What is a gastroscopy?
You have been advised to have a gastroscopy to help find the cause of your symptoms. A gastroscopy is a technique to look directly into your gullet (oesophagus), stomach and first part of the small bowel called the duodenum. This is to help find out what is causing your problems.
The instrument used for this procedure is a gastroscope. The gastroscope is a thin, flexible tube. It has a bright light on the end and is passed through your mouth and down into the stomach.
What are the risks associated with this procedure?
• Perforation of the oesophagus (making a hole) is an extremely rare complication of approximately 1 in 10000 cases. If a perforation does occur, there is the possibility that surgery may be required.
• Aspiration of fluid from the stomach into the lungs may cause a cough.
• Sore throat may occur for up to 24 hours following the procedure.
• There is a small possibility of damage to teeth. Please ensure you inform staff of any dentures, loose teeth and caps or crowns.
• Sedation can occasionally cause problems with allergic reactions, respiratory problems, heart rate and blood pressure. If any of these problems occur, they are usually short lived.
• In approximately 10% of people it may not be possible to complete the procedure. This can be for a variety of reasons, including unsatisfactory emptying of the stomach, mechanical failure or toleration of the procedure. Like all tests, this procedure may not always show up all abnormalities and on rare occasions, abnormalities may not be identified.The person doing the test will discuss any questions you may have about the risks.
What are the side effects of the procedure?
You may have bloating and abdominal discomfort for a few hours.
What are the benefits of this procedure?
Gastroscopy is the only test that allows direct inspection and sampling of the bowel wall.
What are the alternatives to this procedure?
Barium Meal, Barium Swallow or CT scan can show the stomach lining but cannot take biopsy samples. Even though you are having a gastroscopy, you may still require one of these other procedures at a later stage.
Preparing for a gastroscopy
Please bring a complete list of all the medicines that you take when you come for your procedure.
Please inform us if you think you have an allergy or think that you may be pregnant.
To allow a clear view, the stomach must be empty so please follow these instructions:
• Do not have anything to eat/drink for at least 8 hours before the test
• Do not drink milk for 4 hours before the test as this will line the stomach and prevent clear views
• Drink clear fluids (water, black tea, black coffee, squash) for up to 4 hours before the time of your appointment
If you have diabetes
If you are diabetic and use insulin or tablets, please inform us so that you can be offered an appointment at the beginning of the list.
There are two options we can offer to help you with this procedure:
1. Throat spray
This procedure is usually carried out using a throat spray which numbs the back of the throat. It has a bitter taste and may feel hot when you swallow it. It has a very rapid effect and you will notice a loss of sensation to the back of the throat and the tongue. Choosing the throat spray means that once you have recovered and feeling well you can leave the unit and make your own way home or back to work. You will not be able to have anything to eat or drink for about an hour following the procedure, until the effects of the spray has worn off. After this, you can eat and drink normally.
2. Sedation
If you choose to have sedation, an intravenous sedative is usually given through a small needle in your hand or arm. Sedation will make you relaxed and you may not remember the procedure. You will not be put to sleep. If you opt for sedation, you will need to have a responsible person to accompany you home and you will need someone to stay with you for 12-24 hours after the procedure. Advice about the care following the procedure is discussed later in this booklet.
The procedure
You will be taken into the procedure room. If you have opted for sedation, a small plastic cannula will be inserted into a vein in your hand or arm. You will be asked to lie on your left side The sedation will then be given. If you have chosen throat spray, this will be administered. A nurse will stay with you throughout the procedure. To help minimise any damage to your teeth or the scope, a small plastic mouthpiece will be placed between your teeth.
The endoscopist will pass the scope over the back of your tongue and down into your stomach. This procedure will not interfere with your breathing. The test is not painful, but the tube presses on the back of the throat and can make people retch during the procedure and a slight sore throat often follow lasting about 24 hours or so. The air that is blown into the stomach can provoke belching and bloating which wears off very quickly after the procedure. The procedure will usually take between 5 and 10 minutes. Once completed, you will be transferred to our recovery area where you will be
monitored until you are ready to leave.
Going home after the procedure
If you have had sedation, it is essential that a responsible adult accompanies you home by car or taxi – public transport is not suitable.
When you get home, you should rest for the remainder of the day. Someone should stay with you for the rest of the day and overnight. During the first 24 hours following sedation you must not:
• Drink alcohol
• Drive any vehicles (including riding a motorcycle or bicycle)
• Take sleeping tablets
• Operate machinery or electrical items (including a cooker or kettle)
• Sign any legally binding or important documents
• Work at heights (including climbing ladders or onto chairs)
Please note that sedation can impair your reflexes and judgement for up to 24 hours even when you feel fully awake. Once the effects of the throat spray wears off, you are free to eat and drink as normal and carry out any normal activities that you choose.
When will I know the results?
Before discharge, you will be given a brief outline of the test results. If a biopsy or polyp has been removed, the laboratory results will take longer, about 10-14 days. You may be offered a copy of the endoscopy report for your own information, and a copy will be posted to your GP surgery, or you may take this copy to hand deliver to them yourself.
General points to remember
If you are having sedation, please arrange for a responsible adult to collect you and stay with you overnight