This information about upper gastrointestinal endoscopy will help you understand more about the test to find the cause of your symptoms. The test is sometimes called a ‘gastroscopy’ or simply an ‘endoscopy’. If you still have questions, ask your doctor for more information.

What is an Upper GI Endoscopy?

Upper GI endoscopy is a test which allows the doctor to look directly at the lining of the oesophagus (the gullet), the stomach and around the first bend of the small intestine – the duodenum. In order to do the test, an endoscope is passed through your mouth into the stomach. The endoscope is a long flexible tube (thinner than your little finger) with a bright light at the end. Looking down the tube, the doctor gets a clear view of the lining of the stomach and can check whether or not any disease is present. It’s also more accurate than X-ray films for detecting inflammation, ulcers and tumours of the oesophagus, stomach and duodenum. Sometimes the doctor takes a biopsy- a sample of tissue for analysis in the laboratory. The tissue is removed painlessly through the endoscope, using tiny forceps.

What should you expect?

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

In 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. The doctor may give you an injection into your arm to make you feel sleepy and relaxed.

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, you will have to wait until your swallowing reflex is back to normal. This usually takes more than an hour. 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.

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, or drink alcohol. You should arrange for someone to accompany you home because the sedatives might affect your judgment and reflexes for the rest of the day.By the next day, the effects of the test and injection should have worn off and 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.

What are the possible complications of upper endoscopy?

Although complications can occur, they are rare when doctors who are specially trained and experienced in this procedure perform the test. Bleeding can occur at a biopsy site or where a polyp was removed, but it’s usually minimal and rarely requires follow-up. Other potential risks include a reaction to the sedative used, complications from heart or lung diseases, and perforation (a tear in the gastrointestinal tract lining). It’s important to recognise early signs of possible complications. If you have a fever after the test, trouble swallowing or increasing throat, chest or abdominal pain, tell your doctor immediately.

Follow-Up Visit

Your doctor may schedule a follow-up visit within a week or two to check the progress of your healing. More follow-up visits may be scheduled as needed.

When to call the doctor?

If you experience any of the following problems

Click here for Understanding Flexible Sigmoidoscopy
Click here for Understanding EUS (Endoscopic Ultrasonography)

This information about Flexible Sigmoidoscopy will give you a basic understanding of the procedure – how it is performed, how it can help, and what side effects you might experience. It can’t answer all of your questions, since a lot depends of the individual patient and the doctor. Please ask your doctor about anything you don’t understand.

What is flexible sigmoidoscopy?

Flexible sigmoidoscopy lets your doctor examine the lining of the rectum and a portion of the colon (large intestine) by inserting a flexible tube about the thickness of your finger into the anus and slowly advancing it into the rectum and lower part of the colon.

What preparation is required?

Your doctor will tell you what cleansing routine to use. In general, preparation consists of one or two enemas prior to the procedure but could include laxatives or dietary modifications as well. However, in some circumstances your doctor might advise you to forgo any special preparation. Because the rectum and lower colon must be completely empty for the procedure to be accurate, it’s important to follow your doctor’s instructions carefully.

Should I continue my current medications?

Most medications can be continued as usual. Inform your doctor about medications that you’re taking – particularly aspirin products or anticoagulants (blood thinners) — as well as any allergies you have to medications. Also, tell your doctor if you require antibiotics prior to dental procedures, because you might need antibiotics prior to sigmoidoscopy as well.

What can I expect during flexible sigmoidoscopy?

Flexible sigmoidoscopy is usually well-tolerated. You might experience a feeling of pressure, bloating or cramping sensation during the procedure. You will lie on your left side while your doctor advances the sigmoidoscope through the rectum and colon. As your doctor withdraws the instrument, the lining of the intestine will be carefully examined.

What if the flexible sigmoidoscopy finds something abnormal?

If your doctor sees an area that needs further evaluation, a biopsy (sample of the colon lining) will be taken for analysis. Biopsies are used to identify many conditions, and it does not mean that you have cancer for certain. If polyps (growths from the lining of the colon) are found, the doctor may snare them completely or just take a biopsy of them. Polyps can vary in size and type. Certain “hyperplastic” polyps might not require removal, however; other benign polyps such as “adenomas” are potentially precancerous and should be removed. Your doctor might ask you to have a colonoscopy (a complete examination of the colon) to remove any large polyps or any small adenomas.

What happens after a flexible sigmoidoscopy?

Your doctor will explain the results to you when the procedure is done. You might feel bloated or have some mild cramp, because of the air that was passed into the colon during the examination. This will disappear quickly when you pass wind. You should be able to eat and resume your normal activities after leaving your doctor’s office or the hospital, assuming you did not receive any sedative medication, other wise you should follow the instructions given by the medical team regarding sedation.

What are possible complications of flexible Sigmoidoscopy?

Flexible Sigmoidoscopy and biopsy are safe when performed by doctors who are specially trained and experienced in these endoscopic procedures. Complications are rare, but it’s important for you to recognize early signs of possible complications.
Bleeding can occur at a biopsy site or where a polyp was removed, but it’s usually minimal and rarely requires follow-up. Other potential risks include a reaction to the sedation if used, complications from heart or lung diseases, and perforation of the colon which is rare. It’s important to recognise early signs of possible complications.
Contact your doctor if you notice severe abdominal pain, fevers and chills, or rectal bleeding of more than one-half cup. Note that rectal bleeding can occur several days after the biopsy.

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.

Follow-Up Visit

Your doctor may schedule a follow-up visit within a week or two to check the progress of your healing. More follow-up visits may be scheduled as needed.

When to call the doctor?

If you experience any of the following problems

Click here for Understanding Colonoscopy

Introduction:

This information about colonoscopy will give you a basic understanding of the procedure – how it is performed, how it can help, and what side effects you might experience. It can’t answer all of your questions, since a lot depends of the individual patient and the doctor. Please ask your doctor about anything you don’t understand.

What is a colonoscopy?

Colonoscopy enables your doctor to examine the lining of your colon (large intestine) for abnormalities by inserting a flexible tube as thick as your finger into your anus and slowly advancing it into the rectum and colon.

What preparation is required?

Your doctor will tell you what dietary restrictions to follow and what cleansing routine to use. In general, the preparation consists of either consuming a large volume of a special cleansing solution or clear liquids and special oral laxatives. The colon must be completely clean for the procedure to be accurate and complete, so be sure to follow your doctor’s instructions carefully.

Can I take my current medications?

Most medications can be continued as usual, but some medications can interfere with the preparation or the examination. Inform your doctor about medications you’re taking, particularly aspirin products, arthritis medications, anticoagulants (blood thinners), insulin or iron products. Also, be sure to mention allergies you have to medications. Alert your doctor if you require antibiotics prior to dental procedures, because you might need antibiotics before a colonoscopy as well.

What happens during colonoscopy?

Colonoscopy is well-tolerated and rarely causes severe pain. You might feel pressure, bloating or cramping sensation during the procedure. Your doctor might give you a sedative to help you relax and better tolerate any discomfort. You will lie on your side or back while your doctor slowly advances a colonoscope through your large intestine to examine the lining. Your doctor will examine the lining again as he or she slowly withdraws the colonoscope. The procedure itself usually takes 20 to 60 minutes, although you should plan on two to three hours for waiting, preparation and recovery. In some cases, the doctor cannot pass the colonoscope through the entire colon to where it meets the small intestine. Although another examination might be needed, your doctor might decide that the limited examination is sufficient.

What if the colonoscopy shows something abnormal?

If your doctor thinks an area needs further evaluation, he or she might pass an instrument through the colonoscope to obtain a biopsy (a sample of the colon lining) to be analysed. Biopsies are used to identify many conditions, and your doctor might order one even if he or she doesn’t suspect cancer. If colonoscopy is being performed to identify sites of bleeding, your doctor might control the bleeding through the colonoscope by injecting medications or by coagulation (sealing off bleeding vessels with heat treatment). Your doctor might also find polyps during colonoscopy, and he or she will most likely remove them during the examination. These procedures don’t usually cause any pain

What are polyps and why are they removed?

Polyps are abnormal growths in the colon lining that are usually benign (non-cancerous). They vary in size from a tiny dot to several inches. Your doctor can’t always tell a benign polyp from a malignant (cancerous) polyp by its outer appearance, so he or she might send removed polyps for analysis. Because cancer begins in polyps, removing them is an important means of preventing colorectal cancer

How are polyps removed?

Your doctor might destroy tiny polyps by fulguration (burning) or by removing them with wire loops called snares or with biopsy instruments. Your doctor might use a technique called “snare Polypectomy” to remove larger polyps. That technique involves passing a wire loop through the colonoscope and removing the polyp from the intestinal wall using an electrical current. You should feel no pain during the polypectomy.

What happens after a colonoscopy?

Your doctor will explain the results of the examination to you, although you’ll probably have to wait for the results of any biopsies performed. If you have been given sedatives during the procedure, someone must drive you home and stay with you. Even if you feel alert after the procedure, your judgment and reflexes could be impaired for the rest of the day. You might have some cramping or bloating because of the air introduced into the colon during the examination. This should disappear quickly when you pass wind. You should be able to eat after the examination, but your doctor might restrict your diet and activities, especially after polypectomy.

What are the possible complications of colonoscopy?

Colonoscopy and polypectomy are generally safe when performed by doctors who have been specially trained and are experienced in these procedures. One possible complication is a perforation, or tear, through the bowel wall that could require surgery. Bleeding might occur at the site of biopsy or polypectomy, but it’s usually minor. Bleeding can stop on its own or be controlled through the colonoscope; it rarely requires follow-up treatment. Some patients might have a reaction to the sedatives or complications from heart or lung disease. Although complications after colonoscopy are uncommon, it’s important to recognize early signs of possible complications.

When to call the doctor?

Contact your doctor if you notice

• severe abdominal pain
• fever and chills
• rectal bleeding of more than one-half cup. Note that bleeding can occur several days after the procedure

Click here for Understanding Flexible Sigmoidoscopy

This information about endoscopic ultrasonography (EUS), will give you a basic understanding of the procedure, how it is performed, how it can help you and what side effects you might have.
It can’t answer all of your questions, since a lot depends on the individual patient and the doctor. Please ask your doctor about anything you don’t understand. Mr. Sayegh is a highly trained specialists who welcome your questions regarding his training and experience.

What is EUS?

EUS allows your doctor to examine the lining and the walls of your gastrointestinal tract. It is also used to study internal organs that lie next to the gastrointestinal tract, such as the gall bladder and pancreas. The doctor will use a thin, flexible tube called an endoscope. Your doctor will pass the endoscope through your mouth or anus to the area to be examined. Your doctor then will turn on the ultrasound component to produce sound waves that create visual images of the digestive tract.

Why is EUS done?

Why is EUS used for patients with cancer?

How should I prepare for EUS?

What about my current medications or allergies?

Do I need to take antibiotics?

Should I arrange for help after the examination?

If you received sedatives, you won’t be allowed to drive after the procedure, even if you don’t feel tired. You should arrange for a transport home. You should also plan to have someone stay with you at home after the examination, because the sedatives could affect your judgment and reflexes for the rest of the day.

What can I expect during EUS?

What happens after EUS?

What are the possible complications of EUS?

Although complications can occur, they are rare when doctors with specialised training and experience perform the EUS examination. Bleeding might occur at a biopsy site, but it’s usually minimal and rarely requires follow-up. You might have a sore throat for a day or more. Throat lozenges and painkillers help relieve the sore throat. Other potential, but uncommon, risks of EUS include a reaction to the sedatives used; backwash of stomach contents into your lungs; infection; and complications from heart or lung diseases. One major, but very uncommon, complication of EUS is perforation. This is a tear through the lining of the intestine that might require surgery to repair. The possibility of complications increases slightly if a deep needle aspiration is performed during the EUS examination. These risks must be balanced against the potential benefits of the procedure and the risks of alternative approaches to the condition.

Additional Questions?

If you have any questions about your need for EUS, alternative approaches to your problem, do not hesitate to speak to your doctor about it.

Click here for Understanding Upper Gastrointestinal tract endoscopy (OGD)