Preparing for a diagnostic gastroscopy
You will usually receive written information about how to prepare for a diagnostic gastroscopy, along with your appointment letter. If there is anything that you feel needs to be clarified, call the hospital.
If you are referred for an endoscopy, you will need to stop taking any prescribed medicines for dyspepsia (indigestion) at least two weeks beforehand. This is because they can mask some of the problems that could show up. You can continue to take antacids up until your endoscopy.
You will be asked not to eat or drink anything for six hours before having your endoscopy. It is important that your stomach is empty so that the person who is performing the endoscopy can see the whole area clearly.
If you wish, you can choose to have the procedure carried out under sedation (see below) in order to help prevent food or fluid from passing into your lungs.
A diagnostic gastroscopy is not a particularly painful procedure, although some people may find it slightly uncomfortable. Therefore, you can choose the type of anaesthetic that is used during the procedure:
- Local anaesthetic spray is used to numb the back of your throat
- Sedation makes you very drowsy so that you have little or no awareness of the gastroscopy being carried out.
If you choose to have sedation, you will need to arrange for someone to bring you home after the procedure and to stay with you for at least 12 hours afterwards.
Even if you feel very alert, the sedative can stay in your blood for around 24 hours. You may have further episodes of drowsiness during this period. Therefore, during this time, do not:
- Drive a vehicle
- Operate heavy machinery
- Drink any alcohol
If you choose to have a local anaesthetic, you can leave hospital as soon as the procedure has been completed, and you can resume your normal activities within 1-2 hours.
A diagnostic gastroscopy is usually done at the endoscopy unit at your local hospital (although some larger GP surgeries may also offer endoscopic services).
A diagnostic gastroscopy is usually performed on an out-patient basis, which means that you will not have to stay overnight in hospital. If, however, you choose to have a sedative and you live alone, you may have to stay in overnight.
A diagnostic gastroscopy can be performed by:
- A gastroenterologist (a specialist in disorders of the digestive tract)
- A surgeon
- A endoscopist (a doctor who has received special training in using an endoscope)
- A clinical nurse who has received specialist training in endoscopies
A nurse will talk you through the procedure to make sure that you understand why you are having it. They will ask you questions to ensure that you are properly prepared for the procedure and that you understand any associated risks. You will also be asked to sign a consent form.
At the start of the procedure, you will be asked to lie on a bed or X-ray couch, on your left-hand side. This allows the endoscopist to pass the scope more easily into your stomach. You will be given a plastic mouth guard to stop your teeth from being damaged by the endoscope as it goes down, and to stop you biting on it.
If you choose to have your gastroscopy carried out under sedation, the sedative will be injected into your arm. The medication will make you relaxed and drowsy, but you will be awake enough to follow any instructions.
If you choose to have a local anaesthetic, the back of your throat may be sprayed to numb it, or you may be given an anaesthetic lozenge to suck on.
Once the sedative or throat spray has worked, the doctor will put the endoscope in your mouth and you will be asked to swallow the first part of the tube. It may be a little uncomfortable to swallow, but there will be plenty of room for you to breathe around the scope and through your nose.
The doctor will gently and carefully feed the tube down into your stomach, and a short way beyond your stomach and into your intestine. You will be asked to breathe through your nose.
Once the endoscope is in your stomach, air is blown into your stomach to allow the endoscopist to see any patches of redness, holes, lumps, blockages, or other abnormalities on a television monitor.
If any areas of abnormality are detected, a biopsy will be taken (a tissue sample from the abnormal-looking area) to send to the laboratory for closer inspection under a microscope. During the biopsy, you will not feel anything.
Once any necessary samples have been taken, the doctor will remove the endoscope by pulling it back out of your gullet and through your mouth.
After the test, you will need to rest for a while. If you have had a sedative, you may not remember much, if anything, about the test after you come round.
If you have had a local anaesthetic, your doctor should be able to discuss the results and implications of the gastroscopy before you leave hospital. However, if you have had a biopsy, you will usually have to wait for seven days to get the results.
If you were sedated, you will probably still be too drowsy to understand any information. A further appointment will be made so that you can discuss the results with the doctor. Alternatively, the results of the gastroscopy may be sent to your GP.