Upper Gastroscopy/Endoscopy Without Sedation

Hi, I just had my EGD/OGD done. I actually had it done before 5 years ago WITHOUT sedation. The doctor refused to give it to me and convinced me that most patients are ok without sedation. It was the biggest mistake ever. The LA on my throat was burning and I choked while swallowing and before I knew it the tube plunged into my throat and I gagged all the way till the end. When it was pulled out, I agged and vomited all my juices at the same time and literally cried as a reflex.

The one that I had today was under sedation. The nurses and doctor could tell that I was very very tensed and jittery. My BP went up rather high and the doctor decided to give me a slightly higher dose of sedation. Funny thing is, the view of the equipment in front of me went fuzzy and they seemed to move like it has a life of its own! Strangely, I don't even remember the tube going in but I do remember when I was pushed out of the room. I knew I was awake but not entirely clear-headed. That is the power of sedation. I suggest telling the doctor that you are indeed very nervous and request for a safe yet higher dose of sedation to help you.

I had done one with and without sedation, I would definitely prefer the one with sedation. That's what it's for. Besides, I was well awake after the procedure. i only rested for about 1 hour, in which I was awake nearly the whole time and eating the sandwiches given. It was great!

I had my gastroscopy yesterday.  I managed it without sedation or spray i.e. without anything.  I was terrified before hand - I am allergic to bananas so couldn't have the spray and I wanted to feel in control and have less trauma to my gullet (we all fight it under sedation).

Anyway I wanted to encourage people not to worry - I think the worrying makes it worse.  Sure it isn't very pleasant and there are so many things I'd raher do, but if you get yourself worked up and anxious rather than being calm this will make it worse. 

For me the only gagging I had was when it went over the back of my throat - it felt hard and uncomfortable.  Once passed this bit I really concentrated on my breathing rather than thinking about it - I sort of zoned out and closed my eyes.

I elt the air go into my tummy, this was a little odd and felt like ressure.  The worst thing then was the gas coming back up the side of the tubes giving me the most embarrassing burps!

I think I was better off without the spray as I know th sensation of numbess at the back of the troat can make some people panic.

So in summary, it's not great but it's not as bad as I thought so try not to worry too much.  If I can do it without anything by keeping calm and breathing as well as I can then it is possible for most.

Had an endoscopy yesterday. Truly my worst experience ever, but everyone reacts differently. I had to wait four and a half hours due to an admin error by which time I had not had a drink of water for 18 hrs and felt very unwell. 

Far more pain than the previous two. Only throat spray each time. Feel very unwell today not able to fuction at all and in pain. On the previous occasions I was fine within a couple of hours. I hope one day someone will invent something to replace this barbaric procedure. Very envious of those who seemed to cope so well. 

 

Hi Jannena,

Sorry to hear you had such a bad time, and I hope you'll soon be feeling better. I didn't cope well either, so I know how you're feeling.

A lot of conditions that are normally diagnosed with gastroscopy are already diagnosable by other means. There's been a breath test for helicobacter pylori - the organism responsible for causing most gastric and duodenal ulcers - for at least 20 years now. And an MRI will spot most things. However, cost is the issue - especially in the UK, where patients aren't allowed to just pay the difference if they opt for a more expensive procedure, but are forced into paying through the nose for private treatment for the whole thing.

I'm sure you'll soon improve. I was left with scarring in my throat after a particularly barbaric procedure, but soon recovered.

i had both the Gatroscopy and Colonoscopy done yesterday. 6/6/2016. Absolutely barbaric. 

Sedative did not work, the guy doing it was so rough and it felt as if my throat was being torn apart. 

One doctor kept telling the other one to turn this way then , no, turn it as you are bringing it up so you will be able to see downwards as well. 

I cannot believe that in this day and age they can calmly do this to a human being. SURELY there has to be a far more easier way of doing this? I thought I had Jack the Ripper visiting - and I KID YOU NOT!.  From the throat experience I was in so much shock and was so relieved once he had the pipe out that I cared not one iota when they went into the back passage. That was painful but bearable. I just feel like I~ have been invaded by some perverse sick person who cared not one iota of what I was feeling at the time. 

Let me rather die from cancer or whatever, but nothing would make me take that test again. And I may tell you that I am never so melodramatic, but I am still in shock and horrified that I had to be put through that. Every single move was felt. Horrendous. Was it just a bad doctor doing it? 

The only way I got through that was to keep telling myself to breathe and try to relax and it would soon be finished. Gagged at least 5 times, mucus and eyes streaming but most of all the feel of that contraption in back of my throat being wrenched about and then the pipe being inserted then taken out then re inserted a number of times - Still cannot get over it and nightmare day and night on this one. 

Just cannot believe that they can do this and in such a way. Will it be open heart surgery next without aneasthetic. Hmmmmmmmmmm NOT impressed and strongly suspect had I gone with this privately and not with NHS it would probably not have been as bad experience as this was. 

Hi Veronica,

I'm so sorry to hear you had such a bad time with your gastroscopy. I did too - and if it's any consolation I don't live in the UK, so it wasn't done under the NHS.

I fully understand how angry and violated you feel. I felt the same way. I'm not in any way dismissing your outrage - or my own - but perhaps it would help if I explained how so-called conscious sedation works (and very occasionally doesn't). I'm a former nurse, btw.

There's an inherent potential flaw in the process of conscious sedation, which only affects a tiny minority of people who undergo it. The clue is in the word "conscious". Although most people who undergo endoscopy or any other procedure under sedation come out of it with no memory whatever, they remain fully conscious throughout the procedure. The medication takes just takes away the memory. If you don't remember something, it's as if you didn't experience it.

Others do retain hazy memories of the procedure when the sedation wears off, but were sufficiently calmed by the drugs administered that they were able to accept the procedure.

However, a lot of us struggle during gastroscopy, especially under sedation. I did too. It took six people to hold me down. (Though I have to say mine wasn't a straightforward gastroscopy.) And some of us have a paradoxical reaction to the sedation. It damps down our higher intellectual centres, leaving the more primitive "fight or flight" impulses in the driving seat. That's certainly what happened to me.

In these cases the staff continue with the procedure, restraining the patient if necessary, not because they're being deliberately cruel but because they "know" the patient will recall none of this afterwards so will not be traumatised by it. Quite understandably, their aim is to complete the procedure, so they can find out what's wrong with the patient, in order to be able to help.

Unfortunately, in an insignificant minority of us, the cocktail of drugs we're given completely fails to remove our memories of the event. The medical and nursing staff have no way of knowing this will happen at the time they're forcibly completing the procedure. This, combined with a violent struggle on the part of the patient, results in the emotional trauma you experienced.

I'd like to stress to anyone else reading this post that the combination of a paradoxical reaction and full retention of memory of the event is very rare indeed, particularly in the under-65s, who are always given a full dose of sedation. It's slightly more common in over-65s (my case) who are only ever given a half-dose.

If you ever have to have a gastroscopy again, I'd urge you to opt just for the throat spray, without sedation. If you can't tolerate it and start struggling then, the medical staff will know you mean it and will not continue, as this would constitute an assault. Either that, or insist on a GA. I think I'd go the latter route, as I live in a country where I can easily do this (although I'd have to pay the cost of the anaesthetic myself). I used to believe this wasn't available under the NHS, but I've seen a couple of posts on these boards where British patients have been able to insist on a GA.

Once again, you have all my sympathy and understanding for the way you're feeling right now. But the medical staff weren't being cruel and arrogant, they genuinely believed at the time that you would remember nothing of these events and would just come out of it with a sore throat. And the sense of violation does wear off. My experience happened three years ago and I've long since stopped having nightmares about it.

And again, to any others contemplating gastroscopy under sedation: don't worry about this. Only a tiny handful of patients have an unpleasant experience.

Exactly my experience! Next time request a general anaesthetic and then at the hospital (as a day patient) they give you profol which worked for me then I didn't need the general. But the rubbish sedation did nothing to me.

I would never have it again unless in hospital, yes you wait longer but it's not tramatic xx

Yes they held me down despite me pulling it out and saying stop and pushing them away. They tried again - holding me yet again I grabbed it and yanked it hard they shouted at me to stop but I was not having it in my throat I was dying it felt like. I felt violated, I cried profusely and was ignored. I was dumped behind a curtain and left sobbing. Then I decided I was never ever having sedation again! I'm glad I had the second one in a proper hospital with the opportunity to have a general. I explained the sedation didn't work, he tried it again and said oh yes does nothing! Then said lets trying this and if this works we don't need a GA. and the profol worked like a treat. I woke in recovery.

Much better experience

Glad you had a better experience second time round. If I ever had to go through this again I'd definitely insist on GA or propofol.

I actually had mine done in the endoscopy suite of a reputable university hospital. However, the circumstances were unusual. I'd swallowed my spiky one-tooth denture, it was stuck in my throat for three weeks while one hospital after another turned me away, saying I'd imagined the whole thing!

Finally, when I'd lost 7kg/15lb, was badly dehydrated, running a fever and coughing up blood, a friend took me back to one of the hospitals that had thrown me out and insisted something be done. While I retched uncontrollably and spat up blood and mucus (completely unable to swallow or talk by this time) a woman doctor screamed at me that the denture was in my head, not my throat, and to get out of the hospital. Fortunately, my friend stood his ground, with threats of legal action, and I was added to that afternoon's gastroscopy list "to prove once and for all that you didn't swallow your denture". Everyone was quite unpleasant too, implying I was a neurotic nuisance, taking up resources unnecessarily.

In the event, they found the denture as soon as they started on the way down, of course, but it had become embedded and there was a tussle to get it out, with a fair amount of bleeding into my throat to complicate things. In fairness, I think they would have given me a GA without question if they'd actually believed me in the first place and had known what they were going to find.

They were fine after that, kept me in for 24hrs with IV antibiotics. But I never got an apology, even after I sent in a written complaint by recorded delivery.

As I know only too well from my nursing experience, most of these events arise from medical staff "knowing" they're right, even when they're wrong. They "knew" I'd only imagined I'd swallowed the denture and they also "knew" that all three of us wouldn't remember our experiences. I often think a little humility wouldn't go amiss...

It's true about not remembering - my other half had the endoscopy and remembers absolutely nothing from it. Said oh it was fine. So for some it does work! For me it doesn't. I wondered if it was due to long term use of codeine and oramorph? Would that make me less susceptible?

Possibly. But some people are naturally less susceptible to sedatives anyway. We all react differently. That's the problem - the only way the staff know it's not working on you is when you tell them afterwards that you remember the whole thing. And then they may try to tell you you imagined it!

Seniors are automatically given a half dose because of a theoretical risk of respiratory and cardiac depression so we're more likely to have a rough ride. It's possible I got even less than a half-dose, as they were convinced it was going to be a straight-up-and-down affair.

Since everyone reacts very differently and everyone's doctors have different approach, clearly there is no guarantee on how this procedure will be for people.

I've had 4 endoscopies over the years, 1 NHS and 3 Private and quite honestly they all felt the same. I just had the banana tasting throat spray each time and can honestly say that whilst I didn't particularly enjoy any of them, they were manageable with concentration on breathing and focusing on the items around the room! It's certainly far more pleasant than a tooth extraction or a deep filling!!

The only time I've had any of the rohypnol type drug for this was when I had a colonscopy and the funny thing about that is that I remember the entire procedure but have no idea how I got back to the hospital room after!! :-)

If you have a bad gag reflex I would suggest having some sort of anaesthesia, at the end of the day there's a very good reason you're having to have this done, and if it means diseases are caught early or for peace of mind, then surely 5-10 minutes of extreme discomfort out weighs any bad experiences?

Having read this discussion I will decline the endoscopy that I'm liked to be recommended. I have a sick phobia never having been sick and just reading this forum has made me feel so panicky. I wish I hadn't so it would have been done before I discovered how awful it is. Have to just hope it's nothing serious.

Fal, gastroscopy can be unpleasant for various reasons but very few people actually vomit during or after the procedure. I'm speaking both as a former nurse and someone who also had a bad experience during gastroscopy - but which didn't involve any vomiting.

If you've never been sick in your life, this suggests that you're one of those people who don't vomit easily anyway. I'm the same. I've only thrown up a handful of times in my whole adult life (I'm 72!) in spite of having had some horrific attacks of food poisoning when I lived in the Far East. In some of these I used to feel so sick I longed to throw up but it never happened!

The main reason for vomiting during or after endoscopy is failure to observe the usual instruction not to eat anything and only to drink small sips of water from the night before the procedure. People who are having the examination because their stomachs don't empty properly may also vomit, but then they vomit frequently anyway as a symptom of their condition, so you clearly don't fall into that category.

This really isn't a reason for not having the investigation. If your stomach is empty there'll be nothing to vomit up.

Thank you for your quick reply. Apart from the vomiting I'm generally terrified of hospitals and operations etc. If it's decided it's essential I have the procedure I'll have to go for the sedation route. What people say about people being held down sounds horrific.

Actually, very few people who go for sedation retain any memory of the procedure, even those who were very nervous went they went in. It's mainly the over-65s like me who recall the whole thing, because they're not allowed to give us a full dose of sedation. But even most older people recall nothing. The unpleasantness in my own case, which you may have read about somewhere in this forum, was down to a combination of age-related inadequate sedation plus the fact that the doctors refused to believe I'd swallowed my denture three weeks earlier. When they got as far as my throat and saw it embedded in the tissues, they panicked and pushed ahead anyway.

You'll be absolutely fine if you opt for sedation. Don't forget to come back here and tell us all how you got on!

I had mine about 3 years ago, I hate hospitals, especially the smell.

I opted for no sedation, just throat spray - bearing in mind the reason I was there, was that I was been sick throughout my waking hours, randomly and in my profession, very untimely.

It takes 5 minutes and it isnt pleasant but I assure you, follow the nurses instructions and you will be fine. After I had mine, I took 10 minutes just to get back to normal, then I actually decided I would walk home, around a 40 minute trek.

That night I went to my local and had a few beers with my friends, actually relaxed in the knowledge they had found nothing sinister.

My advice, just go ahead and dont worry, Ive done things in my life far worse than this.

That sounds terrible. I'm glad you're ok now. I'm 63 and generally healthy so I'll check and if they can give me full sedation that might convince me to go ahead.

I will report back with the outcome.

The sedation may or may not work; didn't work for me and the test was abandoned. I went to the main hospital to have it repeated with stronger stuff and I remember nothing. It was much more pleasant to go in as a half day patient I found, but it is different for everyone x

Unfortunately I'm pessimistic that I'll have a bad experience like some have experienced so I will request full sedation. How long does the anaesthetic take to wear off? I'll allocate the whole day for the procedure so time won't be a problem. How long does it take to get the results?