Gastroscopy is a visual examination of the lining of the upper part of your digestive tract i.e. oesophagus (food pipe), stomach and duodenum (first part of the small intestine). A gastroscope (long, flexible tube with a small camera on the end) is passed through your mouth and down your digestive tract. Images from the camera are displayed on a video screen and photos can be taken. The endoscope (tube) will not interfere with your breathing. The doctor can look for any abnormalities and if necessary take a small tissue sample (biopsy) using tiny biospy forceps. This is painless and the tissue sample is sent to the laboratory for examination under a microscope.  

Gastroscopy examination may be used to investigate and diagnose:

• indigestion, heartburn, reflux
• bleeding, anaemia
• nausea
• swallowing difficulties
• pain and/or abdominal discomfort
• peptic ulcers, tumours, gastritis etc.

Risks + Complications from a Gastroscopy examination are very rare but can occur. They include:

• a tear (perforation) and/or bleeding from the oesophagus, stomach or duodenum may occur, especially after endoscopic therapies such as biopsies and polypectomy or dilatation 
• allergic reaction to the sedative or throat spray.

If you would like further clarification of these risks and  complications, please discuss them with your specialist or nurse. 

What to expect

The stomach must be empty to obtain a clear view. Therefore you are asked not to eat or drink anything for 6 hours before the examination.

In addition it is important to inform the Endoscopy Unit prior to your procedure if you have any of the following:

• an allergy or bad reaction to medicines or anaesthetics
• take medication to thin your blood including warfarin, aspirin or arthritis medication
• prolonged bleeding/clotting disorders or excessive bleeding
• diabetes
• heart and lung problems including artificial heart valves
• artificial hip or knee joint replacements
• are pregnant or breast-feeding.

On admission into the Endoscopy Unit your medical history is recorded by a nurse and further information given in the form of a patient video and written material. A consent form is discussed and you are requested to sign it, indicating that you understand the procedure and the risks and complications and give consent to have the procedure performed.

In the examination room the back of your throat will be sprayed with a local anaesthetic spray. You will also be offered medication (a sedative) to make you go into a light sleep. This will be given by a small injection into a vein in your arm or hand. The gastroscopy will take approximately 10 to 20 minutes.

You will spend some time in the endoscopy recovery room after the procedure (probably 1-2 hours) to sleep off the sedative and to allow staff to monitor you (take your blood pressure and pulse recordings, etc). Because you have been sedated intravenously (given medication to make you sleep) it is important that you know that you should not drive a car, operate machinery or make any important decisions for 12 hours as the sedation impairs your reflexes and judgement. Therefore you will need to arrange for someone else to drive you home and it is recommended that you have an adult at home with you afterwards.

If biopsies are taken for examination, your GP and specialist will be sent the results within 5 to 7 working days. A medical typed report will be sent to your GP and the specialist. Follow-up information and recommendations will be given to you by the specialist prior to discharge from the Endoscopy Unit.

• Gastroscopy procedure - Printable copy (PDF, 313.5 KB)

Colonoscopy is a visual examination of the lining of your large bowel (colon) using a colonoscope (long, flexible tube with a small camera on the end). The colonoscope is passed into your rectum (bottom) and then moved slowly along the entire colon. A small video camera sends an image onto a video screen and photos can be taken. 

The doctor can look for any abnormalities and if necessary small tissue samples (biopsies) can be taken painlessly through the colonoscope using tiny biopsy forceps. The tissue samples are sent to the laboratory for examination under a microscope. Colonoscopy may also be used to remove polyps in the colon. Polyps (abnormal growths of tissue) can be removed with diathermy forceps or for large polyps a diathermy snare. This is done by passing a wire loop, like a lasso, over the polyp. The polyp is cut from the bowel lining using an electrical current (diathermy) which seals the tissue and stops bleeding. This current cannot be felt and causes no pain. The colonoscopy procedure can take between 10 and 60 minutes.

A colonoscopy may be suggested by your doctor if you have:

• some alteration in bowel habit e.g. diarrhoea, constipation
• unseen blood in the stool (occult)
• bleeding from the bowel
• anaemia
• abdominal pain
• family history of bowel cancer
• abnormal barium x-ray
• previous treatment for polyps, bowel cancer, colitis (inflammation of the colon).

  Risks + Complications from a simple colonoscopy examination are rare but can occur. They include:

• perforation (tearing) of the bowel wall by the colonoscope can cause leakage into the abdomen especially after endoscopic therapies such as biopsies, polypectomy, dilatations
• bleeding may occur from the site of the biopsy or polyp removal 
• allergic reaction to the sedative
• a polyp or lesion can be missed.

If you would like further clarification of these risks and  complications please discuss them with your specialist or nurse.

What to expect

It is important that the bowel is completely empty of faecal material for the procedure to be thorough and safe.  If it is not entirely clean certain areas may be obscured. The preparation for a colonoscopy procedure will involve modifications to your diet. There are more specific instructions about the preparation including a liquid diet for 1 to 2 days and a bowel laxative prior to the procedure. This means drinking oral laxative medication (to make you go to the toilet more) to empty the bowel. All the instructions are given in a written patient information brochure and support is available through the Endoscopy Unit. 

In addition, it is important to inform the Endoscopy Unit prior to your procedure if you have any of the following:

• an allergy or bad reaction to medicines or anaesthetics
• take medication to thin your blood including warfarin, aspirin or arthritis medication
• prolonged bleeding/clotting disorders or excessive bleeding
• diabetes
• heart and lung problems including artificial heart valves
• artificial hip or knee joint replacements
• if you are pregnant or breast-feeding.

On admission into the Endoscopy Unit your medical history is recorded by a nurse and further information given in the form of a patient video and written material. A consent form is discussed and signed indicating that you understand the procedure,  the risks and complications involved and consent to have the procedure performed.

In the examination room you will be given medication (a sedative and a pain medication) to make you go into a light sleep. This will be given by a small injection into a vein in your arm or hand. The colonoscopy can take 10 to 60 minutes and you will be supported by two nurses. If required it may be necessary for the nurse to hold your hands and legs ensuring your safety. At all times your privacy and dignity will be respected. Your heart rate and oxygen levels will be monitored during the procedure. The endoscope is gently inserted into the bowel which is inflated with air to obtain a good view. The air may cause wind-like cramps but will pass. Sometimes you may be asked to roll onto your back or side or the nurse may press on your abdomen (abdominal pressure) to help the doctor guide the colonoscope. 

You will spend some time in the endoscopy recovery room after the procedure (probably 1 to 2 hours) to sleep off the sedative and to allow staff to monitor you (take your blood pressure and pulse recordings, etc). Because you have been sedated intravenously (given medication to make you sleep) you should not drive a car, operate machinery or make any important decisions for 12 hours as the sedation impairs your reflexes and judgement. Therefore you will need to arrange for someone else to drive you home. It is recommended to have an adult with you at home afterwards.

If biopsies are taken for examination, your GP and specialist will be sent the results within 5 to 7 working days. A  medical typed report of the procedure will be sent to your GP and specialist. Follow-up information and recommendations will be given by the specialist prior to discharge from the Endoscopy Unit.

• Colonoscopy procedure - Printable copy (PDF, 390.8 KB)

ERCP is a technique used to study the ducts (drainage routes) of the gallbladder, pancreas and the liver (the drainage channels from the liver are called bile ducts).  A duodenoscope (long, thin, flexible tube-like instrument) is passed through the mouth, oesophagus and stomach into the duodenum (first part of the intestine) while you are under intravenous sedation. The duodenoscope enables the common opening to the bile and pancreas ducts to be visually identified. A smaller narrow plastic tube (a catheter) is passed through the internal channel of the duodenoscope to inject x-ray contrast into the bile and pancreas ducts. X-rays enable the doctor to see the images of the ducts and to photograph them.

What to expext

On admission into the Endoscopy Unit a medical history is recorded and further information given in the form of a patient video and written material. The nurse and doctor will answer any questions you have. A consent form is discussed and signed indicating that you understand the procedure, the risks and complications and you give consent to have the procedure performed.

The stomach and duodenum must be empty for a thorough and safe ERCP. Therefore you are asked not to eat or drink anything for 6 hours before the examination. ERCP is performed in the x-ray Department and endoscopy nurses will be present to support and monitor you. You will be required to lie on your tummy during the examination and be given intravenous sedation and pain relief to keep you comfortable throughout the procedure. If a blockage of the bile duct is seen a small cut (sphincterotomy) may be made to aid the flow of bile or the removal of stones. Occasionally blocked ducts require the placement of a small hollow plastic tube (stent) inside, to encourage internal drainage. On rare occasions the instruments will be unable to enter the bile or pancreatic ducts and in this case it will not be possible to complete the ERCP.

Risks + Complications from an ERCP examination are:

• main complication is inflammation of the pancreas (pancreatitis) caused by the injection of x-ray contrast. This occurs in approx. 5% of people and can cause abdominal discomfort requiring hospitalisation. In rare instances pancreatitis can become serious and lead to a lengthy stay in hospital, surgery and even death
• bleeding from sphincterotomy (small cut in the bile duct)
• infection of the bile duct
• bowel tear (perforation )
• incomplete removal of stones
• allergic reaction to the contrast medium and/or sedative medication
• crown or bridging work on teeth may be at risk during the procedure.

After the ERCP procedure you will either return to the Endoscopy Unit where you sleep off the sedative and staff monitor you (take your blood pressure, pulse recordings and temperature, etc) or you will be admitted into the hospital for overnight observations. 

A detailed medical report is sent to your GP and specialist. Follow-up information and recommendations are given to you by the specialist prior to your discharge.

• ERCP Preparation - Printable copy (PDF, 429.6 KB)