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Gastroscopy

A gastroscopy is a test that allows doctors to investigate the oesophagus and the duodenum (this is the upper portion of the small intestine). A gastroscopy is carried out using a very small flexible tube known as a gastroscope. The test is very quick, usually lasting only 5 minutes, however you may be advised to stay in hospital for 2-3 hours after the procedure. It is important that you avoid eating or drinking anything for at least 6 hours before the procedure, so doctors are able to view the stomach clearly.

Medications

If you are taking medication you will probably be advised to continue taking it as usual, however, in some cases, special precautions may be taken. It is important to tell nurses and doctors if you are taking medication and it is particularly important if you are taking medication to thin the blood, such as Warfarin or aspirin or you are diabetic. If you have any questions or doubts, do not hesitate to ask Dr Bansi or your nurse.

In some cases the findings of the test may be affected by medications used for peptic ulcers and indigestion and for this reason it is advisable to stop taking these medications, including cimetidine (Tagamet), omeprazole (Losec), nizatidine (Axid), pantoprazole (Protium) and ranitidine (Zantac) 14 days before the test. Tests are often carried out to look for a form of bacteria known as Helicobacter Pylori and the test results may not be as accurate if you are taking antibiotics. If you have any questions, ask your doctor or nurse.

The procedure

When you arrive you will be greeted by a member of staff, who will prepare you for your procedure. Your nurse may ask you a few questions and you should say if you are taking any medication or have any allergies. If you are suffering from congestion talk to your nurse and they may be able to ease this with decongestant medication. Please note that if you wear false teeth you will be asked to remove them.

During the procedure your nurse will stay with you and a small device will monitor your breathing and pulse. You may also be given anaesthetic spray to prevent pain and if you are having a sedative, this will be injected into a vein using a needle. A plastic mouthpiece will be placed between your teeth to keep your mouth open and the flexible tube will then be passed down the throat and into the stomach. This should be painless but you may find it uncomfortable and you may feel like you want to retch, which is normal. To help with the nausea try not to talk during the test and try to breathe slowly through your nose. In some cases, a biopsy may be taken from the lining of the stomach.

Alternatives

A barium meal is sometimes used as an alternative to a gastroscopy, this method is less invasive but it does involve radiation and it is not possible to take samples or biopsies during this procedure. In the majority of cases, a gastroscopy is more accurate than a barium X-ray.

Anaesthesia and sedation

A gastroscopy can be performed using local anaesthetic alone or with sedatives, which are administered intravenously. Some patients may choose to be sedated because it eliminates discomfort, however, it does make patients drowsy for some time after the procedure and therefore some people may prefer to go for the local anaesthetic and you should discuss your preference with the doctor beforehand. If you are sedated, after the procedure you may feel tired and drowsy and your doctor will talk to you but if you are too tired, they can speak to a friend or relative, who can relay the information when you feel more alert. It is always advisable to arrange a follow-up appointment. You should avoid driving or operating heavy machinery for 24 hours after the procedure. There is a very small risk of over-sedation and with all medications there is a small risk of side-effects.

If you have local anaesthetic, you will experience greater discomfort during the procedure but you will recover very quickly and you can resume normal activities straight away and you will also be able to talk to your doctor about the findings of the test straight away.

After the test

After the test you should be able to drink and eat normally after around 30 minutes, but you may experience bloating for a few hours after the test due to the air pumped in to make the test clearer. If you have been sedated you will probably feel drowsy for the rest of the day. You may experience mild pain in your throat, but this should soon subside. However, if you begin to experience severe pain in the chest, abdomen or neck see a doctor as quickly as possible.

Side-effects

Side-effects are very rare but they do exist and possible side-effects include damage to dental restorations, drug allergies, damage to the oesophagus or stomach and over-sedation and if damage is sustained surgery may be required. For some patients with respiratory illnesses or heart disease, the test may be fairly stressful.