Gastroscopy + Colonoscopy
Gastroscopy
What is a Gastroscopy?
Gastroscopy (also known as Upper GI endoscopy) is a diagnostic procedure used to examine the inside of the upper digestive tract.
This procedure uses a flexible tube with a camera and light source at the end, enabling the doctor to view the digestive organs on a monitor.
This includes
- the oesophagus (food pipe),
- stomach, and
- duodenum (the first part of the small intestine).
The gastroscope is put down from the mouth, oesophagus and stomach into the duodenum. The lining is visually examined, and small samples (biopsies) are taken for further tests.
A gastroscopy enables a diagnosis based on which specific treatment can be given. If a bleeding site is identified, treatment can stop the bleeding, or if a polyp is found, it can be removed without a major operation.
Other treatments can be given through the endoscope when necessary.
Who is Suitable for Gastroscopy?
Gastroscopy is suitable for individuals who experience symptoms related to digestive health, including.
- Abdominal pain or discomfort,
- Difficulty swallowing,
- Persistent heartburn or acid reflux,
- Nausea or vomiting, and
- Unexplained weight loss.
Gastroscopy is also recommended for people with a family history of digestive diseases or individuals diagnosed with digestive conditions such as Crohn's, ulcers, or celiac disease.
Benefits of Gastroscopy
Gastroscopy is a vital diagnostic procedure that provides numerous benefits, including.
- Accurate diagnosis: Gastroscopy is an effective way to diagnose digestive conditions, including inflammation, ulcers, tumours, and blockages. The procedure lets the doctor view the digestive organs and obtain tissue samples for laboratory testing, enabling an accurate diagnosis.
- Early detection: Gastroscopy can detect digestive conditions early, allowing for timely treatment and management.
- Minimal discomfort: Gastroscopy is a minimally invasive procedure performed under sedation, reducing discomfort or pain.
- Safety: Gastroscopy is a safe procedure with a low risk of complications. However, as with any medical procedure, there is a slight risk of bleeding, infection, or perforation.
Types of Gastroscopy
There are two types of gastroscopy: diagnostic and therapeutic.
- Diagnostic gastroscopy is used to diagnose digestive conditions. The doctor will use the endoscope to examine the digestive organs, take tissue samples for laboratory testing, and remove any polyps or growths.
- Therapeutic gastroscopy is used to treat digestive conditions. The doctor will use the endoscope to remove tumours, stop bleeding, or widen narrow passages.
Alternative Options to Gastroscopy
Gastroscopy is a standard diagnostic procedure for investigating various upper gastrointestinal tract issues, including acid reflux, peptic ulcers, and oesophageal cancer. However, in some cases, alternative diagnostic procedures may be appropriate. These alternative options may include:
- Barium swallow X-ray: This diagnostic test involves drinking a liquid containing barium, highlighting the digestive tract on an X-ray image. It is used to diagnose conditions such as oesophageal strictures and tumours.
- CT scan: A CT scan is an imaging test that uses X-rays and computer technology to produce detailed body images. It is used to diagnose conditions such as tumours and blockages in the digestive tract.
- Magnetic resonance imaging (MRI): MRI is a non-invasive imaging test that uses a magnetic field and radio waves to produce body images. It is used to diagnose conditions such as tumours and inflammation in the digestive tract.
While these alternative options suit some patients, gastroscopy remains the gold standard for diagnosing upper gastrointestinal tract issues.
Preparation Before Gastroscopy Procedure
- You will be asked to fast for a specified period before the procedure.
- You will be given sedation or anaesthesia to help them relax and minimise any discomfort.
- Your doctor will explain the procedure's risks and benefits and answer any questions.
Medications Before the Procedure
You will be informed when to stop eating and drinking or take your usual medicine, depending on the time of day your procedure has been scheduled.
Most medicines can be taken, as usual. However, if you are unsure, please speak to your doctor.
- Omit your diabetes tablets on the morning of the test. If you take insulin, you should take half your usual dose. The nurses will check your blood sugar when you arrive at the hospital.
- Anticoagulants (blood thinners), such as warfarin (Coumadin), apixaban, etc., must be stopped for 3 to 5 days. You must discuss this with your doctor as you may need injections during this period.
- Antiplatelet agents such as aspirin and clopidogrel (Plavix) must stop for one week. If you have stents in your heart, DO NOT stop the medicine without your cardiologist’s permission. If necessary, aspirin can be continued up to the day of the test.
- Most other drugs (for high blood pressure, cholesterol, depression, reflux, etc.) can be taken up to 2 hours before coming to the hospital with some water.
Gastroscopy Procedure
- You will be positioned on your side or back with your head tilted forward. A mouthguard will be placed in your mouth to protect your teeth and the endoscope from damage.
- The doctor will then insert the endoscope through your mouth and throat. The endoscope allows the doctor to visualise the digestive organs on a monitor. The doctor will instruct you to swallow the endoscope as it passes down your throat.
- The doctor will examine the lining of your oesophagus, stomach, and duodenum using the endoscope. The camera on the endoscope will transmit images of the digestive organs to a monitor. The doctor will carefully inspect the organs for abnormalities like inflammation, ulcers, or tumours.
- If the doctor sees any suspicious areas, they may take tissue samples for laboratory testing. The doctor will use specialised tools passed through the endoscope to remove a small tissue sample. The tissue sample will be sent to a laboratory for analysis.
- Once the examination is complete, the doctor will carefully remove the endoscope from your mouth. The entire procedure usually takes between 15 to 30 minutes, depending on the findings and the need for tissue sampling.
What Happens After the Gastroscopy?
After the procedure, you will be taken to a recovery area, where you will be monitored until the sedative wears off.
You will be advised to refrain from driving or operating heavy machinery for the rest of the day.
After the procedure, you may experience mild discomfort, bloating, or sore throat, but these symptoms should resolve within a few hours.
Gastroscopy Procedure Aftercare Instructions
Although gastroscopy is relatively safe and quick, following the appropriate aftercare instructions is essential to ensure a smooth recovery.
Rest and Hydration:
After the procedure, it is essential to rest for several hours until the sedatives or anaesthesia's effects have worn off. You should avoid driving or operating heavy machinery during this time.
Drink plenty of clear liquids, such as water, to help hydrate your body and prevent dehydration. Avoid drinking alcohol or caffeinated beverages, which can cause dehydration.
Diet
Your doctor will provide specific dietary instructions based on your individual needs. Generally, it is advisable to start with small amounts of clear liquids, such as water, apple juice, or broth, and gradually progress to more substantial foods as tolerated. Avoid spicy or fatty foods, which can irritate the digestive tract.
Medications
Your doctor may prescribe medications to help manage discomfort or pain after the procedure. Follow your doctor's instructions carefully, and do not take over-the-counter medications without consulting your doctor first. Avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen, which can increase the risk of bleeding.
Physical Activity
Avoid strenuous physical activity, heavy lifting, or intense exercise for at least 24 hours after the procedure. Light activities like walking or gentle stretching are encouraged to help prevent blood clots and promote circulation.
Follow-Up Care
Your doctor will discuss the results of the procedure and any necessary follow-up care. Attending all scheduled appointments and following your doctor's instructions carefully is essential to ensure the best possible outcome.
Watch for Warning Signs
Although complications are rare, it is necessary to watch for warning signs that may indicate a problem after the procedure. These may include severe abdominal pain, difficulty breathing, chest pain, fever, or chills. If you experience any of these symptoms, seek medical attention immediately.
Gastroscopy Prognosis
The prognosis for gastroscopy is generally excellent, with a low risk of complications. Most patients recover quickly from the procedure and can resume their daily activities the same day. The results of a gastroscopy can help diagnose digestive conditions, enabling appropriate treatment and management.
Risk and Complications of Gastroscopy
While gastroscopy is generally safe, there is a slight risk of complications, including bleeding, infection, and perforation of the digestive organs. You may also experience adverse reactions to sedation or anaesthesia. However, these risks are relatively rare and can be minimised by following your doctor's instructions before and after the procedure.
Colonoscopy
What is a Colonoscopy?
A colonoscopy is an endoscopic procedure that examines the colon's lining, also known as the large intestine.
It is a vital tool in preventing and early detection of colon cancer, Australia's third most common cancer.
A colonoscopy is performed to detect irregularities such as
- inflamed tissue,
- ulcers, and
- abnormal growths.
Why Have a Colonoscopy?
Specifically, a colonoscopy helps in the diagnosis of
- colorectal cancer,
- bowel disorders,
- abdominal pain,
- inflamed tissue,
- ulcers, and
- anal bleeding.
Colonoscopy Device
An instrument called a colonoscopy is used during a colonoscopy. It is a long, flexible tube with a tiny camera and light on the end to examine the inside of the colon (large intestine).
By adjusting the various controls on the colonoscope, your doctor can safely guide the instrument to carefully examine the inside lining of the digestive system or the upper or lower gastrointestinal tract.
Other instruments can be inserted through the colonoscope, which allows various therapeutic procedures to be carried out during a Colonoscopy procedure.
Such therapeutic procedures may include
- Biopsy - taking tissue samples (biopsies) and
- Polypectomy - removal of polyps (benign wart-like growths).
Polyps or growths are removed during a Colonoscopy and can be sent later for diagnostic testing to a pathology lab.
Who is Suitable for Colonoscopy?
Colonoscopy is recommended for adults aged 50 years and above with an average risk of colon cancer. However, people with a family history of colon cancer, inflammatory bowel disease, or other colon-related diseases may need to start screening earlier. Your doctor will determine the frequency of your colonoscopies based on your medical history and risk factors.
Benefits of Colonoscopy
The benefits of colonoscopy are many, including early detection of colon cancer, which can lead to higher survival rates. Colonoscopy can also detect and remove precancerous polyps, preventing them from becoming cancerous. Additionally, a colonoscopy can identify and diagnose other colon-related diseases, such as inflammatory bowel disease or diverticulitis.
Types of Colonoscopy
There are two main types of colonoscopy: diagnostic and screening colonoscopies.
- A diagnostic colonoscopy is performed when symptoms are present, such as abdominal pain, rectal bleeding, or a change in bowel habits.
- A screening colonoscopy is performed on individuals who have no symptoms but are at risk of developing colon cancer.
Alternative Options to Colonoscopy
While colonoscopy is the gold standard for colon cancer screening, alternative options are available. These include faecal occult blood tests (FOBT), faecal immunochemical tests (FIT), stool DNA tests, and virtual colonoscopies. However, it's essential to note that these alternative options may not be as accurate as colonoscopy and may require follow-up testing.
Irregularities During Colonoscopy
Occasionally, narrowing of the bowel or other diseases may prevent the instrument from being inserted through the entire colon length.
If your doctor identifies any irregularities during the colonoscopy, they may recommend further testing or treatment, depending on the type and severity of the irregularity.
The irregularity may sometimes require additional testing, such as a CT scan or MRI. Your doctor will discuss any findings and recommend appropriate treatment based on your circumstances.
How Long Does a Colonoscopy Take?
The procedure typically takes around 30 minutes to an hour to complete, depending on the length of your colon and whether any polyps or other abnormalities are detected.
Consent Forms for Colonoscopy
Because of the risk of cancer, it is recommended that all polyps found be removed during colonoscopy.
Due to sedation, it will not be possible to discuss the removal now; therefore, if you have any questions regarding polyp removal, please discuss this before the procedure.
For the colonoscopy to be performed, a consent form is required to be signed by you on the day of the procedure.
Preparation Before a Colonoscopy
- Bowel preparation: You must follow a special diet and take bowel preparation medication before your procedure. Printed instructions will be provided at the time of your booking, or click here for instructions.
- Fasting: Stop drinking and eating for approximately 6 hours before the procedure. The hospital will contact you one working day before your procedure to advise you of your fasting time.
- Medications: You will be instructed to stop your blood-thinning and diabetes medications.
Colonoscopy Procedure
- You will lie on your left side on an examination table during a colonoscopy. Your doctor will administer a sedative to help you relax and reduce any discomfort.
- Once you're sedated, your doctor will insert a colonoscopy, a long, flexible tube with a tiny camera and light on the end, through your rectum and into your colon. The camera on the end of the colonoscope allows your doctor to view the colon's inner lining on a monitor.
- As the colonoscope is advanced through your colon, your doctor will examine the lining for any abnormalities, such as polyps or lesions. If any polyps are found, they can be removed during the procedure. Your doctor will use small instruments to remove the polyps or take a biopsy of any abnormal tissue for further analysis.
Once the procedure is finished, you'll be monitored briefly to ensure the sedative wears off and you're feeling well enough to go home.
After Your Colonoscopy
After your colonoscopy, following your doctor's aftercare instructions carefully ensures a smooth and successful recovery. Here are some common aftercare instructions you may receive:
- Rest: You should rest for the remainder of the day following your colonoscopy to allow the sedative to wear off fully. Arrange for someone to drive you home after the procedure.
- Diet: You may be instructed to follow a specific diet for a few days after colonoscopy. Your doctor may recommend avoiding certain foods, such as those high in fibre or difficult to digest, to reduce discomfort and promote healing.
- Medications: Your doctor may advise you to stop taking certain medications shortly after the procedure, especially blood thinners. You should also avoid taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, for a few days following your colonoscopy.
- Hydration: Drink plenty of fluids to help flush out your system and prevent dehydration. Avoid alcohol and caffeine for at least 24 hours following your colonoscopy.
- Physical activity: Avoid strenuous physical activity for at least 24 hours after the colonoscopy. Depending on the results, your doctor may recommend you take it easy for a few days following the procedure.
- Follow-up: You'll need to follow up with your doctor to discuss the results of your colonoscopy and any further treatment, such as removing polyps. Your doctor may also schedule a follow-up colonoscopy based on your risk factors and the procedure results.
Colonoscopy Prognosis
The prognosis for colonoscopy is excellent. It is a highly effective procedure for detecting colon cancer and can also identify and remove precancerous polyps. Early detection of colon cancer increases the likelihood of successful treatment and a better overall prognosis.
Risks and Complications with Colonoscopy
For inspection of the bowel alone, complications of colonoscopy are very uncommon. Most surveys report complications of 1:1000 examinations or less.
As with any medical procedure, there are risks associated with colonoscopy. However, relatively low risks occur in a small percentage of cases. Some common risks of colonoscopy include:
- In rare cases, the colonoscope may cause a tear or hole in the colon, leading to bleeding. If bleeding occurs, it's typically minor and stops on its own. However, in rare cases, additional treatment may be needed.
- A perforation occurs when the colonoscope punctures the wall of the colon. This is a rare but potentially serious complication that may require surgery to repair.
- A colonoscopy can introduce bacteria into the colon, possibly leading to an infection. This is a rare complication but can be serious if it occurs.
- Some people may experience an adverse reaction to the sedative used during the procedure, such as breathing problems or an allergic reaction.
- Other rare risks of colonoscopy include adverse reactions to medications used during the procedure, abnormal heart rhythms, and complications related to underlying health conditions.
Discussing the potential risks of colonoscopy with your doctor before the procedure is essential. Your doctor will evaluate your health history and risk factors to determine if a colonoscopy is best for you. The benefits of detecting colon cancer early through colonoscopy generally outweigh the risks, but it's important to understand the potential complications before the procedure.