Seven things you need to know about your endoscopy

An endoscopy is a medical procedure that allows specialists to visualise internal structures and organs via an ‘endoscope’ – a long, flexible cable with a light and camera at the end of it. This kind of procedure can be done to investigate symptoms, confirm diagnoses and even deliver some kinds of treatments. An endoscopy is an invasive procedure and usually involves some preparation so that you are as ready as you can be for your procedure. Here are seven baseline questions that cover the key things you need to know before going into your endoscopy:

1. What is my endoscopy for?

Although there is one overriding term, ‘endoscopy’, there are actually many different types depending on the purpose and location. Your doctor should explain to you whether your endoscopy is purely diagnostic to investigate symptoms, or whether there is any treatment involved. Sometimes, the endoscopy may encompass both (e.g. having an upper endoscopy to look for potential stomach ulcers and then treating any that are found).

Endoscopies also vary by location and so the endoscope itself may be introduced several different ways. For example, an upper endoscopy to look at the stomach or a bronchoscopy to look at the airways will be introduced by the throat. A colonoscopy to look at the large bowel will be introduced through the rectum (back passage), and a hysteroscopy to look at the inside of the uterus (womb) would be introduced through the vagina. It is very helpful to know what to expect when it comes to your endoscopy, and your doctor should explain all of this to you when the endoscopy is arranged.

2. What steps do I need to take in preparation for the endoscopy?

Again, this is dependent on the type of procedure you are going to have. Generally, preparation will include checking your medications and potentially fasting before the procedure. If you are having an upper endoscopy or bronchoscopy, or you are having the endoscopy done under general anaesthetic, then you should not eat for 6-8 hours beforehand. You can drink clear fluids up to 2 hours before. If you are having a different endoscopic procedure with only a local anaesthetic, then you can eat and drink normally beforehand.

If you are having a colonoscopy, it gets a bit more complicated and you will need to do something known as ‘bowel prep’ which will allow the specialist to get a clear view of the bowel. This involves some short-term diet changes and taking a laxative before the procedure. This will all be explained before you come for the colonoscopy as needed.

3. What is going to happen during the endoscopy?

If you are having a general anaesthetic, then you will be asleep during the whole procedure and wake up once it is finished.

If you are not having a general anaesthetic, you will be given a local anaesthetic where the endoscope will be inserted to numb the area and make the procedure easier. You should not experience any pain during the endoscopy, but it may be quite uncomfortable. You will also be offered some sedation, which may help you to relax and may make everything more comfortable throughout.

These procedures can take between 15 minutes and 1 hour, and you will be monitored throughout. This can be done as an ‘outpatient’, which means you won’t have to stay in the hospital overnight.

4. What will recovery from the procedure be like?

Although an endoscopy is invasive, it is a fairly minor procedure. However, it is recommended to allow for some time to rest and recover afterwards. If you have had a local anaesthetic, it should take around an hour to completely wear off. Sedation can take up to 24 hours to completely wear off, and it is recommended that you do not drive or operate heavy machinery, so it is important to organise alternative transport home. General anaesthetics can take a little longer to recover from.

If you have had a cystoscopy (to look at the bladder), you can expect to see some blood in your urine for up to 24 hours. Similarly, if you have had a colonoscopy, you may have some blood in the stools which should settle after a day or so.

5. What are the risks of endoscopy?

Generally, endoscopies are considered to be very safe procedures, with a low risk of complication. There are several potential adverse events, which do occur rarely, that it is advisable to know about before having an endoscopy:

• Infection: as with all invasive procedures, there is a small risk of introducing an infection during endoscopy, although all precautions necessary to minimise this risk will be taken
• Bleeding: for some types of endoscopy (cystoscopy and colonoscopy) a small amount of bleeding should be expected for a day or so after the procedure
• Perforation: this occurs when the scope breaks through the wall of the organ. It is a very rare complication, only occurring 1-2 times per 1,000 colonoscopies for example. Should this issue arise during the procedure, it will be managed immediately with surgery to minimise the damage caused
• Reaction to sedation/anaesthetic: this risk will apply to any procedure using sedation or anaesthetic. Many people find that sedation can make them feel quite nauseous (a mild reaction), but there is a small chance of having an allergic or adverse reaction to the drugs used

6. What do I need to look out for after an endoscopy?

If you experience any of the following after your endoscopy, you should see your GP as soon as possible or go to the nearest A&E department:

• Redness, pain and swelling around where you’ve had the endoscopy, and fever
• Prolonged or unexpected bleeding from the endoscopy site
• Black or dark stools
• Marked shortness of breath
• Chest pain
• Severe and persistent abdominal pain
• Vomiting blood

7. I’ve had my endoscopy and recovered. What next?

You may learn the results of the endoscopy during the procedure itself, or straight afterwards. Depending on the reason for your endoscopy, you are likely to have a follow–up appointment with the specialist who ordered the procedure in order to discuss the results and the plan moving forward. This will also be a good opportunity to ask any more questions you have regarding the procedure, your recovery and the next steps in terms of investigations and managing any ongoing symptoms or problems.