What is a Gastroscopy or an Endoscopy?
In an upper GI endoscopy (sometimes also called gastroscopy), the esophagus (gullet), stomach and the first part of the small intestine (duodenum) is visually examined using a flexible instrument endoscope (a flexible fibreoptic tube less than a third of the diameter of the foodpipe). The endoscope does not interfere with the patient’s breathing. After a local anaesthetic is sprayed onto the back of the throat, the endoscope is passed through the mouth into the oesophagus to see the lining clearly. Some air is blown into the stomach to open
it up to allow the doctor to inspect the stomach before finally passing the endoscope into the duodenum. The air is sucked out and the instrument removed. Photographs & video recordings can be made during the procedure. Are there any other ways to get the same information?
Examination of the upper digestive tract is also possible by a barium test. However, even I the best of hands, some information cannot be got by a barium test. During Endoscopy, the doctor can directly look at specific areas to better evaluate and detect problems.
What actually happens in Endoscopy?
Please do not come to the hospital wearing jewellery or carrying valuables. In case you need sedation, they may remain unattended. You may be asked to change your clothing and given a cap to tuck all your hair into. You may leave your belongings, your dentures, hearing aids, glasses, and contact lens in a secure locker provided by us, the key of which will remain with you or your relations till you leave. At first, our nursing staff will review all your previous medical records. They will ask you about the last time you had anything to eat or drink and if you have any allergies. They will ask about special needs or concerns. You will lie on a stretcher in the procedure room. Monitoring equipment may be applied to your chest and a finger. This allows the endoscopy team to continuously observe your heart rate, blood pressure and oxygen level in your blood. Safety devices will be used to keep you safe, comfortable, and secure throughout your procedure. More commonly, the entire procedure can be comfortably done following just a local anesthetic sprayed on the back of the throat. There may be some gagging as the endoscope passes the mouth, but if you remember to breathe quietly through the nose or the mouth during the procedure it’s not so unpleasant. Patients who smoke may gag violently even with adequate local spray. We offer doing these outpatients under Conscious Sedation (you are in a sleep-like state, feel no pain, and are able to breath on your own without assistance). You may, however, need to wait for 2 to 3 hours following the procedure till the drug effects wane.
After the procedure you will have the privacy to change and tidy up. Your Endoscopy report will be made available to you as soon as possible, and you can discuss the findings with your doctor. In case additional procedures (like biopsy, etc) were done during Endoscopy, please confirm with the Staff when these reports would be available, so you could schedule your Follow up appointments.
Are there any risks in the procedure?
Following endoscopy, you may feel a little bloated for a short while, or feel you have a sore throat. The commoner side effects of the sedatives used include drowsiness, lightheadedness and nausea. But the risk of a complication happening during a diagnostic endoscopy is negligible (less than 0.01%). You to realize that you yourself can minimize the risks when you read the following.
Food in the stomach may get inhaled into the lungs. Thus, we prefer to call patients fasting in the morning. Patients with procedures scheduled after noon may be allowed a cup of tea; but only if the doctor doing the procedure gives prior permission. If sedation is used, it may cause some slowing or lightening of breathing, increasing this risk further.
If you are taking any medication daily on a regular basis (like for diabetes, blood pressure, heart ailments, etc.) please discuss the timing of the doses with the Endoscopist or your regular doctor for the day of endoscopy. If you are using aspirin or medicine that ‘thins’ blood (anticoagulants), the Endoscopist will need to take precautions so that you will not have significant bleeding in case a biopsy is performed during the Endoscopy. He may even need to withold these drugs or even reschedule your Endoscopy.
Please remove your dentures (even partial dentures) before the procedure. If dislodged during the procedure, they may accidentally come into your airway and obstruct your breathing. There is a very small risk dental crowns or bridgework may be damaged. Some of the above risks are more likely if you smoke, are overweight, have heart disease, high blood pressure or diabetes.
All major Hospitals have stringent protocols for sterilization, and we assure that all aseptic precautions are in place to prevent transmission of infections during Endoscopy
Mentioned above are the common FAQs about risks. There may be other unusual risks that have not been listed here. Please ask your doctor if you have any general or specific concerns.
I wish I am unaware the procedure is taking place!!
Usually in children, and in adults where some treatment is being planned during endoscopy; sedation is routinely offered, to reduce the sense of discomfort duing a prolonged procedure. Let me reassure you that the procedure can routinely be done safely with “local” anesthesia to the throat alone. When no sedation is used, you could leave after the procedure immediately; and go to work as well, after eating a breakfast. When sedation is used, you will need to be monitored for about 1-2 hours, and may need to take the rest of the day off from work. We will still respect your choice, if you wish to be unaware of the procedure. It would help if you could inform us of this choice well in advance, so we could arrange to have the neccessary staff ready for you at the time of the procedure.
How do I come for the procedure?
If you are coming as an out patient, please arrive at least 15 minutes prior to your procedure. The Receptionist will greet you & guide you after that. Please look up the section “The staff you will meet” on the homepage for information on your hospital. If you desire, our professional staff will again explain what you and your family members should expect. In case you need more clarifications, please feel free to voice your concerns to the doctor before you give your consent.
Concerns about your family members
Family members are welcome and may wait for you in the designated waiting area. They may bring along something to read. Often (and only with your consent) a member may view the procedure on screen. Family members may be necessary as designated drivers if sedation is considered for your procedure. The procedure may not be performed if you do not have someone to drive home. If the person accompanying you cannot drive but is an adult, a cab ride is permissible. Bus rides are not acceptable following sedation.