A Gastroscopy is a procedure where a thin, flexible tube called an endoscope is used to look inside the oesophagus (the gullet), stomach and first part of the small intestine – (duodenum).
During the procedure a thin flexible tube (endoscope) with a small video camera at the end is passed through the mouth into the stomach. The end of the endoscope contains a light and conveys images to a TV monitor allowing the doctor a clear internal view of the lining of the oesophagus, stomach and duodenum. The doctor can see abnormalities such as ulcers through the endoscope which are not easily detected on X-rays. As well as viewing the lining tissue samples (biopsies) can be taken for analysis. The tissue is removed painlessly by forceps passed down the endoscope.
The test is usually carried out to investigate swallowing difficulties, nausea, vomiting, reflux, bleeding, indigestion, abdominal pain or chest pain.
A gastroscopy can be used to:
• Investigate problems such as difficulty swallowing (dysphagia) or persistent abdominal (tummy) pain
• Diagnose conditions such as stomach ulcers or gastro-oesophageal reflux disease (GORD)
• Treat conditions such as bleeding ulcers, a blockage in the oesophagus, non-cancerous growths (polyps) or small cancerous tumours
A Gastroscopy used to check symptoms or confirm a diagnosis is known as a diagnostic gastroscopy. A Gastroscopy used to treat a condition is known as a therapeutic Gastroscopy.
What do I need to know before admission?
You will be asked to attend the Endoscopy unit. You can expect to be in the unit between 2-4 hours.
A Gastroscopy can be carried out either with or without sedation, please arrange for a friend or relative to collect you to and from the unit if you intend to have sedation. Please try and keep to the time stated on your letter.
Also please be aware that your procedure may be delayed or have to be cancelled at short notice. In these cases we offer apologies for any inconvenience and aim to reschedule your appointment as soon as possible.
If you are taking prescribed medication please bring a list of medication with you to your appointment. You can then be advised on medication you can take on the day of your Gastroscopy. Please bring a list of medication you are taking with you.
If taking iron tablets stop these until after the procedure.
If you are a diabetic on tablets or insulin or if you take any medication to thin your blood known as anticoagulants or antiplatelets such as aspirin, warfarin, clopidogrel, rivoraxaban or apixian please contact the Endoscopy unit so that we can discuss these with you.
We would appreciate it if you could leave all jewellery (except wedding band) and valuables at home as we do not have facilities to secure these items.
You must not have anything to eat or drink for at least six hours before the procedure; it is essential that your stomach is empty at the time of the procedure. If your stomach is not empty there is a risk of aspiration (vomit inhaled into the lungs). This can be a very serious complication. Furthermore having your stomach empty allows a clear view during the procedure. Please wear comfortable clothes.
What happens on admission?
On the day of admission a nurse will complete an admission document with all your personal details. The nurse will check your medical history and any current medication with you.
They will explain the procedure to you, inform you of the potential risks and complications of Gastroscopy, they will discuss with you whether you want a local anaesthetic (throat spray) or a sedative for the procedure and also answer any questions that you may have. The nurse will then ask you to sign the consent form for the procedure once you have read it carefully and understood it in full.
You will not be asked to change into a hospital gown but if you want to you can. Dentures, spectacles and contact lenses can be removed later on; the nurses will tell you when.
What happens during the Gastroscopy?
You will be taken to an examination room for the procedure. Once sat on the trolley the nurse or doctor will spray the back of your throat with a local anaesthetic. This makes your throat go numb quite quickly and you may start to feel as if you can’t swallow, don’t panic you can swallow but just may not feel it.
The nurses will ask you to keep your mouth slightly open so a plastic mouthpiece will also be placed between your teeth.
If you have chosen not to have sedation the procedure will then start, a nurse will talk you through what is happening and tell you if you need to do anything e.g. when to swallow.
If you are having the sedation the doctor or the nurse will insert a cannula (thin plastic tube) into a vein in your hand or arm.
A cannula provides a route for the drugs to be given before the procedure. A sedative drug will be injected via the cannula into your arm. This is not a full anaesthetic and will not put you to sleep however it will make you more relaxed. A fine soft tube will be placed into your nostrils to give you a little extra oxygen to breathe and a small device will be attached to your finger or thumb to monitor your pulse rate and oxygen levels during the test.
Once you are sedated the procedure will be carried out:
- The endoscope is gently passed through your mouth into your stomach. This will not cause you any pain nor will it interfere with your breathing
- The lining of the gullet, stomach and duodenum will then be examined closely. Air may be passed through the endoscope to distend the stomach to give a clear view of the lining. This air is sucked out at the end of the test
- If the doctor finds any change in tissue a tiny piece may be removed (biopsy) using instruments passed through the endoscope. Any samples of tissues removed are sent to the laboratory for specialist examination
- If any bleeding is discovered, the doctor will use a special needle to inject certain medications through the endoscope to stop the bleeding
- When the procedure is complete, the tube is removed quickly and easily. The procedure lasts from 5-10 minutes.
What happens after the Gastroscopy?
If you have not had sedation, you will be able to walk back to the waiting area.
If you have had sedation you will rest for a while in the recovery area on the unit. The nursing staff will check your pulse and oxygen levels regularly and generally assess how you have recovered from the test. If you feel unwell at all please let the staff know.
You may feel a little bloated and experience wind pains due to the air passed into the stomach during the test, although these usually settle quite quickly. If you are in pain please inform the staff as soon as possible.
You will be given something to eat and drink when you feel ready. However if you had a local anaesthetic spray on the back of your throat (throat spray) you will have to wait until your swallow reflex is back to normal (this can take up to 1 hour from when the throat has been sprayed). After this you can eat and drink normally. Your throat may be sore for the rest of the day.
The nurse will speak to you about your Gastroscopy, discuss the findings, and will issue you with a copy of your discharge letter and post procedure advice sheet.
Most patients are well enough to go home the same day as having the Gastroscopy, occasionally patients may be required to stay in hospital longer for observation or further treatment.
Discharge Advice
If you have had sedation it is essential that an adult comes to collect you after the procedure and stays with you overnight. Once home, it is important to rest quietly for the remainder of the day. Sedation lasts longer than you think; therefore you should have someone to stay with you overnight.
You may have a sore throat, which should not last longer than 24-48 hours.
Furthermore if you have had sedation you should avoid the following activities for at least 24 hours after the procedure:
• Going to work
• Driving
• Operating machinery
• Drinking alcohol
• Signing any legally binding documents
• Carrying out any activities involving heights
• Caring for young children ( sole responsibility)
If you start to feel unwell or develop severe abdominal pain, you must contact the unit, your G.P. or the out of hours GP as soon as possible.
Benefits
To obtain direct vision of the lining of the oesophagus, stomach and duodenum to aid diagnosis and treatment.
Risks
The risk of any serious complication occurring in a diagnostic gastroscopy is less than 1:1000.
It is very important that you are aware of the potential risks and complications of Gastroscopy before giving your consent to the procedure. These include:
• Internal bleeding (haemorrhage) – this may occur at the site of a biopsy. The bleeding is usually resolved without any treatment but in a minority of cases may be serious
• Perforation – damage to the lining of the oesophagus or stomach (perforation) may result in admission to hospital and further tests. This can be a potentially serious complication, and may need to be surgically repaired
• Reaction to sedative
• Damage to teeth, crowned teeth or dental bridgework
• Aspiration pneumonia
N.B. There is no evidence that the complication rates after Gastroscopy at the Northern Lincolnshire and Goole NHS Foundation Trust are different from the averages quoted.
Every effort is made to reduce the risk of these complications occurring.
If you are concerned about any of these risks and complications, please discuss this with the consultant or member of staff before the procedure.
Alternatives
In some cases there are, but it will depend on individual factors such as; the symptoms present and the condition being investigated.
There may be alternatives to having a Gastroscopy, such as a barium meal, but this X-ray based test tends to provide less information than a Gastroscopy, and samples of tissue cannot be taken to aid diagnosis and treatment.
Contact Details for Further Information
If you have any questions or concerns, please contact:
The Endoscopy unit at Diana Princess of Wales Hospital
Normal Hours: 8am – 7pm Mon to Fri. and 8am- 6pm Saturday
Endoscopy pre-assessment Nurse: 03033 303078
Telephone the Unit direct on 03033 303611 between the hours of 8am until 6pm, Monday until Friday
or
Telephone Diana, Princess of Wales Hospital, Grimsby on: 03033 306999 and ask for the Endoscopy unit.
Out of Hours:
After 6pm contact Ward C6 via the main switchboard on: 03033 303905 (Out of hours 6pm to 8am).
The Endoscopy unit at Scunthorpe General Hospital
Normal Hours:
Telephone the Unit direct on 03033 302186 between the hours of 8am until 6pm, Monday until Friday
or
Telephone Scunthorpe General Hospital 03033 306999 and ask for the Endoscopy unit.
Out of Hours:
After 6pm contact your GP or phone the G.P. Emergency Centre 01724 290444
Any Comments, Compliments, Concerns or Complaints
If you have any other concerns please talk to your nurse, therapist or doctor. Our Patient Advice and Liaison Service (PALS) is available on 03033 306518 (Grimsby, Scunthorpe and Goole). You can also contact nlg-tr.PALS@nhs.net
As a Trust we value equality of access to our information and services, therefore alternative formats are available on request at nlg-tr.interpreters@nhs.net
Review information
Date of issue: December 2021
Review Date: December 2024
