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Upper GI Endoscopy

What is a oesophago-gastroduodenoscopy (OGD)?

The examination is performed using a long flexible instrument called a gastroscope which is about the width of your little finger. It is passed through your mouth and into your stomach and duodenum (the first part of your small bowel). It allows the Endoscopist (doctor or nurse specialist who performs these procedures) to look directly at the lining of the oesophagus (gullet), stomach and duodenum. It also allows tissue samples to be removed painlessly which can then be sent to the laboratory for analysis. The test usually takes approximately five minutes to complete, however you may be in the department for up to an hour to allow for admission and recovery time. The test can usually be performed using a spray to numb the throat, many hospitals carry out all their tests in this way, however we do offer a sedative for those who feel they require it. This is not a general anaesthetic, you will not be asleep. The sedative will help you to relax but you will still be able to feel sensations, hear what we say to you and follow simple instructions during the test. You may not remember anything after the test if you have sedation, but this cannot be guaranteed. The sedation can stay in your system for up to 24 hours. If you choose to have sedation for the procedure, you will not be able to drive, drink alcohol, sign legal documents, operate machinery or look after small children. A responsible adult must collect you from the endoscopy unit, take you home and stay with you for 24 hours after the procedure.

What are the risks?

Oesophago-gastroduodenoscopy is an established and safe procedure but very rarely it can result in complications:-
A tear or hole in the oesophagus, stomach or duodenum and bleeding (1: 2000 risk).
Breathing difficulties or heart irregularities
This can happen as a result of reacting to the sedation. To help prevent this from happening, your oxygen levels and heart rate will be monitored. Rarely, a heart attack or stroke can happen if you have serious medical problems. We may advise some patients against sedation and in some cases it may be necessary for us to refuse to do the test under sedation. This would be to maintain your safety.
Damage to teeth or bridgework.
A plastic mouthpiece will be placed in your mouth to protect the camera from your teeth. Do not bite down hard onto this mouthpiece. Inform the nursing staff if you have any loose teeth.
Incomplete procedure
The gastroscopy may be incomplete due to technical difficuly, food or blockage in the upper digestive system, complications during the procedure or discomfort. Your Doctor may recommend another gastroscopy or a different test such as a barium meal.
Complications may require treatment and rarely even an operation. Complications are more likely to occur as a result of more complicated procedures, for example if the oesophagus is narrow and requires a dilatation or if treatment is required for Varices (enlarged veins).
Alternatives to this test
Your doctor has recommended a gastroscopy as it is the best way of diagnosing most problems with the upper digestive system. A barium meal is an x-ray test of the upper digestive system, this test is not as accurate as a gastroscopy and if your doctor finds a problem you may still need a gastroscopy to perform biopsies.
On the day of the test
Your stomach needs to be empty to allow a clear view of the lining of the stomach and to prevent vomiting during the procedure. This is important as vomiting during the procedure could allow fluid to enter your lungs.
Morning appointment - before 12 midday
Do not have anything to eat or drink from midnight the night before the test. Do not suck boiled sweets or chew chewing gum. Take any regular medication (except diabetic medication) with a small amount of water.
Afternoon appointment – after midday
Have a light breakfast before 07.30am then nothing else to eat or drink until after your test. Do not suck boiled sweets or chew chewing gum. Take any regular medication (except diabetic medication) with a small amount of water.