Endoscopy is the process of looking inside body cavities, using a very tiny camera attached to the end of a long, flexible tube (endoscope). Images from the camera are sent to a television monitor so that the doctor can direct the movement of the endoscope. It is also possible to pass different instruments through the endoscope to allow small samples or growths to be removed. Endoscopy allows a doctor to make a diagnosis either by seeing directly what is causing the problem or by taking a small tissue sample for examination under a microscope (biopsy). Endoscopy can also be used as a treatment e.g. for removal of swallowed objects in the oesophagus (food pipe), healing of lesions etc.

A thin flexible tube is passed into the mouth, to the back of the throat and into the oesophagus. It is then passed down into the stomach and the first part of the small bowel. Carbon dioxide is put in through the gastroscope so that the lining of the oesophagus, stomach and small bowel can be inspected. Your endoscopist may apply a spray of local anaesthetic to the back of the throat before the procedure. This will make the back of your throat go numb, and the numbness means it may feel as though there is a lump there which requires clearing. May patients opt for sedation during their gastroscopy procedure. The aim is to help you become sleepy and relaxed, but not unconscious. The intravenous sedative medication works quickly and may have subtle effects for up to 24 hours. Interventions commonly undertaken during the procedure Biopsy A small piece of tissue is taken by forceps passed through the gastroscopy and can be sent to the laboratory for analysis. The lining of the oesophagus, stomach and small bowel is not pain sensitive, so biopsies are painless. Haemostatic procedures If there are abnormalities identified which are bleeding or look as though they may imminently bleed, procedures can be undertaken to stop the bleeding or reduce the risk of it occurring. The appropriate course of action will be chosen by your endoscopist during the procedure. Possible complications Complications from this procedure are very rare but can occur. They include: bleeding after a biopsy, if performed an allergic reaction to the sedative or throat spray perforation (tearing) of the stomach with the instrument (this is a serious but extremely rare complication). Before the procedure You will be asked not to eat anything from midnight the night before and not to take any of your medications on the day of the procedure. After the procedure For 24 hours after receiving sedation you should not drive a motor vehicle, operate machinery or potentially dangerous appliances, drink alcoholic beverages, make important decisions, or sign legal documents. If biopsies are taken these will be sent for analysis and results are available within 2-3 weeks. A report and copies of these are sent to your GP.

A flexible tube with a tiny video camera attached (endoscope) is inserted through the mouth into the stomach and small intestine while you are under sedation (medication to make you drowsy). A smaller tube is then moved through the first tube into the bile duct (the tube that connects your gallbladder to your intestines), or the pancreas duct, through which dye is injected and an x-ray is taken to visualise the ducts. This procedure enables the removal of stones from the ducts without the need for surgery and also allows for the placement of small drainage tubes (stents) to relieve a blockage in the bile ducts. Possible complications Possible complications include inflammation of the pancreas in 2-4% of patients, bleeding or perforation of the wall of the intestine.

A thin flexible tube is passed into the bottom and is steered to the point where the colon and small bowel meet. Carbon dioxide gas is put into the colon through the colonoscope so that the lining of the colon and small bowel can be inspected. Most patients opt for sedation and pain relief during their colonoscopy procedure. The aim is to help you become sleepy and relaxed, but not make you unconscious. The intravenous sedation and pain relief medication works quickly and may have subtle lasting effects for up to 24 hours. During the procedure there may be times where you feel discomfort in your abdomen. The endoscopy staff will monitor you closely and will try to make the procedure as comfortable for you as possible. Interventions commonly undertaken during the procedure Biopsy A small piece of tissue is taken by forceps passed through the colonoscope and can be sent to the laboratory for analysis. The lining of the colon is not pain-sensitive, so biopsies are painless. Polyp removal Polyps are small wart-like growths on the lining of the colon. Some polyps may, over a long period of time, grow larger and eventually develop into bowel cancers. If small polyps are identified and it is possible to remove them this will be done at the time of colonoscopy. Some larger polyps may not be suitable for removal – if this is the case they will be photographed, may be biopsied, and their location marked with a tattoo so that their safe removal can be planned for a later date. Possible complications Colonoscopy is generally a very safe procedure, though it carries a small risk of complications. Incomplete examination In most instances the entire colon is able to be examined at the time of colonoscopy, however in a small proportion this is not possible. If this is the case, there are other means by which the colon can be investigated. Arrangements for this will be made by the endoscopist. Perforation Inadvertently making a hole in the colon is rare, occurring in fewer than 1 of every 1000 diagnostic colonoscopy procedures. However, if it occurs it is a very serious complication and may require further procedures or even emergency operations to repair the perforation. Bleeding Minor bleeding occurs after every biopsy is taken, and every polyp removed. This usually settles without specific management. In the event that bleeding is severe or prolonged, a further procedure to stop it may be required. Before the procedure You will need to follow a special diet and take some laxatives (medicine to make you go to the toilet) over the days leading up to the test as the bowel needs to be completely clean for the procedure. After the procedure For 24 hours after receiving sedation you should not drive a motor vehicle, operate machinery or potentially dangerous appliances, drink alcoholic beverages, make important decisions, or sign legal documents. If biopsies are taken these will be sent for analysis and results are available within 2-3 weeks. A report and copies of these are sent to your GP.

A thin flexible tube is passed into the bottom and steered through the lower part of the colon. Carbon dioxide gas is put into the colon through the scope so that the lining of the colon can be inspected Most patients opt for sedation and pain relief during their flexible sigmoidoscopy procedure. The aim is to help you become sleepy and relaxed, but not to make you unconscious. The intravenous sedative and pain relief medication works quickly and may have subtle lasting effects for up to 24 hours. During the procedure there may be times where you feel discomfort in your abdomen. The endoscopy staff will be monitoring you closely and will try to make the procedure as comfortable for you as possible. Interventions commonly undertaken during the procedure Biopsy A small piece of tissue is taken by forceps passed through the scope and can be sent to the laboratory for analysis. The lining of the colon is not pain-sensitive, so biopsies are painless. Polyp removal Polyps are small wart-like growths on the lining of the colon. Some polyps may, over a long period of time, grow larger and eventually develop into bowel cancers. If small polyps are identified and it is possible to remove them this will be done at the time of flexible sigmoidoscopy. Some larger polyps may not be suitable for removal – if this is the case they will be photographed, may be biopsied, and their location marked with a tattoo so that their safe removal can be planned for a later date. Possible complications Flexible sigmoidoscopy is generally a very safe procedure, though it carries a small risk of complications. Perforation Inadvertently making a hole in the colon is rare, occurring in fewer than 1 of every 3000 diagnostic flexible sigmoidoscopy procedures. However, if it occurs it is a very serious complication and may require further procedures or even emergency operations to repair the perforation. Bleeding Minor bleeding occurs after every biopsy is taken, and every polyp removed. This usually settles without specific management. In the event that bleeding is severe or prolonged, a further procedure to stop it may be required. Before the procedure You will need to follow a special diet and take some laxatives (medicine to make you go to the toilet) over the days leading up to the test as the bowel needs to be completely clean for the procedure. After the procedure For 24 hours after receiving sedation you should not drive a motor vehicle, operate machinery or potentially dangerous appliances, drink alcoholic beverages, make important decisions, or sign legal documents. If biopsies are taken these will be sent for analysis and results are available within 2-3 weeks. A report and copies of these are sent to your GP.

A fibroScan is a non-invasive ultrasound scan of the liver that uses advanced ultrasound technology called transient elastography to measure liver stiffness. It is a quick and easy test that together allows you and your doctor to find out the state of your liver health.