoscopy should only take 30–60 minutes.6

Recovery Time

Recovery time after an endoscopy with biopsy will vary depending on the reason for the procedure, your overall health, how much sedation was used, and whether you were intubated for the procedure.

Once you are awake and the effects of your sedation have passed, you may be sent home. You could experience fatigue, sore throat, or dull abdominal pain after your endoscopy and biopsy. Since the procedure is done with sedation, you should have someone with you to drive you to and from the procedure.

Stomach Biopsy: Testing and Results

In some cases, your healthcare provider may be able to determine the cause of your digestive problems during the endoscopy and provide treatment by repairing bleeding or administering medications. If the problem is not clear during the endoscopy and a biopsy is taken, the results will take longer.7

Types of Testing

A portion of the stomach biopsy sample will be cultured. This is done by placing it in a solution to allow for bacterial growth, which could take several weeks.8

Another portion of the gastric biopsy will be sent to the lab, where it is preserved and processed into slides for an anatomic pathologist (a scientist specializing in evaluating tissue specimens) to review under a microscope. The evaluation may take two to three days if the sample is routine but may take longer if a specialized assessment is needed.8

A healthcare provider may be able to evaluate the stomach without having to biopsy internally. Special dyes can be placed onto the stomach to look for Helicobacter pylori (H. pylori), a type of bacteria that causes peptic ulcer disease and gastritis.8

How Long for Results?

Turnaround time for biopsy results will depend on the facility, the workload in the lab performing the tissue examination, and whether or not a culture is needed. Cultures take several days to observe for bacterial growth.9

How to Interpret Results

Your provider will consider your health history with the results of the tissue examination to make a diagnosis.

Conditions that can require a stomach biopsy include:910

Barrett's esophagus
Eosinophilic esophagitis
Infectious esophagitis
H. pylori infection
Environmental metaplastic atrophic gastritis
Gastric polyps
Peptic ulcer disease
Celiac disease
Gastritis
Stomach cancer
Crohn's disease

Risks of a Stomach Biopsy

Endoscopy allows your healthcare provider to use a minimally invasive method to remove tissue samples from your digestive tract, but the procedure isn't free of risk.

Some of the risks that come with endoscopy include:5

Bleeding
Infections
Tears in the mucus membranes of your digestive tract

Signs of Complications

If you experience bleeding or other serious and immediate complications, your healthcare provider will likely see these during the endoscopy or soon after the procedure, while you are still being monitored.

Once you've gone home, your provider will give you a list of warning signs to watch for, which include:7

Fever
Chills
Chest pain
Dark stools
Vomiting, especially with blood
Difficulty swallowing
A sore throat that doesn't go away
Severe abdominal pain

Outlook

Endoscopy with biopsy is an effective tool for diagnosing digestive disorders. The outlook after your diagnosis will depend on the condition causing your symptoms. Infections may be treated with antibiotics, while more serious diagnoses like cancer could require surgery or other ongoing treatments.

Summary

A stomach biopsy is an outpatient procedure done under light sedation with an endoscope. You usually get results from this test within a week. Your biopsy results will be used to diagnose the cause of your symptoms and help your healthcare provider create an effective treatment plan.

Sources

MUSC Health. Upper endoscopy (EGD).

International Foundation for Gastrointestinal Disorders. Upper GI disorders.

Austin Gastroenterology. Upper vs. lower GI tract: What are they?

American Society for Gastrointestinal Endoscopy. Appropriate use of GI endoscopy.

Johns Hopkins Medicine. Upper GI endoscopy.

Johns Hopkins Medicine. Esophagogastroduodenoscopy (EGD).

Fairview Health Services. Upper GI endoscopy with biopsy.

Mégraud F, Lehours P. Helicobacter pylori detection and antimicrobial susceptibility testing. Clin Microbiol Rev. 2007;20(2):280-322. doi:10.1128/CMR.00033-06

Mount Sinai. Gastric tissue biopsy and culture.

Peixoto A, Silva M, Pereira P, Macedo G. Biopsies in gastrointestinal endoscopy: When and how. GE Port J Gastroenterol. September 2015;23(1):19-27. doi:10.1016/j.jpge.2015.07.004.