Gastroscopy

A gastroscopy – sometimes called an ‘upper gastrointestinal endoscopy’ – is a procedure in which a thin, flexible tube called an endoscope is used to look inside the oesophagus, stomach and first part of the small intestine. The endoscope has a light and a camera at one end, which sends images of the inside of your oesophagus, stomach and small intestine to a monitor.

Why might a gastroscopy be performed?

• To investigate problems such as difficulty swallowing (dysphagia) or persistent abdominal (tummy) pain
• Diagnosis of conditions such as stomach ulcers or gastro-oesophageal reflux disease (GORD)
• Treatment of conditions such as bleeding ulcers, a blockage in the oesophagus, non-cancerous growths (polyps) or small cancerous tumours

The procedure
A gastroscopy often takes less than 15 minutes, although it may take longer if it’s being used to treat a condition. It’s usually carried out as a day procedure, which means you won’t have to spend the night in hospital. The procedure will usually be carried out by an endoscopist (surgical or medical gastroenterologist or a surgeon) and assisted by a nurse.

You’ll be asked beforehand if you would like to be sedated during the procedure. Most of our gastroscopies are performed under conscious sedation, so as a patient you’ll be unaware of what will be happening and won’t feel any discomfort. Under certain conditions, a general anaesthetic may be required, while some patients may choose to have the procedure fully awake. All anaesthesia will be carried out by a specialist anaesthesiologist.

You’ll be asked to lie down on your left-hand side and the endoscopist will insert the endoscope into your throat. They’ll ask you to swallow it to help move it down into your oesophagus. This may be uncomfortable at first and you may feel sick or gag, but this should pass as the endoscope is moved further down.

Preparing for a gastroscopy
Before the procedure starts, you’ll be asked to remove any glasses, contact lenses and false teeth. You won’t usually need to get undressed, but you may be asked to wear a hospital gown over your clothes. A local anaesthetic spray will be used to numb your throat for the procedure and a small plastic mouth guard placed in your mouth, to hold it open and protect your teeth.

Recovery
After the procedure, you’ll be taken to the recovery area. If you didn’t have a sedative, you can usually go home soon after the procedure is finished. If you had a sedative, you’ll need to rest quietly for a few minutes or hours until the sedative has worn off. You’ll also need to arrange for someone to take you home and to stay with you for at least 24 hours. Even if you feel very alert, the sedative can stay in your blood for 24 hours and you may experience further episodes of drowsiness. During this time, you shouldn’t:

• Drive
• Operate heavy machinery
• Drink alcohol
• Take sleeping tablets
• Go to work
• Sign any contracts or legal documents
• Be responsible for small children or dependents

Before you’re discharged, your endoscopist will explain the results of the procedure to you. You’ll be required to make a follow-up appointment to discuss your results. You’ll be told if you need to make any changes to your diet during the hours or days after going home.

It’s normal to feel bloated or have a sore throat for a day or two after a gastroscopy. You should contact us immediately if you develop signs of a more serious problem, such as:

• Severe or worsening chest pain or abdominal (tummy) pain
• Passing dark or tar-like poo
• Persistent vomiting
• Vomiting blood
• Shortness of breath
• A temperature of 38°C or above

What are the risks?
A gastroscopy is a very safe procedure, but like all medical procedures, it does carry a risk of complications. These could include:

• A reaction to the sedative, which can cause problems with your breathing, heart rate and blood pressure
• Internal bleeding
• Tearing (perforation) of the lining of your oesophagus, stomach or duodenum