Having a Gastroscopy

You have been advised to have a upper gastrointestinal Endoscopy, to help find the cause of your symptoms. The word endoscopy means looking inside, and the instrument used is called an Endoscope.

You could have a Barium Swallow X-Ray Examination, however a Gastroscopy is a more accurate investigation to find the cause of your symptoms and if necessary allows treatment or a biopsy to be performed.

An Endoscope is a long flexible tube, thinner than your forefinger, with a bright light at the end. The endoscopist can view the image on a television screen.

If you are having a Gastroscopy to allow a clear view, the throat, stomach and first part of the duodenum must be cleared of all contents, you must not eat anything for a minimum of 6 hours prior to the procedure time. You can have small sips of water up to 2 hours prior to the procedure time. Please Note: It is important that you do follow this so it allows the endoscopist to get clear views of your insides.

Most of your normal medication can be taken as normal up to the day of your procedure. However, certain medications may need to be stopped for a short period before the test. In particular:

PPI therapy: if you are taking PPI tablets such as: Lanzoprazole, Omeprazole, Nexium, pantoprazole these need to be stopped for 2 week before the test. You can start taking them again immediately afterwards.

Diabetes: if you are on tablets or insulin for diabetes, then let the doctor or nurse know, so that you can be given instructions on what to do about your medication.

Anticoagulants or Antiplatelet medication: if you are taking antiplatelet medication such as:

• Clopidogrel (Plavix)
• Aspirin
• Dipyridamole

You should have been informed if you need to stop it before your procedure. If you have any quires please contact Endoscopy on 01709 427029

To allow a clear view, the stomach must be empty. This is why you are asked to starve a minimum of 6 hours prior to the test.

A pre-assessment will be performed by a nurse.

Important! Please tell the nurse or doctor if you:

• Have a medical condition that may be worsened by the test, for example a chest or heart condition, epilepsy or diabetes.
• Have had any allergies, or adverse reactions to drugs or other tests.
• Are on any tablets, medicines or injections, for example insulin or warfarin or antiplatelet drugs such as clopidogrel or dipyridamole.
• Are suffering from an illness, for example cough, cold, sore throat etc.

The procedure will be explained to you and then you will be asked to sign a form giving your consent for the Endoscopy. If you have any questions, please ask.

Just before starting the procedure, if you have spectacles, contact lenses or dentures, you will be asked to remove them and these will be kept for you. You will also be asked if you have capped, crowned or any loose teeth. In the examination room, you will be made comfortable on a couch, resting on your left side. A nurse will stay with you throughout the procedure.

The Endoscopist may give you an injection into your arm. This will make you feel relaxed and sleepy, but most gastroscopy’s are now performed without sedation. A probe will be attached onto your finger which will record your pulse and oxygen saturation throughout your procedure. Your blood pressure may also be recorded.

A small sponge which sits just inside the nostril may be inserted if oxygen administration is required during your procedure.

A cannula may be inserted into a vein in the back of your hand or your arm to allow the administration of sedation or other medications if needed.

The back of your mouth/throat is numbed with a local anaesthetic spray. The choice to have the procedure carried out with or without sedation will be yours. 

To keep your mouth open, a plastic mouth guard will be placed gently between your teeth or gums. The scope will then be passed over the back of the tongue. You will be asked to concentrate on breathing normally, this will help you to relax. The endoscopist puts a small amount of air into your stomach, through the gastroscope, to help view all the internal surfaces. This air may make you feel slightly bloated, but is usually removed at the end of the procedure. This may make you burp.

No - but sometimes swallowing the tube may feel a little uncomfortable to begin with, and you may feel “bloated” due to the air being pumped inside your stomach.

No - There is sufficient room around the gastroscope tube to allow you to breath normally.

You may gag at the start of the procedure, whilst the Gastroscope is being passed, but this rapidly wears off, and vomiting is unlikely and infrequent. If you have a lot of fluid or saliva in your mouth, the nurse will remove it using a suction tube, in the same way as the dentist does.

Less than five minutes, on average. It depends upon whether samples (biopsies) have to be taken.

Occasionally, it may be necessary for the doctor to take a Biopsy specimen from the lining, for analysis/testing in the laboratory. A very small piece of tissue is removed, painlessly, through the endoscope, using tiny forceps.

A polyp is a raised area of tissue on the surface of the lining of the gastro-intestinal tract, sometimes with a stalk. If the Endoscopist sees a polyp, they may remove this using a wire snare and diathermy (an electric current is passed through the snare, and it burns through the polyp, cauterising at the same time). the polyp is then retrieved, and sent to the laboratory for analysis/testing.

You may experience a slight sore throat, or a windy/ bloated feeling in you abdomen. Both of these feelings will pass off, after a few hours and need no medication. If you have a sore throat, you can take a throat lozenge to ease it. If an injection for sedation has been given, you will feel very drowsy for the remainder of the day.

If biopsies/polyps are removed, there is a small risk of bleeding. In some cases, you may need a further procedure, or occasionally an operation. There is a very small risk of perforation, in some cases you may require further treatment or an operation.

If you have not had a sedation injection, you will be asked to remain on the unit until any follow-up appointment, tests etc. have been made for you, should you require them. You may be given a drink, but if you have had your throat numbed by a spray, you will have to wait until your swallowing reflex is back to normal - this usually takes about thirty minutes. After this, you can eat and drink normally, unless the Endoscopist has told you to refrain for a longer period. If you have been given an injection for sedation, you will have to rest on the unit for approximately one hour, before being allowed home. You can continue to take your prescription medicines in the normal way, following the procedure.

If you are going home after the procedure following sedation it is essential that someone comes to the unit to collect you, and stays with you until you no longer feel drowsy or wobbly on your feet, approximately 24 hours.

Once home, it is important that you rest quietly for the remainder of the day. Sedation lasts longer than you think.

For the first 24 hours following sedation, you should not do any of the following:

• Don’t drive - your judgment will be poor, and you may have an accident
• Don’t operate machinery
• Don’t drink alcohol - this will make you more drowsy
• Don’t travel by public transport - it is unsafe
• Don’t return to work until the following day
• Don’t sign any legal or official documents

The effects of the procedure and injection should have worn off by the following day, and the majority of patients are able to resume normal activities.

In many cases, the doctor or nurse will be able to give you the results shortly after completion of the procedure. However, if biopsy specimens have been taken, the results may take up to 2 weeks. It is a good idea to have someone with you when the doctor or nurse speaks to you, as the effects of sedation cause many people to forget what has been said to them.

Details of the results, and any necessary treatments, should be discussed with whoever referred you for the test i.e. your own General Practitioner or Hospital Consultant. It may be necessary to repeat the Endoscopy at a later date, in order to confirm the diagnosis, or assess the effects of any treatment prescribed.

If you have any worries, or require further information. please contact the Endoscopy Unit, where the staff will be happy to help.