Preparing for the day
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1. How long should I allow for my appointment in Endoscopy?
Your appointment letter will suggest that you allow approximately
two hours for your examination, which is the average time
people spend in the Department.
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2. Why does it take two hours?
The 'two hours' is measured from the time you register
at Endoscopy reception to your departure from the department.
It includes the time you spend waiting for the examination,
the time the actual examination takes, the time you need
to recover from it and the time taken getting yourself
ready to go home.
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3. How long does the examination take?
The actual time spent on an examination will vary between
patients and examinations. In general, an examination of
the stomach (gastroscopy) will take 5-15 minutes and one
of the colon (colonoscopy) 20-40 minutes.
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4. Do I need to bring anything with me?
You don't need to bring anything specific with you (no
change of clothing etc). You might like to bring the instructions
sent to you with your appointment details.
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5. Do I need to starve beforehand?
The instructions sent to you with your appointment details
will clearly explain what you will need to do to prepare
for the endoscopy.
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6. Do I need to bring someone with me?
Whether you need to bring someone with you as an escort
depends on whether you will have a sedative for the endoscopy.
If you have a sedative, it is important that you have someone
to help you home afterwards, including being driven home. You
will be advised of whether you need to have a sedative
in your appointment letter. For some examinations, you
can opt not to have a sedative and, therefore, do not need
to bring an escort with you (see below).
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7. Why do we offer you a sedative injection?
The gut lining does not have nerves that give sharp pains
but they can sense movement, stretching or pressure. If
no sedative is used, some endoscopies can be uncomfortable
but not painful.
For examinations of the pancreas and gall bladder (ERCP), it is accepted
practice for people to be offered a sedative, and most people decide to have
one. For examinations of the colon (colonoscopy), it is accepted practice
to offer a sedative, and most people decide to have one but some prefer not
to. For a flexible sigmoscopy, which is a shorter examination of the (sigmoid
colon) bowel, more people choose not to have a sedative.
For other examinations, such as a gastroscopy, the use
of a sedative is less necessary because they take less
time and are less uncomfortable. About half of the people
who come for a gastroscopy elect to have a local anaesthetic
throat spray alone, rather than with the sedative injection.
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8. What does the sedative do?
The sedative we use most often is a type of valium (diazemuls),
which makes you feel sleepy and more comfortable. Usually
the sedative does not actually send you to sleep, but makes
you feel sleepy. Also, you might not remember anything
about the examination afterwards. These sedatives start
to work very quickly but take hours to wear off (up to
24 hours).
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9. How will I feel after having the sedative?
If you have had a sedative, after your endoscopy examination
you will feel very sleepy at first and then you might feel
'wobbly' and a bit drowsy, almost as if you are 'drunk'.
After a variable number of hours, you will feel much more
normal again but we advise you not to resume driving for
24 hours or carry out any work or leisure activity that
could be compromised by a lack of attention. These effects
are often why people opt not to have a sedative.
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10. How long do I have to spend in the Department after
the examination?
If you haven't had a sedative, you can usually leave
immediately after the examination.
If you have had a sedative, we encourage you to stay in
the Department until you are feeling more awake, for example
until you can walk safely, which is usually within an hour
of having the sedative. Again, if you have had a sedative, you
must not drive or carry out any work or leisure activity
(including operating machinery) that could be dangerous
if you have a lack of attention immediately afterwards,
and you are strongly advised not to for 24 hours afterwards.
You will also be advised of this in your appointment letter.
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11. Do I have to have a sedative?
This depends on the examination you are to have. You
can discuss this with your referring GP or someone in Endoscopy
beforehand - do phone us in advance to see if you will
need to arrange to bring someone with you. For examinations
of the stomach (gastroscopy), approximately half of our
patients choose to have a local anaesthetic spray to the
back of the throat alone, instead of with a sedative injection.
The choice is yours.
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12. What does the local anaesthetic throat spray involve?
If you have chosen not to have a sedative injection before
a gastroscopy, before your examination, we will spray the
back of your throat with a local anaesthetic to numb it
(preventing any pain). You will still have a gag reflex
but will feel the tube (scope) much less as you swallow
it. The numbing lasts for about half an hour. If you decide
to have the throat spray, you will remain fully conscious
during the procedure and will remember it afterwards. You
will be aware of movement of the tube and we will need
to introduce some air into your stomach to allow us to
see inside it; this can feel like you are 'bloated' and
you might feel burpy for a while. Having the throat spray
is a good alternative if you cannot have a sedative for
any reason, or if you do not want to be sleepy for the
rest of the day. If you choose to have the throat spray
without a sedative, you will be able to leave the department
as soon as the examination is complete, which is usually
within half an hour of the appointment time.
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13. Why does my 'escort' need to stay with me, and why can't
they just come and pick me up from the outpatient entrance?
If you are having a sedative injection for the examination,
it is very important that we know you will have
someone to help you get home safely afterwards (you will
feel sleepy and must not drive). In the past, some people
have told us they were going to be picked up later, so
we did the examination and gave them a sedative, but then
we found out that they intended to drive themselves home.
For this reason, we like to know that someone is ready
to take you from the Endoscopy department and will see
you home safely. If not, this has medico-legal implications
for us and we will worry that you won't get home safely.
If you arrive by hospital transport, you do not need to
arrange your own escort because the drivers can vouch for
your safety, but you will need to make sure that someone
is at home to receive you from the transport.
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14. I will not be able to bring anyone with me, what should
I do?
If you are having an examination of your stomach (gastroscopy),
it is possible to do this while you are awake (see above)
using a throat spray and no sedative. If you can't bring
an escort with you, this is what we will suggest to you.
For other examinations, do discuss the options with your
GP or with someone in Endoscopy. Most people who are very
keen to have a sedative can ask a friend or relative to
come with them for two hours, and see them home safely.
It is very rare that we need to arrange for an overnight
stay for a patient when no escort is available.
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