Gastroscopy And Colonoscopy

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What is a Gastroscopy? 
A Gastroscopy is a procedure where a tube is inserted into the mouth, down the oesophagus, and into the stomach to view these organs. A local anaesthetic to numb your throat will be used, either as a spray or a gargle, and you will be given a strong, short acting sedative anaesthetic. You will feel drowsy during the procedure, and may not remember much about it afterwards. 

Why do l need a Gastroscopy?

A Gastroscopy is often recommended when you have symptoms of upper digestive problems. These may include problems such as indigestion, pain in the upper abdomen or vomiting of blood stained material among other symptoms. 

What can a Gastroscopy show?
- Reflux of acid from the stomach up into the gullet
- Oesophagitis or inflammation 
- Ulcers on the lining of the gullet, the stomach or the duodenum
- Cancer of the stomach
Sometimes your specialist will take a small sample of the tissue lining the walls of the digestive tract. This is called a biopsy. The biopsy sample will be sent to a pathology laboratory where it can be examined under the microscope to look for possible infection or abnormal cells. 

Are there any side effects or complications?
Complications from a Gastroscopy are very rare. Accidental tearing through the wall of the digestive tract has been reported in less than 0.01% of people having the test. Because of the procedure is done under local anaesthetic, the risks of heart or lung complications is also extremely rare - less than 0.05%. All risks should be discussed with you by your surgeon. 

Are there any special preparations before a Gastroscopy?
 You must have nothing to eat or drink for at least 6 hours before the Gastroscopy. A referral and valid appointment will need to be made prior. 

What happens after the test?
You may feel a little bloated after the test and need to belch. You are allowed to eat as normal afterwards.
If any of the following occurs within 24 hours alert your surgeon and attend the nearest hospital: 
- Severe or persistent chest pain or upper abdominal pain
- Vomiting of blood
- Persistent vomiting
- Passage of black bowel actions
- Persistent swelling of the abdomen
- High temperature (fever)

What is a colonoscopy?
A colonoscopy is a procedure that allows your specialist to look directly at the inside lining of the bowel by using a fine flexible telescope called an endoscope. The endoscope is passed through the anus into the rectum and along the length of the large bowel. 

Why have a colonoscopy?
As a screening test for people with a higher than normal risk of developing bowel (colorectal) cancer. It can also detect abnormalities in the bowel of people who have symptoms or signs of bowel disease, such as bleeding, pain or a recent change in bowel habits. 

Who is at a higher risk than normal of developing bowel cancer?
- Those people who have had a first degree relative (parent, brother, sister or child) with bowel cancer. If more than two close relatives have had bowel cancer the risk is even greater.
- Those people who have previously had bowel cancer. 
- Those people who have family members who have a history of familial polyposis, an inherited disease in which the polyps (mushroom like growths) develop along the lining of the bowel. 
- Those people who have had intensive ulcerative colitis for more than 10 years. 

In this situation, how often should a colonoscopy be done?
Your specialist will be the best one to advise you on this, but if your first colonoscopy was completely successful, a repeat colonoscopy every three to four years is suggested. If an abnormality is present, a colonoscopy may be advised more frequently. 

What is the risk of developing bowel cancer if I'm not in this high risk group?
Cancer of the large bowel is the most common internal cancer in Australia. It affects about 1 in 24 Australians and the risk increases after the age of 40. It is thought that bowel cancer takes some years to develop on the inside bowel wall. 

Should people with a normal risk of developing bowel cancer have a screening colonoscopy?
Although a colonoscopy is not necessary if you have none of the above risks and no symptoms of bowel disease, a simply screening test called a faecal occult blood test can be done. This is recommended for people over the age of 40 who have no symptoms of bowel disease. Your doctor will be able to advise you of this. 

If a first degree, relative suffered with bowel cancer, when should screening commence? 
Screening should generally start at the age of 40 years or ten years earlier than your relative who developed bowel cancer. 

Is a colonoscopy painful? 
Although you will not be under a general anaesthetic, you will be given a strong anaesthetic sedative and you are unlikely to remember much about the colonoscopy after it is over. 

Are there any complications?
Complications are rare. Accidental tearing through the wall of the bowel or bleeding, especially if a polyp is removed at the time of the colonoscopy, are all slight risks. However, they occur in less than 0.1% of cases. If haemorrhoids are also treated, it is usual to have some bleeding. 

Are there any special preparations before a colonoscopy?
As it is very important that the bowel is completely empty for a colonoscopy, you will need to be advised about what you can eat and drink before the test. You will also receive instructions about a special preparation you must drink to help empty the bowel. A valid referral and appointment is required for this procedure. 

What happens after the test? 
There may be some discomfort in the abdomen after the test. It normally doesn't last too long. If you have had a biopsy, haemorrhoids treated or polyps removed, there may be a small amount of blood passed in the toilet. You are allowed to eat as normal after the test, unless your doctor advises you otherwise. If the bleeding or discomfort is either severe or lasts over several hours you should go to the nearest hospital and contact your Surgeon. 

Aboriginal Torres Strait Islander Colonoscopy Fact Sheet 

Results for both these procedures will be sent to your referring GP and should be discussed with you by your Surgeon/Specialist.