Abdominal Endoscopy Experiences

Friends treat this urgent and important.

I have been abdominal pain for a week now. This has happened second time in less than a year. It is not getting controlled by meds.

The doctor has advised abdominal Endoscopy.

I am scared as I haven't undergone one till date.

Request you all to please describe your experience of the process. Beginning to end with details so that I can be prepared about

'What to.expect' that day.

Please reply. I am scheduled for the same over this weekend. Your replies will help me. As I will get different experiences to read from all of you

Thanks and waiting

You need to talk to your physician and his staff.

Are you asking about EGD, esophageal gastric duodenoscopy (upper GI) performed with an endoscope that is inserted through your mouth into your throat, to your stomach and into the first portion of your small intestine? Could you be asking about an exploratory abdominal laparoscopy?

If you are having an EGD, I have had so many of them. They are no big deal for me. They give me a bit of propofol and fentanyl. The first one I had was no big deal. My GI (gastroenterologist) takes a few biopsies, and does some stretching of my esophagus. I have never had any post procedure pain, bleeding, GERD issues. Occasionally, I have had a bit of hoarseness. I treat it with sucking on throat lozenges and increasing my water intake. I have not had one in a few years. My mom just had one. It was no big deal for her. It was done by my GI.

Best wishes. I am sure it will go very well.

On the other hand, if they're talking about an exploratory laperoscopy, that's real surgery - you'll be asleep. Please ask the doctor just what he's going to do.

Thanks for your replies.

I forgot to mention it is for upper GI

But one of y.ou mentioned tube n all....is it an OR procedure...with gown etc.... Will I be sedated with General Anesthesia?...that's scary then..

Have been lucky enough to never visit OR till now.

How long is the procedure generally?

I've had an upper G.I. scoping and it was nothing to fear. They give you an I.V. sedative, them spray the back of your throat with a numbing agent. This eliminates the gag reflex and the scope slips right down into your stomach.

Everyone has it right here. Assuming you're in a big city like Delhi, it is likely to go as described. I've had several of these and will have another in a month or so for GERD and Barrett's Esophagus. You might ask your doc, unless you already know, whether they plan an upper plus lower GI scope (colonoscopy) at the same time. This is what I have every time. Common practice here in the US is to give you sedation with Midazolam/Versed plus a narcotic (Demerol or Fentanyl). Depending on the patient, this often hits the borderline between "conscious sedation" and General Anesthesia. Sedation supposedly causes you to have little or no recall and minimal or no pain during the procedure. GA is much deeper sedation/Anesthesia than that, allowing for an otherwise intolerably painful procedure (e.g., laparoscopy or appendectomy). Most times, whether I'm giving or receiving the drugs, the patient is deeply enough sedated/asleep that you feel like you've been given GA but really have had sedation with no recollection. For me, I usually hear the doc say "okay, give him the medications/sedatives," and literally the next thing I know is that I'm waking up in the Recovery Room/PACU. If, by unlikely chance, you feel something during the procedure like movement or pressure, by all means tell the doc you're not fully asleep (though you're unlikely to care), but this is very unlikely. In other words, look forward to a nice nap and don't worry about it.

Just be sure to do exactly what they tell you for preparation. If you're only having the upper GI scope, it usually just involves eating/drinking only clear liquids for a day before and nothing after midnight. If you're having the colonoscopy also, then they need to give you the powerful laxative to clean you out from mouth to anus. Enemas not required but usually not a problem unless the doc says no enemas. Some docs feel enemas cause the colon to look slightly abnormal, but if they don't say anything about it then if you want to for fun or more cleaning, you can. Just use something very benign like salt water only. Write back if you have any other concerns, and good luck with your endoscopy.

Eric

Finally had my endoscopy two months back. Sharing with you all the experience of my first endoscopy. Actually it was almost certain to happen last year but somehow the pain got controlled with medicines and the idea of endoscopy was dropped.

But the pain recurred for the fourth time in July the year and has been there ever since. In August when the medicines dint work endoscopy was advised. It went almost exactly as I was told here. Thanks again for your experience sharing.

It was a surprise procedure for me. I wasn't prepared. I went in the morning to one Gastro for consultation, a new doctor. He did a complete abdominal exam and said that its better an endoscopy is done. So endoscopy was scheduled an hour later at 2 PM. I had taken breakfast at 8.30 so around 5.5 hours of gap was sufficient. The procedure was advised under anaesthesia. The procedure got delayed by 1 hour and I was called in at 3 PM.

I sat with 6 other people who were scheduled for endoscopy around the same time. The nurse first asked me about my last meal. Then she measured my BP which came to 120/80 and pulse which was measured at 72 BPM. Then she took a brief medical history after which I was asked to wait till the OR was ready for me.

15 minutes later I was called in by the nurse. I walked in. To my surprise I wasn't given any hospital gown. I was in my normal clothes only. First one of the persons present sprayed some bitter tasting liquid in my mouth and asked me to swallow it. Then I was asked to lie down on the bed on my left side. One nurse inserted a canula in my right hand and asked me to open my mouth. She inserted some plastic piece and asked me to hold it with my teeth. Then the anesthesiologist said, I am injecting anaesthesia now. You will sleep within two minutes. Meanwhile the doctor was ready with the scope. I kept my eyes open wide so that the doctor doesn't get confused about my state of sleep. He asked" Are you feeling sleepy" I sounded a no. "Just breathe deep and you will be fine" he added. The next minute I heard the anesthesiologist "Sir its done". That was the last words I heard and my eyes got closed.

The next thing I slightly remember is being lifted....maybe from the OR bed on to the stretcher. But when I regained bit of senses in the recovery area I realised that there was a blanket till my neck. What I didn't understand was why underneath the blanket my T-shirt was raised till my chest and my jeans were unbuttoned.

I was not in a position to ask I felt very dizzy with the effect of anaesthesia.Moreover I was concerned about the results. After 20 minutes when I was almost normal the doctor walked up to me and said a small polyp has been found but not removed as it is harmless. He prescribed the medicines and soon I was on the way home.

That day it didn't occur to me but now as I share this experience I feel why my T-shirt was raised and jeans were unbuttoned. Can anyone answer this please?

Actually the pain didn't subside with those medicines. Later a colonoscopy was also done. Will share that experience in separate post. Through colonoscopy IBD (Chron's Disease) was diagnosed in September. Oh Gosh what terrible pain I am in

Is it IBD or Crohn's Disease, which are very different illnesses? Why are you still in so much pain after being diagnosed ~2 months ago? What are you taking?

Eric

It is Crohns.

As far as I know IBD is of 2 types: Crohns and UC

M taking Pentasa (Mesalazine)

My education about Crohn's just got a real jolt. I have a young friend who sells for Jannsen Labs (Div. of J & J). They just released a new Rx drug for Crohn's. He was telling me that he calls on Children's Hosp here in Columbus and he sees little kids with Crohn's. In early childhood if Crohn's is diagnosed, it often will show up in the esophagus as ulcerations that makes it impossible for these little ones to take food P.O. Many have to have I.V. Hyperalimentation.

I didn't know that Crohn's caused ulcerations anywhere outside the sm. and lg. bowel. He was telling me that in adults, esophageal ulcerations don't happen often, but in very advanced cases, can show up in adults a well.

My understanding of I.B.D., Crohn's and UC is that these are an immune system problem. Like rheumatoid arthritis, the body's immune system reacts as if a foreign body has attacked the joints, bowel, etc. The body response is inflammation, swelling, fever and tons of white cells gathering at the site, allowing ulcerations to happen. Most of the newer medications suppress the immune system to get a handle on the process and tone-down the severity of immune response. Then, you face the problem of being subject to infections and viruses, etc. A terrible disease!

You are right Jimmy. Its terrible.

I was prescribed immunosuppresants along with Pentasa as Pentasa alone wasnt working well for my acute problem. The immunosuppressant caused decrease in platlets and I was down with severe cough cold fever and couldnt even breathe properly for a week. So the doctor had to stop it

Ahhh, nice example of talking past each other or about apples and oranges (or different types of apples). My reference in post #9 was using the common abbreviation IBD to refer to IRRITABLE Bowel Disease, NOT INFLAMMATORY Bowel Disease, which was confusing and misleading. Perhaps I need to limit irritable bowel to IBS, or Irritable Bowel Syndrome, which is a neurological disease of the bowel innervation causing cramps and also diarrhea or constipation. It is radically different from IBD, Inflammatory diseases which include Crohn's Disease and Ulcerative Colitis, caused by attack on the bowels leaving severe inflammation and ulcers, even in the esophagus. Sorry for the confusion. As I posted elsewhere, IBS as far as I know receives no benefit except enjoyment or constipation relief from enemas. Again, other docs with more GI training are invited to contribute further detail on these disorders.

Eric

Once I climbed onto the table I was knocked out and don't remember anything about it.

This is an account of an upper endoscopy I underwent yesterday. I hope you enjoy it.

A couple of weeks ago my GP suggested I undergo an upper endoscopy. I had been having recurring issues with GERD which calmed down with medication, but returned instantly when I stopped.

I was quite apprehensive about undergoing the exam, and my GP wasn’t very helpful in giving any additional information. After a few weeks I finally mustered the courage to make an appointment for the endoscopy. I chose to go to a private clinic which was open on a Saturday so that I didn’t have to take time off work.

I woke up on Saturday morning, already exhausted from the short night I had and stomach grumbling from fasting since the previous evening. When making the appointment, I had been given the choice between local anesthetic or “to be asleep”. As I didn’t think I would make it through an entire exam with just a spray in my throat, I opted for the second option. In all honesty I did not think I would truly be asleep during the exam, since there was no pre op visit with an anesthetist or questionnaire to fill in. I had also been told I could return home unaccompanied. I guess I expected some form of light sedation.

To my surprise, when I arrived at the clinic I was asked to fill in a form for the anesthetist, which did nothing to help my nerves. After filling in the form I was sent to a waiting room. As I took in the drab dark green decoration and concrete floors, I started wondering what the difference was supposed to be from a normal public hospital. The only other person in the room was an older gentleman, who occasionally interrupted the deafening silence to clear his throat loudly.

After waiting for about 20 minutes the nurse came in and called my name. I was led to an exam room where I could already see some equipment set up. She led me to the back of the room where there was a screen to undress. Having had no information regarding the exam, I had no idea whether I would have to put on a gown or could stay in my own clothes. Luckily, I was only asked to take off my shoes and leave my coat and handbag on a chair. A few minutes later a handsome dark man in scrubs entered the room. He introduced himself as the anesthetist and asked me to lay down on the gurney which had just been wheeled in. I should mention I am short (5 foot 1), so I knew there was no way I could get on that gurney without any assistance. The anesthetist understood my dilemma, and provided me with a step.

Once I was on the gurney, I felt vulnerable as I could not see much of what was going on around me. The anesthetist asked me to lift up my sleeve so that I could look for veins. He tied a tourniquet around my arm and asked me to make a fist. After tapping a bit he seemed to find what he needed. I am quite ok with needles since I a regular blood donor, however I like to see and know what is happening, and in this situation neither of these was possible. The next thing I know he was disinfecting my hand with alcohol and warning me of a sharp scratch, turns out the IV was going in my hand and not in my arm as I had expected. The nurse had also put an oxygen tube in my nose, along with a pulse oximeter. I must have had a rapid pulse because she immediately asked me why I was stressed. To be fair I had been feeling relatively calm compared to my usual panic when being around doctors.

Next the gastroenterologist performing the exam came into the room. He seemed a bit confused, asking me about a prescription I had supposedly received, and then realizing he was confusing me for another patient. I did briefly wonder whether they were actually planning to do the right exam or if I would wake up with a sore butt. I didn’t have much time to think though, because I was asked to lay on my left side. The anesthetist inserted a bite block in my mouth and told me this was necessary for the procedure. Then he said he would start inserting the medicine and it would feel a bit warm. From then on all I remember is feeling ringing in my ears and everything going black.

I woke up from what felt like an amazing nap to someone shaking me. All the monitoring equipment and oxygen had been removed, and I had an aftertaste of medicine in my throat. The anesthetist told me that the exam was done, I tried to sit up but felt like my head weighed a ton. I was brought my bag and coat and snoozed on the gurney for a few minutes. After 10 minutes the anesthetist asked me whether I could try sitting up with his help. I sat up with much difficulty, and my predicament seemed to amuse the anesthetist. I got help putting on my shoes and was led to another room to recover further.

After some time I got seen by the gastroenterologist who told me everything looked fine, and advised some diet changes. I no longer felt groggy and was able to go home on my own (public transport). Now I’m just waiting to get the biopsy results in about a week.

In the UK , when undergoing a gastroscopy, a procedure where a thin, flexible tube called an endoscope is used to look inside the oesophagus (gullet), stomach and first part of the small intestine (duodenum). It is sometimes called an "upper".

We offer either no sedation with throat spray ( Xylocaine Spray which contains lidocaine a local anaesthetic) or conscious sedation with or without throat spray.

Conscious sedation is a combination of medicines to help you relax (a sedative) and to block pain (an anesthetic) during a medical. We normally used midazolam ( Versed) up to 5 mg and either Fentanyl ( up to 100 mcg) or Pethidine ( Demerol) up to 100 mg. If you are having conscious sedation then you must have an escort to take you home and look after you for the next 24 hrs. You can't drive or go to work during this period .

If using the throat spray , you will be asked to hold your breath as it is spray into the back of your mouth and then swallow , it has a banana flavouring according to some people caused by the presence of propylene glycol. When used in the mouth and throat it causes a loss of feeling. This makes it more likely that food or liquid may go down the wrong way.

Also, this may make it difficult to swallow or cause some people to accidentally bite their tongue or cheek. Some patients also feel that they can't breathe so reassurance is need . We normally say you can breathe via your nose or mouth and this feeling means that the spray is working. As a result of having the spray , you have to be nil by mouth for 1 hr post application of the spray. then start with sips of cold water, if you swallow normally ( no coughing or spluttering ) then eat and drink as normal, if you cough or splutter then waiting another 1/2 hr and try again . About 99% of patient are fine after the 1 hr period.

We always use a bite block , but this is inserted into your mouth after the throat spray but before you are given the conscious sedation. As if you are sedated you will not usually open your mouth to fit the bite block .

Before the sedation you are also place onto your left side for the procedure as well as having nasal specs for oxygen . The procedure takes about 10 to 20 mins for start to finish. During which the gastroenterologist introduces the gastroscope into your oesophagus (gullet), stomach and first part of the small intestine (duodenum). They normally take a few biopsies as well as test for helicobacter pylori ( a bacteria ) which can cause gastritis ( lining of the stomach becomes inflamed) and ulcers.

Some patients report feeling like they are intoxicated from the sedation , but otherwise ok .