Your doctor has proposed that you undergo a gastroscopy. If for some reason you are unable to make it on the suggested date, please contact the endoscopy department as soon as possible to reschedule your appointment. If your procedure takes place under sedation, please make sure there is someone available to accompany you home after the procedure. You are not allowed to drive home or operate any vehicle.

What is a gastroscopy?

During this procedure, the doctor examines the mucosa of the esophagus, stomach, and the

beginning of the small intestine, the duodenum. The doctor uses a flexible tube, an endoscope, with a camera on the tip. If necessary the doctor can decide to take small tissue samples (biopsies) using a special instrument. This will then be sent for further investigation.

What is the function of the stomach?

The stomach is part of the digestive system and plays an important role in the digestion of food. Food goes through the esophagus, past the esophageal sphincter, to the stomach. Under the influence of gastric juices, stomach acid and enzymes the muscles of the stomach wall contract to feed the food to the duodenum, where digestion continues.

What can we detect?

With a gastroscopy we are able to detect abnormalities such as inflammation, stomach ulcers and tumors. The doctor can take biopsies during the gastroscopy for further investigation. Your doctor will make arrangements for any follow-up investigations, if needed.

Preparation for the examination

We recommend that you leave any jewelry and valuable items at home so that they won’t get lost during the exam.

The procedure can only be performed when your esophagus and stomach are completely empty.

  • Examination before 12 noon: The day before the procedure you are allowed to eat until midnight. From midnight up to 2 hours before the procedure you are allowed to drink clear liquids, with a maximum of about 200 mL. Examples are water, clear fruit juice, coffee and tea without milk. Sugar is allowed.
  • Examination after 12 noon: You are allowed to have a light breakfast at least 6 hours before the procedure. This consists of a cup of tea without milk with a cracker/biscuit. Afterwards you are not allowed to eat anything, but are allowed to drink clear liquids (around 200 ml) until 2 hours before the procedure. Examples are water, clear fruit juice, coffee and tea without milk. Sugar is allowed.

Sedation

The procedure is typically performed under mild sedation. This means that a pain-killer and a sedative will be administered via an IV before the procedure. You can read more about this in the provided leaflet about ‘mild sedation’. Some people chose to undergo the procedure without any sedation. The possibilities will be discussed during your preliminary consultation. If you do choose to be sedated, it is required to bring someone who will be able to escort you home. You are not allowed to drive home or operate any vehicle.

Other medical conditions

  • Do you have any heart disease or disease of the blood vessels for which you are required to receive antibiotics before any procedure?
  • Are you currently receiving treatment against thrombosis or are you taking any blood thinning medication (anti-coagulants): Acenocoumarol (Sintrom® or Sintromitis®), clopidogrel (Plavix®), fenprocoumon (Marcoumar®), dipyridamole (Persantin®), rivaroxaban (Xarelto®), dabigatran (Praxada®), apixaban (Eliquis®) or carbasalate calcium (Ascal®)?
  • Do you have a blood clotting disorder?
  • Do you have diabetes (Diabetes Mellitus)?
  • Do you have a pacemaker or an ICD (internal defibrillator)?

Did you answer one or more of the previous questions with yes and have not yet discussed this with your doctor? Please contact the referring doctor to make possible adjustments to your therapy leading up to the procedure.

The gastroscopy

  • Please sign in at desk of the Endoscopy department at the time mentioned on your appointement letter. The location for the procedure is also mentioned on your appointment letter. Please look closely at this.
  • The nurse will pick you up from the waiting room and will take you to the treatment room.
  • You will be requested to place yourself on the bed.
  • You will receive a wristband stating your name, date of birth and patient number.
  • When the procedure takes place with sedation, the nurse will place an IV. In which case your vital signs will be monitored during the procedure. This includes blood pressure, heart rate and blood oxygen levels.
  • The doctor will explain the procedure once more and go through a final check of your credentials.
  • Before the examination, you will be given a drink that will reduce foam in the stomach for better visibility.
  • We will spray a local anesthetic in the throat to reduce your gag reflex. This will create a numbness in the throat and makes it harder to swallow.
  • You will be asked to lay on your left side.
  • If you have any dentures you will be asked to remove these.
  • You will receive a plastic ring between your teeth to protect them and the gastro scope.
  • The doctor will insert the gastro scope through the mouth in to the back of the throat where we will ask you to swallow. This is perceived by most people to be the least pleasant part of the examination.
  • It is important to remain calm and focus on your breathing.
  • During the procedure you can experience some discomfort. This is because air or carbon dioxide is used to inflate the esophagus and stomach for better visibility.
  • It is not possible to have someone present with you in the examination room.

Complications

A gastroscopy is a safe procedure. However, in some cases complications can arise such as, bleeding or a tear (perforation). Also, a respiratory infection or pneumonia can occur in the case of stomach content ending up in the lungs.

Because you undergo the procedure on an empty stomach, the risk of this happening is very small.

If complications occur, most of them occur during the examination and can be treated directly.

After the examination

  • After the examination, you will hear whether a follow-up appointment is necessary. We will send the results to your treating or attending physician.
  • After half an hour the local anesthetic in the throat will have worn off and you will be able to eat and drink normally.
  • If you did not receive any sedation you are allowed to return home immediately.
  • If you did receive sedation, you will be brought to our recovery room for observation. Here we will monitor your blood pressure, heart rate and blood oxygen levels for at least half an hour.
  • If all your vital signs are normal, you will be allowed to leave our recovery room and return home with someone who can escort you home! You are not allowed to drive home or operate any vehicle.
  • You will receive a letter which includes advice for at home.

At home

If you have had sedation, do not make important decisions on the day of the examination. Temporary forgetfulness may occur. If you develop severe stomach pain, loss of bright red blood or a high fever, you should contact the Endoscopy department. 

Questions?

Do you still have questions after reading this leaflet? Please contact our Endoscopy department.

Location VUmc: 020-4441125. Outdise office ours you can call 020-4444444 (telefooncentrale VUmc) Please ask for the Gastrointestinal doctor on duty. (Dutch: MDL arts)

With every visit to the Amsterdam UMC, please bring:

• A valid ID (passport, ID-card, driver’s license)

• A current overview of your medication

• A proof of insuranceA proof of insurance