WHAT IS A GASTROSCOPY?
Gastroscopy (also known Upper GI endoscopy) is a procedure that allows the examination of the upper part of the gastrointestinal tract, including the oesophagus, stomach and duodenum, using a thin flexible tube with a built in video camera, lens and light source (gastroscope).
WHY IS A GASTROSCOPY DONE?
Gastroscopy is usually performed to evaluate symptoms of upper abdominal pain, nausea, vomiting, weight loss, difficulty swallowing and bleeding. Gastroscopy is the most accurate means of detecting inflammation and ulcers of the oesophagus, stomach and duodenum.
Gastroscopy can detect early cancer and by performing biopsies (taking small tissue samples) doctors distinguish between benign and malignant (cancer) conditions. Biopsies are taken for many reasons, and do not necessarily mean that cancer is suspected. Gastroscopy may be used to treat conditions present in the upper gastrointestinal tract. A variety of instruments can be passed through the endoscope, which allow many abnormalities to be treated directly, with little or no discomfort. For example, stretching narrowed areas, removing polyps or treating upper gastrointestinal bleeding.
WHAT PREPARATION IS REQUIRED?
Before gastroscopy the stomach must be completely empty. Have an early breakfast before 7 am and then nothing to eat until after your procedure. You may drink plain water (only) until two (2) hours before you come to hospital. The hospital will give specific information about the time to begin fasting, depending on the time of day that your test is scheduled.
PLEASE ASK YOUR OWN DOCTOR FOR ADVICE:
Diabetes medications: omit your diabetes tablets on the morning of the test. If you take insulin you should take your usual dose with breakfast. The nurses will check your blood sugar when you arrive at the hospital.
Blood thinning medicines: anticoagulants such as warfarin (Coumadin), Pradaxa (Dabigatran), Xarelto (Rivaroxaban), and Eliquis (Apixaban) must be stopped for 3 to 5 days. You must discuss this with your own doctor as you may need to have injections during this period.
Antiplatelet agents such as aspirin and clopridigel (Plavix) usually need to stopped for one week. If you have stents in your heart DO NOT stop any medicine without your cardiologist’s permission. If necessary, aspirin can be continued up to the day of the test.
Most other drugs (for high blood pressure, cholesterol, depression, reflux, etc., can be taken up to 2 hours before coming to hospital with some water.
WHAT CAN BE EXPECTED DURING THE GASTROSCOPY?
Your doctor will review with you why a gastroscopy is being performed, whether any alternative tests are available, and possible complications from the procedure. An anaesthetist will put a small cannula (plastic tube) into your vein and give you medicine so that you are sedated or asleep.
While you are in a comfortable position on your left side, the endoscope is passed through your mouth and then in turn through the oesophagus, stomach and duodenum. The endoscope does not interfere with your breathing during the test. Most patients are asleep for the procedure and do not remember it.
WHAT HAPPENS AFTER THE GASTROSCOPY?
After the test, you will be monitored in a recovery area until most of the effects of the anaesthetic have worn off. Your throat may be a little sore for a while, and you may feel bloated right after the procedure because of the air introduced into your stomach during the procedure. You will be given something to eat and drink when you are awake. In most cases, your doctor will inform you of your test results on the day of the procedure, however the results of any biopsies taken will take several days.
WHAT ARE THE POSSIBLE COMPLICATIONS OF GASTROSCOPY?
Endoscopy is safe. Complications can occur but they are rare when the test is performed by doctors with specialised training and experience in the procedure.
Bleeding may occur from a biopsy site, or where a polyp has been removed. This is usually minimal and rarely requires blood transfusions or surgery. Localised irritation of the vein where the medication was injected may cause a tender lump lasting for several weeks but this will go away.
Other potential risks include a reaction to the sedatives/anaesthetic used and complications from heart or lung disease. Major complications, eg. perforation (a tear that may require surgery for repair) are very uncommon and occur less often than once in 10,000 tests.
It is important for you to recognise early signs of any possible complications. If you begin to run a fever after the test, begin to have trouble swallowing, or have increasing throat, chest or abdominal pain, let your doctor know about it promptly or contact your local Emergency Department.
RECOVERY FROM GASTROSCOPY EUS PROCEDURE
You will need to arrange to have someone accompany you home from the examination. Until the following day we recommend patients do not:
- Drive a car
- Work machinery
- Consume alcohol
- Sign legal documents
- Make important decisions
If any of your questions have not been answered here, please feel free to discuss them with the endoscopy nurse or your doctor before the procedure begins.