How it's performed
Instructions about how to prepare for a gastroscopy should be included with your appointment letter.
Phone the hospital if there's anything you're unsure about.
If you're referred for a gastroscopy, you'll be told whether you need to stop taking any of your medicines beforehand.
You may need to stop taking any prescribed medicines for indigestion for up to 2 weeks before the procedure. This is because the medicine can mask some of the problems that a gastroscopy could find.
If you're taking any of the following medicines, you should phone the endoscopy unit before your appointment, because special arrangements may need to be made:
- any medicine used to treat diabetes, such as insulin or metformin
- any blood-thinning medicine (used to prevent blood clots), such as low-dose aspirin, warfarin or clopidogrel
It's important that your stomach is empty during a gastroscopy, so the whole area can be seen clearly. You'll usually be asked not to eat or drink anything for 6 to 8 hours before the procedure. Follow the instructions given to you by the hospital.
A gastroscopy often takes less than 15 minutes, although it may take longer if it's being used to treat a condition.
The procedure will usually be carried out by an endoscopist (a healthcare professional who specialises in performing endoscopies) and assisted by a nurse. You'll meet the nurse before the procedure and they'll be able to answer any questions you have and you'll also have an opportunity to ask the endoscopist.
The procedure is not usually painful, but it may be unpleasant or uncomfortable at times. A local anaesthetic spray will be used to numb your throat and you'll be asked beforehand if you'd like to have a sedative injection. Young children may have the procedure under general anaesthetic, which means they'll be asleep while it's carried out.
If you have the sedative, it will help you feel drowsy and relaxed during the procedure, but you'll need to stay in hospital for a bit longer while you recover, and you'll need someone to pick you up from the hospital and stay with you for at least 24 hours. You will not able to work or drive during this period.
Before the procedure starts, you'll be asked to remove any glasses, contact lenses, tongue studs or false teeth. (Talk to the hospital if you're worried about this.) You will not usually need to get undressed, but you may be asked to wear a hospital gown over your clothes.
The local anaesthetic spray is then given and a small plastic mouth guard placed in your mouth, to hold it open and protect your teeth.
You'll be asked to lie down on your left-hand side and the endoscopist will insert the endoscope into your throat. They'll ask you to swallow it to help move it down into your oesophagus. This may be uncomfortable at first and you may feel sick or gag, but this should pass as the endoscope is moved further down.
Diagnosing a condition
If the gastroscopy is being used to diagnose a certain condition, air will be blown into your stomach once the endoscope is inside. This allows the endoscopist to see any unusual redness, holes, lumps, blockages or other abnormalities.
It may feel a bit uncomfortable when the air is blown into your stomach, and you may burp or feel bloated. This should start to improve once the procedure is finished.
If abnormalities are detected, a tissue sample (biopsy) can be removed and sent to a laboratory for closer examination under a microscope.
Treating bleeding varices
If you have bleeding varices (enlarged veins), the endoscopist will use the endoscope to locate the site of the bleeding.
They can then stop the bleeding by either tying the base of the varices with a small rubber band (band ligation), or injecting them with a chemical that seals the hole or tear in the blood vessel (sclerotherapy).
Treating bleeding stomach ulcers
If you have bleeding stomach ulcers, a number of techniques may be used to treat them. For example:
- a probe may be passed through the endoscope to seal the ulcer with heat, or small clips may be used to stop the bleeding
- medicine may be injected around the ulcer to activate the clotting process
During the procedure, you may also receive an injection of an acid-reducing medicine called a proton-pump inhibitor (PPI) to stop the bleeding recurring.
Widening the oesophagus
If you have a narrowed oesophagus, the endoscopist can pass instruments down the endoscope to help stretch and widen it.
The instruments can also be used to insert a balloon or stent (a hollow plastic or metal tube) to hold the sides of your oesophagus open.
After the procedure, you'll be taken to the recovery area.
If you did not have a sedative, you can usually go home soon after the procedure is finished.
If you had a sedative, you'll need to rest quietly for a few minutes or hours until the sedative has worn off. You'll also need to arrange for someone to take you home and to stay with you for at least 24 hours.
Even if you feel very alert, the sedative can stay in your blood for 24 hours and you may experience further episodes of drowsiness.
During this time, you should not:
- operate heavy machinery
- drink alcohol
- take sleeping tablets
- go to work
- sign any contracts or legal documents
- be responsible for small children or dependents
Before you're discharged, the nurse or doctor may be able to explain the results of the procedure to you. Sometimes, you may need to have an appointment with the doctor or your GP a few days or weeks later to discuss the results.
You'll be told if you need to make any changes to your diet during the hours or days after going home.
When to seek medical advice
It's normal to feel bloated or have a sore throat for a day or two after a gastroscopy.
You should contact your GP or the endoscopy unit immediately if you develop signs of a more serious problem, such as:
- severe or worsening chest pain or stomach ache
- passing dark or "tar-like" poo
- persistent vomiting or vomiting blood
- shortness of breath
- a high temperature of 38C or above
Read more about the risks with a gastroscopy.