Gastroscopy

A Patients Guide

Important information

• The time on your appointment letter is the time you need to arrive at the Day Treatment Centre. It is not the time your procedure will happen.
• You may have to wait for a few hours before your procedure starts. Please come prepared. It's a good idea to bring something to read.
• Please tell the hospital as soon as you can if:
  • You need a translator or interpreter.
  • You take blood thinners or diabetes medicine.
• Tell the Nurse or Doctor if you have a pacemaker, defibrillator, artificial hips, or any other metal implants.
• If you don't have someone to take you home after your procedure, please tell the Endoscopy Nurses as soon as possible.
• Endoscopy is a restricted area. Friends and family cannot come inside. We have a trained team of Nurses and Doctors to look after you. If you need an interpreter, we can arrange one by phone or in person.
• If your appointment time is not good for you, or if you cannot come, please contact the Booking Services team on 020 7288 3822 or email whh-tr.endoscopy@nhs.net.
• If you have questions about your test or medicines, please call the hospital switchboard on 020 7272 3070 and ask for bleep 2711 (Monday-Friday, 8:30-17:30). You can also call 020 7288 3811/3819 or email whh-tr.endoscopypreassessment@nhs.net.
• Please do not bring valuables to the hospital. We cannot look after them and there are no lockers available.

What is a gastroscopy?

A gastroscopy (also called an endoscopy) is a camera test that lets the Doctor look at the inside of your food pipe (called the oesophagus), stomach, and the first part of your small bowel (called the duodenum).

• The Doctor uses a thin, bendy tube called a gastroscope. It's about the size of your little finger. It has a light and camera on the end and is gently passed through your mouth.
• The test usually takes about seven minutes. It can feel a bit uncomfortable, but it shouldn't hurt.
• You can choose to have a throat spray (to numb your throat) or sedation (medicine to help you relax).

Sedation

• You will be given an injection in your vein. This will include medicine to help you relax and reduce any pain.
• The sedation will make you feel calm and a bit sleepy, but you will not be fully asleep. You may still notice what is happening and be able to follow simple instructions.
• We will check your heart rate, breathing and blood pressure during the test.
• If you choose sedation, you must have someone to take you home afterwards. If you cannot find someone, please tell one of the Endoscopy Nurses using the phone numbers given.

Throat spray

• We can spray a medicine (xylocaine) onto the back of your throat to make it numb. It tastes bitter but works quickly.
• The spray helps the camera go through your throat without you feeling it.
• The benefit of using the spray is that you stay fully awake and can go home by yourself soon after the test.
• Your throat will stay numb for about 45 minutes. During this time, you should not eat or drink anything.

How do I prepare for my procedure?

• Do not eat any food for at least 6 hours before your test.
• If you eat, the Doctor will not see clearly inside your stomach. It also increases the risk of food going into your lungs, which can cause an infection (aspiration pneumonia).
• You may have a few sips of clear fluids (such as water, black tea, black coffee with no milk, or herbal tea) up to 2 hours before your test.
• If you do not follow these instructions, your test will be cancelled.
• Keep taking your regular medicines unless the Endoscopy Nurse or your Doctor has told you to stop.
• If you are also having a colonoscopy on the same day, follow the bowel preparation instructions, but stop drinking clear fluids 2 hours before your appointment time.

What happens when I arrive in the endoscopy unit?

• When you arrive, we will ask you to fill in a short form with your details and information about your medicines.
• Please bring the medicines you are taking, or an up-to-date prescription list. If you cannot fill in the form, we will help you.
• A Nurse will see you and ask a few questions about your health. This is to make sure you are well enough to have the test.
• The Nurse will also check your heart rate, blood pressure, and oxygen levels. If you have diabetes, we will also check your blood sugar.
• The Nurse will ask how you are getting home. If you are having sedation, you must have someone to take you home.
• If you have chosen sedation, the Nurse will put a small tube (cannula) into your arm. If you have chosen the throat spray, the Nurse will give this just before the test.
• You will then go to the waiting area until it is time for your test.
• Remember: The time on your appointment letter is the time you need to arrive, not the time of your test.

What happens during the procedure?

• A team member will take you outside the procedure room. The Doctor or Nurse (Endoscopist) will explain the test and ask you to sign a consent form. This is your chance to ask any questions.
• When everything is ready and we have finished all the checks, we will give you the throat spray.
• You will then be asked to lie on your left side. The Nurse will place a small mouthguard in your mouth. This protects your teeth and gums during the test.
• To help the Doctor see, air or carbon dioxide will be put into your stomach. This may make you feel a little bloated.
• Any saliva or fluid in your mouth will be removed with a suction tube, like the one used at the dentist.
• Please note: Whittington Health is a teaching hospital. Sometimes a student Doctor or Nurse may watch your procedure.

Why do I need a gastroscopy?

• You have been advised to have a gastroscopy to help find out what is causing your symptoms.
• Some common reasons for having this test are:
  • Indigestion
  • Anaemia (low iron in the blood)
  • Weight loss
  • Vomiting
  • Problems swallowing
• Gastroscopy is a safe test. Serious problems are very rare.
• Please read this information carefully and think about the benefits and the risks before you decide. You will be asked to sign a consent form before the test.
• The main risks are:
  • There is a small chance of a tear or hole (called a perforation). If this happens, you might need an operation to fix it.
  • There is a small risk of bleeding.
  • There is a slight chance of damage to your teeth or breathing food or liquid into your lungs (this is called aspiration pneumonia).
  • About 1 in 200 people may have trouble breathing if they have sedation. You will be given oxygen, and your heart and breathing will be checked during the procedure to help keep you safe.

What are the alternatives?

• Barium Swallow: this is a special X-ray test that looks at the top part of your stomach and the tube that carries food from your mouth to your stomach (called the gullet). It does have some downsides: samples of the tissue (biopsies) cannot be taken during the test, and it uses a small amount of radiation.

What happens after the procedure?

• The Nurses will keep checking your breathing, heart rate, and oxygen during and after the test.
• If you had sedation, you would rest for about 30 minutes while we keep monitoring you.
• When you have recovered, you will be offered some refreshments. You can also bring your own food if you prefer.
• You should not feel pain, but you may have some wind (bloating). This usually goes away after a few hours.
• Before you leave, the Nurse or Doctor will give you a copy of the report. They will explain what was seen and if you need any medicines or another test.
• If you live alone, you must arrange for someone to stay with you overnight.
• For the next 24 hours after sedation, you must not:
  • Drive
  • Drink alcohol
  • Use heavy machines
  • Sign any important documents
• Most people feel completely normal again after 24 hours. If you still feel sleepy, wait another 24 hours before driving.

After you go home

• If you have stomach pain that doesn't go away, bleeding from your back passage or fever within the 2 days (48 hours) after your procedure, please go to your nearest Hospital Emergency department - please take a copy of your endoscopy report with you.
• For any other queries, you can contact the endoscopy department:

Endoscopy Department

Tel.: 020 7288 3811 / 3819

Email: whh-tr.endoscopypreassessment@nhs.net