Gastroscopy and colonoscopy

This information leaflet is for patients who are having a gastroscopy and colonoscopy. This leaflet tells you what is involved and about any risks. The tests together take approximately 30-40 minutes to complete. Normally you will be able to go home about an hour later.

What is a Gastroscopy and colonoscopy?

Gastroscopy is an examination of the inside of your stomach. A gastroscope is a thin, flexible tube that is passed through the mouth into the stomach and as far as the duodenum. This is immediately followed by a colonoscopy using a similar tube, a colonoscope. It is passed through the anus to examine the bowel. A sample of the lining of the stomach or bowel (a biopsy) can be taken or polyps (projections of tissue rather like warts) can be removed during the examination.

Preparation for the test

• for this examination to be successful and to have a clear view, your stomach and bowel must be empty. It is very important to follow the advice given about bowel preparation for colonoscopy. You may drink small amounts of clear fluids and take tablets with a sip of water up to 2 hours before.

• if you are taking blood thinning medications (e.g. warfarin or other anticoagulants, clopidogrel or other anti-platelet agents) please inform us. You should continue to take other medications as normal including on the morning of the procedure.

On arrival to the Daycare Unit

• a nurse will check your details, blood pressure and pulse. If you are allergic to anything please tell the nurse.

• the procedure will be explained and you will be asked to sign a consent form confirming that you understand and agree to go ahead.

What does the examination involve?

• a local anaesthetic spray is given to numb the back of your throat. This has a slightly bitter taste.

• an injection of sedative is given into a vein in your hand to make you relax. This may make you drowsy and often leads to a hazy memory of the procedure.

• you will be given oxygen and will have a device attached to your finger which monitors your heart rate and breathing. You will then lie on your left side and a small mouthpiece will be placed in your mouth.

• the gastroscope will gently be inserted into your stomach. This is not painful and will not make breathing or swallowing difficult, but you may feel uncomfortable during the test and it can make you gag. Careful continued slow breathing (through mouth or nose) may alleviate any discomfort. As soon as this is finished a colonoscope is passed through the anus and carefully advanced through the bowel and sometimes into the last part of the ileum (small intestine). The gastroscopy takes 5-10 minutes and then the colonoscopy takes about 20-30 minutes.

• during the tests biopsies are taken and often polyps are removed. You cannot usually feel this but you may visualise what is happening.

After the examination

• if you had a sedative injection you will need to rest for about 30 minutes.

• you will then be given something to eat and drink.

• even though you feel fully awake after having sedation it is important to arrange for somebody to pick you up from the hospital, or if arranging transport home for somebody to be there to look after you. They can then deal with any problems that may arise, despite this being very unlikely.

• it is important that after sedation you do not attempt to drive for 24 hours.

Are there any risks?

This examination is very safe. There is a very small risk of the following:

• a reaction to the sedative that can rarely make breathing difficult

• damage to crowned teeth or dental bridgework.

• these tests are the gold standard for detection of intestinal disease and better than CT or MRI scanning. There remains, however, a minor risk of missing small lesions. It is unlikely a cancer would be missed.

• when a biopsy is taken or a polyp is removed, there may often be a little bleeding which usually stops by itself. More serious bleeding is very rare.

• perforation, which is a tear in the wall of the intestine.  This will require a stay in hospital and treatment with antibiotics, and may require surgical repair. This is more serious but very rare (less than 1:1000).

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