A gastric tissue biopsy and culture are laboratory tests that examine stomach tissue. These tests are typically carried out to determine the cause of a stomach ulcer or other troublesome stomach symptoms. Gastric tissue biopsy is the term used for the examination of tissue removed from the stomach. For a culture, the tissue is placed in a special dish to see if bacteria or other organisms grow.
Tissue samples from the stomach are obtained during an endoscopic exam. In this procedure, a long, flexible tube with a small camera (endoscope) is inserted down your throat and esophagus and into your stomach and upper small intestine (duodenum).
With the endoscope, the doctor can view your stomach for irregularities and remove tissue samples for biopsy and culture. The samples are then analyzed for the presence of infections or cancerous cells and signs of inflammation.
Your doctor may order a gastric tissue biopsy and culture if you are experiencing any of these symptoms:
- pain in your upper stomach
- nausea or vomiting
- loss of appetite
- unexplained weight loss
- black stools
These laboratory tests can help diagnose cancer and infections, including H. pylori, which can cause ulcers of the stomach.
H. pylori are bacteria that can infect your stomach. The risk of having H. pylori infection is greater for those who live in crowded or unsanitary conditions. It is a common cause of peptic ulcers. About half the world’s population carries some H. pylori bacteria, but most will never have symptoms.
Symptoms of H. pylori infection include:
- weight loss
- an ache or pain in the abdomen
Complications can include ulcers, inflammation of the stomach lining and small intestine, and stomach cancer.
Treatment for H. pylori infection includes antibiotics and acid suppression drugs. Follow-up testing may be recommended to see if the treatment is working.
The best way to get tissue samples from the stomach is through a procedure called an esophagogastroduodenoscopy. It is more commonly known as an endoscopy or EGD. This is generally done as an outpatient procedure.
Preparation for Endoscopy
You will be instructed to stop eating and drinking for about six to 12 hours before the procedure. You will also be advised to stop taking blood-thinning medications. Make sure you get specific instructions from your doctor based on your medical condition.
How the Endoscopy Works
Dentures or partials must be removed. An IV will be inserted into your vein for medications. You will be given a sedative, a painkiller, and a local anesthetic in your mouth to prevent coughing and gagging. You will also have a mouth guard to protect your teeth and the endoscope.
You will lie on your left side during the procedure. The doctor will insert the endoscope down your throat, through your esophagus, and into the stomach and upper small intestine. Air is put into the endoscope to help the doctor see clearly.
The doctor will perform a visual inspection and take tissue samples for biopsy and culture.
The procedure will take about five to 20 minutes and the samples will be sent to a lab for examination. The results will be sent to your doctor for review.
After the Endoscopy
You must refrain from eating and drinking until your gag reflex returns. Your throat may feel a little sore and you might feel gas and bloating because of the air in the endoscope. These side effects will wear off shortly, and you will be able to return home the same day.
Biopsy tissue samples from your stomach are sent to a laboratory where they are processed and cultured.
For the processed tissue, the biopsy samples from your stomach are examined under a microscope for signs of damage or disease. This is the only way to confirm cancer.
For the culture, biopsy samples from your stomach are placed in a special culture dish. The tissue is monitored to see if bacteria, fungus, viruses, or other organisms grow.
After the biopsy, the actual processed specimen and culture test take place in a laboratory and carry no risk.
Most people experience few side effects from the endoscopy, but there are some risks from the procedure. These include perforation in the stomach, upper small intestine, or esophagus, and bleeding where tissue samples were taken.
There is also a small risk of a bad reaction to the medication (sedative, painkiller, or anesthesia), which could result in difficulty breathing, excessive sweating, low blood pressure, slow heartbeat, or spasm of the larynx. If you experience any of these symptoms, tell your doctor immediately.
When the stomach tissue biopsy and culture do not show damage, H. pylori bacteria, signs of infection, or cancer, they are usually considered to be normal.
Abnormal stomach tissue biopsy and culture results may be due to:
- gastric cancer
- gastritis (inflamed or swollen stomach lining)
- H. pylori infection (which can cause ulcers)
Your doctor will explain your results in detail. If the results are abnormal, your doctor will discuss the next steps and go over treatment options with you.