Patient Info: Gastroscopy Instructions

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For your convenience, these Gastroscopy (Upper Endoscopy) Instructions are also available as a Adobe PDF file. To view and print the PDF file, you can download the free Adobe Reader if you don't already have it, or if you want to upgrade to the latest version.

Please see Appointments below for important reasons why you should not miss or cancel your appointment without due notice. Also, please read the Precautions set out below.

Instructions

The stomach must be empty, so you should have nothing to eat for 12 hours before the procedure. Clear fluids (apple juice, white grape juice, flat ginger ale, clear soft drinks, water) may be taken up to 3 hours before the examination.

Endoscopy

An endoscope is a long flexible tube that is thinner than most food you swallow. It is passed through the mouth and back of the throat into the upper digestive tract and allows the physician to examine the lining of the esophagus, stomach, and duodenum (the first portion of the small intestine).

What You Should Expect

The tube will not interfere with your breathing. The procedure usually takes few minutes. If you are very anxious, you may request mild medication to help you relax. Major effects of the sedation wear off in about one hour.

What Happens After

If you receive a sedative, you will be kept in the recovery area until most of the effects of the medication have worn off. Even though you may not feel tired, your judgment and reflexes may not be normal. You will be able to resume your normal diet one-hour after the endoscopy, unless you are instructed otherwise.

Please note: You should not drive or operate a vehicle for six hours after receiving a sedative. Driving after receiving a sedative is illegal, and your auto insurance may not cover you in the event of an accident. You will need someone to take you home, or you should take a taxi.

Are There Any Complications?

Endoscopy is safe and is associated with very low risk when performed by physicians who have been trained and are experienced in this procedure. Complications can occur but are rare. Bleeding may occur from the site of biopsy or polyp removal. It is usually minimal but rarely may require transfusions or surgery.

If you have any questions about this procedure, please call our clinic.

Precautions

If you are on Coumadin (Warfarin), you must discontinue this medication 5 (five) days prior to the procedure. You should confirm with your doctor that it is safe to be off this medication.

Only if you are on Coumadin (Warfarin): you must have an INR test done before 12 noon on the day before your procedure and have the lab FAX the result directly to us at 416-597-2912 (Toronto) or 905-607-0013 (Oakville). Patients in the Ottawa region, please ask the lab to FAX the result to 613-216-1824.

If you have not received an INR requisition form, please contact us immediately so we can mail it to you. We must have your results before your procedure. To ensure that we have your result in time, do not book a Monday appointment or before 10:00 a.m. on other days, unless you are diabetic.

• If you are on Aspirin (including Bufferin, Novasen) discontinue the medication 10 days prior to your procedure. It may be restarted the next day if no biopsy was done. Otherwise, restart 3 days after the procedure (Note: No INR needed).
• If you take Plavix (clopidogrel), discontinue the medication 7 (seven) days before your procedure and restart the next day (or 3 days in case of biopsy). You should confirm with your doctor that it is safe to be off this medication.
• If you take iron supplementation, discontinue 5 days before the procedure.
• If you are on anti-inflammatory medications (Indocid, Motrin, Advil, etc.) these should be stopped the day prior to the procedure. Celebrex and Vioxx are alright to take.
• If you need to take medication for pain or headache, use plain Tylenol unless you are on chronic medication.

Other medications: Medications such as pills for blood pressure, thyroid, and cholesterol should be taken in the morning with sips of clear fluids.

Antibiotics should be taken if you have a history of endocarditis, artificial heart valves, or had a joint replacement in the last 6 months. Please obtain a prescription for the antibiotic from your family doctor and get it from your local pharmacy prior to the procedure.

Oral antibiotics should be taken 1 hour before the procedure. If the antibiotic is given intravenously, please bring the antibiotic to the clinic and advise us at the time of booking. In this case you need to arrive at the clinic 1-½ hours before your appointment time so that we can administer the antibiotic at the clinic prior to the procedure. (All other patients: please arrive 10-15 minutes before your scheduled appointment time.)

Diabetics: Please ensure that you are booked early in the day for your procedure.

• If you are on oral medication (pills) for control of your diabetes, only omit your morning dose on the day of the procedure.
• If you are on insulin, please discuss with your doctor about cutting the morning dose in half on the day of the procedure. You can take Ensure as a meal supplement.

Appointments

If you do not show for an appointment, the time is wasted and patients on our urgent waiting list will suffer. To avoid being billed $175 for a missed Gastroscopy appointment, which is not covered by OHIP, you must notify our clinic at least 3 business days before the date of the appointment.

Please use the form we have provided in our Appointments page to cancel an appointment.

Cancelling your appointment the day before your procedure does not give us a chance to prepare another patient. If you fail to show for your appointment, you cannot be rebooked until you have discussed the situation with our clinic. Rebooking a missed appointment requires the approval of our Clinic Administrator.

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