What happens during a gastroscopy?

Before a gastroscopy, your doctor will tell you about the procedure, what it involves, and any associated risks. They will give you information about the mild sedatives or anesthetics you can be given to make the examination more comfortable. If you regularly use anticoagulants, you may need to stop taking them a few days before the gastroscopy. It is usually necessary to have an empty stomach so that the doctor gets a clearer view for the examination. That means that you shouldn't eat anything for six to eight hours before the gastroscopy, and you should drink only clear liquids such as water or tea for up to two hours beforehand. It is also important to wait for one to two hours after the exam to eat or drink anything, until the numbing effect in your throat wears off.

Before the procedure you will be asked to sign a consent form.

If you are given a sedative for the gastroscopy, you won't be allowed to drive a car or operate machinery for 12 to 24 hours afterwards. How long you need to wait depends on what type of sedative is used. Ideally, you should be picked up by someone or take a taxi home after the procedure. Some doctors insist that someone comes to pick you up and take you home afterwards.

Shortly before the gastroscopy, your mouth and throat will be numbed using a spray. Any removable dentures need to be taken out before the procedure. In Germany, the sedatives most commonly used for this purpose are called propofol and midazolam. They are injected into a vein and make you sleep for about half an hour. A gastroscopy generally lasts about 5 to 10 minutes. This is what happens during it:

• You will usually lie on your left side.
• A tube or a protective ring is put between your teeth so your mouth stays open and you don't bite down on the gastroscope.
• First you have to swallow so the gastroscope can enter your food pipe.
• Then it is slowly pushed into your stomach and down to the entrance of your small intestine (the duodenum).

Using the images provided by the camera on the gastroscope, your doctor can look for redness or inflammations in your food pipe and on the lining of your stomach and duodenum. Things like bleeding, varicose veins, unusually narrow passages and stomach ulcers can be seen on the screen too.

It is also possible to take tissue samples using small pincers that are inserted through the gastroscope tube. This is not painful. It is also possible to use the gastroscope to remove air and fluids by suction. Bleeding, unusually narrow passages, and certain medical conditions can be treated directly during the procedure.

Sometimes, the spray used to numb your mouth and throat can cause hoarseness or leave behind a numb sensation in your mouth. You might also feel full and have to burp for a short while if more air was pumped into your stomach to see more in the images. Complications like bleeding and injury to organs caused by the gastroscope are very rare. The same is true of complications caused by sedatives, such as breathing problems or cardiovascular problems.

Although sedatives only cause you to sleep for a short while, you may still have trouble concentrating and feel tired for several hours afterwards.