You have been referred by your GP for an Endoscopy. This is a test which involves placing a small diameter flexible tube with a light source at the end (called an endoscope) into either your gullet or your bowel. This is a safe and very effective way for you to be examined in a convenient location. The clinician performing the procedure can then look for evidence of bleeding, swelling, unusual growths or ulcers. We can also use this test to look for early signs of cancer in the lower bowel. We know from lots of evidence that if we detect and treat pre cancerous changes or cancer early that the clinical outcomes are very good.
During the test, we may have to take a small piece of bowel tissue for further investigation (this is called a biopsy). This is done painlessly through the endoscope using tiny forceps. This helps us to confirm certain diagnoses such as IBS, Barret's Oesophagus or, in much rarer cases, pre cancer or cancerous changes.
We can do the test with or without sedation. Most patients having a trans nasal or flexible sigmoidoscopy do not require any sedation and can return to normal activities immediately after the test. If you choose to have sedation, this will make you sleepy and relaxed but not unconscious. You must, however, be accompanied home and avoid driving, alcohol and operating machinery for 24 hours. Sometimes the clinician may proceed with a minor treatment or procedure during the examination. You will be asked for your consent to this at the time of the examination.
We have a dedicated website which is purely for endoscopy and has much more information including a video you can watch which may help you learn more. Please click here to visit this site. Once you have finished with the www.inhealthendoscopy.co.uk website you can just press the back button on your browser and you can return to this site.
If you need help because you speak a different language, or you want a friend, relative or carer to come with you, please let the Patient Referral Centre know so that the hospital staff are ready for you when you arrive for your appointment.
Please arrive 15 minutes before your appointment time; if you are late we may not be able to carry out your test. Please do not bring children to your appointment.
Most sites operate a direct to test service and explain the procedure to you during a prebooked 'phone call. However, depending on the site and the service that has been commissioned, you may have to attend an appointment for a pre-assessment at the hospital/clinic.
A nurse will ask you to complete a questionnaire about your health and medical history and will then explain the procedure to you and discuss in detail any relevant medical history, allergies and your current medication. They will also run through a simple safety checklist to make sure it is safe for you to have the procedure. You will also be able to ask any questions you may have. This will take between 30 minutes to 1 hour.
The preparation for the examination will be explained to you at this time. All patients who require a flexible sigmoidoscopy or colonoscopy, so that we can get a clearer view of your bowel, will be asked to take a bowel preparation (laxative) the day before your examination and follow some dietary instructions. The medication and instructions for taking it will be given to you at the pre-assessment appointment or will be posted to you after the booking 'phone call. If you have any queries about the bowel preparation please contact the booking team hospital/clinic. You may need to follow some specific instructions from your GP if you are diabetic, are taking anti-coagulation treatment or have an artificial heart valve.
You will then be given a date for the endoscopy examination to be carried out. If you are unable to make your appointment or need to reschedule for your pre-assessment please contact the Patient Referral Centre on 0333 202 0300.
When you arrive, one of our staff will meet you and check your details. We will ask you to change into a gown and explain the procedure plus obtain your informed consent. If you are having a lower procedure you will need to partially undress and put on some dignity shorts. If you have not taken a laxative before the examination, or if the laxative did not work, the nurse will give you an enema. This will help you empty your bowel. If this is necessary, your overall examination time will be longer than usual.
The consultant carrying out the examination will ask you to complete a consent form. Your procedure may not be carried out immediately as the consultant will have a list of patients to see. The staff will tell you approximately when the test will take place.
We will ask you to lie on your left side on the examining couch. You will be awake during the examination and should experience nothing more than mild discomfort. The doctor will insert an endoscope into your bowel and slowly guide it along the lower section. The endoscope sends an image to a screen so the doctor can carefully examine the bowel lining. The endoscope also blows out air to enlarge your bowel a little so that the doctor can see the lining more clearly. If anything unusual is identified, like a polyp or inflamed tissue, the doctor can remove a piece of it using instruments inserted into the endoscope.
The doctor will send the piece of tissue (biopsy) for testing. During the procedure, you might feel pressure and slight cramping in your lower stomach area. You will feel better afterwards when the air leaves your body.
If you have not had sedation you will be able to get dressed and leave as soon as you feel ready, you will usually be offered something to eat before you leave. If you have had sedation you will need to stay in the unit's recovery area for about one hour until you are fully awake, and for the next 24 hours you must not drink alcohol, use heavy machinery, drive or sign any legally binding documents.
Following this procedure, someone over the age of 16 must accompany you home. If you do not have anyone to go home with you, your appointment may have to be cancelled. If you have any questions about this, please contact the hospital where you are having your examination before your appointment.
The results of your examination will be discussed with you before you leave the hospital. Your GP or referring clinician will receive a copy of the report, and if a biopsy has been taken the results will be sent to your GP.
It is important to contact your GP if you experience severe stomach pain or bloating, nausea (feeling sick), fever or chills or if you lose more than half a cup of blood from your bowel. You can bleed for up to several days after a biopsy. You should be able to go back to work the day after the test, unless you are told otherwise.
If you haven't already done so, you will need to make an appointment about 10 days after your examination with your GP or clinician who referred you for the test to discuss the results with them. If you have any queries about the test or to change the date of the examination you need to contact the hospital directly.
How long will it take?
Depending on the type of test, the procedure will take between 10 minutes up to one hour. An endoscopy takes about 20 minutes. You should plan to be in the unit for around 90 minutes if you are having a trans nasal endoscopy and up to 3 hours if you are having a lower procedure which requires sedation.
Are there any side effects?
Flexible sigmoidoscopy, colonoscopy and biopsies are safe when performed by doctors with appropriate training and experience. Complications are rare, but they can happen. The main complication of this type of test is damage to the bowel wall, which may result in a tear or bleeding. This is more likely to happen after a polyp (fleshy growth) is removed. If the bowel wall does tear, you may need surgery to repair it.
There is also a small chance of having complications as a result of receiving sedation. This is very rare and these risks will be explained to you before you consent for the procedure. If you have any questions or concerns, please discuss these with a member of the clinical team.