Patient Information Leaflet Gastroscopy Prepared by Endoscopy Department February 2013 Review due February 2016 1
If you require this leaflet in another language, large print or another format, please contact the Quality Team, telephone 01983 534850, who will advise you. Introduction: You have been advised by your GP or hospital doctor to have an investigation known as a Gastroscopy. A trained endoscopist will perform the investigation; this will either be a nurse or a doctor. This booklet has been written to enable you to make an informed decision in relation to consenting for this investigation, please do take time to read through this as it contains important information. The consent form that you will be given when you attend for the investigation is a legal document; therefore if there is anything that you do not understand or are worried about please DO ask the staff of the endoscopy unit as we are here to help you. If you are unable to keep your appointment please notify the endoscopy unit as soon as possible (telephone 01983 534885). This will enable us to give your appointment to someone else and if necessary, re-arrange your date and time. You will need to make firm arrangements for your discharge home: a) If you decide to have sedation you will need to arrange for someone to collect you from the Endoscopy Unit to take you home. If these arrangements are not in place prior to your appointment your procedure may be postponed. b) If you do not have sedation these discharge restrictions will not apply and you will make your own arrangements for getting home Why do I need a gastroscopy? You have been advised to undergo this investigation to help your doctor find the cause for your symptoms. This will then help you and your doctor to decide on any further investigations and /or treatment that you may need. Symptoms, which may require investigation, include: indigestion anaemia weight loss vomiting passing black motions vomiting blood difficulty in swallowing What is a Gastroscopy? This is an investigation looking at the lining inside the oesophagus (gullet), stomach, and small bowel (duodenum), using a flexible endoscope (camera), which is connected to a television system. The instruments are very slim, about the diameter of an average ball point pen. The instruments give the endoscopist a clear view to check whether or not disease or inflammation is present. During the investigation it may be necessary to take some samples for analysis. This is completely painless. Photographs may be taken for record and documentary purposes. What are the risks of this procedure? This procedure does involve some risks and although these are rare you need to be aware of them:. 1) Damage to the lining of the gullet or stomach may occur which may need surgery to correct this. 2) There may be a change in your heart rate and breathing which may prolong your stay in the unit until they settle. 2
3) Discomfort; this usually temporary and eases as the tube is withdrawn 4) Missed lesion; the lining of your gut is made up of many soft folds and a very small lesion may be hidden from view. Be sure to inform your GP immediately if you have any unusual pain or bleeding following the examination. How do I prepare for the gastroscopy? Eating and drinking On the day of your appointment you should have nothing to eat and drink for at least 6 hours prior to your appointment. This will reduce the risk of vomiting and inhalation of the vomit. Medication Your routine medication should be taken. If you are presently taking tablets or liquid to reduce the acid in your stomach please discontinue taking them on receipt of this letter prior to your appointment, unless advised otherwise by your G.P./the endoscopy unit staff, or you have a condition called Barretts oesophagus. If you are a diabetic on insulin or medication and have been given an afternoon appointment please notify the endoscopy unit as soon as possible, so that if necessary an appointment can be made earlier in the day for you. Please bring your insulin or diabetic tablets with you. Do not take them before you arrive on the unit, and do not have breakfast on the morning of the test. If you are on medication for a heart condition or high blood pressure you should take these tablets with a small amount of water at their normal time. If you are taking warfarin you must arrange to have a blood test (INR) no less than 5 days before your procedure. If you take Clopidogrel or other anti-platelet medication, you should inform the Endoscopy Unit prior to the date of your procedure. Dress If you wear nail varnish this must be removed prior to your arrival in the Endoscopy Unit to allow accurate observations to be taken before, during and after the procedure. What will happen when I arrive in the unit? You will be greeted by the receptionist and shown to the waiting room, where a member of staff will take details concerning the arrangements you have made for going home. You will then be taken through to the recovery area where your admission will be completed. You will be asked a series of questions, including whether you have any allergies, had a bad reaction to drugs or other tests, any operations and if you take any medication on a regular basis (a list will be very useful). If you have any worries or questions please do not be afraid to ask. The staff want you to be as relaxed as possible for the test and will be pleased to answer any queries you may have. The nurse will explain the procedure to you and give you a consent form to read and sign. Your blood pressure and heart rate will be recorded prior to the test. How long will I be in the unit for? This will depend upon whether you have sedation and throat spray or just a throat spray. You can expect to be in the unit for a total of 2 3 hours. This Unit also deals with emergencies and these will take priority. 3
Will I have sedation or throat spray? 1. Sedation: If you decide to have sedation, for your own safety you will not be allowed to drive, operate heavy machinery or sign any legal documents for 24 hours following the procedure. You will also need to have someone at home with you for 12-24 hours after the procedure. It is not recommended that you are home alone during this time because of the possible effects of sedation. If you have not been able to make these arrangements and/or you have not contacted the unit regarding this, the procedure may not go ahead and you will need to make another appointment. The sedation will be administered in the procedure room via a needle placed in your hand or arm. It will help you to feel relaxed but not put you to sleep. This means that you will be able to hear what is being said to you and that you will be able to respond to simple instructions to help you during the procedure. The sedation may cause you to remember very little about the procedure. You will be able to breath normally during the procedure. During the procedure your breathing and heart rate will be monitored by a small probe placed on your finger, so that any changes can be quickly recognised and dealt with. You will also be given some oxygen via small foam tipped tube to your nose. 2. Throat spray: This is a local anaesthetic spray which is given to numb your throat. At least a third of patients choose to have the procedure with just the spray. The benefit of this is that you can leave the unit soon after the procedure; you can drive and carry on life as normal. It is strongly advised that when having your first drink you sip it slowly to ensure that you do not choke on it. Consent Before a health professional examines or treats you, they need your consent. A written record of your decision is helpful. You will be asked to sign a consent form. If you later change your mind, you are entitled to withdraw consent, even after signing. The consent form that you will be given is a legal document; therefore if there is anything that you do not understand or are worried about it, it is important that you ask the Endoscopy staff before you sign it. The investigation (gastroscopy) The Endoscopy staff will explain the procedure to you and try to answer any further questions you may have about the procedure. In the Procedure room if you have any dentures and/or spectacles you will need to remove them now. Then you will be asked to lay on your left side and the probe for monitoring your pulse and heart rate will be placed on your finger. The Endoscopist will give you throat spray and/or sedation. A small plastic mouth guard will be placed in your mouth to protect your mouth and the instrument. Nurses will be with you at all times. Any saliva or other secretions will be removed using a small suction tube. The gastroscopy involves passing a tube approximately the width of an average ball point pen into your mouth, into your oesophagus, into your stomach and then into your duodenum. Samples can be taken from the lining of your digestive tract for analysis in the pathology department. The gastroscopy procedure may cause you to feel some discomfort due to air being passed into your gullet and stomach via the instrument, to enable the endoscopist to obtain good views, however the air will be expelled naturally. The examination usually takes about 10 minutes and the tube is easily removed. Afterwards you will be taken into the recovery area and your condition will be monitored by the nursing staff. What happens after the procedure? 4
If you have not had sedation the endoscopist will explain the results of the investigation to you as soon as possible and give any follow up advice. If you have sedation you will be allowed to rest in the recovery area, your pulse and blood pressure will be monitored. If you are a diabetic your blood glucose will be monitored. You will be offered some refreshments once you have recovered from the effects of sedation. Before you leave the unit results of the investigation and any follow-up recommendations will be explained to you. You may be given a copy of the Endoscopy report to take away with you and one will be sent to your Dr. The results of any specimens taken during the procedure will take about 2-3 weeks and will be sent to the Dr who referred you for this investigation. If you have any concerns the endoscopist will be happy to discuss them at the time of your appointment. If you experience any problems after the examination, please contact your GP or out of hours 8PM 8AM please call Island Healthline 0845 6031 007 or NHS Direct 0845 46 47. Transport home. If you decide to have sedation, for your own safety and that of other road users you will not be allowed to drive yourself home or use public transport, so you must arrange for a family member or a friend to collect you from the unit. The nursing staff will need to have a contact phone number for them in case the collection time is changed. If no discharge arrangements have been made your procedure may be postponed. If you do not have sedation the above restrictions will not apply. You will make your own transport arrangements. The Endoscopy Unit is open from 8AM-5PM. If you have difficulty in organising transport please contact us as soon as possible as we may be able to help you, but at least 24 hours notice is required. You can get further information on all sorts of health issues through NHS interactive available through Sky TV or online at: http://www.nhsdirect.nhs.uk/ For Health advice and out of hours GP service please call the NHS 111 service on: 111 We Value Your Views On Our Service If you wish to comment on the care which you, your relative or friend has received, we will be pleased to hear from you. Please speak to the person in charge of the ward, clinic or service in the first instance or ask them to contact the Quality Team. If you wish to contact them directly, telephone on 534850. Alternatively you may prefer to write to: Chief Executive Isle Of Wight NHS Trust St Mary s Hospital Newport Isle of Wight PO30 5TG All NHS sites are no smoking areas. If you would like help and advice to stop smoking please call: Freephone 0800 169 0 169 to talk to the NHS Smoking Helpline. ref: E/GAS/8 5
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