Types of Endoscopy
A gastroscopy is a procedure that looks inside your esophagus (Food pipe), your stomach and the first part of your small intestine (duodenum).
It’s carried out using a narrow, flexible tube called an endoscope. This has a light at the end, and a camera to allow your doctor to see images of your insides on a video monitor. Read more...
A colonoscopy is a procedure that uses a narrow, flexible, telescopic camera called a colonoscope to look inside your large intestine.
It can be used to check your large bowel for signs of intestine cancer, and to investigate symptoms affecting your intestine. The procedure is performed under anaesthesia. Read More
Why a gastroscopy is used?
It can also be used to diagnose certain medical conditions or as a treatment.
Your doctor may recommend you have a gastroscopy to find out why you’re having certain symptoms. These include:
- Indigestion (acid reflux or discomfort in your upper tummy).
- Difficulty or pain when you swallow (dysphagia)
- Pain in your upper abdomen (tummy)
- Being sick (vomiting) repeatedly
- Vomiting blood or having very dark tar-like blood in your faeces (melaena)
Preparing for a gastroscopy
A gastroscopy is usually done as a day-case procedure in hospital. This means that you’ll be an outpatient and won't need to stay overnight. Before your gastroscopy, you’ll be given information about what is involved and how to prepare for it.
Before coming to hospital
It’s important to follow any advice you’re given.
If you’re taking certain medicines (PPI) that reduce your stomach acid, you may be asked to stop them two weeks beforehand. This is because they might stop your doctor getting a true picture of whether or not there are problems in your gullet or stomach.
It’s particularly important to let your doctor or the hospital team know if you’re taking anticoagulant or antiplatelet medicines (medicines that prevent your blood clotting). These include heparin, aspirin, clopidogrel, warfarin and new medicines such as dabigatran and rivaroxaban. If you continue to take medicines that should be stopped, you may still be able to have a gastroscopy. But you probably won’t be able to have a biopsy or a treatment procedure
You should arrange for someone to take you home, and preferably stay with you for 24 hours afterwards.
On the day
Your stomach must be completely empty during the test, so you’ll probably be asked not to eat or drink anything for 6-8 hours before your gastroscopy.
Your doctor will discuss with you what will happen before, during and after your procedure, and any discomfort you might have. They’ll ask if you wish to have a local anaesthetic or sedation or both. The local anaesthetic is a spray that numbs your throat area. The sedative will make you drowsy, and is given as an injection at the start of the procedure.
Ask your doctor to explain the pros and cons of each type of anesthesia. If you choose to have the local anaesthetic spray, it may feel a little more uncomfortable at the time, but you won’t be drowsy afterwards.
What happens during a gastroscopy?
A gastroscopy usually only takes five to 10 minutes, though occasionally it may be longer. The procedure will be carried out by a qualified doctor .
Your nurse will ask you to remove any dentures or dental plates and your glasses. If you wear contact lenses, you can leave them in.
If you're having a sedative, this is given through a fine tube (cannula) into a vein in your arm. While you’re sedated, your nurse will monitor your heart rate and the amount of oxygen in your blood through a sensor attached to your finger.
You’ll be asked to lie on your left side. Your doctor will place a guard into your mouth to protect your teeth. They’ll then pass the gastroscope through the opening of the guard into your mouth, until it rests on your tongue at the back of your throat. You’ll then be asked to swallow to allow the gastroscope to pass into your esophagus and down towards your stomach. This part of the procedure may be uncomfortable for about 20 seconds, and it’s usual to gag once or twice. The discomfort usually soon passes.
Your doctor will look at images from the gastroscope on a monitor to examine the lining of your esophagus, stomach and duodenum. If necessary, your doctor can use the gastroscope to take a biopsy (a small sample of tissue). The samples will be sent to a laboratory for testing.
What to expect after a gastroscopy?
After your gastroscopy, you’ll need to rest in a recovery area until the effects of the sedative have passed. You’ll be able to go home when you feel ready, usually after 30 minutes to an hour. Someone else should drive you home.
If you had a local anaesthetic throat spray, you won’t be able to eat or drink until it wears off in about an hour. After that you can eat normally.
Before you leave the hospital, you’ll be given advice about your recovery, and what to do if you have any problems. It’s OK to ask questions if you have any concerns.
Your doctor or nurse may discuss the general findings of the gastroscopy with you before you leave. You may find it best to have a friend or family member there as well, because having a sedative can affect your memory.
Recovering from a gastroscopy
If you’ve had a sedative, you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. It’s best to have a friend or relative stay with you for the first 24 hours, while you rest.
Most people have no problems after a gastroscopy, but you should seek medical attention immediately if you:
- cough up or vomit blood (which may look like coffee grounds)
- have blood in your poo (faeces) or odd-coloured faeces
- have severe pain in your abdomen (tummy) or pain that gets worse
- have a raised temperature
- have problems breathing
If you have these symptoms, tell the doctor you see that you have recently had a gastroscopy.
What are the alternatives to a gastroscopy?
The alternative to a gastroscopy is a test called a barium swallow and meal. This involves drinking a special liquid which coats the inside of your oesophagus and stomach and shows up on X-rays. You can find out more from our information on barium swallow and meal.
However, unlike a gastroscopy, a barium swallow and meal doesn’t allow your doctor to take a sample of any abnormal tissue they see. You can ask your doctor whether this may be an option for you.
What are the risks of having a gastroscopy?
As with every procedure, there are some risks associated with having a gastroscopy.
These are the unwanted but mostly temporary effects you may get after having the procedure.
After having a gastroscopy, you may have a sore throat or stomach discomfort for a few hours. You may feel bloated, but this usually passes quite quickly.
- This is when problems occur during or after the procedure.
- Complications of gastroscopy are very uncommon – the vast majority of patients have no problems at all.
When complications do happen, they may include the following:
- A reaction to the sedative, such as difficulty in breathing or heart problems.
- Bleeding, perhaps from where a biopsy is taken or a polyp removed.
- Damage or tears (perforation) to your throat, oesophagus, stomach or duodenum.
Complications are more likely if gastroscopy includes a treatment procedure.
Why do I need a colonoscopy?
You may be offered a colonoscopy as bowel cancer screening programme. Bowel cancer screening is offered to everyone over the age of 60, every two years.
Other reasons for a colonoscopy
There are several other reasons why your doctor may recommend you have a colonoscopy:
- Investigating symptoms that could indicate bowel cancer, such as bleeding from your bottom or a change in your bowel habits
- You have a strong family history of bowel cancer .
- Investigating symptoms of inflammatory bowel disease (for example, ulcerative colitis or Crohn’s disease).
- Monitoring your bowel if you’ve previously had a polyp or cancer removed, or if you have a family history of a genetic polyp syndrome.
Your doctor can also perform a biopsy (remove a sample of tissue) or remove polyps during a colonoscopy if necessary.
Preparing for a Colonoscopy
You’ll usually have a colonoscopy in the endoscopy unit at a hospital and be able to go home the same day. You’ll need to arrange for someone to drive you home, as you’ll usually have a sedative. This can make you feel drowsy for a while afterwards, so you won’t be able to drive yourself until the day after.
Your hospital will give you detailed instructions about what else you need to do to prepare for your colonoscopy.
Medicines to stop
There are certain medicines that you’ll need to stop before having a colonoscopy. These include:
- iron tablets – you’ll need to stop taking these one week before your colonoscopy.
- anti-diarrhoea medicines, or any medicines that may cause constipation
- medicines that affect the way your blood clots (eg warfarin, aspirin or clopidogrel)
If you take any of these medicines (or any others), let your hospital know before you have the colonoscopy.
Clearing your bowel
Your bowel will need to be completely empty for the procedure so that your endoscopist can see everything clearly. Your hospital will give you a strong laxative that you’ll need to take before your colonoscopy. It usually comes as a powder that you mix with water. You may not be able to take the laxative if you’re pregnant or breastfeeding, so be sure to tell the hospital if this applies to you.
The laxative can quickly give you diarrhea, so make sure you stay close to a toilet after you take it. You might feel some discomfort or bloating in your tummy (abdomen), and it can taste unpleasant. Try putting the mixture in the fridge before you drink it, as it can make it taste better. Remember that although taking a laxative can be unpleasant, it’s really important to be able to do the colonoscopy effectively.
It’s important to keep drinking plenty of clear fluids though like water, squash or black tea or coffee, to make sure you don’t get dehydrated.
If you have diabetes, or if you’re having another procedure, such as a gastroscopy, on the same day, the preparation might be different for you. Follow the instructions given to you by your hospital, and if you’re unsure, ask.
At the hospital
When you arrive at the hospital you’ll be seen by a nurse or doctor and will be able to ask any final questions you may have. You’ll be given a hospital gown to change into, and sometimes a pair of paper shorts to wear.
What happens during a Colonoscopy?
A colonoscopy usually takes around 30 to 45 minutes, although the appointment itself will last longer than this.
You might need an anaesthetic for a colonoscopy, or you’ll be offered a painkiller and sedation. A sedative will make you feel more relaxed and a bit drowsy, but you’ll remain awake during the procedure. It’s given as an injection into a vein in your hand at the start of the procedure. At some hospitals, you might be offered gas and air (Entonox) for pain relief instead of a sedative.
Your endoscopist (doctor or nurse) will ask you to lie on your left-hand side and bend your knees. First, they’ll gently examine your back passage using their finger. They’ll then carefully insert the colonoscope, using lubricating gel to make it as comfortable as possible.
Your endoscopist will pump air into your bowel through the colonoscope to inflate it slightly and give a better view of your bowel. This can make you feel a little bloated. Your endoscopist will gently guide the colonoscope through your bowel.
The images from the camera at the end of the colonoscope will appear on a monitor. Your endoscopist might ask you to change your position during the procedure, to help them to look at different areas of your bowel. They may ask an assistant to press on your tummy to help move the colonoscope in the right direction.
Your endoscopist may take a small sample of cells (a biopsy) if needed, and remove any growths (polyps) they find. This is done by passing instruments through the colonoscope. For more information, see our FAQ: What are polyps and should they be removed?
If you find the procedure particularly uncomfortable at any stage, tell your endoscopist and they will stop or change what they’re doing.
What to expect after a colonoscopy?
Recovering from a colonoscopy
You may feel bloated and have some cramping pain after a colonoscopy. This is caused by the gas used during the procedure and usually settles down within a few hours. If you need pain relief, you can take over-the-counter medicines, such as paracetamol or ibuprofen. You may also bleed a little from your back passage if you’ve had a biopsy or a polyp removed. This should stop on its own within a couple of days.
Having sedation can really take it out of you. You might find that you’re not as coordinated as usual or that it's difficult to think clearly. This should pass within 24 hours. In the meantime, don't drive, drink alcohol, operate machinery or make any important decisions
What are the alternatives to a colonoscopy?
A colonoscopy is usually the best investigation to see inside your bowel, as it can examine the whole of your large bowel, and pick up on very small changes. But it isn’t appropriate for everyone so your doctor might suggest other tests.
Other options include the following:
- Virtual colonoscopy. This involves having a CT scan .
- Flexible sigmoidoscopy. This is similar to a colonoscopy but uses a shorter instrument to look inside colon.
- Barium enema. This involves taking X-ray images of your large bowel, using a contrast or dye .
What are the risks of having a colonoscopy?
Complications of a colonoscopy
Complications are when problems occur during or after the procedure. The main complications of a colonoscopy are listed below.
Breathing problems. You may have a reaction to the sedation, which can affect your breathing or your heart rate.
A tear in your bowel (bowel perforation), caused by the colonoscope. This is rare, but if this does happen, it’s likely you’ll need an operation to repair it.
Bleeding. This is most common after having biopsies or polyps removed, and usually stops on its own. In rare cases though it can become more serious and you may need a blood transfusion.
Contact the hospital department where you had your procedure if you continue to bleed from your back passage or have severe pain in your tummy that doesn’t get better within a couple of days.