Gastroscopy

A gastroscopy is an examination of the upper digestive tract using an endoscope.  An endoscope is a thin, flexible tube containing a camera. It is  operated by a doctor and enters the body through the mouth.  A  gastroscopy is performed to investigate a number of symptoms in the  upper digestive tract, such as stomach or chest pain, heartburn, nausea,  and vomiting.

Are there any complications?

As with every medical procedure, the  risk must be compared to the benefit of having the procedure carried  out.  The doctor who has requested the test will have considered this  very carefully.  Gastroscopy is what is known as an invasive procedure  and therefore carries risks/complications.

The major risks/complications include:

• Bleeding from the biopsy site or from where a polyp has been removed.  This bleeding usually stops spontaneously.
• Small tear or damage to the lining of the oesophagus or stomach.   This risk is higher if a polyp is found and removed.  You may need an  operation to repair any damage.

The Procedure

The procedure is performed under conscious sedation.  A local anaesthetic spray is also applied to the back of the throat. The patient lies on his/her left side  with the head resting comfortably on a pillow. A bite guard is placed  between the teeth to prevent the patient from biting on the endoscope.  The endoscope is then passed over the tongue and into the throat. This  is the most uncomfortable stage for the patient as it can feel like  choking. Quick and gentle manipulation under vision guides the endoscope  into the oesophagus. The endoscope is gradually advanced down the  oesophagus making note of any pathology. The endoscope is quickly passed  through the stomach and through the pylorus to examine the first and  second parts of the duodenum. Once this has been completed, the  endoscope is withdrawn into the stomach and a more thorough examination  is performed. Still, photographs can be made during the procedure and  later shown to the patient to help explain any findings.

At it’s most basic, the endoscope is  used to inspect the internal anatomy of the digestive tract. Sometimes  inspection alone is insufficient, and a biopsy may be taken. Small  biopsies can be made with a pincer which is passed through the scope and  allows sampling of 1 to 3 mm pieces of tissue. The lining of the  stomach heals readily. Finally, it is important to note that with  conscious sedation you are able to cooperate fully with the surgical  team but will have no recall of the procedure.

Protocol Preceding Gastroscopy

• NB:  If you are taking WARFARIN (blood thinning medication)  please advise staff on booking your Gastroscopy.  Bloods need to be  taken five to seven days before the procedure and medication may need to  be stopped.
• Preceding your Gastroscopy, please do not eat or drink anything for 6  hours. Please inform unit staff if you are diabetic as this advice may  change.
• Please be here at 06h00 for paperwork to be completed.  If there is a  change in time of arrival, staff will phone you the day before.  Please  note that your appointment time is your arrival time and not the time  of your procedure.  You can expect to be in the Unit from 4 – 6 hours.   We try to ensure that all patients are seen and have their tests within  a short period of time of arriving at the Unit, but occasionally  emergencies take precedence and you may need to wait.

After the procedure

After the procedure, you will be  monitored for about an hour and as soon as you are able to swallow, you  will be offered tea or coffee with sandwiches.  You will be allowed home  approximately two hours after the procedure.  Due to the sedation,  you are not to drive and therefore you will need someone to collect you  from the Unit.   For the next 24 hours, you should not drive, operate  power tools, participate in strenuous activity or make major decisions.

After the procedure, you may resume your  usual diet and activity.  Serious side effects from this procedure are  rare but for the rest of the day you may have a sore throat.  You may  also feel a little bloated if some air we used in the test has been left  behind.  Both of these things will pass off and need no medication.

At home, if you get chest or stomach pain, a fever or start vomiting please contact the unit on 031 7657815 or 0823759611

Results of the test

You will get the result directly after  the procedure.  However, many people do not remember this conversation  following the effects of sedation.  If biopsies were taken, these  results may take up to three days to come through.  A copy of your  gastroscopy report will be sent to your GP.

We charge a non-refundable facility  fee, which is not covered by the Medical Aids.  An invoice will be  submitted to your Medical Aid for consumables, which will be refunded by  your medical aid according to your plan type. We will obtain all  necessary pre-authorization on your behalf.

 A Colonoscopy is a procedure that allows your doctor to look at the  inner lining of your large intestine using a thin, flexible tube called a  colonoscope. A colonoscopy helps find ulcers, polyps, tumors, and areas  of inflammation or bleeding. During a colonoscopy, tissue samples can  be collected and abnormal growths can be taken out.

The test usually takes 30 to 45 minutes, but it may take longer, depending upon what is found and what is done during the test. It is important to note that with  conscious sedation you are able to cooperate fully with the surgical  team but will have no recall of the procedure.

Are there any complications/risks?

As with every medical procedure, the  risk must be compared to the benefit of having the procedure carried  out.  The doctor who has requested the procedure will have considered  this very carefully.  A colonoscopy is what is known as an invasive  procedure and therefore carries risks/complications.

The major risks/complications include:-

• Bleeding from the biopsy site or from where a polyp has been removed.  This usually settles down on its own.
• Small tear or damage to the lining of the bowel.  This risk is  higher if a polyp is found and removed.  You may need an operation  repair any damage.
• An incomplete colonoscopy occurs if the procedure is abandoned due  to technical difficulty or because it was causing you distress.  The  doctor may recommend that you have a barium enema or CT scan so that a  complete examination of the colon can be achieved.

Protocol Preceding Gastroscopy

Before this test, you will need to clean  out your colon to allow a clear view during the procedure.  It is  essential that you follow the bowel preparation instructions.  It is  also important to increase your intake of clear fluids on the day before  your test.  For many people, the prep for a colonoscopy is more trying  than the actual test. Plan to stay home during your prep time since you  will need to use the bathroom often. The colon prep causes loose,  frequent stools so that your colon will be empty for the test. The colon  prep may be uncomfortable and you may feel hungry on the clear liquid  diet. Be sure to have clear fruit juices (no pulp), tea/coffee (no milk)  or soft drinks to drink after the prep because the solution tastes  salty and also to prevent dehydration.

YOU WILL BE GIVEN FULL BOWEL PREPARATION INSTRUCTIONS WHEN COMPLETING YOUR ADMISSION FORMS

• NB:  If you are taking WARFARIN  (blood thinning medication) please advise staff on booking your  Colonoscopy. Bloods need to be taken five to seven days before the  procedure and medication may need to be stopped.
• Please inform unit staff if you are diabetic or possibly pregnant.
• Please be here approximately at 06h00  as booked for paperwork to be completed.  If there is a change in time  of arrival staff will phone you the day before.  Please note that your  appointment time is your arrival time and not the time of your  procedure.  You can expect to be at the Unit for 4 – 6 hours.  We try to  ensure that all patients are seen and have their tests within a short  period of time on arriving at the Unit, but occasionally emergencies  take precedence and you may need to wait.

After the procedure you will be  monitored for about 2 hours and as soon as you are able to swallow will  be offered tea or coffee with sandwiches.

You will be allowed home approximately two to three hours after the procedure.

Please be dropped off in the morning, and have someone collect you later.  You are not to drive.

For the next 24 hours, you should not drive, operate power tools, participate in strenuous activity or make major decisions.

At home, you may resume your usual diet  and activity.  It is not uncommon to feel gas cramps for a short while.   Due to the effects of the sedation, you are advised not to drive a car,  operate machinery or make legal/financial decisions until the following  day.  You may notice a small amount of blood with your next bowel  movement if samples were taken or polyps removed.  Please call 031  7657815 or 0823759611 if you have any of the following:-

• Heavy rectal bleeding.
• Severe belly pain.
• Develop a fever.
• Are very dizzy.
• Are vomiting.
• Have a swollen and firm belly.

Results of the test

You will get the result directly after  the procedure.  However, many people do not remember this conversation  following the effects of sedation.  If biopsies were taken or polyps  removed, these results may take up to three days to come through.  A  copy of your colonoscopy report will be sent to your GP.

We charge a non-refundable facility fee,  which is not covered by the Medical Aids.  An invoice will be submitted  to your Medical Aid for consumables, which will be refunded by your  Medical Aid according to your plan type.  We will obtain all necessary  pre-authorization on your behalf.