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EXPLAINING ENDOSCOPY

EXPLAINING ENDOSCOPY. By: Denise Tiong and Rikki Solaiman. Scenario.

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EXPLAINING ENDOSCOPY

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  1. EXPLAINING ENDOSCOPY By: Denise Tiong and Rikki Solaiman

  2. Scenario Mr. Anderson, a 58 year old gentleman has been experiencing 2 month history of abdominal pain and reflux symptoms. He also reports passing black stools. He has been listed for a gastroscopy and your consultant has asked you to explain the procedure to him.

  3. Introduction- establish rapport Ideas, Concerns, Expectations • Gauge patient’s understanding of procedure • “I understand that you have been experiencing persistent heartburn/passing black stools/difficulty swallowing/vomiting…” • In order to help us find out what is going on, we need to carry out a gastroscopy. “Do you know what I mean by a gastroscopy?” “How much do you know about it?”

  4. Elicit patient’s concerns re symptoms Explain what it is… A gastroscopy/upper endoscopy test is a camera test that enables the doctor to visualise the upper part of the digestive system, from the gullet to stomach to the first part of the intestine. The endoscope is a long thin flexible telescope with a bright light on its tip. If required, the doctor may take a small sample of tissue from inside with a tiny forceps. This is usually painless.

  5. What happens during the procedure? -Common procedure done as day case -Back of throat will be numbed. You may also be given a sedative by injection into a vein in the back of your hand to help you relax. -The doctor will place a mouth-guard to keep your mouth open and to protect your teeth. The thin endoscope will be passed through your mouth, gullet and eventually into your stomach and duodenum. -The video camera at the tip of the endoscope will send images to a screen. -During the procedure, air may be introduced into your stomach to allow a clearer view.

  6. The entire procedure usually takes between fifteen minutes-half an hour. Preparation for procedure… To allow a good view, you will not be allowed to eat and drink at least 6 hours prior to the test Post-procedure… If you choose to have sedative, you must ensure that there is somebody available to accompany you home. You should also avoid driving and drinking alcohol for 24 hours.

  7. Do not forget to explain side effects/complications i.e. mild sore throat, sleepy/tired following sedation, some minor bleeding, risk of infection and very rarely, perforation. Finally… • Check that the patient has understood what has been said • Mention need for follow up -The doctor will write the report. Any samples taken will be sent for analysis

  8. Encourage patient to ask questions • Offer patient leaflet

  9. Colonoscopy Pre-procedure: You will receive instructions on how to take a special diet few days before. You will also be given some laxatives to take During procedure: -Lie on your side. The doctor will gently insert the endoscope through your back passage and up into your colon (large bowel). -Air is passed into your bowel to make the lining of your tract more visible. This may cause you to feel like you need to go to the toilet. The air might also cause you to feel bloated and feel like you need to pass wind. This is normal and there is no need to feel embarassed as it is to be expected

  10. SUMMARY • Good introduction- build a good relationship • Always check patient’s understanding of the procedure • Address their ideas, concerns, expectations • Explain in lay man’s terms • Allow patient to ask questions • Leaflet • If stuck, do not blag your way through. Be honest Tell patient you will find out and get back to them

  11. THANK YOU!!! ANY QUESTIONS??

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