Gastroscopy, colonoscopy and flexible sigmoidoscopy
Being told you need a camera test can be daunting. What will it feel like? How do I prepare? When will I get the results? Here is what to expect, in plain English. I am an experienced endoscopist, and I train other doctors in endoscopy as training lead at St Mary’s Hospital.
Private gastroscopy (OGD) in London
Worried about a camera test for your stomach? A gastroscopy is one of the quickest and most commonly performed procedures in gastroenterology, and the best way to look directly at the upper part of the gut.
What is a gastroscopy?
A gastroscopy, also called an OGD or upper GI endoscopy, uses a thin flexible camera passed through the mouth to examine the oesophagus (food pipe), stomach and first part of the small bowel. The examination itself usually takes around ten minutes. Small tissue samples (biopsies) can be taken painlessly at the same time.
Why might I need a gastroscopy?
- Reflux or indigestion that has not settled with treatment
- Difficulty or pain when swallowing
- Persistent nausea, vomiting or upper abdominal pain
- Iron-deficiency anaemia
- Confirming coeliac disease
How do I prepare?
Your stomach needs to be empty, so please have nothing to eat for six hours beforehand. You can usually drink clear fluids until two hours before. Let us know in advance if you take blood-thinning medicines or medicines for diabetes, as you may need specific instructions. You will receive written guidance when the procedure is booked.
Will a gastroscopy be uncomfortable?
You have two options. A local anaesthetic throat spray numbs the throat while you stay fully awake, and you can leave and drive soon afterwards. Or a sedative injection makes you relaxed and drowsy; you will then need someone to take you home, and should not drive, drink alcohol or sign important documents for 24 hours. We will choose together.
When will I get the results?
I will explain what I have seen before you go home and give you a copy of the report. Biopsy results follow later, and I will write to you and your GP with these and the plan.
Is a gastroscopy safe?
It is a very safe test. A mild sore throat or bloating for a few hours afterwards is common. Serious complications, such as bleeding, a reaction to sedation or a tear in the lining, are rare. I will go through the benefits and risks with you before you sign the consent form, and you can ask anything you like.
Private colonoscopy in London
Feeling apprehensive about a colonoscopy is completely normal. Knowing what to expect, and what your options are, makes a real difference.
What is a colonoscopy?
A colonoscopy uses a flexible camera passed through the back passage to examine the whole of the large bowel, and often the end of the small bowel. It usually takes 30 to 45 minutes. It is the most accurate test for the lining of the bowel, and it allows biopsies to be taken and polyps to be removed during the same procedure.
Why might I need a colonoscopy?
- A lasting change in bowel habit
- Rectal bleeding
- Iron-deficiency anaemia
- A positive stool test for hidden blood (FIT)
- Diagnosing or monitoring Crohn’s disease or ulcerative colitis
- Follow-up after previous polyps
- A strong family history of bowel cancer
What is the bowel preparation like?
A clean bowel is essential for an accurate test. You follow a low-fibre diet beforehand, then drink a laxative preparation, usually split between the evening before and the morning of the procedure. It causes frequent watery stools, so plan to stay close to a toilet. Most people find this the least pleasant part; clear written instructions are provided when you book.
Will a colonoscopy hurt?
Many people have little or no discomfort. You may feel bloating or cramping as the camera passes around bends in the bowel. You can have sedation and pain relief through a small cannula, or choose to have no sedation and stay fully alert, which means you can leave sooner. I will talk you through each stage, and we can pause or add more pain relief at any point.
What if you find a polyp?
Polyps are small growths on the bowel lining. Most are harmless, but some types can slowly turn into cancer over a number of years, which is why they are removed. Most can be taken out painlessly during the colonoscopy and sent for analysis. Larger or more complex polyps may need a separate planned procedure.
What happens afterwards, and is it safe?
I will explain the findings before you leave and give you a copy of the report; biopsy and polyp results follow by letter. If you have had sedation you will need someone to take you home. Colonoscopy is safe, and serious complications are uncommon: bleeding, particularly after a polyp is removed, and very rarely a tear in the bowel wall. We discuss these before you give consent.
Flexible sigmoidoscopy
Do you need the whole bowel examined, or would a shorter test answer the question? Sometimes it will.
What is a flexible sigmoidoscopy?
A shorter camera examination of the rectum and the lower part of the large bowel. It usually takes 10 to 15 minutes, and biopsies can be taken or small polyps removed.
When is it used instead of a colonoscopy?
When the question can be answered by looking at the lower bowel alone: for example, bright red bleeding in a younger person, or checking how active ulcerative colitis is. If anything suggests the rest of the bowel should be examined, a colonoscopy can be arranged.
How do I prepare?
Usually with an enema shortly before the test, rather than the full laxative preparation. Most people do not need sedation and can go straight back to normal activities, including driving.
How do my colonoscopy results compare?
Still have questions about a procedure?
A consultation beforehand is the place to ask them, and to decide whether the test is needed at all. Book online through Welbeck, or contact my secretaries on 020 3198 9826.