Gastroscopy with only throat spray ‘sedation’ + anxiety pill

At my local hospital they do now offer a transnasal endoscopy which is apparently easier to tolerate than the traditional one. They do not offer sedation for this and the throat spray does not freeze your throat and make you feel like you cannot swallow, like the one they give before a traditional endoscopy. Yours may be the same.

Oooh, I don't like the sound of that, either.

Elusivebutterfly

At my local hospital they do now offer a transnasal endoscopy which is apparently easier to tolerate than the traditional one. They do not offer sedation for this and the throat spray does not freeze your throat and make you feel like you cannot swallow, like the one they give before a traditional endoscopy. Yours may be the same.

I’ve had that too and it was fine. Didn’t have time to worry about it as just got letter in post to go for appointment, day/time etc.

Thought I was just going for a check up but the Consultant came to call me wearing theatre gear! We had a chat then he said “I will put a tiny camera up your nose and down your throat on this flexible pipe. I will just spray your throat first.” I nearly fainted and said “does it hurt” and he said nobody had told him it did. I asked the nurse if I could hold her hand and that was fine. Didn’t hurt at all and he told me there and then it all looked fine and there was nothing sinister going on so a good job done.

I had one of these last year and refused any type of medication. I did not want a throat spray or sedation whatsoever, I just did deep breathing and I never felt a thing when the tube went down my throat. It is just like swallowing food and you never think about that when eating.

I had one five weeks ago, I couldn't have throat spray as I am allergic to bananas! Had light sedation and was aware of the procedure but I managed it and I am a panicky person. Tell them you are very anxious and I'm sure they will offer you sedation . Good luck

Sedation is not recommended for certain patients, e.g elderly people, pregnant patients, and patients with chronic obstructive pulmonary disease, heart disease, chronic renal failure, or liver cirrhosis.

I was sedated prior to a procedure to inject cement into vertebraic fractures. I woke up hours later, to be told I had a reaction to the sedation and had to be intubated. I remembered nothing, apart from recalling someone with a terrible cough in the theatre. It turned out to be me.
The ward sister said I gave them a bit of a fright!
No more sedation for me.

The drugs used in endopscopy sedation are opiates, such as meperidine or fentanyl, benzodiazepines, such as midazolam or diazepam or a hypnotic such as propofol. That’s why patients have to be monitored for longer in clinic after the procedure and have to have someone with them for 24 hours afterwards, in case of reaction.

Everybody has a gag reflex. It’s a necessary reaction to prevent swallowing foreign objects and prevent choking but it is literally mind over matter or how else would we be able to swallow food and large pills? A piece of bread going down the esophagus into the stomach is larger than an endoscope.

This is something I discussed with my dentist when I was struggling over oral xrays and having impressions taken. He advised deep breathing and flexing the toes upwards. The latter isn’t to do with reflexology or anything like that. It’s just a way of concentrating the attention on one end of the body while something else is going on at the other.

Having learned that technique from the dentist, I used it when having a sedation-free upper endoscopy and it was fine.

Marydoll

Sedation is not recommended for certain patients, e.g elderly people, pregnant patients, and patients with chronic obstructive pulmonary disease, heart disease, chronic renal failure, or liver cirrhosis.

I was sedated prior to a procedure to inject cement into vertebraic fractures. I woke up hours later, to be told I had a reaction to the sedation and had to be intubated. I remembered nothing, apart from recalling someone with a terrible cough in the theatre. It turned out to be me.
The ward sister said I gave them a bit of a fright!
No more sedation for me.

I have cirrhosis, and it is the gastro doctor that keeps making me have blooming gastroscopies.

Oops!
Sorry, just read properly, as I should have done in the first place.

I have had several - more than I can count - and usually didn't have sedation and I was okay - BUT then a few years later I had one which was a lot more difficult and I had to have a light GA in the end at a specialist place a few weeks later.

I have strictures and narrowing and therefore it's maybe going to be more difficult, not sure.....

Also - Diverticulitis and I also had a colon abscess, they were going to remove part of the colon but avoided that with IV antibiotics in hospital for over a week.
Every single person is different. Every story different.

But I think the person to consult with probably is the specialist rather than mainly the GP.
Okay - the GP too if you have access and can get a letter from them - but I would want to speak to the specialist too. Not sure if you're under a Gastro consultant?

Sorry for late response, just back from babysitting my three grandsons.
I truly wish I could be more like the ‘warriors’ who just soldier on, and get on with it. I do with most things in life, but I just don’t seem to be able to get past the panic stage when I feel I can’t swallow, I have no idea why. I use the breathing techniques I was taught in antenatal classes for so many things, but they are a dismal failure for this.
I am going to push for some form of sedation; I don’t think my doctors’ secretary realised just how anxious I am about this, so as many of you have suggested, I think I need to see my doctor and discuss this.
Elusivebutterfly - I have to say I haven’t heard of a trans nasal endoscopy. The Community Centre that offered me the appointment apparently completes four of these procedures per hour, which is why they don’t offer sedation.

Like you MissAdventure, I don’t like the sound of that either!
I agree with you NotSpaghetti, I thought there was a right to choose, and I would rather wait a while longer to have sedation.

Thank you so much to all of you for your responses, with details of your experiences.. I feel far more assertive now (and not so much of a wimp and will contact my GP as soon as possible. Wish me luck .

Please let us know if you manage to get sedation.

I'm convinced it is a money and time saving thing to persuade people not to opt for sedation.

If you cancel and refuse the option without sedation, you will find that you're offered it.

You may not need to see your GP. Having a telephone consultation will be just as effective.

Before you arrange this if there is a telephone number on the appointment letter phone that and ask why you can't have sedation. At least then you will be able to have that information to hand when you speak to your GP. He may have to re-refer you back in.

It may be, as you suspect, that the community hospital does not offer sedation but the main hospital should still be able to offer this.

I'm a nurse endoscopist (and I wouldn't entertain the idea of a gastroscopy without sedation ). My department trialled offering a non-sedation list a few years ago. We rang every patient and offered it, but it was very labour intensive and the uptake was so low the effort was greater than the gain.

We then trialled just sending an appointment letter out with no choice, but again so many patients refused the appointment unless it was sedation that we eventually gave up on our 'throat spray' only lists.

SuperTinny, I am currently booked in for a telephone ‘appointment’ next week (my Dr works part time), however I have written her a letter which I will drop off at the surgery. I feel I can explain more fully on paper prior to our conversation.
I spoke to the Community Centre for Endoscopy and have cancelled my appointment. It appears to be a dedicated centre that isn’t actually part of the NHS, and is run by GP’s with special interests in Gastroenterology. They do 4 procedures per hour, which I assume is why they only provide the throat spray, and procedures are charged to the NHS. It was suggested to me by the lady I spoke to that I ‘insist’ on sedation and ask to be put on the waiting list (which apparently is 18 months where I live in our main hospital ). She said the last thing they need is for a patient to be over anxious as the consultant would not go ahead with the procedure, so would be a wasted appointment.
Thank you for your advice and opinion. As many of the GN’s on here say I will have to put ‘my big girl’s pants on’ when I speak to my Doctor and not be bullied into backing down!!
Hetty58, I am hoping that refusing the option without sedation will allow me to be put on the list for the procedure with!
MissAdventure, I certainly will let you know if I manage to get the appointment with sedation, although if I have to wait 18 months to find out get a diagnosis, I may possibly have to contact you via seance . Thanks again to all who have replied.

I had a gastroscopy a few years ago without sedation with no
problems. However a few months ago I had one, done by someone in training and just couldn’t cope with, so had IV sedation and wasn’t then aware of the procedure. In future I would definitely opt for sedation.

I’m definitely not a wimp and cope with most procedures but not that!

I had this procedure with throat spray. As I have a very strong gag reflex and felt I was choking I pulled out the tube in a panic. The consultant tried again with the same result. I asked if sedation would help and she said no you will need to have a general anaesthetic as you have a very strong gag reflex. You need to discuss this with your doctor. A pill for anxiety will not remove your gag reflex.

I have had two with throat spray. It wasn’t what I would choose for an afternoon entertainment but it really was perfectly bearable and over quite quickly.

I'm glad you've managed to stand firm, but what a long wait!!!

Well done for persevering HooteNanny.
It doesn’t seem very satisfactory to me to put patients on a conveyor belt of “4 an hour”. Not everyone will cope with the procedure and so there may be a few wasted appointments it strikes me. I think everyone should be offered the choice of sedation if they want.

I think 18 months wait is unacceptable, depending on symptoms. When you receive an appt let them know you are happy to take a cancellation. I would also check if there are other NHS centres with shorter waiting lists that you can be referred to.

"Have you asked why sedation will not be an option for you? Sod being a nuisance, as you call it. I would insist on sedation or referral to another hospital. Don't take No for an answer and good luck"
This is good advice from Sarnia, Hootenanny.
They knocked me out.
I don't know for sure but this sounds like the NHS saving money and it's OK for people who don't care whether they are sedated or not but you do care!!
Sometimes these doors open really easily with just a little push. NHS is just seeing if you'll accept it without challenge?
Challenge it !
I'm a terrible pain Wuss. I won't let a dentist within 10 yards of me without local anasthesia(is that spelt right?) I compensate by sometimes being brave in other areas.
Good luck.

The only person who understands properly how you feel about something like this - and what reaction you are likely to have - is you!

It's not meant to be an ordeal, surely, or a test of courage or mental strength. The person to speak to you about not just fears but facts is the Consultant/Anaesthetist, pre-op. Just loading people onto a conveyor belt for such outpatient treatment is hardly going to fit everyone.

Fortunately, here in France, nobody worries about heroics. I have just had two cataract surgeries - one week apart - when my lifetime phobia about eye-related things was really tested. Surgeon almost fell over when I said that I couldn't even consider it without general anaesthesia. His response was that nobody would ever want to inflict trauma on a patient - especially when they needed someone to be quite still and cooperative, in order to do a proper job!

The whole experience was fine once I knew that I would be fast asleep. Next week I shall be discussing an endoscopy. Again, a gag reflex which prevents me from coping with someone even examining my throat, or checking my teeth, without tears pouring down my face and the prospect of just heaving and heaving! The embarrassment and anxiety is awful.
So, Endoscopy under GA. I'd undergo it otherwise if humanly possible, but it's not and we all must recognise our limitations.

Don't give in OP. Don't put yourself through something awful just because ..... Good luck!

It is nothing to do with heroics. For some of us, GA or sedation is deemed too risky by our clinicians.

Marydoll

It is nothing to do with heroics. For some of us, GA or sedation is deemed too risky by our clinicians.

Same for me Marydoll. It isn’t pleasant but I have no option.

Blossoming

Marydoll

It is nothing to do with heroics. For some of us, GA or sedation is deemed too risky by our clinicians.

Same for me Marydoll. It isn’t pleasant but I have no option.

But, unless that includes the Original Poster, that's not an entirely helpful response.