Normally, you will be asked to lie on your left side on an examining table. Your head will be on the pillow and you should be comfortable and looking straight ahead with your chin tucked in. The examiner will sit or stand before you. There are several techniques of endoscope introduction. The throat is tested with a gloved finger to ensure that the gagging reflex is satisfactorily subdued – it is seldom absent.
A mouthpiece with an aperture wide enough to permit passage of the endoscope is placed in between your teeth. The purpose of this is to protect your teeth, and incidentally to protect the instrument, which can be severely damaged, should you bite it.
The endoscope is then passed through the mouthpiece and gently brought up against your throat by the examiner’s finger. At this point you will be asked to swallow the tube. At first that seems to be a tall order! It is normal to gag, but the reflex usually settles once the tube is passed. It is also common for the first attempt at swallowing not to succeed. With the encouragement of the endoscopy nurse and perhaps some maneuvers by the endoscopist, the tube will pass.
It then remains for you to be patient while the doctor carefully examines the esophagus, stomach, and the first part of the duodenum. If a biopsy or other procedure is necessary, it may take a little longer.
The nurse will coach you on how to breathe. Regular breathing inhibits gagging and maintains good oxygen saturation. Overbreathing may cause you to feel dizzy.
The stomach is usually collapsed, so the examiner will pump a little air through the endoscope to inflate it. This may produce a feeling of fullness or discomfort and the urge to belch the air. If possible you should hold the air so the endoscopist can have a better view of the stomach and duodenum.
The gut itself is insensitive, so the test is usually painless. However, it may be uncomfortable and the tendency to gag is often annoying. The procedure is usually complete in 10 minutes, and the discomfort disappears once the instrument is removed.
If you are not sedated, the doctor can discuss the results of the test and the next steps in your care promptly. If you have been sedated, you will be asked to lie down in a bed in the recovery area where the nurse will monitor you until you are fully alert.
You should not drive or consume alcohol for 24 hours after.
If sedated, or if the laboratory results or a biopsy are awaited, it may be necessary to phone your doctor or schedule a visit for a full explanation of the test results.
It is normal to have a sore throat for a while after the test, but it is important to report any new chest or abdominal pain promptly, or go to the hospital’s emergency room.
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