• You may be offered the option of having sedation and a local anaesthetic throat spray or just local anaesthetic throat spray.
• The local anaesthetic throat spray numbs the back of the throat but you are awake during the procedure. This has many advantages as you will be able to leave more quickly and carry on your day as normal.

• You will be placed in a comfortable position on your left-hand side.
• A nurse will stay with you throughout the procedure.
• The back of your throat will be sprayed with the local anaesthetic spray and a small mouth guard will be placed in your mouth to keep your mouth open.
• If you choose to have a sedative this will be given to you through a small needle.
• The gastroscope is passed through the mouth guard and down into your stomach and will not interfere with your breathing at any time.
• During the procedure, some air will be passed down the gastroscope to open up the stomach and give the endoscopist a clear view.
• If biopsies (tissue samples) need to be taken this can all be done painlessly through the gastroscope.

• There is a very small risk of bleeding or perforation for which a stay in the hospital for observation or surgery may be necessary.
• Other extremely rare complications include irritation of the lungs if secretions spill into the windpipe or a reaction to the sedative drugs that may be used during the procedure.

• Alternative tests to gastroscopy include a barium swallow and meal that outline the lining of the stomach and small intestine however these are not very accurate.
• These examinations, however, do not allow direct viewing, removal of polyps or the taking of biopsies.

A colonoscopy is a procedure which allows the endoscopist to look at the lining of your colon (large bowel) with a flexible telescope (colonoscope). Pictures are relayed to a monitor screen for the endoscopist to see.

• Colonoscopy is a diagnostic test used to investigate bowel symptoms such as bleeding, loose stools, diarrhoea or to investigate anaemia by inspecting the colon for any abnormalities.
• Some small tissue samples (biopsies) can be taken painlessly during the procedure for laboratory analysis and any polyps (abnormal growths of tissue) can sometimes be removed using an electrical wire snare and areas of bleeding can be treated.

• In preparation for your colonoscopy, you will need to take a strong laxative (bowel preparation) to empty and cleanse the bowel.
• Instructions regarding bowel preparation and information about your if any medication will be provided in detail.

• Your colonoscopy will usually be performed under conscious sedation (drowsy but responding to verbal stimuli) to help you through the procedure.
• The medication helps with the pain and anxiety and in some patients have an amnesic (some patients even forget they had the procedure) effect.
• In many cases, it is a painless procedure that can be performed without any sedation or with occasional nitrous oxide (gas and air) as pain relief.

• You will be placed in a comfortable position on your left-hand side and will be given some sedation by injection through a vein to make you feel relaxed.
• A nurse will stay with you throughout the procedure.
• The endoscopist will pass the colonoscope through your back passage into your rectum and around your colon.
• To allow them to have a clear view some carbon dioxide will be introduced into your colon, this may cause you some discomfort but it should pass quickly.
• The procedure will take approximately 15 minutes to 1 hour.

Colonoscopy is a very safe procedure with minimal risks however these may increase in therapeutic procedures such as polypectomy or APC to stop bleeding.

• Bleeding (1/ 100).
• Perforation (tear) of the bowel may develop (1/1500). If this occurs it may require a stay in hospital and urgent treatment or an operation.
• In a small number of cases (patients with pelvic surgery/high BMI), the procedure can be very difficult and painful.
• As the colon is a long and tortuous tube with many folds and turns there is a possibility that small lesions may be missed (especially if the colon is not sufficiently clean).

• Alternative tests to colonoscopy include a barium enema and CT colonography that outline the colon and allow a diagnosis to be made.
• These examinations, however, do not allow direct viewing of the colon, removal of polyps or the taking of biopsies.

• In preparation for your sigmoidoscopy, you will need to have an enema to help empty your bowels.
• There is usually no need to alter any medication unless instructed.

• Your flexible sigmoidoscopy will normally be performed without sedation allowing you to leave more quickly and carry on your day as normal.
• If you are extremely anxious or there is a clinical reason where it is deemed to be appropriate, then you may be offered the option of having sedation.
• If appropriate, you may be offered nitrous oxide (gas and air) as pain relief.

• You will be placed in a comfortable position on your left-hand side.
• A nurse will stay with you throughout the procedure.
• The endoscopist will pass the colonoscope through your back passage into your rectum and around your left colon.
• To allow them to have a clear view some carbon dioxide will be introduced into your colon, this may cause you some discomfort but it should pass quickly.
• The procedure will take approximately 15 minutes.
• If any pathology is encountered you may be booked for a complete colonoscopy.

Flexible Sigmoidoscopy is a very safe procedure with minimal risks however these may increase in therapeutic procedures such as polypectomy or APC to stop bleeding.

• Bleeding (1/ 100).
• Perforation (tear) of the bowel may develop (1/10,000). If this occurs it may require a stay in hospital and urgent treatment or an operation.
• In a small number of cases (patients with pelvic surgery/high BMI), the procedure can be very difficult and painful.
• As the colon is a long and tortuous tube with many folds and turns there is a possibility that small lesions may be missed (especially if the colon is not sufficiently clean).

• Alternative tests to Flexible Sigmoidoscopy include a barium enema and CT colonography that outline the colon and allow a diagnosis to be made.
• These examinations, however, do not allow direct viewing of the colon, removal of polyps or the taking of biopsies.