Dr Laksh Ayaru, Bsc MBBS (hons) MRCP PhD
Consultant Gastroenterologist
Charing Cross Hospital
Hammersmith Hospital
Highgate Hospital
Fulham Palace Road
London
W6 8RF
Du Cane Road
London
W12 0HS
17-19 View Road
Highgate
London N6 4DJ
Tel: 07586 903 741
Fax: 020 8 866 3620
What is a gastroscopy?
Gastroscopy (also known as ‘OGD’ and upper endoscopy) is a visual examination of
the lining of the oesophagus (gullet), stomach and duodenum (small intestine). An
endoscope (long, flexible tube) is passed through your mouth and down into your
throat. Using the light on the end of the endoscope, the doctor is able to look for any
abnormalities that may be present. If necessary, biopsies (small samples of tissue)
may be taken during the examination and sent to the laboratory for further
investigation.
Gastroscopy helps your doctor check symptoms of persistent upper abdominal pain,
nausea (feeling sick), vomiting and difficulty in swallowing. It is also used for finding
the cause of bleeding from the upper gastrointestinal tract.
As your stomach needs
to be empty for the
gastroscopy, you must
not eat or drink anything
for 6 hours before your
appointment.
Failure to follow these
instructions may result in
your gastroscopy being
cancelled.
Please note
You can choose to have this procedure done either with a local anaesthetic spray to
numb your throat, or with conscious sedation, where intravenous drugs are used to
make you relaxed and/or drowsy. It is different from general anaesthetic as it does
not ‘knock you out’ completely and you are still able to respond to your doctor or
nurse. Most people have little or no recall of the procedure afterwards.
The advantages of having the throat spray are:
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You can go home immediately after the test.
You do not need a relative or friend to take you home.
You will be able to drive yourself home after the test.
You can return to work after the test.
If you choose to have sedation, you must arrange for a relative or friend to
take you home approximately 1 hour after the test. This person should be 18
years of age or older. It is recommended that someone stays with you for 12 hours
after your procedure. You will not be able to drive or operate any machinery for the
remainder of the day and will need to rest quietly at home. Please note that your
appointment will be cancelled on the day if you wish to have sedation but have
not organised an escort home.
Are there any alternatives to gastroscopy?
The principal alternative to the test is a ‘barium meal’ x-ray. During this procedure,
you drink a special liquid (barium) which allows images (pictures) of your stomach to
be seen using x-rays. It is less accurate than gastroscopy at detecting inflammation,
ulcers and tumours of the oesophagus, stomach and duodenum. Unlike endoscopy,
barium meal does not allow for biopsies to be taken for examination in the
laboratory.
Please note
A ‘capsule endoscopy’ (where a pill-sized video capsule is swallowed) is not a
substitute for this type of gastroscopy, as it does not give adequate pictures of either
the oesophagus or the stomach and biopsies cannot be taken.
Are there any risks associated with gastroscopy?
Although complications can occur, they are rare. There is a 0.2% risk of the following
occurring after endoscopy:

Bleeding, which may require a blood transfusion.

Reaction to the sedatives, if used during the test.

Perforation (tearing) of the lining of the gastrointestinal tract, which may require
surgery to repair.

‘Aspiration pneumonia’ - inflammation of the lungs, caused by inhaling the
contents of the stomach. This is why it is important that you follow the instructions
about not eating or drinking before the test.

Disturbance of crowned teeth or dental bridgework. It is important that you tell us
any crowns or bridgework before we start the test.
The risk of complications may be increased if treatments such as stretching a narrow
area are required, or if you have any pre-existing heart or lung conditions. Your
doctor will discuss any increased risks with you before you have the test.
Is there anything I should do to prepare for my
appointment?
 If you choose to have sedation, you will not be able to go home by
yourself afterwards – a friend or relative who is 18 years of age or older must
escort you. It is recommended that someone stays with you for 12 hours after your
procedure. Please make sure that you will have access to a telephone when you
return home. If you have not been able to make these arrangements, please
speak to the nursing staff. We cannot do the test with conscious sedation on
this day if you do not have an escort.
 Please contact us at least 2 weeks before your appointment if you are on any
blood-thinning medications, such as warfarin or aspirin, as you may need to
stop taking them for a few days before the test.

Please also contact us at least 2 weeks before your appointment if you are
taking Clopidogrel (Plavix), as you may need to stop taking it for a minimum of
10 days before the test.

Preparation for the test involves not having anything to eat or drink for
6 hours before your appointment time. If you are diabetic, you should
contact your GP or your Diabetes Nurse Specialist for advice before your
appointment.
2 weeks before your appointment
Unless you have been told otherwise, please stop taking
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‘Losec’ (Omeprazole)
‘Zoton’ (Lansoprazole)
‘Protium’ (Pantoprazole)
‘Pariet’ (Rabeprazole)
‘Nexium’ (Esomeprazole)
‘Tagamet’ (Cimetidine)
‘Zantac’ (Ranitidine)
‘Axid’ (Nizatidine)
‘Pepcid’ (Famotidine)
The day before the test
As an empty stomach allows for the best and safest examination, please
do not have anything to eat or drink (not even sweets or chewing
gum) for at least 6 hours before your appointment.
What happens on the day of the test?
If you regularly take medicines in the morning, you should take them before 7.00am
on the day of the test, with a small sip of water if necessary, unless you have been
advised otherwise.
We advise you to wear loose-fitting clothes to your appointment, as during the
procedure, the doctor will introduce air into your bowel/ stomach (see below), which
may cause bloating afterwards. The bloating will go down, but if you are wearing
tight-fitting or tailored clothes, this may increase any initial discomfort you
experience.
The gastroscopy will be done as close to your appointment time as possible. Every
effort is made to keep waiting times to a minimum, but it is not possible to predict
how long individual procedures will take. You may wish to bring something to read
with you.
The procedure will be discussed with you in detail and you will be asked to sign a
consent form. This is to make sure that you understand the risks and benefits of
having the test.
You will be asked to remove any dentures and glasses in the examination room. We
will ask you to lie on your left side on a trolley, with your knees slightly bent.
 If you chose to have the local anaesthetic throat spray, this will be sprayed onto
your throat.
 If you chose to have sedation, you will have an intravenous cannula/drip inserted.
You will be connected to a monitor, which will record your blood pressure and
pulse throughout the procedure. Oxygen will be given to you through your nose.
The conscious sedation will then be given to you.
A small probe will be placed on your finger to monitor your pulse and blood oxygen
level.
A mouth guard will be placed in your mouth to protect your teeth. The doctor will then
place the endoscope (long, flexible tube) in your mouth and pass the tube down your
throat and into your stomach. Introduction of air will help him/ her to see inside your
stomach and duodenum. If any saliva collects in your mouth, the nurse will clear it
with a small suction tube similar to that used by dentists.
If the doctor thinks an area needs further investigation, s/he might pass an
instrument through the endoscope to obtain a biopsy or cytology (sample of the
lining of the gastrointestinal tract) for testing in the laboratory. These tests are used
to diagnose many conditions and your doctor may request one even if s/he does not
suspect cancer. For example, your doctor may use a biopsy to test for Helicobacter
pylori, the bacterium that causes ulcers.
Gastroscopy can also be done to treat conditions of the upper gastrointestinal tract
by passing instruments through the endoscope. For example, your doctor might
stretch a narrowed area or treat bleeding with little or no discomfort. Your doctor
will discuss any such treatment with you in detail before the test.
The endoscope will not interfere with your breathing or cause you any pain. Most
patients consider the test to be only slightly uncomfortable.
Endoscopy can take up to a maximum of 15 minutes to complete.
What happens after the test?
If you chose to have the throat spray, you will be able to go home almost
immediately afterwards. You should not have anything to eat or drink for half an hour
after the test, as your throat may still be numb from the anaesthetic.
If you chose to have sedation, you will be left to rest for about an hour before you
can go home, accompanied by your escort. Once you are fully awake, you will be
able to have something to eat and drink.
When will I get the results?
In many cases, the results are available immediately after the test. However, biopsy
results may take at least a week before they are available. Details of the results and
any necessary treatment will be discussed with you at your next clinic appointment.
Is there anything I need to watch out for at home?
It is normal to experience bloating and mild abdominal discomfort for a few days after
having a gastroscopy If you have any severe pain, black tarry stools or persistent
bleeding in the hours or days after your gastroscopy, please either contact Dr Ayaru,
your GP or telephone switchboard of your local hospital,
You may experience a feeling of pressure, bloating or cramping during or after the
procedure due to the air that was introduced. This will disappear quickly once you
have passed wind.
Please do not worry if you have a sore throat for the rest of the day. This is normal
and will pass.
When can I get back to normal?
If you chose to have the throat spray, you may be able to return to work
and all your usual activities half an hour after your endoscopy.
If you chose to have sedation, you must have a friend or relative (18
years of age or older) to escort you home. It is recommended that
someone stay with you for 12 hours after your procedure.
For the rest of the day, you must not:
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drive or operate machinery (including kitchen equipment).
drink alcohol.
sign any important or legal documents.
You should be able to return to work and all your usual activities the day after your
appointment.