Dr Graeme Dickson - Gastroenterologist |
Having an endoscopic procedure |
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Endoscopy An Upper Gastrointestinal Endoscopy allows direct visualisation of the swallowing tube (oesophagus), stomach and upper small bowel (duodenum). Common reasons to perform endoscopy include:
Regular medications should be discussed with the doctor prior to the procedure as most can be continued but some may need to be stopped (eg warfarin). Sedation is given through a small plastic cannula inserted in the back of the hand and is often combined with anaesthetic spray to make the throat numb. Any dentures or oral piercings are removed before a mouth guard is inserted to protect the teeth and endoscope. The procedure takes approximately 10 minutes and many patients either sleep during the test or are very relaxed. Air introduced to distend the stomach and allow full views can cause minor discomfort. This is relieved simply by belching. If any tissue biopsies are taken during the examination these are not felt. Patients often feel bloated afterwards but this resolves quickly. There may be a mild sore throat. Endoscopy is a relatively safe procedure with a complication rate of 1 in 1000. Complications include:
Patients will need to arrange for someone to drive them home after the procedure as the sedatives make it unsafe to drive. Back to the top Sigmoidoscopy Flexible sigmoidoscopy allows examination of the lower part of the gastrointestinal tract (rectum to descending colon). Common reasons to have this done include:
Regular medications should be discussed with the doctor prior to the procedure as most can be continued but some may need to be stopped (eg warfarin, iron). The procedure is performed with the patient lying on their left side with their knees curled up into their chest. The sigmoidoscope is roughly the size of a finger and easily inserts into the rectum. Any cramping from air introduced can be relieved by passing wind. Try not to feel embarassed. Tissue biopsies are painless and the patient will be unaware that they are being taken. The procedure takes 10 minutes and is often performed without sedation as any discomfort is mild. Complications are rare but include:
Colonoscopy Colonoscopy allows visualisation of the whole of the large bowel (colon). Common reasons to have this done include:
Regular medications should be discussed with the doctor prior to the procedure as most can be continued but some may need to be stopped (eg warfarin, iron). Sedation is given through a small plastic cannula inserted in the back of the hand. A combination of sedative (to help patients relax) and narcotic (to prevent discomfort) is usually given. Patients often sleep during the test or are very relaxed. The procedure is performed with the patient lying on their left side with their knees curled up into their chest. The colonoscope is roughly the size of a finger and easily inserts into the rectum. It takes anywhere between 20 minutes and 1hour depending on what procedures (eg polyp removal) are done during it. Any cramping from air introduced can be relieved by passing wind- try not to feel embarassed. There may be tissue biopsies taken or polyps removed. Polyps are growths inside the colon which are usually harmless (benign) but can become cancers (malignant) if allowed to grow. They range in size from a few mm to several cm. Both tissue biopsy and polyp removal are painless. Following colonoscopy it is common to feel bloated and drowsy from the sedation. Colonoscopy is a relatively safe procedure with a complication rate of 1 in 500. Complications include:
Back to the top Bowel preparation The following is for afternoon procedures: On the day before the examination Normal breakfast Liquids only from 10am (water, thin soup, strained fruit juice, cordial, fizzy drinks, tea or coffee without milk) In the afternoon put 4 litres of flat lemonade/water in the fridge At 5pm drink the first Fleet (by diluting it into 500mls juice and drinking over 30mins.) Follow this with 1-2 litres of flat lemonade/water sipped SLOWLY over the next 4 hours On the day of the examination At 7am take the second bottle of Fleet (as above) Again, follow this with 1-2 litres flat lemonade/water sipped SLOWLY over the next 5 hours At 12 midday, nothing further by mouth This preparation will purge the bowel and produce liquid diarrhoea which should eventually become colourless Back to the top |
