Gastroscopy
What is a gastroscopy?
Gastroscopy is a procedure, which allows the endoscopist to examine your oesophagus (gullet), stomach and the first part of your duodenum (small bowel). A long thin flexible tube about the thickness of your little finger with a mini video camera built into its tip, called an endoscope, is used for this procedure.
It will not be necessary for you to undress for the gastroscopy, but you will have to remove dentures and tongue/lip piercings. In the endoscopy room you will be made comfortable on a couch, lying flat on your left side. A nurse will stay with you throughout the test. A plastic mouthpiece will be placed gently between your teeth or gums, in order to keep your mouth open. When the endoscopist passes the endoscope through the mouthpiece and into your stomach, it will not cause any pain, nor will it interfere with your breathing at any time.
During the test, some air will be passed down the endoscope to distend the stomach and allow the endoscopist a clear view. The air is sucked out at the end of the test. When the examination is finished the endoscope is removed quickly and easily. The actual procedure should last less than 5 minutes.
During the procedure, the endoscopist may take a small tissue sample (biopsy) to be analysed under a microscope. This is a painless procedure.
The appointment time you are given is the time you can expect to see the nurse for your pre procedure assessment and is not necessarily the time of your procedure. Please be aware that the time you spend in the department from arrival to departure may be 2-3 hours.
Preparing for the Procedure
It is essential that you have nothing to eat for SIX hours before your appointment. However, you can drink water up to 90 minutes before your appointment time. After that have nothing to eat or drink until you are informed by the nurse after your procedure that it is okay to do so.
Medicines and Medical Conditions
It is important you bring a list of your current medication with you so that you can give it to the nurse on arrival. If you have a latex or other allergy, please telephone the Unit for medical advice and inform staff of your allergy when discussing your procedure.
Warfarin / Phenindione / Clopidogrel / Rivaroxaban / Apixaban/ Dabigatran/ Prasugrel/ Ticagrelor, Low Molecular Weight Heparin, Intravenous Heparin (blood thinning medication)
If you are taking any of the above, please let us know as soon as possible, as our doctors may decide that it is necessary for you to stop taking your tablets for a limited time before the procedure.
Diabetes
If you suffer from insulin dependent diabetes, please inform the Gastroenterology Unit as soon as possible, as it may be necessary to change the time of your appointment or be admitted to hospital a day before your procedure for treatment. If your diabetes is managed by your GP, please contact the surgery for advice. If under the care of Elsie Bertram Diabetes Centre, please contact your Diabetes specialist nurse on 01603 288513.
Pregnancy
If you are pregnant or breast-feeding, please contact us for advice.
The Procedure
The majority of people can manage this test using Throat spray. This is a liquid local anaesthetic which is sprayed onto the back of your mouth to numb the back of the throat and help to make it less sensitive (this is a good option for you if you are concerned about gagging during the test). You will not be able to eat and drink for half an hour after the test. You can drive and go about your normal activities immediately after the investigation.
If for a particular reason you feel that you need to have sedation for this test (a medicine which will make you drowsy but does not ‘put you to sleep’), you will need to discuss it with your nurse on admission. Please be advised that sedation means you MUST have someone with you to take you home and care for you after the test. We advise that you should have someone must then stay with you for 12-24 hours following your procedure to look out for any complications and during this time you must not:
- Drive a motor vehicle
- Drink Alcohol
- Operate Machinery
- Sign Legal Documents
Please take advice from your nurse discharging you about whether you should work the next day.
You will be asked to consent to the procedure, so we have enclosed a consent form for you to read before you come for your appointment. This is to ensure that you understand the test
and its implications/risks. Please bring it with you to your appointment but DO NOT sign it until
AFTER you have had a discussion with the nurse or doctor in the Unit.
Please be aware that in order to protect the privacy and dignity of all patients, relatives/carers will not be allowed in the theatre/recovery rooms. They are welcome to accompany the patient during the initial admission process but will then be required to leave the admission/recovery area once the patient has been made ready for the procedure. If you have had sedation, we will tell your escort about the outcomes as the medication will make you forgetful.
We hope that your visit to the gastroenterology department will be made as pleasant as possible for you; however please be aware that this is an emergency department and any emergencies will take priority over outpatient appointment times and this may result in delays to your procedure. Appointment times are approximate as we try to give each individual as much time as he or she needs, so we would ask you to be patient if you experience delays and be assured, we are doing our utmost to ensure appointments are on time.
After the Procedure
The endoscopist or nurse will discuss the findings with you at the end of the procedure and explain the results and any planned follow-up or further investigations. If a biopsy has been taken, your GP will be sent the results and informed of any necessary treatment, or we may arrange for you to see us in our clinic.
Once you have returned home, or back to your ward you may begin to eat and drink normally and resume your normal medication, unless instructed otherwise by the Doctor. You will be given an advice sheet on after care and signs to watch for before you leave the hospital.
If required, normal painkillers such as paracetamol may be taken.
What are the Risks/Complications?
Side effects of this procedure are usually minimal, sometimes patients may feel bloated and / or have a sore throat for the rest of the day. This can be relieved by normal pain killers. You will be given an advice sheet on after care and signs to watch for when you have had your procedure. There is a risk of damage to loose or damaged teeth if you bite down too hard on the mouth-guard.
The possible complications of a gastroscopy include the possibility that the oesophagus, stomach or intestine may be damaged or, in rare and extreme cases, perforated during the procedure. This can lead to bleeding and infection, which may require treatment with medicines or surgery.