Гастроскопия (ФГС) во сне – «ФГС под наркозом – лучшее, что случилось со мной в больничных стенах »

Не так давно у меня резко прихватило в районе правого подреберья. Так резко, что утром я еще была полна замыслов относительно ближайшего грядущего, а в обед уже расхаживала в скрюченной позе и строила планы на загробную жизнь. Первые мысли были о печени. Должна же она когда-то крякнуться от той тонны медикаментов, которую приходится пить чуть ли не ежедневно. УЗИ печени, желчного, а заодно и поджелудочной не выявили никаких отклонений и тревожных “звоночков”. А значит остался один из самых труднодоступных с точки зрения исследования органов – желудок.

Трижды клятое ФГС за жизнь я проходила дважды и поняла одно: больше я этого делать не буду. По крайней мере, без наркоза. Первый раз с этой процедурой мне повезло, но вторая вытравила всю смелость и отвагу.

Поискала в Воронеже, где можно проделать ФГС под общей анестезией и остановилась на нашем Диагностическом центре (том, что на Кирова). Во-первых, меня устраивало его расположение. Во-вторых, по отзывам там работают опытные медики. Но тут надо учитывать еще пару моментов. Цены в этом центре всегда выше средней температуры по больнице, а сервис остался на уровне “совка” с длинным очередями и хамством. Ну да фиг с ним.

В Диагностический я пришла утром на пустое брюхо, уверенная, что вот прямо сейчас и глотну во сне эту жуткую трубку. Но оказалось, что не все так просто. Для доступа к ФГС под наркозом требуется консультация анестезиолога. Первая консультация оказалась бесплатной. Ты просто поднимаешься на нужный этаж, находишь указанный в листочке кабинет, отсиживаешь длииииинную очередь и получаешь дальнейшие инструкции от профильного врача.

Чтобы получить “зеленый свет” на наркоз нам потребуется: кардиограмма, общий анализ крови (свежие) и заключение анестезиолога на основании этих исследований.

Так же эскулап собирает анамнез, интересуется хроническими болячками, аллергией на препараты, измеряет давление, осматривает вены, оценивая перспективы быстрого ввода препарата. Кста, я так и не поинтересовалась, что именно будут вводить, но по неподтвержденным данным усыпляют всех единым средством – пропофолом.

Вообще, мой доктор дико удивился, что я хочу проделать под наркозом именно ФГС. Таких неженок на его памяти было немного. В основном народ предпочитает делать под наркозом аналогичную процедуру с другого входа. Ну что ж… Дойдет очередь и до этого когда-нибудь)

Кардиограмму и анализ крови можно сдавать в любом месте, главное, чтоб они были не старше 10 дней на момент проведения исследования.

Так вышло, что моя ЭКГ-шка равно как и общий ОАК оказались очень не очень. Закралась мысль, что пошлют меня далеко и надолго, но – нет. Анестезиолог повздыхал, поохал и дал добро на проведение процедуры.

Итак, день Х. Идем в регистратуру и оплачиваем “удовольствие”. С моей колокольни бюджетника-нищеброда платим мы прилично, но что ж поделать. Комфорт того стоит.

Меня проводили до нужной двери и попросили подождать. Сижу, луплю глазами по сторонам, осмысливаю цитату напротив палаты.

Надеюсь, вот это вот “про силы” не относится к неуверенным в себе эскулапам. Черт. Мимо протопал парад ординаторов. Завернул в мою палату. Видимо, относится) Удачи вам, парни.

Довольно скоро меня позвали внутрь. Попадаю в большое помещение, поделенное на сектора больничными занавесками. В каждом секторе тумбочка и кровать. Это и станет нашей “палатой”.

Какая-то женщина приносит одноразовые тапки. Один тут же рвется. Приносит новый. Тапки огромные. В длину еще туда-сюда, а в ширину размером с толковый словарь.

Она же объясняет, что надо снять водолазку и бюстгальтер. Майку можно оставить.

Мимо прогромыхала каталка. Мою соседку-бабулечку повезли на колоноскопию. Следующая я.

Можно отдернуть занавеску и посмотреть, как там у других.

“Палата” соседки оказалась больше и с окном) Ну и ладно)

К слову, про “совок” и все такое. Весь персонал оказался весьма дружелюбным. Санитарка помогла понадежнее заныкать мобильник (мало ли что), показала туалет, взбила подушку, подоткнула со всех сторон одеяло. Лежу, точно “куколка”, считаю минуты.

Слышу, как еще в каком-то секторе приводят в чувство дядечку. Мол, пора просыпаться. Кажется, хлопают по щекам. Не нравится мне это.

Немного страшно. Коллеги по работе предупредили, что наркоз отходит ужасно. Многих тошнит, рвет. Потом весь день будешь ходить как пьяная и не соображать. А я, вообще-то, собираюсь через час на работу) Ну посмотрим)

Каталка прогромыхала в обратном направлении. Пришла моя очередь. До процедурной (или как там это называется) надо топать ноженьками. В казенных тапках. Тапки все время слетают с ноги, сопровождающая санитарка хохочет.

На стол укладывают сразу в нужной позе эмбриона: на бок, ноги к груди. Тапки окончательно куда-то улетучиваются. Прощайте.

Анестезиолог (не тот, кто давал зеленый свет на исследование) сразу начинает шебуршить с венами и ловко ставит капельницу. Свои действия не комментирует, о препарате нет говорит. Я грешным делом подумала что это и есть наркоз, но когда через минуту сознание так и не покинуло, сообразила , что это обычный физраствор. Такую же манипуляцию проделывали во время родов. Ну просто для того, чтоб в нужный момент не мучить вену, а перекрыть одно лекарство и ввести другое.

Приходит…эх, как бы мне хотелось сказать “доктор”, но нет. Приходит мальчишка с толпой таких же мальчишек и девчонок, только-только миновавших порог пубертата. При плохом раскладе этот хлопчик мог бы быть моим сыном. С надеждой смотрю на бейдж. Хоть бы медбрат, хоть бы медбрат. Нет, это и есть мой врач. Ну ладно. Ставь опыты, сынок. Набивай руку)

Мальчик интересуется жалобами, кто направил, хроническими болячками. Я объясняю, что наверное у меня метастазы. Ну потому что сильно болит, а я – параноик. Говорю, что не приемлю никаких прелюдий и после процедуры (как только приду в сознание), сразу хочу знать диагноз. Сразу! Без этих ваших “сейчас все лечится”, “за вами есть кому ухаживать?”, “попробуйте экспериментальное средство”. Мальчишка заливается смехом. Похоже всем, кроме меня, весело.

Наконец, в рот вставляют ту штуку с дыркой, через которую в вас будут засовывать трубку, анестезиолог пускает по вене лекарство. Я напрягаюсь. В голову приходит мысль, что похоже, лекарство меня не берет и тут мир исчезает. И я исчезаю.

Через секунду слышу, как меня везут на каталке в “палату”. На кровать перескакиваю сама. Самочувствие хорошее. Буквально за 3 минуты прихожу в себя, тут же встаю в туалет (Правда, мне сказали, чтоб лежала полчаса, но моему мочевому пузырю есть что на это возразить).

Возвращаюсь в палату. Рука замотана в 3 слоя пластыря.

По коридору несется мой напуганный мальчишка. Напуганный мною.

– Все хорошо, не волнуйтесь!

Прекрасный юноша. Надеюсь, из него получится отличный врач. Правда, “все хорошо” – это означает абзац с труднопроизносимыми словами типа “эзофагит”, что-то там про кардиальную розетку, “дуоденит”. Но все это фигня, когда ты нафантазировала самое плохое.

В памятке было сказано, что нельзя покидать больничный покой без разрешения анестезиолога, но санитарка заговорщицки подмигнула и сказала:

– Беги, детка.

Это глупо, Правда, глупо. Но осознав, что умирать в ближайшие дни не придется, я наплевала на безопасность и помчала на работу.

Подведем итог:

– В моем случае наркоз не вызвал никаких последствий. Голова не болела, не тошнило, балбеска соображала в обычном режиме (не очень резво, но анестезия тут не при чем).

– Не болело горло. По отзывам у многих после ФГС саднит в этом месте, возможно, из-за неудачного ввода трубки. У меня все было отлично.

– Быстро. От момента прихода в процедурную, до возвращения в палату прошло минут 20, включая те 10, когда врач проводил опрос. А еще через полчаса я уже неслась приносить пользу социуму.

Из минусов.

– Дорого. Но я нисколько не жалею о потраченном бабле. Нервы дороже.

Да, еще. После ФГС в течение часа нельзя есть и пить. Не знаю, почему. Просто нельзя.

Конечно же, рекомендую. Быстро, классно, весело, много приятных знакомств)

как делают и стоит ли?

Гастроскопия под наркозом − вариант процедуры, при котором пациент становится объектом исследования, а его сознание и даже некоторые физиологические функции отключены.

Это не «гастроскопия во сне», которую можно сравнить с глубокой дремой. Наркоз делает процедуру более рискованной, однако в некоторых случаях риск оправдан и даже необходим.

Особенности и разновидности гастроскопии

Исследование пищевода, желудка и двенадцатиперстной кишки позволяет поставить точный диагноз и спланировать лечение.

Такова цель одной из разновидностей эндоскопии, гастроскопии или эзофагогастродуоденоскопии (ЭГДС) − исследования полых внутренних органов, в том числе желудка, с помощью эндоскопа.

Это прибор с длинным, тонким, гибким шлангом и оптической системой. Эндоскоп вводится через естественные отверстия: задний проход (колоноскопия), слуховой проход (отоскопия), рот и пищевод (гастроскопия) и другие.

Фото:

Гастроскопия − способ изучить состояние пищевода, внутренней поверхности желудка и двенадцатиперстной кишки.

Диагностика происходит как во время процедуры, поскольку врач видит изображение с камеры на экране, а также позволяет изучить видео процедуры позже, если у врача возникнет подозрение, что он что-то упустил при осмотре желудка в режиме реального времени.

Гастроскопия и колоноскопия открывают дополнительные диагностические возможности, позволяя взять соскоб или биопсию тканей.

Все шире распространяется эндоскопическая хирургия, когда при помощи эндоскопа удаляют инородное тело, небольшой полип или опухоль.

Врач может даже прижечь сосуд, кровоточащий в желудке, пищеводе или кишечнике.

Любое российское отделение гастроэнтерологии или медицинское учреждение, в котором есть кабинет гастроэнтеролога, должны быть оснащены двумя гастроскопами с наборами для биопсии.

Такое постановление показывает, какое значение государство придает своевременной диагностике заболеваний желудка.

Существует три разновидности гастроскопии. Классическая проводится без седации, однако возможна местная анестезия горла.

Фото:

Процедура предполагает сотрудничество врача и пациента, специалист должен чувствовать обследуемого, соизмерять свои действия с ритмом его дыхания, понимать, где нужно действовать быстро, а где замедлиться, чтобы дать отдышаться.

В свою очередь пациент должен быть готов к неприятным ощущениям, чтобы избежать психологического стресса.

Седация во время гастроскопии обеспечивает пациенту комфорт, не подвергая его риску. Перед процедурой анестезиолог вводит седативное средство, которое погружает пациента в глубокую дремоту.

После процедуры он довольно быстро возвращается к привычным занятиям и может покинуть клинику в течение часа.

Гастроскопия с общим наркозом используется гораздо реже и предназначена для исключительных случаев: при экстренных показаниях или риске попадания содержимого желудка в дыхательные пути.

Наркоз погружает человека в глубокое бессознательное состояние, поэтому следящая аппаратура контролирует его самочувствие, а дыхательные приборы вентилируют легкие.

Обычно приходится поддерживать проходимость дыхательных путей с помощью набора для интубации или ларингеальной маски.

Гастроскопия: классическая или с седацией?

Обычно исследование желудка, пищевода и двенадцатиперстной кишки с помощью гастроскопии проводится в амбулаторных условиях, но может проходить в условиях стационара, когда у пациента в тяжелом состоянии нет диагноза.

В первом случае исследование поводится либо в классическом виде − без седации, но с обезболиванием корня языка и пищевода, либо с седацией.

Седативные средства в последнее время все шире используют при эндоскопических исследованиях, таких как гастроскопия, гистероскопия, колоноскопия.

Видео:

Как правило, без необходимости врачи стараются наркоз не использовать. Во-первых, это позволяет избежать осложнений, во-вторых, врач не может наблюдать за состоянием пациента, как при классическом варианте проведения процедуры.

Классическая гастроскопия имеет ряд преимуществ:

• врач чувствует пациента, по его реакции отслеживает состояние дыхательной и сердечно-сосудистой системы, соответственно, может быстро отреагировать, если что-то не так;
• реакция пациента покажет возможную перфорацию быстрее, чем врач увидит ее на мониторах;
• не нужно задействовать анестезиолога;
• седация создает лишнюю нагрузку на организм;
• по окончании процедуры пациент сразу может уйти из клиники.

Однако отзывы людей, которые прошли через классическое исследование желудка, однозначны: если есть возможность седации, ею нужно воспользоваться.

Даже колоноскопия вызывает не такое сильное отторжение, как исследование желудка с помощью зонда.

Недостатки гастроскопии без седации:

• далеко не все врачи чувствуют пациентов настолько, чтобы подстраиваться под их дыхание и своими действиями облегчать их мучения;
• состояние, при котором человек не может сглотнуть слюну, произнести хоть слово и постоянно чувствует рвотные позывы, вызывает сильную панику;
• даже после местного обезболивания в горле першит до конца дня, а иногда – несколько дней;
• психологический стресс мешает решиться обследоваться, поэтому есть риск упустить время и дать болезни фору;
• в очень редких случаях зарегистрированы психические нарушения у детей после гастроскопического исследования.

Соотношение плюсов и минусов исследования с седацией привело к ее все более широкому распространению.

Большинство врачей признают, что недостатки седации − необходимое зло, поскольку преимуществ больше. Гастроскопия с седацией и гастроскопия под наркозом − это две разные процедуры.

Нужно ли бояться наркоза?

Отзывы пациентов показывают склонность впадать в две крайности по отношению к наркозу. Одни принимают решение по принципу «я не хочу ничего чувствовать».

Такие люди во что бы то ни стало избегают любого дискомфорта, боли, неприятных психологических переживаний, особенно если речь идет о таких болезненных процедурах, как колоноскопия или гастроскопия.

Другие, наоборот, верят любым мифам, которых вокруг наркоза немало, и готовы терпеть, лишь бы не подвергаться опасностям, часто надуманным.

Видео:

Собранные в статистику отзывы анестезиологов показывают: осложнениями чреват один случай наркоза из 250 тысяч. Это количество во много раз меньше, чем число пострадавших в автомобильных авариях.

Тем не менее, люди, которые не боятся улиц и автомобилей, часто пугаются наркоза.

Реакция на анестезию зависит от множества индивидуальных факторов, причины которых не только физиологического характера.

Отзывы многих анестезиологов свидетельствуют, что реакция на наркоз зависит также от психики. По словам выдающегося канадского врача Уильяма Ослера, если бы люди были одинаковы, медицина стала бы наукой, а не оставалась искусством.

Искусный врач умеет разделять ситуации, когда без наркоза не обойтись, от тех, где от него можно отказаться, а также сумеет правильно выбрать препарат.

Гастроскопия, как и колоноскопия − это процедуры, при которых в большинстве случаев можно и нужно обойтись без общего наркоза.

Еще одна сложность заключается в честности пациента, поскольку на выбор анестезии влияют вредные привычки, возможные аллергические реакции, прошлые травмы и заболевания и другие факторы.

Пациент может солгать, чтобы выглядеть лучше, не зная, какой опасной может оказаться ложь для здоровья, а может не знать или забыть о чем-то, что окажется важным при использовании наркоза.

Это свидетельствует о том, насколько сложной, ответственной и, к сожалению, часто недооцененной является работа анестезиолога.

Эндоскопия (колоноскопия, гастроскопия) под наркозом противопоказана при многих состояниях организма.

Речь идет о любой дыхательной или сердечной недостаточности, некоторых особенностях строения пищевода или прямой кишки, недостаточной кардии желудка, ожирении, сильных аллергических реакциях, значительном варикозном расширении вен в пищеводе и так далее.

К сожалению, в России весьма распространена ситуация, когда пациенты не доверяют врачам, причем нередко обоснованно.

Видео:

Время патерналистской медицины прошло, когда пациент не нес никакой ответственности за свое здоровье, не имел права на всю информацию о собственном состоянии, а все решения за него принимал врач.

Сегодня, по примеру стран с развитой медициной, у российских пациентов все больше прав относительно собственного организма и здоровья. Однако, как это часто бывает, свои права пока что приходится отстаивать.

Мудрый пациент, которому предстоит гастроскопия или колоноскопия, обязательно прислушается к рекомендациям врача относительно наркоза, постарается узнать несколько мнений и на их основании примет взвешенное решение, основанное на доводах, а не эмоциях.

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90000 Gastroscopy: is it painful to do, indications, types 90001 90002 Gastroscopy is carried out in a special room. The patient needs to lie on his side. Preliminary treatment of the throat by local anesthetics is carried out. Often used a solution of lidocaine in the form of a spray. The throat is irrigated, while the gag reflex is reduced, and painful sensations are eliminated. This also makes it possible to relax the muscles, so that the probe will swallow freely without injuring the walls of the organs.Often used sedation. This is a procedure in which the patient is administered various sedative and anesthetics, which greatly facilitate the procedure. In some cases, general anesthesia is carried out. In this case, an injection is made, most often intravenously. 90003 90002 After preliminary preparation is carried out, the patient is laid, the patient is given a mouthpiece, which must be clamped in the teeth. It prevents damage to the teeth and lips, prevents the bite of the gastroscope. The gastroscope is slowly injected into the throat, then promotes into the esophagus.At this time, the gag reflex inevitably arises, the patient should breathe deeply and calmly. Then air is fed through the device, which makes it possible to straighten the walls. The examination of the mucous membranes, walls, cavities. The esophagus, the stomach, the upper part of the duodenum are examined. If necessary, a biopsy, therapeutic effects. Many modern gastroscopes make it possible to visualize the image on the screen, to make photo and video. After the examination and the necessary manipulations, the gastroscopy is extracted outward.90003 90006 Sensations of gastroscopy 90007 90002 At a gastroscopy at the patient there are unpleasant sensations. There is discomfort during the swallowing of the tube. This is accompanied by an emetic reflex. If the patient is too nervous and afraid, the procedure can be delayed for an even longer time. So you need to behave calmly, try not to be nervous, then the procedure will pass quickly, and will bring a minimum of inconveniences. Many patients have unpleasant pain in the throat, which last from 1 to 3 days.90003 90006 Gag reflex with gastroscopy 90007 90002 During the procedure, a vomiting reflex may occur. It occurs almost in all, since it is a natural protective reaction. Desires can be quite intense, but, as a rule, the content can be restrained. Thanks to modern pharmacological means, the gag reflex can be successfully overcome and suppressed. Anesthesia and muscle relaxants make it possible to relax the muscles of the esophagus, to calm the nervous system. Usually, local anesthesia is used.90003 90006 How to breathe with a gastroscopy? 90007 90002 During the procedure, you should breathe slowly and calmly, in the usual rhythm. The tube does not affect the respiratory tract and does not block the flow of air. Moreover, the diameter of the tube is very small, so that the air freely circulates through the respiratory tract. The more a patient relax and less nervous, the easier it will be to breathe, because in many ways lack of air is a far-fetched mechanism. 90003 90006 How long does gastroscopy take? 90007 90002 Usually the procedure lasts 2-3 minutes.If this is a medical procedure, or during the examination, there will be a need for medical treatment, it can take up to 15-20 minutes. 90003 90006 Anesthesia with gastroscopy 90007 90002 Many patients dream of gastroscopy without pain. Today, this is made possible by the use of solutions of anesthetics and anesthetics. This makes it possible not only to eliminate pain, but also suppresses the gag reflex. At the request of the patient, even a gastroscopy is performed under complete anesthesia.The peculiarities of local anesthesia are that it acts in the region of the pharyngeal ring. There is local anesthesia and simultaneous relaxation of the muscles of the larynx. But while the person is in full consciousness, he can control everything that is happening, sees and realizes. 90003 90002 90027 [8], [9], [10], [11] 90003 90029 Types of gastroscopy 90030 90002 There are three main types of research. 90003 90002 Esophagogastroduodenoscopy, or EGDS, makes it possible to examine the internal organs with an endoscope.In this case, the mucous membranes of the internal organs are examined. It gives an opportunity to assess the condition of internal organs, in the early stages to evaluate possible pathologies and to select the optimal treatment. 90003 90002 Fibroesophagogastroduodoscopy, or PHEGS, allows examination of the mucous membrane of the stomach and duodenum with the help of a conventional gastroscope. This is a traditional gastroscopy. 90003 90002 Video endoscopes are also used, which make it possible to obtain a detailed and clear image from the cavity of internal organs.The image is displayed on the monitor screen, then can be printed using the printer. It gives an opportunity to put the correct diagnosis, choose a treatment. The main advantage of this method is the ability to save the result. 90003 90006 Gastroscopy with sedation under anesthesia 90007 90002 Some people are too sensitive, with a weak nervous system. They are too afraid, nervous, which makes it impossible to conduct the procedure. Therefore, there is a gastroscopy under anesthesia, during which the person is injected into anesthesia, he is in a state of sleep, and the doctor in the meantime can safely carry out the procedure.This method is also used for children, because often they find it difficult to conduct such a procedure because of their restlessness, fear, excessive activity. 90003 90006 Gastroscopy of the stomach without swallowing the probe 90007 90002 The study can be conducted without the traditional ingestion of the probe. For this, the capsule method is used. The essence of the method is the ingestion of a special capsule, which contains an optical system. The capsule is washed down with water, then it starts to move along the digestive tract and transfers the image to the screen.It is released after a certain time in a natural way and does not harm the body. 90003 90006 Transnasal gastroscopy through the nose 90007 90002 Very unusual, however, an effective method that allows you to examine the stomach and esophagus. It is used for fear of suffocation or inability to insert an endoscope through the oral cavity. In this study, the tube is inserted first into the nose, then through the throat goes into the esophagus and stomach. The difference is in the method of reference and the size of the endoscope.It has extremely thin dimensions – no more than 6 mm. It makes it possible to investigate the gastrointestinal cavity no less effectively than when the endoscope is inserted by the traditional method. In this case, the urge to vomit does not arise, but there may be a cough as the endoscope passes through the throat. 90003 90002 In most cases, a cough only occurs if the throat is tight, and something goes wrong. With a relaxed throat and in a relaxed state, there is no coughing. At this stage, you just need to relax and trust a specialist who will perform all the necessary manipulations as accurately and harmlessly as possible.90003 90002 The rest of the procedure is similar to traditional gastroscopy. If necessary, the doctor can take a piece of tissue on a biopsy. With the help of this technique, various pathologies can be diagnosed, including gastritis, ulcers, and cancerous tumors. 90003 90002 In addition to biopsy, chromoscopy and therapeutic procedures are carried out. The duration of the procedure is no more than 15 minutes. Many patients who conducted this study, were satisfied, because you do not have to swallow the probe, there is no vomiting reflex.The patient also lies on his side, while the device is inserted into one nostril. The second remains free. The mouth is also closed and not occupied. In this regard, there is no panic and a sense of lack of air. Many patients note that with such a procedure, anesthesia is not needed, since it passes absolutely painlessly. To facilitate the introduction of the tube, a special lubricating gel is used. If necessary, anesthesia can be used. Discomfort can be felt for a short time, when the doctor turns the gastroscopy, but they quickly disappear.90003 90002 Of interest is the fact that even a runny nose is not a contraindication for the procedure. But this procedure can cause nasal bleeding in the event that a person has a tendency to bleeding, or there is damage to the mucous membrane. 90003 90002 The procedure itself is much simpler. Complications almost do not arise, there is no need for anesthesia. Painful sensations also do not arise. A person can do his own business right after the procedure. The patient does not experience sore throats, which often accompany traditional gastroscopy, and are much less nervous.The risk of injury to the mucous membrane is significantly reduced, respectively, there is practically no risk of developing an infectious and inflammatory process. 90003 90006 Capsular gastroscopy 90007 90002 Under capsular gastroscopy is meant a new method of investigation, which is performed with a disposable capsule. The patient swallows the capsule, drinks it with water. The size of the capsule does not exceed 1.5 cm. In the middle of the capsule there is a color miniature video camera, light sources, and a mini radio transmitter.The device is designed for 6-8 hours of operation. At this time he moves along the digestive tract and transfers the image to the doctor’s screen. Also on the move you can take pictures and video, save images. After the study is completed, the capsule will pass the remaining pathway and be excreted from the body with calves. 90003 90002 During the transfer of data, their registration takes place using a special reader. It can be in different forms: sometimes a patient is put on a device with wires, similar to an armored vest.Sometimes in the patient’s pocket there is simply a device similar to a telephone. He perceives the signal from the capsule. The materials are downloaded to the computer with the installed program to decrypt them. Processing of the received data takes place. Preliminary diagnosis is automatically set by the program. Impulses and all the data on the basis of which this particular diagnosis was determined are also preserved. The doctor looks at the result. He can either confirm the diagnosis, or assign additional studies.90003 90002 Using this method of research, the doctor determines what problems exist in the stomach and intestines. The peculiarity of this method is that it makes it possible to diagnose the small intestine. No other method has such capabilities, because before this site does not reach. The capsule makes it possible to identify numerous diseases of the digestive tract, which practically can not be studied by any other methods. This is the most effective method of diagnosing intestinal cancer, Crohn’s disease, gastrointestinal pathologies and hidden bleeding.Also with the help of this method, it is possible to diagnose iron deficiency anemia, damage caused by taking hormonal drugs. 90003 90002 The disadvantages of this method can be attributed to the fact that if any pathology is found, the capsule will simply transmit a signal about it to the computer. No medical manipulation is possible. Also, you can not take a piece of tissue for histological examination, you can not take smears on the microflora and Helicobacter. It should also be taken into account that the capsule is evenly moving along the digestive tract, at a certain rate, and the doctor remains just an observer.He can neither deploy, nor slow down, nor accelerate its passage. However, researchers are working on improving the technique constantly, and in the near future it will be possible to control the camera from a computer, deploy it if necessary, adjust the angle and speed of passage. 90003 90002 90027 [12], [13], [14], [15], [16], [17], [18], [19] 90003 90006 Gastroscopy with a thin probe 90007 90002 A thin probe, whose diameter does not exceed 6 mm, is used for intranasal gastroscopy, in which the probe is inserted into the stomach and intestine through the nose.Also, a thin probe is used in the study of children. 90003 90006 Gastroscopy of the esophagus 90007 90002 The examination of the esophagus is carried out in the presence of indications. Most often, the need for such a study occurs when a person has a suspicion of any damage to the surface of the esophagus, mucous membranes. The study can give a lot of information on suspicion of an oncological process, in the diagnosis of esophageal cancer. Obstruction of the esophagus is the main indication for gastroscopy.The procedure is painless. Its duration ranges from 2 to 15 minutes. It can be tightened if there is a need for any additional research. Often when examining the esophagus, it becomes necessary to take a biopsy for further histological examination. Sometimes polyps, or other formations on the esophagus wall, are found. They need to be removed immediately. 90003 90002 Gastroscopy of the esophagus is the main method of early detection of esophageal cancer. Preliminary preparation includes preliminary adherence to dietary intake, refusal of alcohol.The last meal should be 8 hours before the test. Drinking water on the day of study is also not possible. For the study, a capsule or endoscope is used. Each of the methods has its own advantages, as well as its shortcomings. Therefore, the doctor independently decides whether to conduct a particular method of research. 90003 90002 Most often, however, they resort to traditional gastroscopy with the help of an endoscope, since this method makes it possible to carry out immediately and therapeutic manipulations, if necessary.Also, with the help of an endoscope, you can take a biopsy, scraping or smear for the study. In the process of gastroscopy all the walls of the esophagus are examined. In addition, the air and water are supplied by means of an endoscope, which makes it possible to examine more thoroughly the walls that will be straightened. Using the camera built into the endoscope. 90003 90006 Gastroscopy of the intestine 90007 90002 A full intestine can be examined only with the help of capsular gastroscopy.Colonoscopy is used to examine the lower intestine. But it makes it possible to examine only the rectum and partially the large intestine. When examining the upper sections with the help of gastroscopy, only the upper sections can be achieved. The study will end on the duodenum. With the help of the capsule, it is possible to examine absolutely all the sections, as it moves along the entire digestive tract and is subsequently discharged outward through the rectum with calves. 90003 90002 The essence of the procedure is that the patient swallows the capsule, which contains a built-in sensor.The capsule moves along the digestive tract and transmits the signal to the doctor’s computer. Then, with the help of a special program, data processing takes place. The procedure is absolutely harmless, the patient does not experience any painful sensations or discomfort. 90003 90006 Definition Helicobacter in gastroscopy 90007 90002 If a person has a suspicion of a stomach ulcer, or gastritis, scraping is taken from the mucosa of the esophagus for further investigation on the content of bacteria of the genus Helicobacter.They live in the stomach and are the causative agents of gastritis and peptic ulcer. 90003 90002 90027 [20], [21], [22], [23], [24], [25], [26], [27], [28], [29] 90003 90006 Gastroscopy with biopsy 90007 90002 During the procedure, it may be necessary to take a biopsy for further investigation. The material is taken for further histological examination if there is a suspicion of an oncological process. After taking the material is studied under a microscope, characteristic cells are found that can indicate the development of malignant growth.When such cells are found, they are sown on special nutrient media. Within a few weeks, the cells are incubated, then by nature and rate of growth, they confirm or disprove the oncological process. This study is the main method of diagnosing intestinal cancer, esophageal cancer. If a cancer cell is detected at an early stage, it is possible to remove the tumor without any consequences, and to prevent the development of a malignant tumor with further metastases. 90003 90002 Also, a fragment of the mucous membrane can be taken for histological examination in order to detect the depth and extent of damage to internal organs by bacteria.This need often occurs with peptic ulcer. With the help of this method, it is possible to determine the causative agent, its quantitative and qualitative characteristics. Also, the great advantages of this method is the ability to select the optimal drug in the proper dosage and as precisely as possible to conduct antibiotic therapy. 90003 90006 Gastroscopy in a dream 90007 90002 It is carried out in the event that a person is overly afraid of the procedure. Sometimes due to fear, or previous unsuccessful experience, the procedure can not be carried out.The way out is: gastroscopy can be done in a dream. The patient is given special medications that act like anesthesia. The person is in a state of medical sleep. The doctor at this time is conducting a study. 90003 90002 The advantage is that it does not use anesthesia, and not anesthesia, which have a negative effect on the heart, blood. Special short-acting hypnotics are used, during which the person calms down and sinks into sleep. Sleep lasts about 20-30 minutes. During this time the doctor has time to conduct a study.After that, the patient wakes up, does not remember anything. Such a dream is absolutely harmless to the body, does not have any stress on vital organs. Can be used repeatedly. It is often used when it is necessary to track changes in dynamics in the treatment of ulcers. With this diagnosis, the procedures are carried out 2-3 times a week. 90003 90002 The disadvantage of this method is that the doctor conducts all manipulations almost “blindly”. In the ordinary state, the doctor monitors the patient’s condition, depth and strength of movement, focusing on reactions and reflexes.During sleep, such indicators are not available. In this connection, the probability of damage is increased. Also after the procedure, you can not sit for a long time behind the wheel, as the concentration of attention, the speed of reaction decreases. Heavy physical activity is also contraindicated during the day. 90003 90006 Diagnostic Gastroscopy 90007 90002 Gastroscopy is used primarily for diagnostic purposes. It makes it possible to diagnose various diseases of the esophagus and stomach.They are used to confirm inflammatory and infectious processes, such as: gastritis, colitis, ulcers. It is the main method that can detect cancerous tumors in the early stages. Using this method, you can perform a biopsy and take a scraping from the mucous membrane. Determine the degree of contamination with bacteria of the genus Helicobacter, which are causative agents of gastritis and ulcer diseases. 90003 90002 90027 [30], [31], [32], [33], [34], [35], [36] 90003 90006 Treatment Gastroscopy 90007 90002 Gastroscopy can also be used for therapeutic purposes, for example, to remove polyps, which are formations on the mucosa of the esophagus, or in the submucosa.They can also make manipulations related to the need to stop bleeding from ulcers. Gastroscopy is used to apply ligatures to damaged vessels of the esophagus or veins that have undergone varicose dilatation. Can be used to extract foreign bodies from the esophagus and stomach. 90003 90002 Also, the gastroscope makes it possible to inject directly into the tissues of the stomach and esophagus, inject medicines and irrigate them with mucous membranes. Treatment of the vascular and lymphatic system is also performed with the help of a gastroscope.The procedure makes it possible to solve the problem of narrowed lumen in the esophagus. If necessary, a special probe is inserted, by means of which a nutrient mixture is fed into the stomach. The therapeutic effect is achieved by inserting into the cavity of the endoscope various auxiliary instruments. 90003 90006 Virtual gastroscopy 90007 90002 A procedure known as virtual gastroscopy is known. The essence of the procedure is that special X-rays are used for the study. The image of the esophagus and intestines is displayed on the monitor screen.Usually the image is two-dimensional or three-dimensional. Virtual research is no less informative, gives a clearer picture than a conventional X-ray study, takes less time. The patient does not need help after the procedure and can immediately go home. 90003 90029 Esophagogastroduodenoscopy and gastroscopy 90030 90002 EGDS – a method of visual examination of the walls of the esophagus, stomach, duodenum. It allows to diagnose the most part of diseases at early stages, allows to visualize the clinical picture of diseases.There is also the possibility of carrying out a histological and cytological study, the results of which become known about after about 5-7 minutes. During the procedure, material is taken for this study. 90003 90002 The duration of the procedure is 10-20 minutes, standard preparation is needed, which is in compliance with the diet and drinking regimen. Do not eat food and water 8 hours before the test. It must be remembered that the procedure has its contraindications, so the doctor needs to talk about the presence of concomitant diseases and the taking of medications.90003 90002 The essence of the procedure consists in the introduction into the esophagus of a tiny device containing a sensor. Signals from it are converted into an image on the monitor screen. 90003 90002 A big plus is the ability to diagnose cancer at an early stage, which allows for timely treatment. According to statistics, approximately 80% of patients with cancer learn about their disease only in the late stages. With the help of EGDS and gastroscopy, it is possible to diagnose cancer in 99% of cases at an early stage, or at the stage of the onset of a cancerous tumor.Also, with the help of this study, it is possible to perform an analysis for lactase deficiency, for Helicobacter pylori. 90003 90002 90027 [37], [38], [39] 90003 90029 Gastroscopy with monthly 90030 90002 It is better to postpone the procedure for several days, because during menstruation, a woman’s sensitivity increases. This can increase pain and vomiting reflex. Also during this period the blood coagulability decreases, the risk of bleeding increases accordingly, even with minimal tissue damage.If there is a need to take a biopsy or remove polyps, there is a risk of bleeding. 90003 90029 Protocols of gastroscopy 90030 90002 First, the patient’s age, a history of the disease, is indicated. Subjective complaints and results of objective examination of the patient are noted. In the protocol of gastroscopy, the status of the mucosa of the upper gastrointestinal tract is displayed. There is a presence or absence of erosion, ulcers, foci of cellular transformation. It is noted whether there is leukoplakia, Barrett’s esophagus, or tumor formations.A biopsy is taken, information about this should also be indicated in the protocol. If there was a need for medical measures, their essence is also displayed in the protocols. 90003 90002 Separately describes the state of the esophagus, stomach, their mucous membrane, pylorus, bulb 12 duodenum, postbulbar department. 90003 90029 Ultrasound after gastroscopy 90030 90002 Sometimes after a gastroscopy, ultrasound may be required. These studies open up to the doctor absolutely different pictures of pathology, give an opportunity to comprehensively assess the situation.Each of the procedures has its own shortcomings, as well as its advantages. The doctor makes a choice in favor of one or another technique based on the expected results and what exactly needs to be investigated. 90003 90002 Ultrasound examination makes it possible to study the structure of the stomach from various angles, allows you to study the features of the circulation of blood through the vessels of the stomach. It makes it possible to study the state of neighboring organs, which are located nearby, in the zone of action of ultrasound.It is possible to study the basic processes in dynamics. In addition, this method excludes the possibility of damage to the walls and mucous membranes. Allows you not to involve the patient in a state of stress, since the method is quite comfortable and natural for a person. There are no contraindications. You can even hold people with a weak heart and psyche. 90003 90002 The shortcomings of ultrasound should include the inability to take a biopsy and physiological fluids for research. With the help of this method, it is possible to evaluate only the external picture of the organ.The method is ineffective in the diagnosis of tumors, since it does not make it possible to detect the tumor in the early stages. It is not always possible to diagnose gastritis. 90003 90002 Thus, each method has its pros and cons. To get a more accurate picture, it is better to go through 2 studies. Therefore, they are often appointed together. Ultrasound gives an opportunity to evaluate the external side, structure and functional activity of organs. With the help of gastroscopy it is possible to detail the image and examine the organs from the inside.Traditionally, first appoint ultrasound, then gastroscopy, which is justified by logic: from general to particular. First, we study the picture as a whole, then we can proceed to special cases. 90003 90029 Gastroscopy for children 90030 90002 The principle of the method does not differ from that for adults. The difference is in the size of the probe for swallowing: for children the probe is shorter and thinner. The diameter is 5-6 mm. Preparation is the same as for adults. Gastroscopy for children is much more difficult, since they are mobile, restless.Many refuse to swallow the tube, make hysterics. For the child is important the psychological preparation and support of a loved one, especially mother. The study should be carried out with extreme caution, since the mucosal and muscle layers are not developed enough, they are easily damaged. Children under 6 years of age undergo general anesthesia. 90003 90029 Gastroscopy during pregnancy 90030 90002 With various diseases of the digestive tract, there is often a need to conduct a study for a woman, despite pregnancy.The procedure begins with the application of a special anesthetic to the larynx and the back surface of the throat. After the onset of numbness, sedatives are given. The woman falls asleep, is half asleep, but at the same time with full consciousness, which makes it possible to maintain constant contact. To increase the efficiency of the procedure, air is introduced into the cavity of the stomach. This spreads the walls and improves visibility. The duration of the procedure ranges from 10 to 25 minutes.90003 90002 When pregnancy is used, if other methods of diagnosis are ineffective. It makes it possible to clearly determine the location of the inflammatory and infectious process, to detect possible pathologies, in particular, cancerous tumors. The procedure is considered safe in the first and beginning of the second trimester. The main condition for safety is the correct choice of anesthetic. Lidocaine is most commonly used. Pregnant food should not be consumed 10-12 hours before the start of the study.For half an hour after the end of the procedure, you can neither eat nor drink. If a biopsy was performed, the food for the next 24 hours should only be warm and soft to avoid complications. 90003 90002 Also, many people tend to the expediency of performing the procedure in a dream. In themselves, drugs that provide medication sleep, do not harm the body of a woman. But the benefit from them is palpable – the pregnant woman is not nervous, is in an absolutely calm state, accordingly, anxiety is not transmitted to the fetus.90003.90000 Safety and efficacy of etomidate and propofol anesthesia in elderly patients undergoing gastroscopy: A double-blind randomized clinical study 90001 90002 Introduction 90003 90004 Gastroscopy is a well-established, highly effective diagnostic and therapeutic procedure. The frequency of this procedure in the elderly is increasing rapidly as the general population ages (1,2). Although it is a non-traumatic invasive procedure, it often causes significant discomfort in the majority of patients.With the collaboration of the anesthesia and digestive system departments, gastroscopy under anesthesia minimizes the risk of physical injury occurring during examination, and provides the endoscopist with a suitable environment for a thorough examination. This has been reported to be safe in high risk patients, including elderly, frail and seriously ill patients (3,4). Despite the benefits of using anesthesia for gastroscopy, it has significant drawbacks. Anesthesia can delay patient recovery and discharge time, and increases the risk of cardiopulmonary complications, which are understood to account for ~ 50% mortality and ~ 60% morbidity associated with upper gastrointestinal endoscopy (5,6).This risk is increased in elderly patients or those with cardiovascular diseases and upper gastrointestinal bleeding (7). Arterial hypoxemia, arrhythmias and myocardial ischemia have been reported following gastroscopy with anesthesia (7). 90005 90004 Anesthesia strategies for gastroscopy have been explored for decades. There are numerous reports on the safety profile of propofol used for anesthesia during gastrointestinal endoscopy (8-10). Propofol is currently the most frequently used intravenous anesthetic, due to its rapid recovery profile, and is widely used in outpatient surgeries and examinations (4,10).The most prominent undesirable effect of propofol is its marked depression on cardiovascular and respiratory parameters, particularly in elderly patients (9-10). The distinct pharmacological characteristics of etomidate include improved hemodynamic stability and minimal respiratory depression (11). This results in a wider margin of safety for patients with significant risk factors, including patients with valvular heart disease and myocardial ischemia, and elderly patients. However, due to side effects, including myoclonus and post-operative nausea and vomiting (PONV), etomidate is rarely used in patients undergoing gastroscopy.90005 90004 The aim of the present prospective study is to determine the safety, efficacy, cost effectiveness, side effect profile and recovery time of a combination of propofol and etomidate, compared with propofol and etomidate alone, as anesthetic regimens for gastroscopy. 90005 90002 Materials and methods 90003 90012 Patients and study design 90013 90004 The current study is a double-blinded, randomized, parallel-group study, performed in accordance with the International Conference on Harmonization Good Clinical Practice guidelines (8).The study was approved by the Ethics Committee of Renmin Hospital of Wuhan University (Wuhan, China), and informed consent was obtained from all patients. A total of 200 healthy, American Society of Anesthesiologists grade I-II patients, consisting of 97 males and 103 females, aged between 65 and 79 years, who were scheduled for gastroscopy with anesthesia, were included in the study. Patients had normal serum chemistry, and normal liver and renal function test results. No patients were experiencing cardiac or respiratory disease.Exclusion criteria included the following: Severe dysfunction of heart; lung, liver, kidney and adrenal insufficiency; sleep apnea syndrome; gastric retention; history of an allergic reaction to the study drugs; history of previous experience with endoscopy; patients receiving analgesics, such as nonsteroidal anti-inflammatory drugs; patients administered α-methyldopa, clonidine or a β-blocker; patients with psychiatric, neurological or neuromuscular disorders; or patients who had used drugs, drank alcohol or smoked tobacco two weeks prior to the study.Demographic data obtained included age, weight, gender and primary diagnosis. Propofol and etomidate doses, administered by bolus and continuous infusion, were recorded. 90005 90012 Medicine preparation, anesthesia monitoring and gastroscopy procedure 90013 90004 Drugs used in the study included 200 mg / 20 ml propofol (AstraZeneca, London, UK), 20 mg / 10 ml etomidate (Nhwa Pharmaceutical Group, Jiangsu, China) and 100 mg / 2 ml fentanyl (Yichang Humanwell Pharmaceutical Co., Ltd., Yichang, China).Etomidate and propofol were diluted to 20 ml prior to administration. All dugs were pr 90005.90000 Gastroscopy – NHS 90001 90002 90003 A gastroscopy is 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). 90004 90005 90002 It’s also sometimes referred to as an upper gastrointestinal endoscopy. 90005 90002 The endoscope has a light and a camera at one end. The camera sends images of the inside of your oesophagus, stomach and duodenum to a monitor.90005 90010 Why a gastroscopy may be used 90011 90002 A gastroscopy can be used to: 90005 90002 A gastroscopy used to check symptoms or confirm a diagnosis is known as a diagnostic gastroscopy. A gastroscopy used to treat a condition is known as a therapeutic gastroscopy. 90005 90002 Read more about why a gastroscopy may be used. 90005 90010 The gastroscopy procedure 90011 90002 A gastroscopy often takes less than 15 minutes, although it may take longer if it’s being used to treat a condition.90005 90002 It’s usually carried out as an outpatient procedure, which means you will not have to spend the night in hospital. 90005 90002 Before the procedure, your throat will be numbed with a local anaesthetic spray. You can also choose to have a sedative, if you prefer. This means you will still be awake, but will be drowsy and have reduced awareness about what’s happening. 90005 90002 The doctor carrying out the procedure will place the endoscope in the back of your mouth and ask you to swallow the first part of the tube.It will then be guided down your oesophagus and into your stomach. 90005 90002 The procedure should not be painful, but it may be unpleasant or uncomfortable at times. 90005 90002 Read more about how a gastroscopy is performed. 90005 90010 What are the risks? 90011 90002 A gastroscopy is a very safe procedure, but like all medical procedures it does carry a risk of complications. 90005 90002 Possible complications that can occur include: 90005 90038 90039 a reaction to the sedative, which can cause problems with your breathing, heart rate and blood pressure 90040 90039 internal bleeding 90040 90039 tearing (perforation) of the lining of your oesophagus, stomach or duodenum 90040 90045 90002 Read more about the risks associated with a gastroscopy.90005 90002 Page last reviewed: 12 June 2018 90049 Next review due: 12 June 2021 90005 .90000 Gastroscopy (endoscopy) 90001 90002 What is gastroscopy? 90003 90004 Gastroscopy (or endoscopy) is an examination of the oesophagus (gullet or food pipe), stomach and duodenum (upper part of the small bowel) using a flexible telescope called a gastroscope. 90005 90004 When necessary, during the examination, a number of small procedures can also be carried out.These procedures may include: 90005 90008 90009 taking a small tissue sample (biopsy) 90010 90009 stopping bleeding from an ulcer 90010 90009 removal of polyps. 90010 90015 90016 Terms explained 90017 90004 Gastroscope – a long flexible plastic tube (about the thickness of your little finger) fitted with a tiny camera that allows the doctor to have a clear view of the oesophagus and other internal organs. 90005 90004 Polyp – a growth on the lining of the oesophagus, stomach or small bowel.90005 90002 Why am I having a gastroscopy? 90003 90004 Patients have gastroscopy for several reasons. For example, there may be symptoms such as indigestion or discomfort suggesting an ulcer. Alternatively, it may be done to treat certain conditions through the gastroscope. 90005 90002 Benefits of a gastroscopy 90003 90004 An alternative method of examining this part of the body is by X-ray. Gastroscopy has the advantage over X-rays of generally being more accurate for detecting diseases, and also of allowing tissue samples or biopsies to be taken.90005 90002 Risks of a gastroscopy 90003 90004 Complications of a gastroscopy, such as perforation (puncture) of your stomach or bowel wall or major bleeding (for example, requiring blood transfusion) are extremely uncommon. 90005 90004 When the examination only inspects the bowel or taking a biopsy, these complications occur in less than 1 in 10,000 procedures. 90005 90004 When other procedures or operations are carried out through the gastroscope the risk may be greater and this will depend on the condition being treated and the operation proposed.Ask your doctor, or the doctor performing the gastroscopy, about the risks related to any additional procedures or operations. 90005 90004 Very uncommonly, there may be damage to teeth from the mouthguard used during the gastroscopy. If you have false or loose teeth, please inform the staff before the test. 90005 90004 Gastroscopy can involve sedation. Risks of sedation are uncommon but may include difficulty breathing and abnormal heart rhythms. 90005 90004 Serious sedation reactions may be more common in patients with severe heart or chest disease.These complications are usually avoided by administering oxygen during the procedure and monitoring the oxygen level in the blood. 90005 90004 Some patients wish to have the gastroscopy without sedation, so if this applies to you please discuss this when you attend for the examination. 90005 90002 Preparation 90003 90004 You will usually be asked not to eat or drink for 6 hours before gastroscopy. 90005 90004 Tell your doctor before the procedure if you: 90005 90008 90009 are sensitive (allergic) to any drug or substance 90010 90009 are taking blood thinning tablets such as Warfarin 90010 90009 have heart valve disease 90010 90009 have a pacemaker.90010 90015 90016 On the day of the procedure 90017 90008 90009 Wear something comfortable and loose with short sleeves. 90010 90009 If you are an outpatient, report to the hospital as outlined in your referral letters. 90010 90015 90002 What happens during a gastroscopy? 90003 90004 A spray may be applied to the throat to numb it, and it is important that any dentures or plates are removed. 90005 90004 Some patients wish to have the gastroscopy without sedation, so if this applies to you please discuss this when you attend for the examination.Otherwise, you will be given a sedative injection through a vein in your arm before the procedure. 90005 90004 Doctors will gently insert the gastroscope through your mouth and into the oesophagus, stomach and duodenum (upper part of the small bowel). 90005 90004 The test usually takes about 5 to 10 minutes. Any discomfort at the back of the throat is minimised by using the throat spray and sedative injection, and is helped by calm deep gentle breathing during the test. 90005 90002 After a gastroscopy 90003 90004 Any sedative you are given before the procedure is very effective in reducing discomfort.However, it may also affect your memory for a few hours afterwards. Even when the sedative appears to have worn off, you may find that you are unable to recall details of your discussion with the doctor and nursing staff. For this reason a relative or friend should come with you if possible. 90005 90004 For your personal safety following the sedated procedure, we strongly encourage a friend or relative to escort you from our day ward and drive you home. 90005 90004 After the sedative you should not: 90005 90008 90009 drive a car for 24 hours 90010 90009 operate machinery for 24 hours 90010 90009 sign any legal documents until the next day 90010 90009 undertake any other activities likely to place you at risk.90010 90015 90004 The vast majority of patients having a gastroscopy with sedation do not return to work on the day of the examination. 90005 90004 Following the procedure you may have a slightly sore throat for up to 24 hours. 90005 90002 Costs of gastroscopy 90003 90004 For an Australian patient in a public hospital in Western Australia: 90005 90008 90009 public patient – no cost to you unless advised otherwise 90010 90009 private patient – some costs can be claimed through Medicare and your health insurance provider, however there is often a gap 90010 90015 90004 For a patient in a private hospital or private imaging site in Western Australia – ask your doctor or the staff where you are having your test done.90005 90002 Where to get help 90003 90116 90004 90118 Acknowledgements 90119 90120 Gastroenterology Department, Royal Perth Hospital 90005 90116 90004 This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional.Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions. 90005 .