Hi all. Following my inability to stop omeprazole without having apparent reflux symptoms I am scheduled for a gastroscopy in a few weeks time. I am an extremely anxious person prone to panic attacks and am freaking out about the procedure already. I think I will need sedation, but I am also really quite sensitive to benzos, for anxiety 0.5 or 1 mg diazepam is usually sufficient to calm me down and 2mg makes me woozy and sleepy and makes me feel a bit like I'm not breathing enough. I'm a bit worried that the normal dose of midazolam or diagram (5mg) might be too much for me. I'm only 33 so I expect they will want to give me the full dose. Does anyone have any advice on this?
Thank-you autocorrect. Diagram = diazepam
Phone your hospital, just call and ask for endoscopy. A nurse will most likely pick up. Go through your concerns, you won't be the first, nor the last.
I spoke to them and they confirmed me down for sedation as I had mentioned to the gastro I have a gag reflex and they also told me that has would be performing it himself. I'm also due to go in on Monday when it is their quiet day/time and have a look at the scope.
Hi sparklypickle (lovely name!)
If you're feeling panicky I'd say go for the full dose, even if it does make you a bit woozy. You'll be in a hospital surrounded by nurses and doctors, they monitor your blood oxygen saturation throughout and they keep an IV line open in case of emergencies, so nothing terrible is going to happen to you. Even if you ask for a half dose they'll still keep you in the hospital till you're judged fit to leave, and they won't let you drive yourself home. The benzo they use isn't diazepam anyway, plus they normally use a cocktail of drugs. Either that or just opt for the throat spray.
A half-dose of sedation really isn't a good idea. That's all I was given because I was 69 at the time. This is an automatic rule for the over-65s. The only effect it had was to depress my higher centres and put me in "fight or flight" mode, so it wasn't a good experience. If I ever have to have another one I'll opt for throat spray only, in spite of my phobia about the whole thing.
The vast majority of people your age, and even a lot of seniors, come out of the experience remembering nothing whatever about it and often not even feeling groggy.
Just one caveat. You say you've taken benzos for your underlying anxiety. Obviously you should tell the staff if you've taken benzos or any other medication in the 24 hours before the procedure.
Hi RHGB,
thanks for your reply - I may phone closer to the time for some reassurance, I just rang to ask about omeprazole and the stopping thereof that was not mentioned by my GP or in my appointment letter. It turns out I DO need to stop omeprazole for two weeks before the procedure and the nurse I spoke to was really nice and understading about it. Gaviscon at the ready then!
I'd have been a bit annoyed if I went through with the procedure without stoppong omerazole because no-one told me to, then havd to haev it again...at least I'm aware of the implications - that omeprazole can mask things, like the helicobacter test (which I need confirmed).
Oh well, I've been on Omeprazole (as well as others) for two years now and I saw my gastro three weeks ago and he of course knows and is doing the procedure, so it must be different for me.
Mines for oesophageal varices, so slightly different.
Thanks for the reply Lily,
I have read that midazolam is the sedative of choice for this procedure, and the dosage is quite similar to diazepam, but it lasts a lot longer.
Oh I didn't realise that they kept an IV in..not sure if that worries or reasures me though, I've never had one before and I find injections and blood samples icky enough.
You are of course right that there will be medics all around and they will be monitoring me. Sometimes I'm so stressed that I forget that other people actually DO know what they are doing!
Interesting that you found the half dose made you feel panicky, that doensn't sound fun at all. At least if you have it done again you know what to expect (good or bad) so it isn't the great unknown any more. I will discuss my worries with the nurses there and maybe they can start with half dose, check me and decide whether to give more? I think that they do that sometimes...I'm such a baby about things like this, I'm weirdly convinced I'm going to stop breathing or something..
I will be sure to steer clear of benzos in the few days before the procedure even if I am freaking out because I don't want to end up with a horible mixture in my system. I take them very rarely but thinking about this gastrocopy has me thinking about reaching for the packet...
I know it is a routine thing, and it will probably be perfectly fine.
Don't worry about the omeprazole confusion. There's currently a controversy going on about this. Some doctors are adamant you have to stop taking it before endoscopy or any other investigation, whereas others insist it doesn't make a bit of difference. Situations like this have always been commonplace in the medical world. Believe me, it can be a nightmare for nurses having to negotiate the minefield of conflicting instructions from different consultants!
I think for your condition omeprazole won't be a problem, My GP is convinced I do not have helicobacter any more because I had two neagtive stool tests (only stopping omeprazole two days before), but then again, I had a negative test a few months before I got a positive one, so I'm not sure about the accuracy of my post-treatment tests.
I imagine it must be tough to keep up - the nurse I spoke to said it wuld be bbest if I can stop the omeprazole, but if I can't then its not the end of the world, the helico biopsy just might come up as a false negative.
They'll either put in a re-usable line or an infusion. This is essential. If ever they needed to reverse the sedation or give you a stimulant because anything was going wrong, they could get it into your bloodstream immediately without poking around looking for a vein. And also, as you say, this gives them the opportunity to start with a smaller dose and add more if they think it's necessary.
You're right not take benzos on the day. It's OK if you take a small dose up to the day before, but if you do, be sure to tell the staff when you arrive.
As you say, it is indeed a routine thing and you will be perfectly fine!
Don't forget to come back here afterwards and tell us how you got on!
Thanks lily,
These replies and a few good posts about it not being a traumatic procedure have managed to calm me down a bit. I'll be sure to come back and let people know how it went because if there is someone else out there equally freaked out about the idea, I'd like to be able to reassure them like others be done for me
Is your appointment before the 21st?
It's July 4th. Why what happens on the 21St?
I have my endoscopy, I was kind of hoping yours was first and you could give me some feedback.
oh I'm sorry, of course I'd have done that but looks like the shoe is on the other foot!
Good luck for tomorrow 
Two weeks to go and I took my last dose of omeprazole on Friday. I gradually weaned off, and unlike last time, have only experienced an acidic sensation in my stomach, a little nausea, a few flashes of heartburn and a couple of days of a vaguely sore throat but now I'm left wondering why I'm having this endoscopy done!! If I truly don't have bad reflux or gastritis symptoms without omeprazole then I feel like I'm wasting everyone's time with having this procedure just to put my mind at rest. I'm honestly worried that when I get to the hospital they are going to be angry with me or something. Having said that I've stopped caffeine entirely and am eating a rather boring stomach safe diet. Maybe if I have a big dinner with wine followed up with chocolates and coffee then it may well be a different story!
I'll let you know how it was. If I forget, just post a message here and I will automatically get a reminder about this thread. I'm in at 9:00am. I'm fine now, but it will be different in the morning.
Your doctor certainly won't be angry with you for not having the gastroscopy. All doctors prefer to do as many investigations as possible. You're more likely to get into trouble if you don't have it.
But you're making a valid point about diet.
I started getting acid reflux 40 years ago, when I was in my early 30s. I got severe pains in the centre of my chest nearly every night and sometimes during the day too. Because I prefer not to live a "medicalised" life, I started looking at what triggered attacks and how to avoid the triggers. As a result, I quickly reduced my attacks to three or four per year, and it's stayed that way ever since.
I certainly don't have a boring diet. I drink a bit too much wine for a start! (Though I'm working on that one for other reasons.) The main culprit in my case is bread. I can still eat a little at breakfast or lunch-time, but eating bread late in the evening is a guaranteed way of waking up with an acid attack at 2am. Combinations of foods are also important. In my case it's eating very oily foods with acids. That means my favourite smoked salmon with plenty of lemon juice (and toast!) has to be kept for special occasions, and only at lunch-time. One of the main things that made a difference to me was slightly raising the head of my mattress. That halved night-time attacks even before I figured out all the food rules. I also learned that constipation can bring on an attack, as well as wearing tight trousers. The last one sounds comical, but I think too-tight pants increase my lower abdominal pressure and force gas and stomach contents upwards. People who are overweight or obese often find losing a bit of weight is helpful too.
There are very few things I've had to cut out. The only ones I can think of are neat spirits - I used to enjoy a very occasional brandy but can't tolerate the stuff now - and hard green apples like Granny Smiths, which I used to love. But that's only happened since the menopause, which often changes your metabolism. I also have to be a bit careful with stone fruits, especially cherries - again only since the menopause - but can still eat small amounts earlier in the day.
I've never taken omeprazole. I find a single tablet of Motilium (domperidone) is enough to see off my occasional attacks. It was a bit of a bummer when this went to prescription-only all over Europe a few years ago. When I first asked my doctor to prescribe it, he tried to sell me on omeprazole - even though that has to be taken every day to work. Fortunately, I live in a country where you can fire your GP and get another one as often as you like, so that tends to concentrate their minds wonderfully! I get my prescription for 30 tablets of Motilium every two years, and that's more than enough.
It really is worth working out your triggers - which might be completely different from mine. It doesn't work for everyone, but I suspect quite a lot of people who've condemned themselves to a lifetime on omeprazole, with all its side-effects, could just as easily cure themselves with a bit of observation and a few minor lifestyle changes.