Gastroscopy

(PANENDOSCOPY OR UPPER GASTROINTESTINAL ENDOSCOPY)

What is a Gastroscopy?
Gastroscopy is a procedure to examine the oesophagus, stomach and duodenum. The procedure is usually done under sedation so that you are comfortable throughout.  While you are asleep a thin, flexible tube is passed through your mouth into the oesophagus and then into the stomach.  The most common reasons for having a gastroscopy are to investigate symptoms of reflux, abdominal pain, diarrhoea or any other suspected condition of the oesophagus, stomach or duodenum. Samples (biopsies) are usually taken from the lining of the duodenum, stomach and/or oesophagus during the procedure.  Sometimes polyps are removed or other interventions such as treatment of bleeding ulcers or dilatation (stretching) of the oesophagus.

Gastroscopy is often performed at the same time as colonoscopy and if so the preparation, what happens on the day and your recovery are the same as for colonoscopy alone.

How do I prepare?
The stomach needs to be empty for the procedure. No food should be taken for 6 hours before the procedure and no liquid should be taken for 4 hours before. Bowel preparation is not required for gastroscopy alone.  There’s often waiting before or after the procedure so it’s a good idea to bring something to read.

Should I take my usual medications before the procedure?
Important tablets and medicines can be taken with a sip of water on the morning of the procedure. If you are taking medications such as aspirin, clopidogrel or anticoagulants such as Warfarin, Xarelto or Pradaxa they may need to be stopped before the procedure.  You should discuss this with your Gastroenterologist when the procedure is booked.  Diabetics may need to modify their insulin or anti-diabetic medications on the morning of the procedure but this should be discussed with me prior to the procedure.

Are there any risks?
Gastroscopy is a very low risk procedure. The risk of a tear (perforation) or bleeding is extremely low but is increased in some circumstances such as if dilatation is performed, treatment is given for bleeding or polyps are removed.  The sedation used is generally well tolerated and problems are unlikely in the absence of serious underlying health problems.  Medical problems such as heart disease, severe lung disease, diabetes or neurological problems may increase the risks and should be discussed with your Gastroenterologist before the procedure.

What happens on the day?
When you arrive at the hospital the nursing staff will greet you and prepared you for the procedure.  The anaesthetist will meet you and once you are in the procedure room you will have an intravenous cannula placed and a sedative given.  The procedure is done with you asleep but it is not a general anaesthetic. You should recover quickly after the procedure.  Patients rarely have any memory of the procedure.  Once you have been sedated your Gastroenterologist will perform the gastroscopy.  This usually takes approximately 15 minutes.

What happens after the procedure?
After the procedure you will be taken to the recovery room.  When you have recovered sufficiently your Gastroenterologist will talk to you about the findings although you may not recall everything that is said.  A written report will be sent to your doctor. If any biopsies are taken the results will be sent to your GP.  Your Gastroenterologist will usually see you in the rooms a few weeks after the procedure to discuss any important findings, management of your symptoms and the need for any further procedures.

You must not drive, return to work, drink alcohol, operate machinery, sign legal documents or use public transport unaccompanied until the following day. You should be escorted home by an adult and have someone with you at home until the following day.

The recovery after gastroscopy is almost always uneventful however if you develop significant pain or bleeding it is important to contact the hospital your Gastroenterologist immediately.  In an emergency call 000.

If you have unanswered questions about the procedure please contact your Gastroenterologist.  Further information is available from the Gastroenterological Society of Australia on their ‘consumer information’ page at www.gesa.org.au.