Gastroscopy

What are the benefits of this procedure?

The procedure is to help diagnose your problem. Like all tests, this is not guaranteed to demonstrate all abnormalities and on rare occasions conditions are not identified.

What are the risks associated with this procedure?

• Bloating and abdominal discomfort is not unusual for a few hours
• You may have a sore throat for 24 hours
• Bleeding or perforation of the oesophagus are a very rare complication (less than one in 10,000) but may require an operation to repair the damage
• Using sedation can cause breathing complications in up to one in 200 procedures, which usually are not serious
• No test is 100% accurate and abnormalities may be missed, including cancers
• Damage to dental work

The person doing the test will discuss with you any worries you have about the risks associated with this procedure.

What are the alternatives?

This is the best form of examination of your stomach lining. Sometimes a barium swallow or barium meal is the alternative investigation ordered.

Preparing for a Gastroscopy

Please read the information enclosed carefully. If you have any queries, contact the unit where

you will be having your procedure.

If this is your first procedure and you are currently taking any stomach tablets, for example:

• ranitidine (ZANTAC)
• cimetidine (TAGAMET)
• nizatidine (AXID)
• omeprazole (LOSEC)
• lansoprazole (ZOTON)
• pantoprazole (PROTIUM)
• rabeprazole (PARIET)
• esomeprazole (NEXIUM)

You should stop taking them for two weeks before your gastroscopy if time allows.

If we are repeating your gastroscopy or you have been diagnosed with Barrett’s Oesophagus, you should continue to take your tablets up to and including the day of your test

You may continue to take antacids i.e. Gaviscon or Asilone if required but not within three hours of your test. You may continue to take any other medication.

If you are diabetic, on warfarin, clopidogrel, rivaroxaban, apixaban, or dabigatran please contact the unit for further information.

If you take medication for your blood pressure, please make sure you take this as usual prior to your procedure with small sips of water (at least two hours before).

Please bring any medication you are currently taking (including sprays and inhalers) with you to your appointment. If you are taking a number of tablets please bring in your repeat prescription sheet.

To allow a clear view the stomach must be empty, so please follow these instructions:

• do not have anything to eat for at least six hours before the test
• do not drink milk for four hours before your test. Milk will line the stomach and not allow a clear view of the lining
• you may drink clear fluids (water, black tea or black coffee) up to two hours before the time of the appointment

When you arrive at the hospital

Please report to the reception desk where a receptionist will check your details and direct you to the waiting area.

Please be aware the appointment time you have been given, will be your admission time. Your procedure will be carried out as near to this time as possible however on occasions due to emergency patients being seen, this may be delayed.

• Please do not bring any valuables to the hospital with you
• Please do not wear any nail varnish, lipstick or jewellery (tongue studs must be removed
• Please bring a contact number of a relative or friend with you

A nurse will then explain the procedure to you, to make sure you understand the benefits, and possible risks as detailed in this leaflet. The staff will want you to be as relaxed as possible and will not mind answering your questions.

Provided you are happy for the procedure to be performed, you will be asked to sign the consent form to confirm your understanding of the procedure. You will be offered a copy of this.

Your consent to further procedures may be necessary, including taking tissue samples (biopsies) that may be helpful in diagnosing your problem. Tissue may be used for research but you can request that no removed samples be used for this purpose on your consent form.

Just before the procedure you will also see the person who will be performing the test and provided you are happy for the procedure to be performed, they will ask you to confirm your agreement and they will also sign your consent form.

If you need the help of an interpreter to understand any of this information, or on the day of the procedure, please contact the unit where you will be having the test, as soon as possible.

Please note relatives/friends or children should not be used as interpreters when you are required to sign your consent form.

During the test

You will not have to undress, but we may give you a gown to wear. You must remove dentures, glasses and contact lenses and loosen tight clothing around the neck.

In the examination room you will be made comfortable on the couch, resting on your left side. A nurse will stay with you throughout the procedure. To keep your mouth slightly apart, a plastic mouthpiece will be put gently between your teeth or gums. When the person doing the test passes the endoscope into your stomach it will not cause pain, nor will it interfere with your breathing. The whole procedure usually takes 10- 20 minutes.

Sedation

The procedure is normally done with sedation. Occasionally, sedation may not be required. If this is the case it will be discussed with you. If you do not want to have sedation, discuss this with your nurse and the person doing the test.

Sedation will make you slightly drowsy and relaxed but not unconscious. You will be in a state called co-operative sedation. This means that although drowsy you will still hear what is said to you and therefore able to follow simple instructions during the procedure.

Please note that we will not be able to give you sedation if you do not have a responsible adult to collect you and stay with you for 24 hours following your procedure.

You will be given oxygen through small tubes placed gently in your nostrils or through the plastic guard in your mouth. A clip will be attached to a finger or ear-lobe so that the levels of oxygen in the blood can be monitored. Your blood pressure may also be measured automatically during the procedure using a cuff around your arm

After the test you will remain in the unit to rest for two hours. Following this, you will be asked to have a drink of water before going home.

Going home

It is essential that a responsible adult comes to pick you up from the unit and accompanies you home by car or taxi – public transport is not suitable. Please note the unit closes at 6pm. Your relative/friend should arrive no later than 5.30pm to collect you.

When you arrive home, it is important to rest quietly for the remainder of the day, with someone to look after you for 24 hours. It is advisable to have the following day off work.

For the first 24 hours following sedation do not:

• drive a car
• drink alcohol
• take sleeping tablets
• operate any machinery or electrical items – even a kettle
• sign any legally binding documents
• work at heights (including climbing ladders or onto chairs)

Sedation can impair your reflexes and judgement. The effect of the sedation will have worn off by the next day and most patients will be able to resume normal activities.

You will only be able to drink fluids for the first 24 hours following your procedure. Following this you will need to gradually increase the thickness of your food over the next few days.

When will I know the results?

Before discharge from the unit, the nurse who has been looking after you will be able to give you a brief outline of the test results. A copy of the report will be sent to your GP or the doctor who referred you for the procedure. If a biopsy has been taken, the laboratory results will take longer, about 10 – 14 days. You will be given a copy of the report to take home with you.

If you have any questions about the test, please contact the unit where you will be having your procedure.