Endoscopy
What is an endoscopy?
Upper GI endoscopy is the examination of the inside of the oesophagus, stomach and upper duodenum using a narrow flexible instrument called an endoscope. The endoscope contains a small camera which transmits light and video images back to the doctor. Instruments can be passed down the endoscope to take samples (biopsies), to remove growths (polyps), stop bleeding and stretch narrow areas (strictures) using dilators. The endoscope is gently passed down your throat while you are sedated, and the procedure takes 10 to 15 minutes.
Why have an endoscopy?
Endoscopy is a very useful way to diagnose problems in the upper digestive tract because it allows direct visualization and enables biopsies and treatment to be done at the same time. Common problems where endoscopy can be useful include pain due to ulcers, reflux, difficulty swallowing, bleeding and diarrhoea.
Will I be awake, and does it hurt?
All procedures are assisted by an anaesthetist, who will discuss the anaesthetic with you on the day. The anaesthetist will provide you with deep sedation, using a drug called propofol. Because you are deeply sedated it would be unusual for you to experience awareness, pain or discomfort during important periods of the procedure. You may have a dry or sore throat for a day or so and a small bruise where the injection is given.
Is there any preparation required?
It is important for the stomach to be empty before the procedure to help the doctor see clearly and to reduce your risk of stomach contents passing into your lungs (aspiration). Therefore, you must not eat any solid food 6 hours before your admission time. If you are thirsty during this fast you are permitted to have small amounts (no more than two thirds of a cup per hour) of clear fluids (i.e., water, cordial) but must cease these 2 hours before you admission time. If you are on blood thinning drugs or diabetic medication you will receive instructions about managing these medications.
Is the procedure safe and what are the risks?
Endoscopy is a very safe and routine procedure. However, all procedures have risks which are detailed below.
1. Aspiration- This is a rare complication in which stomach contents pass into the lungs to cause a chest infection. This occurs in approximately 1 in 1000 procedures and the risk is reduced by making sure you fast properly. If this occurs, you may need an admission to hospital for treatment of the chest infection.
2. Perforation of the oesophagus- Perforation of the oesophagus is when a tear is made in the wall of the gullet. This is very rare and happens only in about 1 in every 2000 endoscopies. The risk of perforation is increased if you require stretching of strictures using dilators or removal of foreign objects which are trapped in the oesophagus.
3. Risks of anaesthesia- these risks are very small due to modern day anaesthetic agents and monitoring equipment but will be discussed with you by the anaesthetist, prior to the endoscopy.
4. Damage to teeth- a mouthguard will be used to protect your teeth and the scope during the procedure. Despite this occasional damage to teeth is seen. For this reason, you will be asked to remove dentures/plates and inform us of crowns or dental work prior to the procedure.
What should I bring with me on the day?
You will be in the hospital for several hours so you may like to bring some reading material to pass the time. A list of your current medications is also useful.
What happens after my endoscopy?
After the procedure you will be taken to a recovery room and monitored until you recover from the anaesthetic. You will be given light refreshments prior to discharge. Our doctors will discuss the results of the procedure with you and make follow up arrangements if required. Driving is not permitted for the 24 hours post the anaesthetic and you must make arrangements for a responsible adult to pick you up and remain with you until the following day.
What will the cost be to me?
For patients with private health insurance our gastroenterologists do not charge an out-of-pocket gap. The only expense you may have is if your private cover has an excess. Uninsured patients will be provided with a quotation of costs at the time of booking the procedure.