WHAT IS A GASTROSCOPY? 

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There is some confusion regarding the terms Gastroscopy and Endoscopy, often individuals think they are 2 different tests, when they are the exact same tests and the terms are used interchangeably.  A Gastroscopy is a semi-invasive procedure performed with sedation during which a physician passes a small tube the size of a small finger through the mouth to visualize the upper intestinal tract (the esophagus, stomach and the duodenum). 


REASONS FOR GASTROSCOPY

Common reasons a physician may order a Gastroscopy:

  • Unexplained discomfort in the upper abdomen
  • Heartburn or chest pain
  •  Persistent nausea or vomiting
  • Bleeding, vomiting blood or blood in stool thought to originate from the upper gastrointestinal tract
  •  Difficulty swallowing; problems swallowing liquids and/or solids, pain when swallowing
  •  An abnormality on imaging tests such as an x-ray, MRI or CT scan
  • To rule out or confirm Celiac disease; it is important for the individual to be eating food containing gluten for 3 weeks prior to the Gastroscopy or the test may be falsely negative.  Gluten is in foods that contain wheat, oats, barley and rye. 
  •  To check on previously found ulcers, polyps or tumours

TO DO 3 WEEKS BEFORE THE GASTROSCOPY

Medication

Most individuals can take their prescription and non-prescription medications right up to the day of the Gastroscopy.   If there are medications that need to be temporarily stopped, your doctor will advise you.  Some medications can increase the risk of bleeding including Aspirin®, Warfarin/Coumadin®, and Clopidogrel/Plavix®.  Usually for a Gastroscopy these medications can be continued, but sometimes your doctor will recommend you stop this before the Gastroscopy.  If you are not sure if you should stop the medications, talk to your doctor a few weeks before your Gastroscopy.

Diabetics should check with their family physician regarding the dose of insulin or oral medication a few weeks before the Gastroscopy.

If you have questions or must cancel, please our office at least 3 working days before your appointment. There is usually a charge for cancellations less than 3 days before your appointment.

DAY OF THE GASTROSCOPY

You  will need to be fasting. If the Gastroscopy is in the morning you will need to fast from midnight on.  If the test is in the afternoon, you should not drink or eat anything for at least 6 hours before the procedure.  If there is food in the stomach, sometimes things can be missed due to poor visualization.  You may gargle and brush your teeth the morning of the test.

**Every effort will be made to keep your appointment at the scheduled time, but in medicine, unexpected delays and emergencies may occur and your wait time may be prolonged.  We give each patient the attention needed for his or her procedure. You should plan to be at the clinic or hospital anywhere from 1-2 hours.**

What to Bring?

  • The first and last name and address of all doctors you want to receive a copy of your procedure report.
  • Sedation is given during the procedure.  Therefore you have to arrange for someone to drive you home and you cannot drive for 24 hours, operate machinery, make important decisions or return to work for the rest of the day.  You may resume normal activities the next day unless your Gastroenterologist states otherwise.
  • A list of all your medications.
  • Your health insurance card (OHIP card)

 What to Wear?

 Wear comfortable, loose fitting clothing that is easy to step into.  Wear comfortable shoes, flat shoes or running shoes.  Do not wear jewellery or bring valuables.  Do not wear nail polish or makeup.

Procedure

When you arrive for a Gastroscopy you will be provided with a gown to change into.  To receive sedation an intravenous line (IV) will be started.  The IV will be used to give sedation during the test.  You will probably  sleep during the test, or become very relaxed and comfortable.  The role of sedation is to relieve apprehension and prevent pain and discomfort during the procedure.   

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Your throat and mouth will be frozen with a spray.  You will lie on your left side and the nurse will place a plastic mouth guard between your teeth to protect your teeth and prevent damage to the scope.  The gastroscope is about the thickness of a small finger with a  video camera on the end that transmits video to a monitor. It will be placed in your mouth and slowly advanced into your esophagus, then your stomach and finally into the first part of your small intestine, the duodenum.   The test takes, on average, 5-10 minutes. 

POST-PROCEDURE                                                                   

  • Eating: You can eat and drink after the freezing wears off (20-30 minutes) unless otherwise instructed by your Gastroenterologist.
  • Driving: After receiving sedation you are considered legally impaired and will require transportation home afterwards.  IT IS ILLEGAL TO DRIVE FOR 24 HOURS IN ONTARIO AND QUEBEC AFTER RECEIVING IV SEDATION. 
  • Decision Making: You shouldn’t make any important decisions, return to work or operate machinery.

 

COMPLICATIONS

With any medical procedure, there is some risk.  That said, complications are rare with Gastroscopy.

  • Perforation (hole in the intestine) is rare as the stomach is the thickest part of the gastrointestinal tract.
  • Bleeding, if a polyp is removed or biopsies are taken, bleeding can occur but this is rare.   If you are vomiting blood or passing blood in your stool or have jet-black stool in the first few weeks after a Gastroscopy, go to your nearest Emergency Room immediately.
  • Irritation to the vein in which medications are given is uncommon but may cause a tender lump lasting a few weeks.  Warm, moist towels will help to relieve discomfort. 
  • Heart problems or stroke can occur in a patient with underlying medical problems, but these are very rare.
  • Allergic reactions to the IV medication such as rash, fever, or breathing problems are very rare.