Having an endoscopy under general anaesthetic

[Petal02]

I’ve been having indigestion symptoms on and off for a while, and I’ve been terrified that my GP will send me for an endoscopy. I’m a huge wuss when it comes to anything medical, and even though the doctor hasn’t recommended this procedure yet, just the ‘worst case scenario’ thoughts have been keeping me awake at night. I’d manage OK if they knocked me out completely, but I gather than most hospitals offer sedation, which might not be enough for a highly-strung coward like me …….

However I’ve just phoned our local BMI Hospital, I spoke to the secretary of one of the gastro specialists, who confirmed that endoscopy with a general anaesthetic is available for nervous patients, and that it costs £1396. The specialist in question also practices at two local NHS hospitals, so hopefully that’s good. But this information has really calmed me down – obviously I really hope I don’t need an endoscopy, but if I can have this was a general anaesthetic for £1396, then that’s such good news!!!

Am I being ridiculous? I can’t help being such a coward, but if I’m properly knocked out then surely it won’t be such an ordeal? And DH will drive me to/from hospital, and keep an eye on me for as long as is required, so I won't be trying to drive or use power tools!!!

[Egghead68]

I had one a month ago. Absolutely barbaric. Only throat spray active as the endoscopist was in too much of a hurry to let the sedation work (it kicked in when I was in recovery). I put up my arm for the procedure to be aborted but they just held me down. When I complained they said I had "misremembered" what happened... General anaesthetic for me next time (I'll pay what it takes).

[rosie39forever]

I had a gastorscopy this morning without sedation just had the throat spray, I was really nervous but it was totally manageable, you do gag as the scope goes down but if you just concentrate on your breathing it’s fine, I had 5 biopsies which just pinched slightly, it was all over and done in 5 minutes and I was walking round Sainsbury’s half an hour later, I can understand your fear but the fear is much worse than the reality. I think a GA carries more medical risk than an endocopy so would only be given only in extreme cases.

[DebRutter]

I’d love to know how you got on Petal02 because I attempted an endoscopy yesterday and it was Mission Abort! It was barbaric. Never again. In fact I still need one so if I can have it by GA then that’s how it’s going to be done! If some people can do that with just the throat spray then well done them - I have no idea how anyone endures it. I couldn’t. It was HIDEOUS.

[gamerwimp]

Hiya, I see this thread is ages old, but just in case it helps anyone........I had a naso-endoscopy today under General..because I’m that much of a wimp I guess. I’m just so glad and grateful I did though despite it being essentially a very basic procedure normally, up your nose as outlined above by hiccupgirl. If it’s a full tube in your mouth job, I couldn’t even begin to imagine suffering through that! My experience today, if it helps:
I originally just refused the procedure being done (without any anaesthesia) and went home, not realising it was even an option to go general. I had been told originally that no invasive procedure would be done on my original visit at the time you see, and it really freaked me out. I have a phobia about being sick, I have quite debillitating anxiety often, and basically the idea of anything down my throat even a bit like that with this mean looking bloke, a student nurse who had literally just started, and a nurse all there springing it on me was intolerable. Anyway, a month later, after going back to a different and understanding GP, I returned with my friend to see the same specialist and politely insisted that I felt I needed the procedure but under General as it was literally a phobia. He was cross but agreed and I left his office feeling ashamed that I was costing the NHS money doing this, as well as putting myself at risk by obviously all this delay and well, cowardice!?
However, though I was worried about the GA as it makes it all more of a big deal, overall I must say that it was clearly the humane thing to do for me at least. Also luckily I had a different specialist who came to see me and explain that as I was asleep it meant they could really examine my larynx, oesphagus and that whole area more easily in detail and do whatever they wanted really, take a biopsy if needed (they didn’t need to my relief). My throat now is a bit sore. It is totally fine, not even bothering me really, but that goes to show that it gets knocked about a bit, let alone if you have to have a biopsy done. Also, during my stay today, I spoke to 2 workers at the hospital informally who had had the procedure themselves in the past just normally, and said it wasn’t pleasant, so general would spare all that. My recovery from the anaesthetic has surprised me even. They must be so good these days with them drugs I reckon, and as you aren’t out for long perhaps that makes it easier on your body? Anyway, I took maybe just over an hour or so to go from just coming to, to awake and sat up in bed drinking and slowly eating. I woke up at 2.30 ish and by 4.30 I was waiting to be allowed to go home. And that was just taking my time, having a lie there for a bit, start getting used to sitting up without feeling dizzy (also just cos of fasting I guess, just takes a while but again not unpleasant). They discharged me a bit later, around 5. I can’t believe how quickly I started to feel normal once I properly came around. Definitely bring someone with you too btw. You are allowed one visitor and it doesn’t bother anyone (I was unsure whether just to do whole thing alone). I was even worried about the time between the anaesthetic going in and going asleep by the way, and in the three seconds I had to contemplate the cold burn beginning in my arm and yet feeling totally fine, then suddenly that’s it immediately byee. Having the needle put in is a tiny bit sharp, but no biggie, and here’s the joke, probably the worst bit is having that needle taken out before you are discharged, just because of the sticky tape on your hairy hands and the slight tugging on the needle while it’s being taken off, but really, I could almost laugh about it, it wasn’t a big deal.
Gosh what a ramble, maybe the drugs aren’t quite out of me after all, heehee but hope it was of some use to someone in a similar situation so scared they don’t feel they can go ahead without GA.

[annekh510]

Petal02, how are things now? Did you go to the GP? As I understand it the GP can't refer you for a gastroscope (an endoscope is just the name of the instrument). See www.nhs.uk/conditions/endoscopy/ for more details.

I also think it would be unusual for a GP to directly refer to a specialist, mine wanted a stool sample first, she showed me a document of the pathway for upper gastro referral and that was something that needed to be done first. I think it's to test for heliobacter pylori the bacteria that is behind ulcers. This was a while back so things may have changed or it may have been an area thing.

When my partner has gone to the GP for indigestion, they've just prescribed omeprazole. I don't know what would trigger them thinking he needs further tests.

I got to this page from google when searching for "gastroscopy general anaesthetic" as that is what I am scheduled for in 2 weeks time. I don't actually have indigestion symptoms, though the suggestion is reflux is causing my other symptoms it's because of those other symptoms I was referred. We are on a private health insurance plan through my partners work, as we live across the road from the a private hospital, it's simply easier to go there, getting to the NHS hospital for muliple appointments and test is very difficult and often requires him taking time of work to assist me.

For my symptom set, CT scan with contrast, ultrasound and gastroscopy were suggested. We discussed how he would do it and he said he only does intravenous general anaesthetics, I had never heard it distinguished like this before. His business card says he also practices at the local NHS hospital where like everywhere else the default seems to be sedation.

I get the impression that both safety and recovery from intravenous only sedation (propofol I presume) is different from one involving gas. A while back it came up in conversation with an anaethetist friend just how different GAs have got over the last 20+ years, he says that now on any given day you are safer in hospital under a GA than on the streets and that wasn't distinguishing type.

Propofol is used in A&E for setting bones when you really need to have someone unaware of what is going on, I've watched someone have that and it's really odd, they appear awake and will talk, scream from the pain, but remember nothing.

I would be anxious about sedation only, like some other people I have a strong gag reflex, but I also have a condition that means I don't really respond to local anaesthetic, so I don't know if the throat spray would help that gag reflex. However what it sounds like is that he prefers GA as the easier route for everyone concerned, this must especially be the case if it's for treatment when it's down for longer.

I've had procedures under sedation, a difficult joint injection, the mix of fast acting benzo and painkiller left me still aware of what was going on but it went faster and could be acheived whereas an attempt without was too painful in the joint for them to touch me and get the needle in. Unfortunately it wore off before the MRI was complete (it was a contrast injection) and I had specific concerns about the MRI, though fortunately with it being my hip not my head like the most recent one prior to that had been I was fine. That MRI was also done under sedation, whilst I was an inpatient, again I experienced everything and at first being a bit out of it made it harder to cope but once they put a mirror in so I could see out it was fine. Fundamentally I've had procedures with sedation that I think are easier for me than a gastroscopy and still found them hard.

I don't want to scare anyone, you'd really like to think you could trust a doctor to stop if you said stop, but I've had dental surgery where the local hadn't worked (and I'd told them it wouldn't beforehand) and I didn't have enough pain relief or sedation and when I was yelling no and physically fighting to have them stop. They didn't. The surgeon found me alone at one point and said something like "I did it for your benefit" well, he might think it's for my benefit, but after that experience I couldn't face him for the follow up and have not been to a dentist which I was already scared of and my teeth are a mess. He took my dental phobia and crushed it to the point where I can barely cope with seeing a dental surgery let alone going in one.

Also when in labour with my 2nd I had a vaginal exam that was very painful and I literally yelled "get your arm out of my vagina" she didn't, she never said anything, if she thought it was in my best interests she was probably right, if I actually need the exam, I was clearly in transition they just wanted numbers.

[flumpybear]

Tell the consultant of your concerns, I'm sure they'd rather do a scope on a non stressed person, so discuss anaesthetic options with them and I'm sure they'll listen
They do also realise people are frightened for many reasons - they're only humans so talk it through and tell them your fears
Good luck

[LadyoftheLake123]

And the procedures were fine! Bit uncomfortable, but not painful, and over relatively quickly.

[LadyoftheLake123]

I've not had a gastroscopy but have had a couple of colonoscopies, both under sedation. Both times I was awake and to greater or lesser extent aware of what was going on (although I think I might have drifted off a couple of times) but went from extremely nervous (pre sedation) to incredibly chilled out and really not caring what was going on (post sedation). If I ever had to have another one I'd definitely opt for sedation again rather than GA - GA is a major undertaking which will take a good few days to recover from, with sedation you should be feeling back to normal reasonably quickly after.

[AndreaNF]

Silentsigh you have given me a bit of hope as you have had endoscopies at St George's (where we attend) under GA - was this difficult to achieve? Can't really afford to go private. Thanks in advance for any advice.

[AndreaNF]

Hi Petal02 came across your post just this morning - hi! I was researching as my partner has had 2 endoscopies just recently both unsuccessful due to his extreme gag reflux. Poor him it was so distressing - anyway he too would like to have GA as we really need this test due to very severe GERD symptons which are making his life so awful (on top of COPD and asthma amongst other ailments I am so sad to say) - did you manage to get your GA on the NHS? Thanks in advance am so stressed for him.

[alittlequinnie]

I had one under sedation - awful - was kept waiting for four hours before I went in and then pushed through really really fast. The nurse couldn't find a vein for the canula and really hurt me. I could feel myself panicking and asked them to wait a minute but they didn't. They sedated me and it knocked me out instantly.... but I woke up half way through and ripped the tube out of my own throat because I didn't have a clue what was going on - the tube feels like a broomstick going down your throat. They went mad at me for trying to pull the tube out but I was acting on instinct. The result was they only got the camera half way down my throat and 5 years later they are still refusing to do the test, despite my vomiting every 4/5 weeks for 2/3 days at a time none stop. I would go for the throat spray next time.

[Legalmum26]

I have had an endoscopy under sedation and it unfortunately was one of the worst experiences I've had having had multiple surgeries, several of which I was awake during.

I was due to have another one carried out under sedation and had a severe anxiety attack which meant I had to stay in hospital overnight for monitoring even though I'd not had the procedure done. My consultant therefore suggested I have the procedure carried out under GA (NHS Procedure). I'm going in for the procedure in a couple of weeks - No way was I going to have another done under sedation!
There are limited numbers of surgeons who will carry this out under general I was told it was due to the size and skill of the team required.

Speak to your consultant - they are the only ones that can answer the question.

[Bloopbleep]

I've had endoscopy with sedation and a nasogastric tube without and neither were that bad. The sedation was lovely. I was aware but I didn't care. I'll be honest I gagged a bit but as soon as they passed the point of the gag reflex I felt absolutely nothing. With the nasogastric tube I had no spray or anything. They kepT telling me to swallow to ensure it went in the right place and aside from being aware of something in my throat it didn't hurt or feel uncomfortable and I was totally unaware of it being anywhere deeper than the back of my throat. The endoscopy was over so quickly that it really wouldn't have been worth the hassle and risk of a GA.

[silentsigh]

I've had a few endoscopies on the NHS (at St Georges Hosp and King's College Hosp, both in London). I had them all under full GA with an anasethetist. I told them it was either a GA or not happening at all so they alllowed the GA, thankfully. I believe if you are insistent about it they will.

[Crumbs1]

Has your GP actually suggested a gastroscope? It reads as if not. Maybe discuss your anxieties and the treatment plan with your GP. The NHS is well,practiced in management of nervous patients.

[Petal02]

Sorry, pressed send too soon - there must be a BMI hospital in the West Midlands area?

[Petal02]

user I've only just seen your post (it's an old thread)! Have you made any further enquiries? My local BMI hospital offers a GA,

[user1488829813]

Hi-I'm in exactly the same position- having symptoms and knowing deep down I'll end up having an endoscopy. I'm terrified ! Does anyone know which consultants in the West Midlands offer this procedure privately with general anaesthetic ? I know one contributor said she had spoken to a medical secretary who said this was possible. I'd be grateful for any help as I can't face this procedure without one !

[Nospringflower]

The sedation I had was administered by nurses in a room before you went into the endoscopy suite. They tried very hard to persuade me not to have the sedation and only to have the throat spray due to needing to recover afterwards.

As I said above I was awake throughout and the person carrying out the procedure told me their findings prior to me leaving. The staff were great at trying to help the process.

[cuntinghomicidalcardigan]

Just make sure you ask about any extra costs before going private. The consultant may well want you to have a private consultation as a new patient, the book a followup privately.for the results. If (God forbid) they found anything then there may be pathology charges for the cost of analysing a sample. I used to work as Secretary for the private practice of a general surgeon.

Hope it all goes well and easily for you. For what it's worth there was never a single complaint from any of the patients in that practise, and there were hundreds (the majority) who only had sedation.

[sadie9]

Before any procedure like this there is a big chat and consent form signing with one of the attending or junior consultant (?) . So plenty of time to ask them questions, explain your fears and request the charging Rhino dose.

[Piemernator]

In my very first career I worked in a day surgery unit assisting at sedations and general anaesthetics. I would never opt for a GA unless necessary. I had a minor gynae op a couple of years ago under local though offered local, epidural or general.

Have you ever had a GA? Obviously you won't be under for long but people's recovery can vary quite a bit. I feel ropey for days afterwards and there are always risks. They are very small and though you are obviously suffering from more than general worry and its actual anxiety it is more risky having a GA than a procedure under sedation.

[gingeroots]

All the endoscopies I've had done have been routine in NHS hospitals .

They've all had an anesthatist present ,everyone in gowns ,including me .None of them have involved a GA .

They do calculate how much drug to give you by your buils/weight /height . I always ask them to make sure I'm out of it and to ensure that whatever drug they're using is sufficient to make sure I don't come round while they're still conducting the procedure .

[Petal02]

I'm really grateful for all the responses - and have made a decision: Unless the NHS will offer me a GA, thus negating weeks of pre-appointment worry, I will be going to our local BMI Hospital.

I realise there's every possibility I could be OK under standard sedation, but because it's clearly not guaranteed, then going privately is the only acceptable route for me.

And of course I don't even know if I'm going to need an endoscopy yet ...... !!!

[sadie9]

Oh, I see. I don't know if the bog standard sedation is administered without an anaesthetist. I would think there has to be one there for it, but I really don't know. So I should probably shut up now trying to tell you what to do. There must be some way you could get to actually speak to an anaesthetist and ask them. Or someone else in the hospital who could get you the information you seek...