Upper GI Endoscopy

A gastroscopy or Upper GI endoscopy is a test which allows your doctor or endoscopist to look at the inside of your gullet or oesophagus, the stomach and the first part of the small bowel by passing a long flexible tube with a camera and bright light at the end. The thickness of this tube is roughly that of your little finger. This tube is passed through your mouth down into your gullet, through your stomach up to your duodenum.

A gastroscopy allows the doctor to examine the inner lining of your gullet, stomach and first part of the small bowel, the latter is also called duodenum. It allows your doctor to take biopsies from any areas of interest and examine the collected sample under a microscope. A real-time report of the procedure is generated as soon as the test is done by your endoscopist. The result of the microscopic assessment of tissue /biopsy sample may take longer (7 – 10 days) to be available.

General anaesthesia is not usually recommended for upper GI endoscopy as it is a short procedure. Most people have this test under local anaesthetic which is achieved by applying a numbing spray (xylocaine) on the back of your throat. This reduces the gag reflex and thus allows patients to swallow the scope without being sick. Patients also benefit from additional intravenous sedation (midazolam / fentanyl) prior to the test, if they feel apprehensive. Although this does not put patients to sleep but makes them slightly drowsy and allows them to tolerate the test more effectively. Sometimes Entonox or ‘gas and air’ can help in this respect too. Please ask your doctor or your endoscopist prior to your test if you have further queries.

Complications can develop during or after endoscopy. Every effort is made to prevent, recognise, and treat any complications prior to your discharge from the hospital.

A sore throat after the test is very common and should get better within a few hours after your test.

Significant complications are extremely rare but there is a very small risk of bleeding (1 in 500 patients), tearing of the intestine, the stomach or the gullet (1 in 2000 patients). Unfortunately, if any of this happens you may need hospital admission and possibly an operation.

Some patients may react to the drugs used during the procedure. This is also a very rare complication. If this happens you will need to be admitted to the hospital for observation.

There is a possibility of damage to teeth, particularly crowns, caps, and bridge work during endoscopy. It is extremely important that you make us aware of any loose teeth and dentures prior to the procedure. There is a small risk (2%) of missed diagnosis. If your endoscopist finds you extremely distressed during the procedure, it is recommended that the procedure is abandoned to prevent harm to your gastrointestinal tract. In such cases, repeat tests can be booked with deep sedation or under general anaesthesia.

Chances of dying from the effect of endoscopy is very rare.

You will need to fast for 6 hours before your Upper GI endoscopy. This means, you are not allowed to eat or drink anything for six hours prior to your procedure.

Please however make sure that you take your regular prescription anti-hypertensive (anti blood pressure) medications in the morning prior to your endoscopy. If you are on any regular blood thinning tablets, anti-diabetic tablets, or any other medications you are unsure about, please consult your doctor or endoscopy department for advice.

Most patients are accompanied by a responsible adult for endoscopy. You will need a responsible adult to accompany you home and to look after you for next 24 hous, if you have been administered intravenous sedation during the procedure. Patients who undergo the procedure without sedation or with only throat spray, can travel alone and do not require a responsible adult to be present.

Gastroscopy or Upper GI endoscopy is usually a very short procedure lasting from 10 – 20 minutes. However, you may have to wait prior to the procedure to be consented and be admitted by the endoscopy department staff. Additionally, after the test, you may have to spend approximately one hour on the endoscopy unit recovering from the effects of the drug (if you were administered sedation during endoscopy).