Medication
If you are referred for a gastroscopy, you will need to stop taking any prescribed medicines for indigestion at least two weeks beforehand. This is because medication can mask some of the problems that the gastroscopy could show up. You can continue to take antacids up until your endoscopy.
If you are taking any of the following medications, you should telephone the endoscopy unit before your appointment because special arrangements may need to be made:
- any medication that is used to treat diabetes, such as insulin or metformin
- blood-thinning medication (medication that is used to prevent blood clots), such as low-dose aspirin, warfarin or clopidogrel
You should not wear nail polish on the day of your appointment because it interferes with a device that is attached to your finger to monitor your oxygen levels.
Diet
It is important that your stomach is empty so that the whole area can be seen clearly. You will be asked not to eat anything for six hours and drink nothing for two hours before having a gastroscopy.
Sedation
You will usually be sedated during a gastroscopy. This means you will be very drowsy during and after the procedure so it’s a good idea to arrange for someone to bring you home and to stay with you for at least 12 hours after a gastroscopy.
The procedure
A gastroscopy is usually carried out by a nurse and an endoscopist (a health professional who specialises in performing endoscopies). You will meet the nurse before the procedure and she will be able to answer any questions that you may have.
You should remove any glasses, contact lenses and false teeth. A nurse may then spray your throat with a local anaesthetic spray and insert a small plastic mouth guard to protect your teeth.
You will be asked to lie down on your left-hand side and the nurse will attach a small probe to your finger. This measures your oxygen level and heart rate.
At this point, you will normally be given an injection of sedatives into your arm. This will make you feel very drowsy so that you will be mostly unaware of the procedure and will probably have no memory of it. However, you will still be able to follow any instructions given to you by the endoscopist or nurse.
The endoscopist will insert the endoscope into your throat and tell you to swallow it to help move it down into your oesophagus.
Diagnosing a condition
If the gastroscopy is being used to diagnose a certain condition, air will be blown into your stomach once the endoscope is inside. This allows the endoscopist to see any patches of redness, holes, lumps, blockages or other abnormalities.
If abnormalities are detected, a biopsy can be taken (a tissue sample from the problem area) to send to the laboratory for closer inspection under a microscope. You will not feel anything during a biopsy.
Treating bleeding varices
If you have bleeding varices, the endoscopist will first use the endoscope to locate the site of the bleeding.
If the bleeding varices are located in your oesophagus, they can normally be treated using a technique called band ligation. This involves passing a small rubber band down the endoscope, which is used to seal the base of the varices and cut off the blood supply to prevent further bleeding.
If the bleeding varices are located in your stomach, the site of the bleeding will be injected with a chemical called cyanoacrylate. Cyanoacrylate is the active ingredient in the extra-strength glues (‘superglues’) that are sold in shops. It is also very useful in sealing holes or tears in body tissue.
Treating bleeding ulcers
If you have bleeding ulcers, one of a number of techniques may be used to treat them. For example:
- a probe may be passed through the endoscope to apply heat or small clips to stop the bleeding
- a weak solution of adrenaline may be injected around an ulcer to help activate the clotting process, narrow the arteries and enhance blood clotting
During these procedures you may also receive an injection of a fast-acting acid-reducing medication, called a proton-pump inhibitor, to prevent bleeding recurring.
Narrowed oesophagus
If you have a narrowed oesophagus, the endoscopist can pass instruments down the endoscope to stretch and widen it. These instruments can also be used to insert a rigid balloon or stent (a hollow plastic or metal tube) to hold the walls of your oesophagus open.
Recovery
A gastroscopy takes around 20-40 minutes to perform. The endoscope will then be removed and you will be taken to a recovery room until the effects of the sedation have worn off.
You may not remember much about the procedure after you come round.
If you received a gastroscopy as part of a treatment, you may be given a series of tests to assess how effective the treatment was and check for any complications.
These tests may include:
- a chest X-ray
- a measure of your heart rate
- a blood pressure test
Depending on your individual circumstances, you will then either be transferred to a hospital ward or discharged (sent home).
Even if you feel very alert, the sedative can stay in your blood for 24 hours and you may experience further episodes of drowsiness.
It is important that you do not drive a vehicle, operate heavy machinery or drink any alcohol during this time.
Depending on what type of procedure you have had, it may be several days before you can resume a normal diet. The endoscopy nurse will give you more information about your specific dietary recommendations.
Results
If the gastroscopy was used to diagnose a condition, a further appointment may be made so you can discuss the results with the doctor, or the results of the gastroscopy may be sent to your GP.
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Overview - How a gastroscopy is performed
