Gastroenterology - Gastroscopy

Your stay on the endoscopy unit could be up to 2 hours or more depending on individual recovery time, also please note that your appointment time is only your admittance time.

A gastroscopy is a test which allows the endoscopist to look at the oesophagus (the gullet); the stomach and duodenum (part of the small intestine).

This is done by passing a long flexible tube with a bright light at the end, (which is the thickness of your little finger) through your mouth, down the oesophagus into the stomach and duodenum. Sedation may be offered for this procedure to help you relax.

What are the possible risks?

Complications can develop during or after the procedure. Every effort is made to prevent, recognise and treat these.

• A sore throat after the test is very common and should get better after a few hours
• Significant complications are extremely rare, but there is a very small risk of bleeding or tearing of the intestine. If this does occur it will require an admission to hospital and may require an operation. This happens 1 in 2000
• A reaction to the drugs used is another complication and although very rare, if it does occur you may be required to stay in hospital
• There is also a possibility of damage to teeth particularly crowns/caps/bridgework during the procedure. It is important that staff are aware of any loose teeth

What are the benefits?

This test gives a direct view of the inside of your stomach, oesophagus and duodenum, rather than the shadows seen on an x-ray (barium meal). We can take small samples of the lining for examination under the microscope.

Alternatives

• Doing nothing may mean that we miss something important
• X-rays and scans might be performed alongside your procedure or as an alternative

Starving before the test

You will need to starve at least 6 hours before the test. That means nothing to eat OR drink.

Morning appointments – starve from 12 midnight.

Afternoon appointments – you can only have an early light breakfast, then nothing to eat or drink until after the procedure.

Medication

• If you take blood thinning tablets (anticoagulants e.g. Warfarin) please consult your Consultant or the anticoagulant clinic who deals with your anticoagulant medication
• Please make sure that the doctor requesting the procedure and the one performing the procedure are both aware that you have been on anticoagulants and what instructions you have been given regarding this medication
• If you are diabetic on medication or insulin please contact your Diabetic Nurse for specific instructions
• If you take Clopidogrel, please consult either your Consultant or contact the Endoscopy Unit for specific instructions
• If you have a latex allergy then please contact the relevant Booking and Scheduling Team prior to your admission as the date/time might be affected

You must keep taking any essential prescribed tablets with a minimal amount of water.

Sedation/Local anaesthetic

A local anaesthetic spray is used to reduce the sensation in your throat. The benefit of having throat spray is that you can leave the department shortly after the test and continue with your normal daily routine.

Xylocaine Topical Solution Local Anaesthetic Spray used for a Gastroscopy

Topical pharyngeal anaesthesia reduces discomfort during upper gastrointestinal endoscopy. Xylocaine Spray contains a medicine called lidocaine which belongs to a group of medicines called local anaesthetics.

Lidocaine spray is one of the most effective, safest and widely used methods for a gastroscopy. This local anaesthetic used to temporarily numb the back of your throat making the gastroscopy easier to tolerate. Xylocaine Spray contains the active ingredient lidocaine, and each dose (one spray) contains 10 mg of lidocaine. You will be administered between 3 and 10 sprays
(30-100mg).

The benefit of choosing throat spray is that you will remain fully conscious and aware and can go home unaccompanied soon after the examination. You will be allowed to drive and can carry on life as normal. The only constraint is that you must not have anything to eat or drink for about an hour after the examination, until the sensation in your mouth and throat has returned to normal. It is strongly advised that when having your first drink after the examination, it should be a cold drink and should be sipped to make sure you do not choke.

How long does xylocaine spray take to work?

The local Xylocaine local anesthetic is sprayed onto the back of your throat before the procedure by the qualified nurse or the endoscopist, in most cases the numbing effect is instantaneously, but can sometimes take up to 5 minutes to take full
effect. (Severe allergic reactions is very rare, may affect up to 1 in 1,000 people).

How long does xylocaine spray last?

This generally lasts between 20-30 minutes, but we advise the patient does not eat or drink anything for up to an hour after the spray has been administered, as it may be more difficult to swallow or cause some people to accidentally bite their tongue and it is more likely that food or liquid may go down the wrong way.

Who may not be able to have Xylocaine Spray?

If you have ever had an allergic reaction to lidocaine (or any medicines in the same classification)If you are very sensitive/ hypersensitive to any of the ingredients of the spray.
You may request a sedative injection, this involves a drug being given through a needle (usually in the back of the hand). The sedation you receive is only a conscious sedation, not a general anaesthetic, so this will only make you drowsy not put you to sleep.

For your own safety following sedation please comply with the following:

• After the test you may spend approximately 1 hour on the unit recovering from the effects of the drug
• You need a responsible person to accompany you home and stay with you for at least 24 hours after the sedation, as the sedation can remain in the bloodstream for this length of time. If you are a main carer for somebody then please arrange an alternative carer
• You must not sign any legal documents for at least 24 hours
• You must not return to work, drive or drink alcohol for at least 24 hours after the sedation
• For some patients, sedation is not advised. The doctor performing the examination will discuss this with you

Contact details:

Fairfield General Hospital - 0161 778 3341

Rochdale Infirmary - 01706 517547

The Royal Oldham Hospital - 0161 624 0420

Salford Royal Hospital - 0161 206 5959

Booking and Scheduling Department (Fairfield, Rochdale and Oldham Only) - 0161 778 2233

Booking and Scheduling Department (Salford Only) - 0161 778 5402