Please see letter for appointment details
Please telephone the Endoscopy department on 01234 792269 if this is not convenient for you.
Please contact 07392 126603 if you would like to discuss any aspects of the procedure before your appointment.
If you have not attended a Pre Assessment appointment you will receive a phone call for you to be pre assessed over the phone. This may come through as an unknown number.
Introduction
You have been advised by your GP or hospital doctor to have an investigation known as a gastroscopy (OGD). You have agreed to have this carried out as a Naso-Endoscopy. We will need to have your formal consent before we can carry out this examination. This leaflet explains how the examinations are carried out and what the risks are. This will help you to make an informed decision when agreeing to the examinations.
What is an Naso-Endsocopy?
Naso-endoscopy is a procedure which allows the doctor to examine your oesophagus (gullet), stomach and the first part of your small bowel. This is done by passing a long thin flexible tube with a small video chip built into its tip, called a Naso-endoscope, through the nose and into the gastro-intestinal tract.
Preparation
You must not have anything to eat or drink for six hours before the examination but can have sips of water up to 2 hours before your appointment time. Please bring all your regular medication with you. Please bring a list of the medication with you to the hospital. If you are taking Warfarin or Aspirin tablets or have any other concerns please contact the endoscopy department upon receiving your appointment. Please inform us if you take steroids on a regular basis.
Pre Assessment Appointment
Once you have a booking date you will be pre-assessed over the phone. Please ensure you have contact details of your next of kin, escort and a list of your medicines to hand. The nurse will go into detail about the procedure, check your medical history and answer any questions you may have.
Medication
Your routine medication can be taken with sips of water but this will be discussed at Pre-Assessment.
If you take blood-thinning tablets such as Warfarin, Clopidogrel, Edoxaban etc., please let the endoscopy unit know at least 7 days before the procedure unless instructions have been given to you by your doctor or you were already instructed during your telephone pre-assessment.
Diabetic medication:
If you taking medication to control your diabetes (insulin or medication) please ensure the Endoscopy Unit is aware so that your appointment can be made at the beginning of the list. You will be told what to do with regards to your medication at your telephone pre-assessment.
What happens when I arrive?
When you arrive, please book in at reception, you will be then called into the admission area where a nurse/assistant practioner will ask you to confirm some details, you will also be able to ask any questions you may have.
The nurse will ensure you understand the procedure and you will be offered Nasal Spray. Your heart rate will be recorded and if you are diabetic, your blood glucose level will also be recorded. If you have any questions about the Naso-endoscopy examination, please ask one of our nurses. The doctor will speak to you before the procedure and will be available to answer any additional questions.
Nasal Spray
This examination is performed with a local anaesthetic spray. The nurse will spray your nostril and throat to make it numb which helps to reduce the sensation in your nose allowing the doctor to pass the endoscope down into your gullet. They may also spray the back of your throat as well. Once the procedure is complete you will be able to eat and drink within 30 minutes. You will then be able to leave the endoscopy unit unaccompanied, as you will be awake throughout the procedure.
The nurse will advise you when you can eat and drink. You may need to wait until the end of the list to speak to the doctor.
What the examination involves
You will either remain sat in an upright position or be asked to lay flat for the procedure. The endoscope is passed through the nostril, over the back of the tongue, down the throat and into the stomach and first part of the small bowel, called the Duodenum. During the procedure the doctor may take a small sample of tissue to check for any infection or inflammation. This is called a biopsy. Once the doctor is happy they have seen all they need to see, the scope is then removed.
Risks
When a biopsy is taken from the lining of the stomach there is a very small risk that bleeding may occur. Usually this will stop by itself. If bleeding continues you may have to stay in hospital to be observed until the bleeding stops.
When a stricture is found and dilated during endoscopy there is a very slight risk that a leakage may occur at the site being treated (less than 1%). If this occurs you would have to stay in hospital. Very occasionally an operation may be required to repair any leakage.
After the procedure
As soon as the examination has finished you will be allowed to rest for as long as necessary. Your blood pressure and heart rate will be recorded and if you are diabetic, your blood glucose will be monitored. Once you have recovered a nurse will explain the findings and any other medication or further investigations required.
As you have had nasal and throat spray you will be able to leave the department once your observations have been recorded in recovery. Please note you must not eat or drink for 30 minutes after throat spray.
If biopsies were taken then the results will be sent to your referring Consultant or if you were referred by your GP, they will go to the Endoscopist who completed your procedure.
A nurse will take you to the Endoscopy discharge lounge and you will be given refreshments.
Results
Before you leave the department, a nurse or doctor will explain the findings of your examination and discuss any changes of medication and further investigations or appointments you may require, for example, if a sample (biopsy) has been taken or polyps removed for examination. The results may take 4-6 weeks and will be sent to your GP or referring consultant.
Going home
As you have had Nasal spray you can carry on your day as normal.
You may resume your normal diet and prescription medication unless otherwise instructed by the doctor.
Points to Remember:
- If you are unable to keep your appointment please notify the Endoscopy unit as soon as possible
- It is our aim for you to be seen and investigated as soon as possible after your arrival. However the department is busy and your investigation may be delayed. If emergencies occur, these patients will obviously be given priority over less urgent cases
- The hospital cannot accept any responsibility for the loss or damage of personal property during your time on these premises.
Concerns
If you have any queries regarding the procedure, you should contact the endoscopy unit on 01234 792269 between 8am and 6pm Monday to Sunday and the nursing staff will be happy to give you information or advice.
FOLLOWING THIS PROCEDURE YOU MUST NOT DONATE BLOOD FOR 4-6 MONTHS
The reason for this is that your ability to donate blood in the future is dependent upon your diagnosis and the possibility that you might need to undergo further investigations or complete treatments. (British Society of Gastroenterology, 2019).
Additional information
Having a procedure with a training endoscopist
Endoscopy Training at Bedford Hospital
Bedford Hospital contributes to the training of endoscopists and as a result has several trainees working in Endoscopy; this leaflet is provided to inform you about how this may affect your Endoscopy procedure, and support your decision as to whether you are happy to have a trainee perform the procedure.
Although the idea of a trainee may be unnerving it is often a very positive experience. All our Endoscopy trainees are in a structured training programme within the national guidelines. Around a quarter of Endoscopy lists at Bedford Hospital involve training of endoscopists.
Will they be supervised?
Under no circumstances are trainee Endoscopists unsupervised. Depending on the experience of the trainee, the experienced Consultant or Senior Nurse Endoscopist will be present, and supervising your Endoscopy procedure throughout or will be immediately available in the endoscopy department. If at any time you or the trainee has any difficulties the trainer can intervene. All the Endoscopy trainers at Bedford Hospital are accredited Endoscopy trainers and we regularly monitor their training skills.
Is it safe?
We carefully monitor our complication rates for Endoscopy and there is no difference in safety with a trainee Endoscopist.
Will it be more uncomfortable?
We carefully monitor patient comfort and have not found any suggestion it will be more uncomfortable.
Will it take longer?
While learning a trainee may be slower than an independent Endoscopist, however, our trainers are experienced in monitoring the length of a procedure and will take over if procedure seems prolonged. On a training list we allow a longer time for the whole Endoscopy experience, and patients often find this makes for a more relaxed atmosphere.
What should I do if I don’t want a trainee?
If you wish to let us know you are not happy to have a supervised trainee perform your procedure please inform us at least one week in advance of the procedure, so we can ensure you are not booked on a training list. The Endoscopy administrative team are on 01234 792269 or 01234 730567.