Gastroscopy and Varices Patient information Leaflet October 2013 What is a Gastroscopy? The doctor is going to carry out a procedure called a gastroscopy to look at your gullet (food pipe) and stomach, so that your varices can be treated. The gastroscopy will be carried out using an endoscope (a small flexible telescope), which will go in through your mouth, down your gullet and into your stomach. What are varices? Varices are enlarged sections of the viens in the gullet. The treatment available for varices. Injection of varices An injection needle will be passed down through the endoscope. A special chemical, which is aimed at shrinking the varices, is injected directly into the enlarged vein. This treatment can be used for more than one vein. Banding of varices A special piece of equipment is attched to the endoscope and bands (very similar to elastic bands) are placed around it, with the aim of shrinking the vein. Each band will fall off and pass harmlessly through the digestive tract when it is no longer needed. Again this treatment can be used for more than one vein. You may need to return for further treatment which will be arranged for you be your consultant. What are the benefits? Gastroscopy and Varices GMED 4.0 Page 1 of 5
The benefits are that the problem will be diagnosed and treated as necessary. Are any side effects or possible complications? A gastroscopy is a very safe procedure. There is a small risk of a tear in the gullet, although this is very rare. You may have a slightly sore throat afterwards but usually there are no other significant problems. Treatment for varices does carry some risks. Very rarely, the special chemical used in the injection of varices may cause scars and shrinkage of the gullet leading to swallowing difficulties. The risk of this happening is no more than about 1 in 200. The main risk when banding the varices is perforating (tearing) the gullet, but again this is rare with a chance of no more than 1 in 500. What are the alternatives? These can be discussed with the doctor. How long will I be in Hospital for? The length of stay in hospital depends on the doctors advice which they will give you. What happens before the procedure? You will be shown to your bed and asked to change into a hoapital gown. A nurse will care for you throughout your stay. The nurse will ask you some questions and complete the necessary paperwork. The nurse will also check your pulse and blood pressure and insert a needle into the back of your hand in preparation for the sedation. The doctor will explain what will happen during the procedure, the benefits and risks and answer any questions that you may have. You will be asked to sign a consent form to confirm that you have understood the information that you have been given (you may have already done this at a prior appointment). If you have any questions or concerns, please ask. What happens during the procedure? You will be asked to remove any false teeth or glasses. You will then be made comfortable on a trolley lying on your left hand side. A nurse will stay with you throughout the prodedure. You will be given the sedation, which will Gastroscopy and Varices GMED 4.0 Page 2 of 5
make you feel sleepy and relaxed. This is not a general anaesthetic. You will be able to hear the nurse talking to you and be able to co-operate. A plastic mouth guard will be placed between your teeth to keep your mouth open. You will be given some oxygen to help you breathe more easily and the nurse will keep your mouth clear of excess saliva. An endoscope will be gently inserted into your mouth, over the back of your tongue, down your gullet and into your stomach. Some air will be passed through to inflate the stomach and allow the doctor to have a clear view. The doctor will check your stomach before treating the varices in your gullet. When the treatment is finished the endoscope and air will be gently removed. What happens after the procedure? You will be sleepy for about one hour following the procedure. During this time your blood pressure and pulse will be monitored. When you are fully awake, you will be able to get dressed. The doctor will discuss the results of the gastroscopy with you before you go home and will advise you when you will be able to eat and drink normally again. Your GP will receive a copy of the results a few days later. Occasionally, the seadative injection can lower the blood pressure or cause breathing problems. If this happens, you will be treated before you go home. Discharge Arrangements? It is essential that someone collects you and drives you home after the procedure. Once you are at home, it is important that you rest quietly for the remainder of the day. The sedation will remain in your bloodstream for up to 24 hours, so it is important that you do not drive (vehicle insurance would become invalid), operate any machinary, drink alcohol or sign any legally binding documents for 24 hours after the procedure. If you experience any discomfort after the procedure you may take your preferred pain relief to ease this. The back of your throat may be sore and you may feel bloated with air, however this should settle within 24 hours. If these symptoms persist, please contact your GP for advice. If there is a problem? Gastroscopy and Varices GMED 4.0 Page 3 of 5
If you have any problems concerning your procedure please contact either your G.P. or telephone the hospital on 0161 922 6000 and ask to be connected to the ward/department where the procedure took place. Alternatively if you are very concerned please attend the Accident and Emergency Department. Other Useful Contacts or Information NHS Direct: Tel 0845 46 47 http://www.nhsdirect.nhs.uk!f you have any questions you want to ask, you can use this space below to remind you If you have a visual impairment this leaflet can be made available in bigger print or on audiotape. If you require either of these options please contact the Patient Information Centre on 0161 922 5332 Gastroscopy and Varices GMED 4.0 Page 4 of 5
Document control information Author: J. Butterworth (Staff Nurse)/L. Penny (Matron) Division/Department: ES&CC Date Created: Date Reviewed: October 2009 October 2013 Reference Number: GMED 4.0 Version: Version 1.2 Gastroscopy and Varices GMED 4.0 Page 5 of 5