Gastroscopy Procedure Query

[MWxxxx]

Hi. Just wondered if anyone has had a gastroscopy with PV on Hydroxy and aspirin? I need to have some polyps removed and the letter says I should just continue with all my meds prior to the procedure. I've emailed Haematology for advice but wondered if anyone else had experience of this procedure and could offer any thoughts/advice. I am an extremely anxious patient so it is unlikely I will be brave enough to just go for the throat spray and will have to be sedated, which I understand carries greater risks but I am not sure they will get me in the room without it!

I'm also worried about staying hydrated as I cannot eat or drink anything from midnight, despite my procedure being any time during the following morning. I usually take my hydroxy and aspirin in the morning and like to take the aspirin after breakfast so it does not irritate my stomach. Clearly I won't be able to do this on the day.

Any advice or hearing from anyone who has been through this procedure would be really helpful. Thank you.

[bruddery]

Hithere. I recently had gastroscopy a week ago and advice from hospital was to continue taking my meds I’m on Rux and aspirin etc. the no drink thing was hard because I normally drink at least tw litres of water a day. However it was all very manageable and good to get the gastroscopy done. Bruddery

[MWxxxx in reply to bruddery]

Thank you, that's reassuring.

[21Rosie in reply to MWxxxx]

Hi,I recently had gastroscopy and was told to stop aspirin, blood thinners and fish oil for at least 7 days prior to my procedure. In fact I hadn’t done this and my gastroenterologist then postponed it until I had the 7 days clear. He said that if he needed to remove polyps etc bleeding might well be an issue otherwise.

Hope it goes well for you,

Rosie

[MWxxxx in reply to bruddery]

thank you. I was confused about the aspirin and thought I should probably stop. I don'tunderstand why medical professionals never share information with one another. It says in the letter to inform them if you take aspirin but at the appointment, not before. If they want you to stop why don't they tell you? It must be awful to get all prepared and then turned away on the day. I had a double sided leaflet about the procedure and it mentions nothing about checking what medication to stop. I also take omeprozole and everywhere I read it says this must be stopped beforehand, but I've not been told. I will have to try and check but I only have a number for the booking people and doubt if they will know. To be honest I am confused about the whole thing. Apparently my scan did not identify any action needed to be taken and the GP said the polyps were so tiny they didn't thing anything needed to be done. They just said they were going to check with the Gastro team and then suddenly I get the letter out of the blue giving only 2 1/2 weeks notice. I understand that they probably just want to be sure but it was a bit of a shock.

[Wilbert2018]

Hi

I’ve had numerous gastroscopy/endoscopy procedures. I’m on warfarin and interferon and was told to stop the warfarin before the procedures. And needed an up to date INR result before being able to proceed. I once had the procedure stopped before taking place because my INR was deemed to be too high to be safe because of the risk of bleeding.

I would second all the advice which says to contact your Heamatology dept and get advice from them. You can’t make the decision to stop/carry on with meds on your own, and better to know in advance about what to do. If you don’t have a contact number for the Heamatology team/MPN nurse, you should be able to be connected through the hospital outpatient number, or they might have numbers on the hospital website. Or you could look at the clinic report letters which should have the number on.

In terms of the endoscopy itself, I’ve always had sedation - every time I don’t think the sedation will work and then I’m suddenly waking up back in the recovery area with no memory of what has happened! So I think sedation is definitely the way to go - or it is for me at least. Overall they are pretty simple procedures but the gastro team do need to know that you’re on Aspirin etc. And you do need your Heamatology team to be aware and to engage in the preparation.

Hope it all goes well.

[MWxxxx in reply to Wilbert2018]

Thank you, that's really helpful. I have emailed heamatology but with it being a bank holiday weekend hopefully they will get back to me next week. Good to know someone else who taken the sedation route.

[hunter5582]

The norm in my experience is to continue hydroxy and discontinue the aspirin 2-3 days before the procedure. You would likely plan to take your hydroxy as scheduled with small sip of water like you would with a blood pressure medicine. Be sure to consult with both the GI-doc and your hematologist about this and ensure that all are in agreement.

Note that the newer hydration protocol used by some anesthesiologists would have you drink as much as 8oz of water up to several hours before the procedure. Not all have caught up to this however. The thinking is that heading into surgery dehydrated is not good for the patient.

"In 1999, 2011, and again in 2017, the American Society of Anesthesiologists issued NPO guidelines that permitted the consumption of clear liquids until two hours before surgery for all healthy patients undergoing elective procedures requiring general anesthesia, regional anesthesia, sedation, or analgesia."

mhealthfairview.org/blog/No....

Suggest you review this protocol with the GI doc and the hydroxy protocol with your hematologist.

All the best.

[MWxxxx in reply to hunter5582]

Thank you. I definately agree on the hydration. Although its not mentioned in the instructions I think ensuring you are well hydrated the previous day makes absolute sense and some effects should carry through to the next day (or at least I hope so anyway). Yes, I will be sure to check regarding medication but good to know everyone seems to be thinking the same.