About your endoscopic ultrasound examination

This is a simple examination which enables the clinician to view the inside of your oesophagus and stomach. A tiny ultrasound probe incorporated in a flexible tube will be carefully passed into your mouth and down your gullet (oesophagus).

It is not a painful examination and does not interfere with your breathing. However, some people may find it uncomfortable, so we can give you a sedative or throat spray to anaesthetise the back of your throat. The sedative will make you feel relaxed and drowsy. You may even sleep throughout the procedure.

• Have NOTHING to eat, and do not drink milk, for 6 hours before your appointment.
• Have NOTHING to drink for 2 hours before your appointment.
• Please contact your GP surgery or nurse specialist if you are diabetic and need advice regarding your medication.
• Please contact the endoscopy unit if you take warfarin or any other anticoagulant or antiplatelet medicine.

• Because you will be having sedation for your procedure, you will need someone to act as an escort and stay with you for the remainder of the day and overnight. Your escort must come up to the unit to collect you. We cannot take you down to meet them.
• A list of ALL your medication.
• Your reading glasses.
• Wear loose and comfortable clothing.
• Do not bring any valuables with you.

It is very important that you follow all the instructions carefully, or your examination may need to be postponed.

The Royal Sussex County Hospital is on Eastern Road, Brighton. The Endoscopy Unit is on Level 9 of the Tower Block. The entrance is via the Milennium Wing. (Please see map at the end of this booklet).

Parking space at the Royal Sussex County Hospital is very limited, so please set off in plenty of time for your appointment and be prepared to wait in the car park queue. Alternatively, your escort may drop you off at the Millenium Wing and then return to the unit to collect you later.

If you have sedation for your procedure and intend to go home by taxi, you will need a responsible adult to accompany you, as taxi companies will not accept responsibility for you travelling alone. Although you may use public transport to come to hospital, we strongly advise you not to travel home by bus or train, following sedation.

Please report to the desk. Our receptionist will check your details and ask you to take a seat in the waiting room. You will then be called through by a nurse or health care assistant, who will explain the examination / procedure to you and ask you some questions about your medical history. Please ensure that you have your escort’s contact details with you so that we can call them when you are ready to be collected. If you have any questions or if there is anything at all that you don’t understand, please ask.

You will be asked to sign a consent form before the examination / procedure. Please see a copy of the form at the back of this booklet.

Endoscopic ultrasound is often performed alongside other imaging investigations (CT and/or PET-CT scanning) as part of a process of staging for oesophageal or stomach cancer. Specifically this involves looking at the oesophageal / gullet wall and around the oesophagus / gullet, with an ultrasound scope, to ascertain the exact site and extent of oesophageal or stomach cancer and is a key factor in planning treatment. Endoscopic ultrasound is sometimes used to obtain biopsies from abnormalities that cannot be reached with standard endoscopy.

The risks of endoscopic ultrasound are the same as those of standard endoscopy, all of which are very unusual. These telescopic examinations are very safe but some risks are associated with the procedure:

• These include a reaction to the sedative which can affect 1:2500 people. This may affect your breathing or blood pressure, both of which are closely monitored during any procedure.
• A tear or perforation in the lining of the stomach or oesophagus can occur in any telescopic test. The national figures for this are 1:1500. If this does occur you will need to be admitted to hospital and may require an operation to repair the tear.
• Minor bleeding is common if biopsies or pieces of tissue (polyps) are removed but this bleeding usually stops spontaneously. More significant bleeding can occur in 1:1000 procedures and may require admission to hospital and a blood transfusion. Specialist equipment and training reduce all these risks considerably. The figures quoted here are national averages and for BSUH are much lower. There is also a risk of small lesions being missed. This is currently quoted as approximately 5%.

Please speak to the doctor or nurse performing your procedure if you have any concerns.