What is a gastroscopy?

• It is an upper gastrointestinal (GI) endoscopy or oesophago-gastro duodenoscopy (OGD)
• It is an examination of the lining of your gullet (oesophagus), stomach, and the first part of your intestine (duodenum).
• It is performed by passing a gastroscope (a flexible tube with a small camera at the end) through your mouth and into your stomach.
• The complete test takes approximately 5-10 minutes, but if treatments are carried out procedures do take longer.

What is a colonoscopy?

• It is an examination of your large bowel (colon).
• It is performed using a colonoscope (a flexible tube, with a small camera at one end) which is passed carefully through your back passage (anus), and air is inflated into the bowel.
• The colonoscope is then advanced around the large bowel enabling the endoscopist to look directly at its lining.

Alternative Tests:

Although there are alternatives your doctor has decided that these are the best tests for you.

A barium meal x-ray examination is an alternative investigation to a gastroscopy. It is not as informative as a gastroscopy and has the added disadvantage that tissue samples cannot be taken.

An alternative to a colonoscopy is a barium enema x-ray examination. It is not as informative as a colonoscopy and has the added disadvantage that tissue samples cannot be taken.

If you want further information, please discuss this with your GP or the doctor who has referred you for this test.

What are the risks of having a gastroscopy and colonoscopy?

These occur extremely infrequently, the doctor who has requested the test will have considered this. The risks must be compared to the benefit of having the procedure done.

• A sore throat after a gastroscopy is common and should resolve after a few hours.
• There is a small risk of damage to crowned teeth or dental bridgework during a gastroscopy.
• Inhalation of gastric contents can cause pneumonia which would require antibiotic treatment.
• Complications include perforation or tear of the intestine or bleeding. These complications occur in less than 1 in 1000 examinations but may require urgent treatment or an operation. If a perforation or tear occurs in the large bowel an operation is nearly always required to repair the hole. The risk of perforation is higher with polyp removal.
• Bleeding may occur at the biopsy site or polyp removal (1 in every 100-200). This may stop on its own but may require further treatment and an operation may be required.
• A reaction to the drugs used during the procedures may require you to stay in hospital.

How do I prepare for the gastroscopy and colonoscopy?

• If you require ambulance transport, please arrange this with your GP at least seven days before your appointment.
• If you are a Diabetic or taking Warfarin, Aspirin or Clopidogrel tablets please contact the Endoscopy Unit.
• In order to examine the stomach properly, it must be empty.
• To give the endoscopist a clear view of your bowel you should stop iron preparations and bulking agents (bran, Fybogel, Regulan) for one week before the test
• Ulcer healing drugs such as Tagamet (Cimetidine), Zantac (Ranitidine), Losec (Omeprazole), Pariet (Rabeprazole), Protium (Pantoprazole), Nexium (Esomeprazole) or Zoton (Lansoprazole) should be stopped for four weeks before the examination, unless otherwise instructed. If you are unsure of the tablets you are taking, check with your GP or hospital doctor who recommended the test.
• If you take any other medication take them at the normal time.

The day before the procedures:

• It is extremely important that the bowel is clean during your test so you must drink as much clear fluid as possible.
• Please follow the instructions carefully and take the provided bowel preparation as directed.
• Be prepared for frequent bowel actions starting within three hours of taking the laxatives and make arrangements to be near toilet facilities.
• Aim to drink at least one full tumbler of clear liquid per hour to avoid becoming dehydrated.

The day of the procedures:

• Please continue to drink clear fluids up to two hours before your appointment time.
• Please bring your dressing gown and slippers with you.

What will happen when I arrive for my gastroscopy?

Freeman Hospital Appointments

• Please report to the Admission Desk (Main Entrance)
• Go to the Day Treatment Centre (Ward 21) Level 3.

Royal Victoria Infirmary Appointments

• Please report to Ward 39 (Gastroenterology Unit), Leazes Wing.

Newcastle General Hospital Appointments

• Please report to Ward 19, Endoscopy Unit.

In all Hospitals

• Before the procedure you will be seen by a qualified nurse and the Endoscopist and you will have the opportunity to discuss any problems or worries.
• You will be asked to sign a consent form indicating that you understand the nature and risks of the procedure. The consent form is a legal document, therefore please read it carefully.
• Please leave any valuables at home.
• Your tests will be performed by a qualified endoscopist or a trainee endoscopist under direct supervision.

What will happen during the procedures?

• In the examination room you will be made comfortable on a trolley.
• A qualified nurse will remain with you throughout the procedure.
• You will be asked to remove any dentures or glasses.
• A plastic guard will be placed in your mouth to protect your teeth and the gastroscope.
• A clip will be lightly attached to your finger to check your pulse rate and oxygen level.
• Oxygen will be administered into your nostril.
• You will be asked to lie on your left side and then be given an injection to make you relaxed and sleepy. This is not a general anaesthetic and you will not be unconscious, but it is unlikely that you will remember much about the procedure.
• The Endoscopist will carry out the gastroscopy first. The endoscopist will pass the gastroscope over your tongue, down into your gullet and into your stomach. This will not interfere with your breathing and will not be painful, but may be slightly uncomfortable due to the air that the Endoscopist puts into the stomach to obtain a good view.
• Any saliva or other secretions produced during the test will be removed using a small suction tube, rather like the one used at the dentist.
• Small tissue samples (biopsies) can be taken through the gastroscope which is painless. These will be retained.
• A video recording and /or photographs may be taken for your records and will only be seen by those involved in your care.
• Once the gastroscopy is completed then the colonoscopy will be carried out.
• When the colonoscope is inserted into your bottom, air is gently passed into the bowel. This opens up the bowel so the endoscopist can see where they are going. At first you may feel that you want to go to the toilet. You may feel a little embarrassed that you will pass a motion. Do not worry! It is the air that causes this feeling. You will not soil yourself.
• Throughout the test the endoscopist will put air into your bowel to provide a clear view. This may result in some mild discomfort.
• Small tissue samples (biopsies) can be taken through the colonoscope, which is painless. These will be retained.
• If a polyp, a small growth on the wall of the bowel is found, then it may be removed. A polyp is a protrusion from the lining of the bowel. Polyps when found are generally removed or sampled by the endoscopist as they may grow and later cause problems.
• You may require Argon Plasma Coagulation Treatment. This involves the use of a jet of argon gas that is directed through a probe which is passed through the colonoscope. It is used to destroy abnormal tissue and /or to seal off bleeding blood vessels.

What will happen after the procedures?

• You may have a sore throat after the gastroscopy.
• You may feel bloated but this will settle quickly.
• You will be allowed to rest quietly in the recovery area where a qualified nurse will observe you until the main effects of the injection have worn off.
• Please arrange for a relative or friend to collect you directly from the ward to take you home after your colonoscopy. Please liaise with the ward staff to arrange collection time. You will not be fit to go home by public transport.
• Once home you should rest quietly for the remainder of the day.
• Please ensure a responsible adult remains with you until the next morning as the after effects of the injection make you sleepy or forgetful for 24 hours after the test.

For 24 hours following the test you must not:

• Drive a vehicle
• Operate machinery
• Drink alcohol
• Sign any legal documents
• Be left alone to care for children

When will I know the result of my procedures?

• Sedation makes you forgetful, but the endoscopist or nurse, in the presence of your accompanying relative or friend, will discuss the results of the test with you, if you wish.
• If you have had biopsies taken you will receive the results at your out patient appointment or by letter if you require treatment.
• A full report will be sent to your doctor.
• Before you are discharged you should be given clear details concerning follow-up arrangements.

If you have any further questions you should contact:

Freeman Hospital:

• Endoscopy Unit between 9.00 am - 4.30 pm 0191 2231208
• Day Treatment Centre (Ward 21) 0191 2231294

RVI

• Endoscopy Unit between 9.00 am - 4.30 pm 0191 2825655

NGH

• Endoscopy Unit between 9.00 am - 4.30 pm 0191 2336161 extension 22913

If you have any queries or require any further information out of these hours, please contact your GP or NHS Direct (0845 46 47).