About your endoscopic ultrasound examination

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What is an endoscopic ultrasound?

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.

How do I prepare for my examination?

• 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 anti-platelet medicine

What should I bring with me to the unit?

• 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.

How do I find the endoscopy unit and can I park at the hospital?

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.

What happens when I arrive in reception?

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.

What are the benefits?

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.

Are there any significant risks?

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.

What happens after my examination?

You will be taken into recovery and will be given time to rest. The nurses will check your vital signs regularly. You will not be able to have anything to eat or drink for up to 1 hour afterwards. If you have a gluten allergy please bring something to eat. You will need to rest for the remainder of the day and refrain from smoking, and drinking alcohol. You MUST NOT drive, sign legal documents or operate any machinery for 24 hours. Before you leave the unit an explanation of the findings will be given to you, and your GP will receive a copy of the report.

Will it hurt?

Endoscopic examinations and procedures can be uncomfortable, so we have a variety of interventions at our disposal to make it more comfortable for you. Sedation can be given for an EUS.

We can also give intravenous pain killers. Please let us know if you are uncomfortable in any way and we will do our best to help you. After an EUS you may suffer from a sore throat and bloating. These effects should disappear after a few days but you will be given written aftercare advice when you go home, which tells you what to do if your symptoms do not settle.

How long will it take?

Examination / procedure times vary. An EUS examination can take anything from 15 minutes to 30 minutes, or longer. You should be prepared to be in the unit for possibly 3 to 4 hours.

When will I get my results?

The findings are reviewed by your consultant, who will then arrange follow up. This is usually a clinic appointment, sometimes on the same day, to discuss your results, or it could be a letter explaining your results. Your GP will also be informed.

What do I do if I need to cancel or change my appointment?

If you need to cancel or change your appointment please call us on 0300 303 8517.

Your comments and suggestions

Thank you for taking the time to read this leaflet, if there is anything at all that you don’t understand, or you have any questions, please ask a nurse at the unit,  or call us on 01273 696955, extension 64570 for the Royal Sussex County Hospital and 01444 441881, extension 68187 for the Princess Royal Hospital.

If you have any concerns about your treatment or care, please bring them to our attention. We will do our best to help.

We always welcome new ideas and suggestions. Please let us know if you feel there are ways in which we could improve our service.

At the end of the leaflet is an example of the form ‘Patient agreement to investigation or treatment’. Please print off the PDF version to obtain the example form.