Gastroscopy & Colonoscopy
Gastroscopy allows visualization of the lining of the oesophagus, stomach and duodenum (first portion of the small intestine). The gastroscope is a thin flexible tube that has its own lens and light source, it allows viewing of images on a monitor as the camera is moved around inside the stomach. Gastroscopy may also be referred to as upper endoscopy, esophago-gastro-duodenoscopy (EGD) or panendoscopy.
Gastroscopy is performed under light sedation and is used to evaluate symptoms of reflux, pain, nausea and vomiting or difficulty swallowing. It can identify a cause of bleeding, inflammation, ulcers and tumours. It allows a biopsy (small tissue sample) to be taken at the time of the procedure allowing accurate diagnosis of any abnormalities discovered.
For patients with chronic reflux routine screening and surveillance is performed to assess Barrett’s oeosphagitis, when this condition is diagnosed and treated early oesophageal cancer can be prevented. Therapeutic procedures such as dilatation of strictures, insertion of feeding tubes and removal of polyps may also be undertaken via a gastroscope.
Colonoscopy allows visualization of the linging of the rectum, colon and sometimes distal small intestine. Colonoscopy is used to evaluate symptoms of change in bowel habits, diarrhoea, bloating, bleeding, pain or abnormal findings on imaging studies. It is also used for screening and surveillance of colon cancer which is the second leading cause of cancer death in Australia. A positive faecal occult blood test (FOBT) which you may have received in the mail or via your GP will lead to a colonoscopy.
Colonoscopy is particularly useful for the removal of precancerous polyps with a small hot wire lasso called a snare. Other abnormalities that are found may be biopsied to obtain an accurate diagnosis before treatment. Haemorrhoids may also be managed with rubber band ligation at the time of colonoscopy.
The procedure itself is performed under sedation, it is well tolerated and rarely causes much pain. You will lie down on your side or back while the colonscope is advanced through your large intestine. The procedure itself usually takes 15-60 minutes.
Preparation and Recovery
If undergoing gastroscopy alone then the stomach needs to be empty for the procedure. No food should be taken for 6 hours before the procedure and no liquid should be taken for 4 hours before. Bowel preparation is not required if you are having gastroscopy alone.
For colonoscopy, the large bowel must be completely clean for the procedure to be accurate and safe. Bowel preparation (clearing out and emptying the bowel of all solid matter) takes place on the day before the procedure, it will involve pre-operative diet modification and laxatieves, you will be given an instruction sheet for this when booking your procedure. It is important to remain well hydrated during the bowel prep to avoid fainting and electrolyte disturbance. It is also important to clear your day of appointments and stay close to a toilet.
A plan for taking your medications will also be given to you when booking your procedure. Many blood thiners will need to be stopped before the procedure in case a polyp needs to be removed and may also need to be with-held a short time afterwards if a polypectomy is performed.
Diabetics require special consideration and in complex cases a plan for your medications will be discussed with your physician.
Someone must drive you home and stay with you. You may have some cramping or bloating because of the gas introduced into the colon during the examination. This should disappear quickly when you pass flatus.
You should be able to eat after the examination, but your diet and activities may be restricted if an intervention has been performed during the procedure.
You must not drive, return to work, drink alcohol, operate machinery, sign legal documents or use public transport unaccompanied until the following day.