Gastroscopy is a procedure to examine the oesophagus, stomach and duodenum. The procedure is usually done under sedation so that you are comfortable throughout.  While you are asleep a thin, flexible tube is passed through your mouth into the oesophagus and then into the stomach.  The most common reasons for having a gastroscopy are to investigate symptoms of reflux, abdominal pain, diarrhoea or any other suspected condition of the oesophagus, stomach or duodenum. Samples (biopsies) are usually taken from the lining of the duodenum, stomach and/or oesophagus during the procedure.  Sometimes polyps are removed or other interventions such as treatment of bleeding ulcers or dilatation (stretching) of the oesophagus.

Gastroscopy is often performed at the same time as colonoscopy and if so the preparation, what happens on the day and your recovery are the same as for colonoscopy alone.

The stomach needs to be empty for the procedure. No food should be taken for 6 hours before the procedure and no liquid should be taken for 4 hours before.

Bowel Preparation is not required.

Important tablets and medicines can be taken with a sip of water on the morning of the procedure.

If you are on blood thinning medication for various heart, stroke or clotting reasons, these may need to be stopped prior to the Procedure.

Please tell reception if you take any of the following:

• Warfarin
• Aspirin
• Clopidogrel
• Xarelto
• Eliquis
• Brilllinta

If you are DIABETIC, please inform reception, as diabetic medication or insulin may need adjustment.

• With all procedures there is risk, however Gastroscopy is considered very LOW RISK.
• The risk of tear or perforation is approximately 1 in 5000 for a simple diagnostic gastroscopy, however in circumstances where dilation is performed, or ulcers are treated, or a polyp is removed, this risk is greater.
• The sedation used is administered by experienced anaesthetists and is equally low risk. If you have had problems with anaesthetics in the past, please discuss this with your anaesthetist prior to the procedure.
• If you have underlying medical problems such as severe lung or heart disease, complex neurological problems or previous clotting episodes, please discuss this with your Gastroenterologist  prior to the procedure.

• You will be greeted by Nursing and administration staff at the hospital, admission paperwork will be completed.
• You will be asked to change out of your clothes into a gown, although if your procedure is being undertaken at the Newcastle Endoscopy Centre, rather than in a hospital operating theatre, you may not have to get changed at all.
• You will meet the anaesthetist and run through the planned anaesthetic and an intravenous Cannula will be placed.
• If you have a needle phobia, we understand this is a very real thing and a very challenging time for you. We work with patients who have needle phobia frequently.
• Sedation will commence and the procedure is usually finished in 10-15 minutes.

There are usually two stages of recovery. In the first stage, you be will allowed to emerge from anaesthesia in a safe environment where you will be monitored constantly by recovery nurses.

• When you are sufficiently awake, you will be moved to the second stage of recovery and offered a drink and sandwich.
• The Gastroenterologist will come out at this time and discuss the findings of the procedure and what follow up may be required.
• Whether you are followed up by the Gastroenterologist or simply with your GP will depend on each Gastroenterologist and physicians have different ways of working.
• Often for small unconcerning polyps, you can be followed up by your GP, however if it is thought you may need further procedures, investigations or treatment you will probably need to see the Gastroenterologist for a follow up procedure.
• You must not drive, return to work, drink alcohol, operate machinery, sign legal documents or use public transport unaccompanied until the following day.
• You should be escorted home by an adult and have someone with you at home until the following day.

Any questions? Call us on 02 4910 0591, or email us reception@beechnutmedical.com

Polyps are growths that are usually benign, but some carry a risk of transforming into cancer. The time taken for benign polyps to turn into cancer varies, but it is generally in the order of many years. This is obviously not a hard and fast rule for all polyps. Polyps will generally be removed in a fairly simple fashion by snaring the polyp with a small catheter which will cut it off. Some larger polyps require more complex interventions such as burning or clipping.

Some very large polyps carry an increased risk of perforation. These procedures are usually fairly lengthy and you will often be asked to come back for a second procedure once the risks are explained to you.

For a successful procedure it is important that your Gastroenterologist can see the lining of your bowel clearly.  Bowel preparation takes place on the day before colonoscopy. This is explained on a separate sheet. It is important to keep well hydrated (drink lots of fluid) while having the bowel preparation. You must stop all fluids 4 hours before your admission to the hospital.

Important tablets and medicines can be taken with a sip of water on the morning of the procedure. If you are on blood thinning medication for various heart, stroke or clotting reasons, these may need to be stopped prior to the procedure.

Please tell reception if you take any of the following:

• Warfarin
• Aspirin
• Clopidogrel
• Xarelto
• Eliquis
• Brilllinta

Usually these medications will need cessation prior to the procedure and, depending on the reason why you are taking the medications, you may need to have Clexane injections for up to a week before and after the procedure.

This is because even though polyp removal is a safe procedure, if you are on medications to thin the blood you may bleed excessively after the procedure. Most oral diabetic medications will be stopped on the morning of the procedure and insulin doses will be adjusted in the 24 hours before the procedure.  Iron tablets should be stopped a week before the procedure. Anti-inflammatory drugs should be stopped 48 hours before the procedure.

All other important medications can be taken normally.

You will be greeted by Nursing and administration staff at the hospital, admission paperwork will be completed. You will be asked to change out of your clothes into a gown. You will meet the anaesthetist and run through the planned anaesthetic and an intravenous Cannula will be placed. If you have a needle phobia, we understand this is a very real thing and a very challenging time for you. We work with patients who have needle phobia frequently. Sedation will commence and the procedure is usually finished in 30 minutes. If there are many polyps, colonoscopy can take longer.

Colonoscopy is generally a low-risk procedure. However, it does carry a small risk of complications.

Perforation – a tear in the bowel can occur rarely. This may occur when polyps are being removed or when instruments are moving through the bowel.

Perforation is serious and would need admission to hospital and sometimes, surgery to fix the tear.

Bleeding can occur, especially when polyps are removed or if haemorrhoids are fixed. Bleeding in the lower GI tract is rarely serious or life threatening but it can be alarming and a nuisance. It usually settles after a few days, however bleeding which persists after polyp removal will usually require a second colonoscopy.

Anaesthesia used for colonoscopy is very safe and well tolerated. There is always risk whenever anaesthesia is used, usually of aspiration and chest infection. It is for this reason that most anaesthetists are very strict about the nil by mouth rule prior to the procedure.

Of course if the bowel prep is less than ideal, polyps can be missed. The risk of this happening is minimised by excellent bowel prep.

You will emerge from anaesthetic in the recovery room. It is common to have some abdominal discomfort after a colonoscopy. Passing flatus often helps relieve this. The bowel is suspended on ligaments and sometimes during the procedure these can pull and this can cause some persisting discomfort for a day or two.

After bowel prep it will take a few days for your bowel to settle into its regular routing.

Sometimes people who suffer chronic constipation feel much improved after their bowel prep.

Your Gastroenterologist will have a conversation with you after the procedure and will discuss the findings. If further tests, procedures or discussions are thought necessary, you will be booked for a follow up appointment. If you need onward referral to another specialist we will arrange that.

If you have a fairly benign polyp or lesion removed, often you can follow up with you GP. Every Gastroenterologist has different approaches to follow up.

You must not drive, return to work, drink alcohol, operate machinery, sign legal documents or use public transport unaccompanied until the following day. You should be escorted home by an adult and have someone with you at home until the following day.

Any questions? Call us on 02 4910 0591, or email us reception@beechnutmedical.com

Any questions? Call us on 02 4910 0591, or email us reception@beechnutmedical.com

Flexible sigmoidoscopy is a simple and safe procedure. It is usually very well tolerated with a minimum of discomfort. It is often performed in specialists private rooms without anaesthesia, however for patient comfort, we choose to perform all of our procedures in an appropriate environment.

The risks are similar to those for colonoscopy, however the lower part of the bowel is somewhat more robust than other parts of the bowel and these risks are significantly less than with colonoscopy.

Usually patients will be given an enema shortly before the procedure to empty out the last part of the colon. A small tube will be inserted into the passage and some liquid will be inserted into the rectum. You will be asked to hold the liquid in the bowel while lying on your side for 5 or 10 minutes and then use the toilet to empty the lower part of the bowel. If you wish to have sedation for the procedure you will need to be fasted (nothing to eat or drink) for at least 4 hours before the procedure.

Important tablets and medicines can be taken with a sip of water on the morning of the procedure. If you are on blood thinning medication for various heart, stroke or clotting reasons, these may need to be stopped prior to the procedure.

Please tell reception if you take any of the following:

• Warfarin
• Aspirin
• Clopidogrel
• Xarelto
• Eliquis
• Brilllinta

Usually these medications will need cessation prior to the procedure and, depending on the reason why you are taking the medications, you may need to have Clexane injections for up to a week before and after the procedure.

This is because even though polyp removal is a safe procedure, if you are on medications to thin the blood you may bleed excessively after the procedure. Most oral diabetic medications will be stopped on the morning of the procedure and insulin doses will be adjusted in the 24 hours before the procedure.  Iron tablets should be stopped a week before the procedure. Anti-inflammatory drugs should be stopped 48 hours before the procedure.

All other important medications can be taken normally.

Flexible sigmoidoscopy can be performed under sedation but is often  well tolerated with the patient fully awake. For this reason the procedure is quicker, the recovery is quicker and the risks of a complication are smaller.

You will emerge from anaesthetic in the recovery room. It is common to have some abdominal discomfort after a colonoscopy. Passing flatus often helps relieve this. The bowel is suspected on ligaments and sometimes during the procedure, these can pull and this can cause some persisting discomfort for a day or two.

After an enema,  it will take a few days for your bowel to settle into its regular routine. Sometimes people who suffer chronic constipation feel much improved after an enema.

Your Gastroenterologist will have a conversation with you after the procedure and will discuss the findings. If further tests, procedures or discussions are thought necessary, you will be booked for a follow up appointment. If you need onward referral to another specialist we will arrange that.

If you have a fairly benign polyp or lesion removed, often you can follow up with you GP. Every Gastroenterologist has different approaches to follow up. You must not drive, return to work, drink alcohol, operate machinery, sign legal documents or use public transport unaccompanied until the following day. You should be escorted home by an adult and have someone with you at home until the following day.

Any questions? Call us on 02 4910 0591, or email us reception@beechnutmedical.com

Polypectomy is the procedure for removing polyps from the digestive tract. Normally polypectomy is performed for polyps in the colon during colonoscopy but polyps can form in other parts of the digestive tract including stomach and small bowel and sometimes require removal from these sites as well. Polypectomy is an important part of colonoscopy. Looking for polyps and removing them is one of the most common reasons for performing colonoscopy.

Polypectomy is performed with specialised equipment that allows your Gastroenterologist to safely remove the polyp from the lining of your bowel. This is usually performed with a loop of wire called a ‘snare’. Sometimes a small amount of electrical current is administered during polypectomy to assist the cutting and reduce the risk of bleeding after the procedure.

When polyps are detected during colonoscopy it is often possible to determine whether they are cancerous or pose a risk of becoming cancerous. However, the most accurate way to determine if a polyp poses a risk is to remove it and look at it under a microscope. For this reason, polyps are usually removed at the time of colonoscopy where it is safe to do so. This eliminates any risk of the polyp becoming cancerous in the future and also allows your doctor to determine how regularly you should be checked for polyps in the future.

Removing polyps is generally safe and a routine part of colonoscopy. There is a small risk of bleeding after polyp removal although usually the bleeding is minor and will settle without any particular treatment. People who take medications that increase the risk of bleeding are at higher risk of bleeding and may need to avoid taking these medications for up to a week after the removal of polyps. There is a very small risk of tearing of the bowel (perforation) during removal of polyps. The risk may be increased during removal of very large polyps and under some circumstances large polyps may be left so the risks of removal and the alternatives (surgery) can be fully discussed.

Any questions? Call us on 02 4910 0591, or email us reception@beechnutmedical.com

Some people who have difficulty swallowing have a narrowing of the oesophagus. This can be caused by chronic reflux disease, muscle spasm or previous oeosphageal injury from medication or ingested liquids.

To fix this, Gastroenterologists may perform Oesophageal Dilatation. This is a procedure for stretching the oesophagus (gullet) and there were various modalities which can be employed to do this including using a balloon which is inflated within the oesophagus or using a tapered rubber tube or bougie.

There are risks associated with all medical procedures. Oesophageal dilatation is generally considered safe, however there is the risk of perforation which is greater than that of a regular gastroscopy. It is important for you to tell the Gastroenterologist if you are taking any blood thinning medication such as:

• Warfarin
• Aspirin
• Clopidogrel
• Xarelto
• Eliquis
• Brilllinta

If there is a tear through the oesophagus, you may need to stay in hospital for a day or two for observation, an Xray or CT scan and antibiotics, as necessary. Sometimes surgery may be required to repair a tear in the oesophagus.

We take these risks very very seriously.

There are usually two stages of recovery. In the first stage, you be allowed to emerge from anaesthesia in a safe environment where you will be monitored constantly by recovery nurses.

When you are sufficiently awake, you will be moved to the second stage of recovery and offered a drink and sandwich.

The Gastroenterologist will come out at this time and discuss the findings of the procedure and what follow up may be required.

Depending on the outcome of the dilatation, your Gastroenterologist may want you to delay eating for some time.

If the dilatation was successful there may be some mild chest discomfort for a day or two.

Whether you are followed up by the Gastroenterologist or simply with your GP will depend on each Gastroenterologist and physicians have different ways of working.

It often is the case that you may need several sequential dilatations to achieve a good outcome, this is normal and you should not be alarmed if you are told you need several procedure to achieve the desired outcome.

You may need additional reflux treatment for a few weeks after the procedure to promote healing.

You must not drive, return to work, drink alcohol, operate machinery, sign legal documents or use public transport unaccompanied until the following day.

You should be escorted home by an adult and have someone with you at home until the following day.

Any questions? Call us on 02 4910 0591, or email us reception@beechnutmedical.com