Mission statement
"We will provide excellent, high quality care supported by research and development, education and the
empowerment of patients and staff"
INFORMATION ABOUT
ENDOSCOPY
 
Things you may wish to know about having an Endoscopy (Gastroscopy)
After considering alternative ways of investigating your symptoms your doctor has advised
that you should have an upper gastro-intestinal endoscopy, this is a routine test commonly
carried out to help to clarify the cause of your symptoms. The following is some information
and instructions you need to know before having this procedure.
What do you have to do?
When we receive a request from your doctor to carry out this examination, our appointments
office will contact you by telephone or letter to arrange an appointment. You will be sent
written information about the procedure, which you must read. We ask you to arrive on
time, and to contact the Receptionist, situated on the ground floor, where you will be directed
to the Endoscopy Department.
You must arrange for someone to take you home. If you have had sedation you will not
be able to drive yourself. It is recommended that you do not drive for the next 24 hours, or
do anything that requires fine judgement involving machinery, in case you injure yourself.
What is an Endoscopy (Gastroscopy)?

Gastroscopy is a technique by which the doctor can look directly into your oesophagus
(gullet), stomach and duodenum, to investigate your problem. It also allows samples
of tissue to be taken, painlessly, for testing.

The endoscope is a thin flexible tube with a bright light and tiny video camera on the
end. This is passed through your mouth and down into your stomach. The camera
plays the images on a screen, which allows the endoscopist, (the person who is doing
your test) to view the interior of your gullet or stomach.

As with any medical procedure, there is an element of risk involved in endoscopy.
However, all our staff are highly trained and are able to deal with any situation which
may arise.

According to the British Society of Gastroenterology Guidelines, endoscopic
procedures carry a 1 in 3000 risk of bleeding (haemorrhage) or perforation of the gut,
following which surgery may be necessary.

Other rare complications include aspiration pneumonia and a reaction to the IV
sedative drugs or local anaesthetic throat spray if it is used. Upper gastro-intestinal
endoscopy may involve a slight risk to crowned teeth or dental bridgework. Each of
these risks occurs in less than 1% of procedures.
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What should I expect?
The Preparation

To allow a clear view, the stomach must be empty. Therefore you must not have
anything to eat or drink for several hours before the examination. Once your
appointment had been made you will receive further information and guidance on this.

As space on the Unit is limited, please bring only 1 person (an adult) to accompany
you. This person will need to leave after the initial admission and will be advised
when to return.

When you come to the Department, a nurse will explain the procedure to you in detail.
The endoscopist will also see you, and they will also want to know about any previous
endoscopies 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.

The doctor will ask you to read and sign a consent form and make sure that you
understand the investigation and its implications. If you need reading glasses please
bring them with you.
Please tell the endoscopist or nurse if you have had any allergies or adverse reactions
to drugs or other tests.
During the test

In the examination room you will be made comfortable on a couch, resting on your left
side. You will not have to undress, but must remove dentures and glasses. A nurse
will stay with you throughout the test.

You may have an injection in your arm to make you sleepy and relaxed. Some
patients now find that the test can be performed without sedation, but with a local
anaesthetic throat spray applied to the back of the throat.

To keep your mouth slightly open, a plastic mouthpiece will be put between your teeth.
When the doctor passes the endoscope into your stomach, it will cause you little
distress, and will not interfere with your breathing at any time. Modern endoscopes are
quite thin and easy to pass.

The examination will take approximately 5-10 minutes. During this time some air will
be passed down the tube to distend the stomach and allow the doctor a clear view.
The air is sucked out at the end of the test.
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
If you collect saliva in your mouth, the nurse will clear it using a small suction tube.
When the examination is finished the endoscope is removed quickly and easily.
About Sedation

A canula will be placed into the back of your hand or arm and the sedative will be
injected through it. Sedation will make you relaxed and makes you drowsy. You may
not remember the procedure taking place. However, this is not a general anaesthetic.

You may wake up fairly quickly – or more slowly: each person reacts differently.

You will have your blood pressure and pulse monitored.

You will probably remain in the Unit for about 40 minutes but the effects of the
sedation will not wear off totally for 24 hours. Your thinking processes and
movements will be slower than usual; hence you must not drive or operate machinery
for 24 hours.
About Throat Spray

Throat spray is a local anaesthetic that is sprayed onto the back of your throat to numb
it. This will enable the endoscope to pass more easily.

It means that you can stay awake during the procedure and you can leave the Unit as
soon as the examination is over. However, you should have nothing to eat or drink
until after the effect of the spray has worn off, because your swallowing will be
impaired.
After the Test

If you have had sedation, you will be left to rest in the unit for about 40 minutes. Your
blood pressure and pulse recordings will be taken. You will be given a drink and
biscuits when you are fully awake.

You may also feel a little bloated if some air has remained in your stomach. This
discomfort will pass, and needs no medication.
Going Home

If you have had a throat spray you can make your own way home or go back to work.

If you have had sedation (an injection) and are going home after the test, a
responsible adult should come to the Unit to pick you up.
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
When you get home it is important to rest quietly for the remainder of the day, with
someone to look after you for 24 hours if possible. The effects of the sedative
lasts longer than you think.

It is also advisable that you do not take sole responsibility for children or anyone who
is in need of your care e.g. the elderly for 24 hours after having sedation.
For the first 24 hours after having sedation you should not:



Drive a car
Operate any machinery – not even a kettle.
Sign any legally binding documents
The effects of the test and injection should have worn off after 24 hours when most patients
are able to resume normal activities.
Please note that some insurance companies will not insure you if you do not follow these
instructions.
When will you know the results?

The doctor will be able to tell you the results straight after the test, or if you have been
sedated, as soon as you wake up. However, if samples (biopsies) have been taken
for examination, the results may take up to two weeks and will be sent to your General
Practitioner (GP). You will be given a report of your examination to take to your GP
surgery.

You should discuss the details of the results and necessary treatment with your GP or
hospital specialist – whoever it was who referred you to have the test.
If you need further information about your procedure, between
9-5 Monday to Friday please telephone 01225-473409, where a
member of the unit staff will be pleased to help you.
Out of these hours, you may get general advice for serious
problems relating to your procedure by telephoning the on
call doctor on 01225 465941.
Cancellation of appointment
If you need to cancel the appointment please:

Always inform the Appointments Office as soon as possible so that alternative
arrangements can be made for you (tel: 01225-473401).
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
Never fail to let the Hospital know that you cannot attend, the more notice you can
give us the more chance we have to give another patient your appointment time.
Transport
If transport has been arranged for you by your GP, and for any reason you do not require it,
please ensure that it is cancelled.
Bath Spa railway station and the coach station is within half a mile of the hospital. Taxis are
available. We regret that the hospital does not have a car park for the use of patients and
their escorts. There are a number of public car parks available and that are close to the
hospital, and a map will be sent to you to show you where these are located.
Cars may drop patients off outside the front entrance of the hospital, but may park only if they
display a “disabled” sticker.
Access to the hospital
Automatic doors allow easy access to the hospital, and a lift is available to take you to the
ground floor, where Reception is situated, if you cannot manage the steps.
Please ask the Switchboard/Enquiry Desk if you need assistance to operate the lift.
Comments, suggestions and complaints
We are continually striving to improve our care and achieve maximum customer satisfaction.
We welcome constructive criticism and comments to help us attain our aim. To this end we
would like you to take part in our Patient Satisfaction Survey. This will involve filling in a
simple questionnaire. It is anonymous.
If you are worried or concerned about anything it is best to try to resolve it with the person
involved and/or a senior member of staff. Very often they will be able to reassure you, sort
out the problem, or bring in someone who may be able to do so.
If you wish to make a formal complaint, you may write to the Chief Executive, or, if you prefer,
someone will make a note of your complaint and pass it on to the Chief Executive. The
Nurse in Charge will arrange this for you. Your complaint will be investigated and a reply
sent to you.
If you are then dissatisfied with the way your complaint is dealt with, you may write to the
Community Health Council or the Health Services Commissioner (The Ombudsman).
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Clinical Training
It would be impossible to train future members of the health professions without the help and
co-operation of patients. This is a hospital where such staff are trained. Training takes
place in the Endoscopy Unit as well as in the wards and Out Patient Department. This
means that a student may be present at the time of your examination.
We hope you will co-operate in this work if we need your help. If, however, you do not
wish students to be present, you are absolutely free to refuse without your treatment
being affected in any way.
Please inform the nurse at the earlier opportunity if you do not wish students to be present
during your examination.
The Trust believes that all patients who attend the Royal National Hospital for Rheumatic
Diseases as day patients have the right to expect certain levels of care which include the
right to:

Receive competent health care according to their individual needs without undue
delay.

Expect privacy, dignity and respect at all times.

Expect all information to be dealt with confidentially.

Not be subjected to any treatment without their consent.

Choose to be informed about all aspects of their illness if they wish
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