Endoscopy. The procedure explained. Please read this information leaflet carefully and bring it with you to your next appointment

Endoscopy The procedure explained Please read this information leaflet carefully and bring it with you to your next appointment. Version 3 February ...
Author: Briana Burke
0 downloads 1 Views 362KB Size
Endoscopy The procedure explained

Please read this information leaflet carefully and bring it with you to your next appointment.

Version 3 February 2013 Diagnostic Team Review date: February 2016



Things you may wish to know about having an Endoscopy (Gastroscopy) Why have you been referred for a Gastroscopy? After considering alternative ways of investigating your symptoms your doctor has advised that you should have an upper gastro-intestinal endoscopy, this is a routine test commonly carried out to help to clarify the cause of your symptoms. In some cases, depending on individual factors such as the symptoms present and the condition being investigated, there may be alternatives to having a gastroscopy. These may include: a barium meal, Ultrasound, Computerised Tomography (CT) scan. The Gastroscopy will benefit you by providing a clear diagnosis and enable biopsies to be taken if required. It is your decision to go ahead with the procedure or not. If you prefer not to be investigated we advise you to discuss the possible consequences with your GP. The following is some information and instructions you need to know before having this procedure.

The Preparation Medications Before your appointment • All medications should be taken as normal with a little water. • If you take Warfarin please read below as you will need to have an INR test seven days before your procedure. • If you have diabetes please read below. If you have any questions or do not know whether to stop your medication before your endoscopy please phone 01225 473409

For patients who take Warfarin: • You should have an INR test seven days before the Endoscopy. • If that INR result is 3.0 or less, continue with your usual daily Warfarin dose.

If that INR result is more than 3.0, ask your supervising anticoagulant service for advice to reduce your daily Warfarin dose so that your INR is 3.0 or less when you have the Endoscopy.

1

Diabetic advice - Morning Appointment Please follow these instructions if you have diabetes controlled with insulin or tablets. If you have any questions related to your diabetes during this preparation, please contact your GP. Food and drink • Do not eat for six hours prior to your appointment. • Do not drink for three hours prior to your appointment. • Test your blood glucose regularly. If it drops below 4, please treat with a sugary drink such as lucozade 100ml, apple or grape juice 200ml, until your level is 5. • After your procedure, you may eat and drink normally unless specifically told otherwise. Insulin and tablets Please adjust your normal insulin and tablet doses as instructed below. If you take insulin once daily • No change to insulin dose necessary. If you take insulin twice daily • Do not have your morning insulin. Bring it with you, plus something to eat. • If you are able to eat before 11:00, have your normal morning dose with food. • If you are able to eat after 11:00, have ½ your normal morning dose with food. • Have your normal evening dose. If you take insulin four times daily • Do not have your morning insulin. Bring it with you, plus something to eat. • If you are able to eat before 11:00, have your normal morning dose with food. • If you are able to eat after 11:00, omit your breakfast dose and have your normal lunchtime dose with food. • Have your normal tea time and bedtime evening doses. If you take tablets for diabetes • Do not have your morning diabetic tablets. • After your procedure, re-start your tablets at the next dose time.

Diabetic advice - Afternoon Appointment Food and drink • Do not eat for six hours prior to your appointment. • Do not drink for three hours prior to your appointment. • Test your blood glucose regularly. If it drops below 4, please treat with a sugary drink such as lucozade 100ml, apple or grape juice 200ml until your level is 5. • After your procedure you may eat normally unless specifically told otherwise.

2

Insulin and tablets Please adjust your normal insulin and tablet doses as instructed below. If you take insulin once daily • No change to insulin dose necessary. If you take insulin twice daily • Have your normal morning insulin dose unless your breakfast is smaller than usual. If so reduce your normal dose by 1/2. • Have your normal evening dose. If you take insulin four times daily • Have your normal morning insulin. • Do not have your lunchtime insulin. • Have your normal tea time and bedtime evening doses. If you take tablets for diabetes • Do not have your morning diabetic tablets. • After your procedure, re-start your tablets at the next dose time.

INSTRUCTIONS FOR ENDOSCOPY EXAMINATION Endoscopy taking place in the morning. 1. You must not eat any food from 12.00 midnight. 2. You may have small sips of water up to 6 hours before your appointment time. 3. You may continue with any important medications that you take on the day of the test. Simply take them with small sips of water at least 2 hours before your appointment. 4. It is important that you stop any medication you are taking for your stomach complaint one week before your endoscopy, or as soon as you receive your appointment, if less than a week.

Endoscopy taking place in the afternoon. 1. You may have black tea/coffee and toast but must not eat anything after 07.00am 2. You may have small sips of water up to 6 hours before your appointment time.

3

3. You may continue with any important medications that you take on the day of the test. Simply take them with small sips of water at least 2 hours before your appointment. 4. It is important that you stop any medication you are taking for your stomach complaint one week before your endoscopy, or as soon as you receive your appointment, if less than a week. We ask you to arrive at least 15 minutes before your appointment time, and to contact the Receptionist, situated on the ground floor, where you will be directed to the Endoscopy Department. You must arrange for someone to take you home. If you have had sedation you will not be able to drive yourself. It is recommended that you do not drive for the next 24 hours, or do anything that requires fine judgement involving machinery, in case you injure yourself. What is an Endoscopy (Gastroscopy)?  Gastroscopy is a technique by which the doctor can look directly into your oesophagus (gullet), stomach and duodenum (the first part of the small intestine connected to the stomach), to investigate your problem. It also allows samples of tissue to be taken, painlessly, for testing.  The endoscope is a thin flexible tube with a bright light and tiny video camera on the end. This is passed through your mouth and down into your stomach. The camera produces the images on a screen, which allows the endoscopist, (the person who is doing your test) to view the interior of your gullet or stomach.  As with any medical procedure, there is a small element of risk involved in having an endoscopy. According to the British Society of Gastroenterology Guidelines, endoscopic procedures carry a 1 in 3000 risk of bleeding (haemorrhage) or perforation of the gut, following which surgery may be necessary. However, all our staff are trained in this technique and are well able to look after you.  Other rare complications include aspiration pneumonia and a reaction to the IV sedative drugs or local anaesthetic throat spray if it is used. Upper gastrointestinal endoscopy may involve a slight risk to crowned teeth or dental bridgework. Each of these risks occurs in less than 1% of procedures.

What should I expect?  As space on the Unit is limited, please bring only 1 person (an adult) to accompany you. This person will need to leave after the initial admission and will be advised when to return. 4

 When you come to the Department, a nurse will explain the procedure to you in detail. The endoscopist will also see you, and they will also want to know about any previous endoscopies you have had.  If you have any worries or questions at this stage, don’t be afraid to ask. The staff will want you to be as relaxed as possible for the test, and will not mind answering your queries.  The doctor will ask you to read and sign a consent form and make sure that you understand the investigation and its implications. If you need reading glasses please bring them with you. Please tell the endoscopist or nurse if you have had any allergies or adverse reactions to drugs or other tests. During the test  In the examination room you will be made comfortable on a couch, resting on your left side. You will not have to undress, but must remove dentures and glasses. A nurse will stay with you throughout the test.  The test can be performed with a local anaesthetic throat spray applied to the back of the throat. Alternatively, you may have an injection in your arm to make you sleepy and relaxed.  To keep your mouth slightly open, a plastic mouthpiece will be put between your teeth. When the doctor passes the endoscope into your stomach, it will cause you little distress, and will not interfere with your breathing at any time. Modern endoscopes are quite thin and easy to pass.  The examination will take approximately 5-10 minutes. During this time some air will be passed down the tube to distend the stomach and allow the doctor a clear view. The air is sucked out at the end of the test.  If you collect saliva in your mouth, the nurse will clear it using a small suction tube. When the examination is finished the endoscope is removed quickly and easily.

About Throat Spray  Throat spray is a local anaesthetic that is sprayed onto the back of your throat to numb it. This will enable the endoscope to pass more easily.  It means that you can stay awake during the procedure and you can leave the Unit as soon as the examination is over. However, you should have nothing to eat or drink until after the effect of the spray has worn off, because your swallowing will be impaired for 40 minutes. 5

About Sedation  A canula (small flexible tube) will be placed into the back of your hand or arm and the sedative will be injected through it. Sedation will make you relaxed and makes you drowsy. You may not remember the procedure taking place. However, this is not a general anaesthetic.  You may wake up fairly quickly – or more slowly: each person reacts differently.  You will have your blood pressure and pulse monitored.  You will probably remain in the Unit for about 40 minutes but the effects of the sedation will not wear off totally for 24 hours. Your thinking processes and movements will be slower than usual; hence you must not drive or operate machinery for 24 hours. After the Test  If you have had sedation, you will be asked to rest in the unit for about 40 minutes. Your blood pressure and pulse recordings will be taken. You will be given a drink when you are fully awake.  You may also feel a little bloated if some air has remained in your stomach. This discomfort will pass, and needs no medication. Going Home  If you have had a throat spray you can make your own way home or go back to work.  If you have had sedation (an injection) and are going home after the test, a responsible adult should come to the Unit to pick you up.  When you get home it is important to rest quietly for the remainder of the day, with someone to look after you for 24 hours if possible. The effects of the sedative will last longer than you think.  It is also advisable that you do not take sole responsibility for children or anyone who is in need of your care e.g. the elderly for 24 hours after having sedation. For the first 24 hours after having sedation you should not:  Drive a car  Operate any machinery – not even a kettle.  Sign any legally binding documents

6

The effects of the test and injection should have worn off after 24 hours when most patients are able to resume normal activities. Please note that some insurance companies will not insure you if you do not follow these instructions. When will you know the results?  The doctor will be able to tell you the results straight after the test, or if you have been sedated, as soon as you wake up. However, if samples (biopsies) have been taken for examination, the results may take up to two weeks and will be sent to your General Practitioner (GP). You will be given a report of your examination to take to your GP surgery.  You should discuss the details of the results and necessary treatment with your GP or hospital specialist – whoever it was who referred you to have the test. Alternative Procedures In some cases, depending on individual factors such as the symptoms present and the condition being investigated, there may be alternatives to having a gastroscopy. These may include: • a barium meal • Ultrasound • Computerised Tomography ( CT) scan

If you need further information about your procedure, between 9-5 Monday to Friday please telephone 01225-473409, where a member of the unit staff will be pleased to help you. Out of these hours, you may get general advice for serious problems relating to your procedure by telephoning the on call doctor on 01225 465941.

Cancellation of appointment If you need to cancel the appointment please:  Always inform the Appointments Office as soon as possible so that alternative arrangements can be made for you (tel: 01225 473401).  Never fail to let the hospital know that you cannot attend. The more notice you can give us the more chance we have to give another patient your appointment time.

7

Transport If transport has been arranged for you by your GP, and for any reason you do not require it, please ensure that it is cancelled. Bath Spa railway station and the coach station is within half a mile of the hospital. Taxis are available. We regret that the hospital does not have a car park for the use of patients and their escorts. There are a number of public car parks available and that are close to the hospital, and a map will be sent to you to show you where these are located. Cars may drop patients off outside the front entrance of the hospital, but may park only if they display a “disabled” sticker. Access to the hospital Automatic doors allow easy access to the hospital, and a lift is available to take you to the ground floor, where Reception is situated, if you cannot manage the steps. Please ask the Switchboard/Enquiry Desk if you need assistance to operate the lift. Clinical Training It would be impossible to train future members of the health professions without the help and co-operation of patients. This is a hospital where such staff are trained. Training takes place in the Endoscopy Unit as well as in the wards and Out Patient Department. This means that a student may be present at the time of your examination. We hope you will co-operate in this work if we need your help. If, however, you do not wish students to be present, you are absolutely free to refuse without your treatment being affected in any way. Please inform the nurse at the earlier opportunity if you do not wish students to be present during your examination. The Trust believes that all patients who attend the Royal National Hospital for Rheumatic Diseases as day patients have the right to expect certain levels of care which include the right to:  Receive competent health care according to their individual needs without undue delay.  Expect privacy, dignity and respect at all times.  Expect all information to be dealt with confidentially.  Not be subjected to any treatment without their consent.  Choose to be informed about all aspects of their illness if they wish 8

We hope that you find this information useful. If you require any further information, please telephone the Diagnostic Department on Tel: 01225 473409.

Royal National Hospital for Rheumatic Diseases NHS Foundation Trust Upper Borough Walls Bath BA1 1RL Telephone: 01225 465941 Website: www.rnhrd.nhs.uk

For details in a different format please contact PALS 01225 473424

9

Suggest Documents