Endoscopy (and I have read previous threads)

[Bus429]

Hi All,
I'm interested in endoscopies - well, not interested, more concerned - and I've read previous threads but most of you are so flippant that there is no reassurance :{. I'm pretty cool with most things but with matters medical, I'm an absolute WIMP! (But curiously, the dentist has never perturbed me).

Anyway, I've been taking PPIs for over two years to relieve acid reflux and moved from 30 to 15mg daily and it seems to have done the job (go a few days without and it comes back pronto). In the last few months, I've had occasional slight chest & back pains, lump in throat and minor belching (still on the PPI).

Saw doc today and he has referred me for an endoscope (upper GI). Lovely, I thought; I'd had a colonoscopy last year and that wasn't nice (and I squirmed like a conga eel). Doc says that colonoscopy is worse than an upper GI (have doctors ever had these things to try them out?).
I've asked to be given elephant sedative, throat spray, hypnosis - the lot.
Point is, I've done the stupid thing and scanned the web to see what the symptoms indicate; I've also looked into the procedure.
However, could those of you who have had one give me a bit of background? Or is it better to act like a man - I am a man, actually - and just get on with it?

[air pig]

Hi

Have had a flexible and rigid gastroscopy, in the later case, throat sprayed first, and shot of intravenous Midazolam, shorter acting than Valium, only remember talking broken biscuits to the medic then waking up being wheeled out to the recovery area. You can have it with just the throat spray, me, coward with a yellow streak a mile wide down my back with things like this and I'm a nurse. Did give me nice colour pictures of the results though.

Regards

Air pig

[gingernut]

Ah yes, the wonders of Midazolam.

One of the most fun experiences I've had recently, even when having a tooth extracted. The dental nurse was fantastic, and deep down, I think I still love her.:)


Bus 429, it does sound like your symptoms are quite benign, and it's likely that your GP has satisfied himself that there is nothing serious going on.

I think he may have referred you for an endoscopy because your symptoms have changed, which is probably fair enough. I'm not sure how the results will change the management of your symptoms though.

I hate to try and second guess my primary care colleagues, ('cos generally they seem to get things right), but if you are adamant that the next step forward shouldn't be an endoscope, then ask him about an alternative plan. (H2 antagonists,H-pylori testing etc.)

Be armed with information... CG17 Dyspepsia: quick reference guide (http://guidance.nice.org.uk/CG17/QuickRefGuide/pdf/English)
if you do decide to follow that route.

It may also be worth looking at any lifestyle changes that might help. Have you been advised about these, and if so have you given them a trial?

If the end result is that you attend for your endoscopy, it's not the end of the world. It's a safe, albeit sometimes uncomfortable, procedure . Keep us posted.:ok:

[wotthe]

G'day Bus

Had 3 colonoscopies and 2 gastroscopies done over the last 15 years.

Both done at the same time for convenience whilst under a twilight anesthesia so couldn't remember anything. Took about 25 mins. for both procedures with no ill aftereffects other than a a slightly sore throat for a couple of hours.

Just do it, it's the most definitive way to diagnose GI issues.

[HEATHROW DIRECTOR]

Doddle. My wife and I had them at similar times, both because of chronic indigestion which antacids did not relieve. We both just had the throat spray. Whole procedures took about 10 minutes and were no problem at all. Instant results - no ulcers, no cancer, just keep taking the tablets.

In both our cases, we stopped tablets and were "cured" probably because the worry was over.

[Bus429]

Thank you very much for your inputs - I suspect Gingernut has more than a passing knowledge about this stuff - but I like hearing it from the victims.
Lifestyle changes - good idea. I've kept up with the tea, coffee, wine and beer even while on PPIs but have decided to change. Problem is, I'm a veggie, eat a lot of fresh fruit and I note that some of the stuff that is good for veggies is not necessarily good for someone with reflux etc.

[Bus429]

Years of research - or trial and error - have gone into anesthetics and analgesics so I think they should be used! :zzz:

[gingernut]

Problem is, I'm a veggie, eat a lot of fresh fruit and I note that some of the stuff that is good for veggies is not necessarily good for someone with reflux etc.

I was thinking of you last night as I was washing the pan that Mrs Ginger had used to make some soup.

I always notice the the left over onion bits are always the hardest thing to flush down the plug 'ole afterwards.

I reckon the same thing's going on in the bottom of your tum.

One of the few words of wisdom I heard from a surgeon friend, was let your teeth do the work, rather than your tum:)

[Bus429]

The conversation above has got me thinking more about something that has been on my mind for a while. I'm prescribed Lansoprazole, Atvorstatin (precautionary due family history and a cholesterol level of 6 but not overweight/non-smoker) and occasional Congestor.
Would it be better to wean off them and look at other means or put my faith in the medical profession? I know loads of people on 2 or more regular medications but is it "normal"?

[Bad medicine]

I think we're getting off the thread topic here, and miles away from application to aircrew/aviation.

[Bus429]

C'mon Bad, I think that is a tad unreasonable; the information we glean or share could be of benefit.

[gingernut]

I know loads of people on 2 or more regular medications but is it "normal"?

No, it's probably a reflection of our lifestyles.

I myself treat modern medicine with a healthy dose of cynicism, which is not a bad thing, but as BM alludes to, on here we have to stick on:

a)what's improtant for aircrew.
b)the evidence for our interventions.

If you start a debate on Jet Blast you may get broader arguments, and I'll probably chip in myself:)

[Bad medicine]

As you know, we allow a pretty wide degree of lattitude on these threads, but rather than change a thread on endoscopy into a thread on the horrors of Valium following a judo injury, or the relative benefits of polypharmacy, it may be better to start a new thread topic. Easier for people to find the information they may be looking for too!

Cheers,

BM

[Loose rivets]

Quite so.

The two or three years that my feelings on the subject were made a sticky will probably suffice, though I still feel for the people that may well have been imprisoned for violence that was probably not their fault at all. This drug has been handed out to dozens of PpruNe members in various forms in the last ten years..

Posts gone.

[Bus429]

Point taken :O

[Desertgirl]

Bus429, I have had regular upper endoscopic examinations for the past 6 years. About to have another one in a few weeks. My very first one involved the throat spray which is very bitter but otherwise okay. But, must admit I am pleased that these days my hospital's protocol is to use the full twilight anaesthetic (Midazolam + Fentanyl) and you're asleep. No need for "swallowing" the scope. Procedure only takes about 15 mins including taking biopsies, might take a little longer if they opt to repair anything they can whilst down there. You wake up in recovery, the nurses monitor you closely (BP, temp, etc etc), they get you up and once you can eat they feed you. It is a very comfortable procedure if a little strange. The hardest part I found was having my jaw opened so wide to bite down on the mouth guard (so you don't bite down on the scope during examination!).

If you are a bit nervous, just mention that to the admitting nurse. I have always found all the doctors and nurses to be very reassuring, they want you to be comfortable.

As for reflux/GORD/GERD having an impact on aviation activities, here in Australia the DAME (aviation medical examiner) needs to make an individual assessment. Most PPIs and H2As don't prevent you from flying but your doc needs to look at the whole picture.

Good luck!

[zondaracer]

I had an endoscopy once and they put me completely under with general anesthesia... it was AWESOME! I would do it all over again.

[Bus429]

Further to my earlier posts: once I started taking a higher daily dose of PPI (Lansoprazole) I felt worse. Stopped and after 36 hours felt good again. Tried Zantac: same result; stopped and after 36 hours felt good again.

Checked with doc and he said he had heard of cases of people suddenly not tolerating certain PPIs, particulalry if they had heliobacter in the past (I have).
I'm now on industrial strength Gaviscon (prescribed in 500ml bottles) and the symptoms are controlled well with this. Still got the acid and (now reduced) gurgle and still have to have endoscopy as a precaution; but strange that what should make you better can make you worse!

[Loose rivets]

As an aside, I've been taking Tagamet (Cimetidine.) For longer than I like to confess to. One 400mg before going to bed stops me eating myself in the early hours.


Since reacting badly to a modern drug, I've gone back to the
'Tags' and take one or half of one, mid afternoon as well.

Diet has been the other thing. No more bucketloads of beef for dinner. Eat like a bird now...well, by comparison. Wished I'd started that 50 years ago.

[Loose rivets]

Had a think about this before writing, but better armed than not. There is a very positive link between helicobacter pylori, and stomach cancer. The research was not simply a direct link to an increase, but in essence, it increased the chances by 30% I think it was.

It more or less added up to remaining vigilant for some years after the ulcer had been cured.

[Bus429]

Hi Loose,
It's frightening but we have to be adult about it so it is a point well made. My heliobacter manifested itself as really bad breath but after a short course of antibiotics it went, never to reappear. I suppose the endoscopy may give some indication.
Question about the 'scopy: I had a sigmundfreudoscopy (the otherendoscopy) last year; do they ever do both at the same time and, if so, which do they do first?:eek:

[Desertgirl]

"do they ever do both at the same time and, if so, which do they do first?http://images.ibsrv.net/ibsrv/res/src:www.pprune.org/get/images/smilies/eek.gif"

Often called a top & tail, I'm about to have one of those myself later this month. My gastro-doc tells me it's preferable to have them done together for anaesthesia-safety reasons. And it means one less trip to the hospital. :)

[gingernut]

do they ever do both at the same time and, if so, which do they do first

I think they use different scopes!!

The difference between a colonoscope and a gastroscope?

The taste:8

[Bus429]

I had my OGD endoscopy yesterday and, as some of you suggested, the anticipation is worse than the event. I was sedated and remember a little discomfort as the probe went down. Next thing I knew after about 10 minutes total was it was all done. Nice staff in a great facility at Carlisle Royal Infirmary. Confirmed small hiatus hernia and a routine sample taken from stomach to check for bugs. No other problems reported so far.