Endoscopic procedures
Gastroscopy / OGD
Gastroscopy (also known as endoscopy, or oesophagogastroduodenoscopy - OGD) is an endoscopic procedure for examining the oesophagus, stomach, and first part of the small intestine. Gastroscopy is a key investigation for symptoms such as heartburn, reflux, swallowing problems, abdominal pain, bloating, low iron levels, low B12 or folate levels, and suspected coeliac disease. Dr Michael FitzPatrick is an experienced endoscopist, performing gastroscopy in Oxford at the Manor Hospital, Oxford.
Colonoscopy
Colonoscopy is an endoscopic procedure which is used to examine the large bowel (colon), the end of the small bowel (also known as the terminal ileum), and the rectum and anus. Colonoscopy is an investigation used for symptoms such as a change in bowel habit, diarrhoea, blood in the stool, and iron deficiency. Colonoscopy is used to investigated and assess conditions including inflammatory bowel disease including Crohn’s disease and ulcerative colitis, other forms of colitis including microscopic colitis, diverticular disease, and suspected polyps or cancer in the bowel. Colonoscopy can also allow treatments to be performed, most commonly removal of bowel polyps (polypectomy) which can reduce the risk of bowel and colorectal cancer. Dr Michael FitzPatrick performs colonoscopy and polypectomy in Oxford at the Manor Hospital, Oxford.
Colonoscopy
What is a colonoscopy?
A colonoscopy is a procedure where the lining of the large bowel (the colon) is inspected using an endoscope. The endoscope is a thin, flexible device with a camera and light source at the tip. A colonoscopy allows us to diagnose conditions of the bowel, to take samples (biopsies) for laboratory examination, and for the treatment of polyps. Dr Michael FitzPatrick is a gastroenterologist who performs colonoscopy at the Manor Hospital, Oxford.
Why is a colonoscopy performed?
Colonoscopy is an important investigation to work out the cause of a range of gastrointestinal symptoms. Symptoms that may require a colonoscopy include a change in bowel habit, diarrhoea, abdominal discomfort, blood or mucus in the stool, iron deficiency and anaemia. Colonoscopy is also performed to assess the activity of some conditions, including inflammatory bowel disease (Crohn's disease and colitis), as part of screening and surveillance programmes to reduce the risk of bowel cancer, and to allow the removal of polyps in the bowel. Dr Michael FitzPatrick will discuss the reasons for colonoscopy in your gastroenterology clinic appointment.
How safe is colonoscopy?
Colonoscopy is a routine procedure, with nearly 1 million colonoscopies performed each year in the UK. The risks of the procedure are low, but it is important that you are aware of these risks, so that you can make an informed decision about proceeding.
The main risks are:
Damage to the lining of the bowel called a perforation. The risk of this is very low, affecting less than 1 in 1,500 patients in a diagnostic colonoscopy. If larger polyps are removed, this risk is higher.
Bleeding after a biopsy is taken, or after a removal of a small polyp. Bleeding is uncommon, and usually settles on its own. If larger polyps are removed this risk is higher. Sometimes a second endoscopy is required to treat the site of bleeding.
Missed pathology. No test is perfect, and there is a small risk of missed polyps and cancer. The miss rate for significant findings is small, less than 1%.
Incomplete procedure. Sometimes it is not possible to complete the colonoscopy procedure due to technical difficulties or if the bowel preparation has not been completely effective.
Will I have sedation for my colonoscopy?
Colonoscopy can cause discomfort as the endoscope is passed around your bowel. Patients are therefore offered conscious sedation with two medications, usually midazolam (a benzodiazepine sedative) and fentanyl (an opioid painkiller). We can also use inhaled nitrous oxide (entonox) to provide additional pain relief. Dr Michael FitzPatrick and the endoscopy team at the Manor Hospital, Oxford will discuss this with you in advance.
Patients who receive sedation cannot drive for 24 hours and will need someone to accompany them home. Some patients may not be able to have sedation for this reason, but entonox can be given alone to provide relief.
What does a colonoscopy involve?
In order to enable careful examination of the bowel lining, you will need to undergo bowel preparation. This consists of dietary changes in the days before the procedure, as well as taking a type of laxative the day before or day of the procedure. This will ensure the bowel is clear for the colonoscopy. You will be sent instructions about what to do from Dr Michael FitzPatrick and the endoscopy department at the Manor Hospital (Nuffield), Oxford in advance of your procedure, and will usually receive a phone call to go through the information thoroughly.
On the day of the procedure you will come to the Endoscopy department at The Manor Hospital (Nuffield), in Headington, Oxford. You are likely to be in the department for 2-3 hours in total. An endoscopy nurse will admit you to the unit, and allow you to change into a procedure gown. A cannula (drip) will be inserted into a vein in the arm to allow us to provide sedation. Dr Michael FitzPatrick will then meet with you to confirm your consent for the procedure and ask you to sign a consent form.
In the procedure room, monitoring equipment will be placed on you to monitor your heart rate, blood pressure, and oxygen levels throughout the procedure. Oxygen will be given to all patients receiving sedation. Once all pre-procedure safety checks are complete, sedation will be given. The endoscope will then be gently inserted into the colon via the anus with lubricating gel. The endoscope will then be carefully and gently passed around the colon. Samples called biopsies may be taken during the procedure, and any polyps may be removed during the colonoscopy. During the colonoscopy, you may be asked to move into different positions on the procedure bed. This allows us to gain better views of the bowel and pass the endoscope more smoothly, and can aid with comfort. The procedure itself will typically take 20-40 minutes.
What happens after the procedure?
Following the procedure, you will be taken to the recovery area, monitored by the specialist endoscopy nurses. You will be offered light refreshments. Dr Michael FitzPatrick will then check on you in the recovery area to ensure you are comfortable. You will then leave the department with a copy of the procedure report, and with clear post-procedure instructions. Usually you will have a follow-up appointment with Dr Michael FitzPatrick in his gastroenterologist clinic at the Manor Hospital, Oxford, or by phone, a few weeks after the procedure, once all test results are back.
Gastroscopy
What is gastroscopy?
A gastroscopy (sometimes just called endoscopy) is a procedure where the lining of the stomach, oesophagus (food pipe) and the start of the small intestine is inspected using an endoscope. The endoscope is a thin, flexible device with a camera and light source at the tip. A gastroscopy allows us to diagnose various gastroenterology conditions, and to take samples (biopsies) for laboratory examination. Dr Michael FitzPatrick is a gastroenterologist who performs gastroscopy at the Manor Hospital, Oxford.
Why is a gastroscopy performed?
Gastroscopy is an important investigation to work out the cause of a range of gastrointestinal symptoms. Symptoms that may require a gastroscopy include abdominal pain, reflux, heartburn, sore through, bloating, dyspepsia, change in bowel habit, and diarrhoea. It is also used to investigate conditions including iron deficiency, anaemia, Helicobacter pylori infection, and coeliac disease. Gastroscopy is also performed to assess the activity of some conditions, including coeliac disease and eosinophilic oesophagitis. Gastroscopy may be performed as part of screening and surveillance programmes to reduce the risk of oesophageal and stomach cancer. Dr Michael FitzPatrick will discuss the reasons for gastroscopy in your gastroenterology clinic appointment.
Is gastroscopy safe?
Gastroscopy is a routine procedure, with around 2 million gastroscopies performed each year in the UK. The risks of the procedure are low, but it is important that you are aware of these risks, so that you can make an informed decision about proceeding. The main risks are:
- Damage to the lining of the stomach, oesophagus, or bowel called a perforation. The risk of this is very low, affecting less than 1 in 2,000 patients in a diagnostic gastroscopy.
- Bleeding after a biopsy is taken. Bleeding is very uncommon, and usually settles on its own.
- Missed pathology. No test is perfect, and there is a small risk of missed findings. The miss rate for significant findings is small, less than 1%.
- Incomplete procedure. Sometimes it is not possible to complete the gastroscopy procedure due to anatomical variations between people, or lack of tolerance of the procedure if without sedation. This is uncommon.
- We use a mouthguard to protect your teeth from damage.
Will I have sedation for the gastroscopy?
Gastroscopy can cause discomfort as the endoscope is passed into the stomach, most often due to the sensation in the throat and retching. Patients are therefore offered conscious sedation with two medications, usually midazolam (a benzodiazepine sedative) and fentanyl (an opioid painkiller). Often this is in combination with a local anaesthetic spray to the back of the throat, which numbs the area. Dr Michael FitzPatrick and the endoscopy team at the Manor Hospital, Oxford will discuss this with you in advance.
Patients who receive sedation cannot drive for 24 hours and will need someone to accompany them home. Sometimes the procedure can be performed with the throat spray alone.
What does a gastroscopy involve?
In order to enable careful examination of the bowel lining, you will need to fast for a period before the test. You will be sent instructions about what to do from Dr Michael FitzPatrick and the endoscopy department at the Manor Hospital (Nuffield), Oxford in advance of your procedure.
On the day of the procedure you will come to the Endoscopy department at The Manor Hospital (Nuffield), in Headington, Oxford. An endoscopy nurse will admit you to the unit, and allow you to change into a procedure gown. A cannula (drip) will be inserted into a vein in the arm to allow us to provide sedation. Dr Michael FitzPatrick will then meet with you to confirm your consent for the procedure and ask you to sign a consent form.
In the procedure room, monitoring equipment will be placed on you to monitor your heart rate, blood pressure, and oxygen levels throughout the procedure. Oxygen will be given to all patients receiving sedation. Once all pre-procedure safety checks are complete, sedation will be given. The endoscope will then be gently inserted via the mouth into the oesophagus, stomach, and duodenum. Samples called biopsies may be taken during the procedure. The procedure will typically take 7-10 minutes.
What happens after the procedure?
Following the procedure, you will be taken to the recovery area, monitored by the specialist endoscopy nurses. You will be offered light refreshments. Dr Michael FitzPatrick will then check on you in the recovery area to ensure you are comfortable. You will then leave the department with a copy of the procedure report, and with clear post-procedure instructions. Usually you will have a follow-up appointment with Dr Michael FitzPatrick in his gastroenterologist clinic at the Manor Hospital, Oxford, or by phone, a few weeks after the procedure, once all test results are back.