Gastroenterologists

Gastric EndoscopyA gastric endoscopy is procedures that allow us to visualize the upper portion of the digestive system (esophagus, stomach, and duodenum) by introducing a flexible tube through the stomach or nostril into the stomach.

The procedure is carried out in a room specially designed for endoscopic procedures. The endoscope carries a light and a ICCD Chip down through the upper digestive tract. The procedure is carried out in a room specially designed for endoscopic procedures. These images are in real-time on a television screen next to the patient in the procedure room. The fibroptic material of the scope allows all corners of the upper digestive to be thoroughly explored.

The Preparation

To allow a clear view, the stomach must be empty. You will therefore be asked not to have anything to eat or drink for at least six hours before the test. When you come to the department, a doctor will explain the test to you and will usually ask you to sign a consent form. This is to ensure that you understand the test and its implications. Please tell the doctor or nurse if you have had any allergies or bad reactions to drugs or other tests. They will also want to know about any previous endoscopy you have had. If you have any worries or questions at this stage don't be afraid to ask. The staff will want you to be as relaxed as possible for the test and will not mind answering your queries. You may be asked to take off your shirt or jumper and to put on a hospital gown. It will also be necessary for you to remove any false teeth. They will be kept safely until after the examination.

During the test

ColonoscopyIn the examination room you will be made comfortable on a couch, resting on your left side. A nurse will stay with you throughout the test. Some doctors may spray a local anaesthetic on the back of your throat or give you a tablet to suck to numb the area. The doctor may give you an injection into your arm to make you feel sleepy and relaxed but many hospitals now find that the test can be performed without any sedation, as the endoscopes have become much smaller and are easier to swallow. To keep your mouth slightly open, a plastic mouthpiece will be put gently between your teeth. When the doctor passes the endoscope into your stomach it will not cause you any pain, nor will it interfere with your breathing at any time. It may take up to fifteen minutes to examine all the areas of the stomach carefully. During this time some air will be passed down the tube to distend the stomach and allow the doctor a clearer view. The air is sucked out at the end of the test. If you get a lot of saliva in your mouth, the nurse will clear it using a sucker. When the examination is finished, the tube is removed quickly and easily.

After the test

You will be left to rest in the unit for at least thirty minutes. You will be given a drink but if you have had your throat numbed by a spray or lozenge, you will have to wait until your swallowing reflex is back to normal. This usually takes about 15min. After this you can eat and drink normally. The back of your throat may feel sore for the rest of the day. You may also feel a little bloated if some of the air has remained in your stomach. Both these discomforts will pass, and need no medication. Normally you can do routine work the same day.

Occasionally some patients may require Anesthesia; Short GA/Sedation for Esophago-gastro-duodenoscopy. They may require special instructions after the procedure including some person to accompany & not to drive or operate machinery on the same day.

Going Home

If you are going home after the test it is essential that someone comes to pick you up. Once home, it is important to rest quietly for the remainder of the day. Sedation lasts longer than you think, so if you have been given an injection during the examination you should not:

  • Drive a car
  • Operate machinery
  • Drink alcohol

The effects of the test and injection should have worn off by the next day when most patients are able to resume normal activities.

When do I know the result?

In many cases the doctor will be able to tell you the results straight after the test, or if you have been sedated, as soon as you are awake. However, if a sample (biopsy) has been taken for examination, the results may take several days. It is a good idea to have someone with you when you speak to the doctor after the test since if sedation has been used, people are often find they forget everything that has been said to them, and many do not recollect having the test at all. Details of the results and any necessary treatment should be discussed with your general practitioner or hospital specialist-whoever recommended you to have the test.

Colonoscopy

What is a Colonoscopy?

Colonoscopy is a test which allows the doctor to look directly at the lining of the large intestine (the colon). Diagnostic colonoscopy is recommended for alterations in bowel habits, occult or frank blood in the stool, unexplained anaemia and as a screening test for colon cancer. In order to do the test a colonoscope is carefully passed through the anus into the large intestine. The colonoscope is a long flexible tube, about the thickness of your index finger, with a bright light at its tip. The video camera on the colonoscope transmits images of the inside of the colon to a monitor allowing the physician to examine the lining of the colon checking for any disease or abnormalities.

The physician may take a biopsy - a sample of the lining of the bowel for closer examination under the microscope. A small piece of tissue is removed painlessly through the colonoscope, using tiny biopsy forceps.

It is also possible to remove adenomas (polyps) during colonoscopy. Polyps are abnormal projections of tissue, rather like a wart, which the doctor will want to remove and examine in more detail.

Preparation

To allow a clear view, the colon must be completely empty of waste material. If it is not, certain areas may be obscured and the test may have to be repeated. The links below provide information on patient preparation for a colonoscopy procedure.

  • Bowel preparation instructions for colonoscopy am & pm appointments
  • Bowel preparation instructions for colonoscopy when carried out with an upper endoscopy (OGD)
    - morning appointments
  • Bowel preparation instructions for colonoscopy when carried out with an upper endoscopy (OGD)
    - afternoon appointments
  • Diabetic colonoscopy patient advice (insulin or tablet controlled)
  • Diabetic colonoscopy patient (insulin or tablet controlled) example light diet

It is important to take all of the laxative prescribed and also considerably increase your intake of clear fluids on the day before the examination, which will help clean the bowel.

When you come to the department, a member of staff will explain the test to you and will usually ask you to sign a consent form. This is to ensure that you understand the test and its implications. Please tell the doctor of nurse if you have had any allergies or bad reactions to drugs of other tests. They will also want to know about any previous endoscopy you have had, or of any other medical conditions which you may suffer from and any medication which you may be taking. If you have any worries or questions at this stage don't be afraid to ask. The staff will want you to be relaxed as possible for the test and will not mind answering your queries.

 

What will happen?

You will be placed in a comfortable position on your left side, and may be given medication by injection through a vein to make you sleepy and relaxed. The doctor will then pass the colonoscope through the anus into the rectum, and advance it through the colon. You may experience some abdominal cramping and pressure from the air which is introduced into your colon. This is normal, and will pass quickly. You may also be asked to change position during the examination, and will be assisted by a nurse. The examination takes 15-60 minutes.

Afterwards

You will be left to rest in the recovery area for up to 1 hour, until the main effects of any medication wear off. A responsible adult must be available to escort you home as the sedation impairs your reflexes and judgment. For the remainder of the day you should not drive a vehicle, operate machinery or make important decisions. We suggest that you rest quietly.

When will I know the results?

In many cases the doctor will be able to tell you the results of the test as soon as you are awake. However if a biopsy sample or polyp was removed for closer examination, these results may take up to ten days to process.

Many patients find that sedation tends to make them forget any explanations that may have been given them. Details of any results or further investigations may be obtained from your GP or specialist (whoever referred you for the test).