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GASTROSCOPY"Gastroscopy" refers to the passing of a flexible tube, about 1 metre long and 10 mm. wide, through the mouth in to the oesophagus (gullet), stomach and duodenum (the upper part of the small bowel). This tube contains optical fibres or a video camera, so I can see through this a magnified image of the inside of these parts of the body. This enables a diagnosis of such things as ulcers, cancers, or scarring, which can cause a variety of symptoms. Prior to the test, you must have fasted completely (no food or drink) for at least 6 hours: this makes the stomach empty, and enables complete visualisation of the interior. It is important to take your regular medication, with a sip of water, during the fasting period. At the time of the procedure, you will be lying on your left side on a trolley, supported by a pillow, and the throat sprayed with a solution to make it numb. A specialist anaesthetist will administer some very short-acting sedative drugs in to a vein, and then the examination will begin. The entire test usually takes less than ten minutes, and most people have little memory of the event. After the procedure, as the throat is numb, I advise against eating or drinking for about an hour. Usually, with the effect of the sedatives, most people are sleepy for at least that long anyway. After that time, you may go home, but you must be escorted. You must not drive a car until the following day, and the rest of the day must be taken off work. A full report will be sent to your doctor in the mail. Anything requiring urgent therapy or action will be communicated to your doctor on the day of the test. There are potential hazards to this procedure, as in any test involving the use of sedatives and the examination of the interior of the body. Like similar procedures,this may include the potential for death. The overall risk is in reality very small, including such things as vomiting, pain and bleeding, the last of which could require surgery. A mouthguard is used to minimise the possible risk of dental damage. If at any time you have any questions regarding this procedure, please ask. I shall answer as completely as possible. If you have any questions about the above procedure, please contact us.
COLONOSCOPYTHE PROCEDURE“Colonoscopy” refers to the passing of a flexible plastic tube through the anus into the colon (large bowel) and through to the lower part of the small bowel. This enables the doctor to diagnose cancers, polyps, colitis and diverticular disease.
THE BOWEL PREPARATION
Note: If you take the oral contraceptive pill, you must use additional barrier methods until the next period, as the pill’s absorption is affected by diarrhoea. POST-PROCEDUREAfter the test you will be sleepy for at least one hour. Once you awaken you will be given some light refreshment. If you feel well you will be able to go home within one to two hours. You must be escorted. The sedative drugs impair judgement, so you must not drive a car until the next day; the entire day must be taken off work. POTENTIAL COMPLICATIONS There are potential hazards to this procedure including the potential for death. The overall risk is very small. It includes such things as vomiting, pain and perforation (bursting) of the colon. Perforation occurs very rarely (about 1 in 1000) cases. If it occurs you would require surgery within 24-48 hours and would likely recover in hospital over 7-10 days. If at any time you have any questions regarding the colonoscopy, please ask. We shall answer as completely as possible. Please inform us if you have any pain, fever or vomiting in the 24 to 48 hours following colonoscopy. If you have any questions about the above procedure, please contact us.
ERCP/SPINCTEROTOMY(Endoscopic retrograde cholangiopancreatography) isused in the diagnosis of disorders of the pancreas, bileduct, liver and gall bladder. The doctor passes an endoscope (a thin flexible telescope) through your mouth, to inspect your stomach and duodenum. The doctor then injects contrast dye into the drainage hole (papilla) from the bile ducts and pancreas, to take detailed xrays (you should inform us if there is any possibility of pregnancy). SPECIAL CONSIDERATIONSX-rays are used as part of this procedure. It is therefore essential for women that there is no possibility of pregnancy. You should tell the hospital staff before the procedure if you have any doubt about this. It is desirable that you are not taking aspirin or arthritis tablets. If you are on these medications you should discuss the matter with Dr. Noack. You should also inform Dr. Noack if you are taking blood thinning tablets, have heart valve disease or have a pacemaker implanted. To prepare for this procedure please make sure that you fast for 6 hours(no food or drink)prior to the procedure. WHAT WILL HAPPEN?The doctor and the nurse will explain the procedure, and answer your questions. Please tell them if you have had any other endoscopy examinations, or any allergies or bad reactions to medications or contrast dye. You will be asked to sign a consent form giving permission for the procedure, to put on a hospital gown and remove eye glasses, contact lenses or dentures. A Specialist Anaesthetist, will take a short history and examination prior to your procedure. They will provide sedation to make you very relaxed and comfortable for the procedure. The examination is performed on an x-ray table. With you in a comfortable position on your leftside, the doctor will pass the endoscope down your throat. A guard will be placed to protect your teeth. The endoscope will not interfere with your breathing and will not cause any pain. You may be asked to change positions during the examination which takes 15 - 60 minutes. AFTERWARDSYour throat may feel slightly sore. Because of the sedation you should not attempt to take anything by mouth for at least 1 hour. If you are an out-patient you will remain in the clinic area for at least 1 hour. A companion must be able to drive you home as the sedation impairs your reflexes and judgement. For the remainder of the day you should not drive a car, operate machinery or make any important decisions. We suggest that you rest quietly. RISKSEndoscopy can result in complications, such as reactions to medication, perforation of the intestine and bleeding. The risk of dental damage is minimised by using a mouthguard. Injection of contrast dye through the endoscope can cause allergic reactions, inflammation of the pancreas (pancreatitis) and of the bile duct (cholangitis). These complications are rare but may require urgent treatment, and even an operation. Be sure to inform us if you have any pain, fever or vomiting in the 24 hours after ERCP. If you have any questions about the above procedure, please contact us.
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