Gastroscopy
This procedure is an excellent modality to examine the upper intestinal tract. It is usually performed with the patient moderately sedated (“twilight” sedation) and maybe with local anaesthetic sprayed into the throat. The instrument, an endoscope, is a flexible tube supplying fibreoptic light and camera to allow visualisation on a monitor.
Indications: Some common reasons you may require a gastroscopy include investigation of upper abdominal pain, difficulty swallowing, suspected reflux or ulcers, anaemia, unexplained weight loss, investigation of diarrhoea, malabsorption or suspected coeliac disease. Gastroscopy is also performed for screening for cancer in patients with risk factors, or with Barrett’s oesophagus or other medical conditions.
How to prepare: Most likely this will be booked as a day procedure implying that you will be discharged home the same day. You will need someone to drop you and pick you up as the sedation given to you precludes you from driving, even if you are not tired. You will need to be fasting from all solid food usually for 8 hours before the procedures, with water allowed up to 2 hours before the procedure. Wear comfortable clothing, wear glasses instead of contact lenses if you can, bring in your medication. Your doctor will tell you whether or not you are to take your usual medication on the day of the procedure.
What to expect: Upon arrival, you will be admitted and observations taken. You may be asked to change into a hospital gown. Your doctors will see you before your procedure. Ask any last minute questions, voice any concerns that you may have. A canula will be placed in your arm and monitoring equipment and a mouthguard will be applied. You may have your throat sprayed with anaesthetic. You will be given some oxygen by mask or under the nose and usually a mild sedative is infused into your vein. During the procedure, the endoscope will be passed through your mouth, into the oesophagus and stomach and into the duodenum, as far as the scope length allows. Biopsies, tiny pieces of tissue, will likely be taken depending on the indication for the procedure; you can’t feel this happening. Photographs documenting the findings will also be taken. The instrument is then withdrawn, and you will be taken to recovery where you will be offered refreshments when you are awake. Your doctor will see you before you are discharged and preliminary written copy of the report (usually with the pictures) is given to you also.
Afterwards: Most people do not remember the procedure, enjoy the rest, and wake up feeling very well. It is not unusual to be awake for some of the procedure. Some people have a sore throat, or some bloating. Rarely, there may be some nausea. You may return to work the following day. You may make an appointment to see the specialist, or sometimes return to your GP for results.
Complications: These are very rare and include chest infection, bleeding, or perforation. If you have persistent chest pain, abdominal pain, shortness of breath, fever, vomiting or blood loss, contact the doctor or present to the nearest emergency department.
