Gastroscopy
This leaflet has been written by the staff working in the Endoscopy Unit at both Chelsea and Westminster Hospital and West Middlesex University Hospital.
We hope you find it useful. If, after you have read it, you have any questions or concerns, please contact us :
Chelsea and Westminster Hospital: 020 3315 3056/5223 - Endoscopy Unit - 2nd Floor, Lift Bank B
West Middlesex Hospital: 020 8321 2585/5191 - Endoscopy Unit - ground floor of the Main Hospital Building in the East Wing.
Please talk to us about any worries and ask any questions you have.
If you would like to change your appointment time or date, please contact the Endoscopy Unit booking team on:
Chelsea and Westminster Hospital : 0203 315 4141/5984 or email us Chelwest.cwdiagnosticcentre.admin@nhs.net
West Middlesex Hospital: chelwest.endoscopy.westmid@nhs.net
What is a Gastroscopy?
A gastroscopy, also known as an endoscopy or OGD is a test in which a long flexible telescope called an endoscope is passed through the mouth allowing the Endoscopist to look directly at the lining of the oesophagus (gullet), stomach and duodenum (small bowel).
Sometimes a biopsy - sample of tissue – is taken for analysis (testing) in the laboratory. The tissue is removed through the endoscope using tiny forceps. This is not painful. The whole procedure only lasts 5–10 minutes.
Some people will require treatment through the endoscope to treat/prevent bleeding, or to dilate (open) the oesophagus. If this is needed the procedure will be explained and may take longer.
There is a considerable variation in the way people react to this procedure and the sedation. General anaesthesia is not required. The procedure is safe but may be unpleasant and at times uncomfortable.
If you chose to have sedation, we aim to use enough sedative to relax you. We do not send you to sleep but we will do our best to make you as comfortable as possible. Some people will not remember all of the procedure after having the sedative—this is normal and nothing to worry about.
What should I do before I come in?
As you will be having sedation, you must organize for someone to take you home after the test and be with you for 24 hours.
Drugs
Unless advised otherwise, if you are taking any of the following medicines please stop taking them accordingly:
1 week before the test: Omeprazole (Losec), Lansoprazole (Zoton), Esomeprazole (Nexium)
48 hours before the test: Ranitidine (Zantac ), Cimetidine (Tagamet)
These tablets are protecting the lining of your stomach and if you stop taking the medication it will help us to get a clearer diagnosis. It is not necessary to stop these medicines if your procedure is for Barrett’s surveillance, or to assess response to treatment for oesophagitis or an ulcer.
Unless you have been advised otherwise, you should take any other usual medicines normally (with a few sips of water).
If you are diabetic please let us know in advance.
Unless advised otherwise, if you are taking any of the following medicines, please inform the pre-assessment nurse or a member of the Endoscopy team for further instructions:
- Warfarin, rivaroxaban, apixaban, dabigatran, edoxaban
- Clopidogrel, prasugrel, ticagrelor, dipyridamole
- Any other medication used to thin the blood
On the day of the Gastroscopy
You should not eat or drink anything for 6 hours prior to the test, with the exception of clear fluids (water, black tea or black coffee) which can continue until 2 hours prior to the test.
What are the benefits and risks?
The benefit is that this procedure will help us to investigate your symptoms and it may help us to treat you. There is an extremely small risk of bleeding or a tear in the lining of the gut (perforation 1 in 9000), which may require urgent treatment, blood transfusion or an operation. Gastroscopies also involve a slight risk of damage to crowned teeth or dental bridgework.
What options are available for the procedure?
Throat spray - If you chose this, you will be fully awake during the examination. The endoscopist and nurses will talk you through it. A local anaesthetic spray will numb the back of the throat, helping the endoscope to go down.
Sedation via a needle- If you chose this, we will give you a sedative via a needle in your arm. This is not a general anaesthetic but will make you relaxed and may make you feel sleepy. If you have sedation you will need to rest in the department for at least an hour afterwards until the effects of the sedation have worn off.
Please note with sedation or General anaesthesia, even if you feel wide awake your reactions may still be affected. You may find it difficult to concentrate and you may forget things that you have been told after the procedure. The nurses will give you written discharge information. This includes the advice that for 24 hours after sedation you should not drive, ride a bicycle, operate machinery, take sedatives or drink alcohol, or sign legal documents.
If you have sedation, your escort must collect you from the unit, take you home and be with you for the next 24 hours. We cannot escort you home.
What will happen when I come in?
On admission to the unit a nurse will ask you several questions about your health, current medication (please bring an up to date list with you), take your blood pressure and pulse.
Please leave any valuables at home, as we cannot be responsible for any valuables lost whilst you are in the unit. You do not need to bring anyone with you to your appointment, unless they are acting on your behalf (e.g. interpreting for you). Your escort/relative will only be needed when you are discharged if you have sedation.
Prior to the test you will be seen by the endoscopist. This is an opportunity to discuss the test before you sign a consent form. Please ask any questions you may have. It is important that you understand what is going to happen.
What will happen during the procedure?
In the procedure room you will lie on a trolley (narrow bed), on your left side. Two nurses and the endoscopist will stay with you throughout the test. You will be asked to bite on a small plastic mouthpiece to help keep your mouth open. This will also help to protect your teeth during the test. Dentures have to be removed if they are loose.
During the test you may be given oxygen through little prongs that fit just inside your nostrils. Your blood pressure, pulse and oxygen levels will also be monitored. When the endoscope is passed through your mouth it is likely to be uncomfortable. It may make you feel sick or you may retch. The endoscope will not interfere with your breathing.
During the test air is passed down the endoscope into your stomach to get a clear view. This may make you burp. The air is sucked out at the end of the test. If you get a lot of saliva in your mouth, the nurse will clear it using a sucker (the sort of tube that is used when you go to the dentist).
FAQs
Will I get the results of my test on the same day?
What happens to my medication?
We will talk to you before you go home about any changes/additions to your medications.
How long will I be in the endoscopy unit?
Your appointment time in Endoscopy is approximate because some procedures may take longer than expected and emergency procedures need to take priority. Please expect to be in the department for several hours – having pre-procedure checks, the procedure and for recovery after the procedure.
What can I expect when I go home?
You may feel bloated if some air remains in your stomach. It is advisable to sit upright and if possible walk around to help relieve this. Warm drinks and peppermints will also help you to pass the wind. You may have a sore throat, which can last up to 48 hours. Taking throat lozenges will help. Pain relieving tablets such as paracetamol may be taken according to manufacturer’s instructions.
If the pain continues, or you have concerns or questions, please contact the Endoscopy Unit from:
Chelsea and Westminster Hospital
8am–6pm : 020 3315 3056/5223. Outside of these times please call St. Mary Abbot ward on 020 3315 8602 / 8603 or go to your nearest Accident and Emergency and remember to take your Endoscopy report with you.
West Middlesex Hospital
8am–6pm: 020 8321 2585/5191. - Outside of these times please call 020 8560 2121or go to your nearest Accident and Emergency and remember to take your Endoscopy report with you.