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BRAVO

 

Coronavirus: endoscopy update

In response to the coronavirus (COVID-19) outbreak, we are only performing emergency endoscopy. Non-urgent endoscopies, including cancer surveillance procedures, will be deferred. 

Please read our advice and information before attending the service.

I'm having a BRAVO: what do I need to know?

A small capsule, about the size of a gel cap, is temporarily attached to the wall of the esophagus during an upper endoscopy.

The capsule measures pH levels in the esophagus and transmits readings by radio telecommunications to a receiver about the size of a pager  worn on your belt or waistband.

  • Before my procedure - booking

    I’ve been told I need a BRAVO procedure. How do I get it booked?

    Once our booking team receives your referral (there may be a few days to get this referral processed) and have an appointment date for you, they will try to call you so please make sure that Guy's and St Thomas' and your GP have the correct telephone number.

    We aim to do your procedure within six weeks, if it was asked as a routine procedure, or within two weeks if it was requested as an urgent.

    If you have further queries about this, please call us on 020 7188 8887. 

    What if the endoscopy booking team can’t contact me?

    You will be sent a validation letter stating that we have tried to contact you and asking you to get in contact with us within a certain timeframe. If you do not contact us, you will be removed from our waiting list and discharged back to the care of your GP or referring clinician.

    Can I change the date of my procedure?

    You are only allowed to reschedule your procedure once and, if you fail to attend your procedure, will likely be removed from our waiting list and discharged back to the care of your GP or referring clinician.

    Short notice rescheduling and failing to attend costs the NHS money, please give us as much notice as possible so that we can try to get another patient in for that time slot.

    What happens if I feel I do not need or want the procedure anymore?

    You were referred for a clinical reason. This is a diagnostic test to try to find out more about a particular problem or condition you have. However, please contact the team if you do not want your booked procedure.

  • Before my procedure - preparation

    Do I have to take bowel preparation?

    No, you do not need to take any bowel prep for this procedure.

    Can I continue taking medication?

    It is important to have your medication list with you, either on a face-to-face, or telephone pre-assessment appointment for the nurses to give you further advice.

    Four days before your procedure, please stop taking iron tablets.

    Three days prior to your procedure, please stop taking anything that contains codeine phosphate or loperamide.

    If you are diabetic, on tablets or insulin, or if you are taking anticoagulants such as clopidogrel, apixaban or dabigatran and you have not received advice on how to manage them before your procedure, please call our unit

    You can continue with all your other medication as usual. If you are fasting for the procedure, please take the medication with small sips of water.

    Do I need to declare any allergies?

    Yes, it is important to tell us anything you are allergic to, medicine and food.

    Even though we are a free latex unit, please let us know if you are allergic to latex.

    What if I have C Diff, MRSA or TB?

    If you have any of these infections, your procedure will be done at the end of the endoscopy list morning or afternoon for purposes of cleaning and infection control.

  • On the day of my procedure

    Can I have my procedure if I am ill?

    A cough or cold will not be a problem for your endoscopy procedure.

    If you feel however that you are too unwell to attend your procedure (i.e. fever), please give us a call as soon as possible to rebook.

    When should I arrive at reception?

    Please can you arrive at the time stated on your letter – this is your arrival time not the time of your procedure.

    You are welcome to arrive five minutes before but we advise you not to get to reception too early as you may be waiting a long time until you are seen.

    How do I get here and can I claim for my travel expenses?

    We do not reimburse travel expenses except if we have had to cancel your procedure on the day or at very short notice. For more information, see our pages on help with travel and travelling to our hospitals.

    What should I wear?

    A gown, socks and dignity shorts will be given. You may wish to bring a dressing gown and slippers as you may be waiting a while and it may be cold in the department.

    What happens when I arrive on the day of my procedure?

    You will be seen by one of our nurses, they will discuss your procedure and any potential risks and ask you to complete the consent form. You will then be given a gown to get changed into.

    At St Thomas' Hospital, you will then be taken through to the waiting area called 'subwait' where you will wait before you are called in for your procedure.

    At Guy’s Hospital, you will be in day surgery.

    How long will I have to wait in reception? What can I bring with me?

    At St Thomas' Hospital you have a view of the Thames at the reception, where you can find a TV and magazines.

    At Guy's Hospital, we have TV and magazines. If you would like to bring a book, reading material or a tablet to watch a movie, you are most welcome.

    Note that we do not take responsibility for your valuables. At St Thomas’ Hospital you will carry your belongings around, whilst at Guy’s Hospital your bag will be put in a locker.

    At Guy's Hospital our reception area is shared by day surgery unit so can be busy with patients awaiting non-endoscopy procedures.

    Please note you may not be called in the order you arrive at reception.

    Will there be toilets to use in the endoscopy unit?

    Both St Thomas' Hospital and Guy's Hospital have toilets for patient use.

    Who will be doing my procedure?

    Please note that it may not be the referring clinician who does your endoscopy procedure.

    Your referral will be reviewed by our clinical team and booked onto an appropriate list.

    The endoscopists carrying out your procedure will have been clinically assessed as competent to conduct the procedure.

    Your procedure will be completed by a consultant, registrar or nurse endoscopist.

    Does the procedure hurt?

    These procedures are not usually painful and we all aim to make you as comfortable as possible.

    Patients can experience some cramping pain and discomfort but the endoscopist and nurses in the room will reassure you and are prepared to deal with this.

    What pain relief options are there?

    You may wish to use Entonox® gas, a 50-50 mixture of oxygen and nitrous oxide, also known as 'gas and air'.

    We may give you sedation, which will make you feel sleepy and drowsy. Note that this is different from general anaesthesia, commonly used in surgery.

    For further information, please read our leaflet, Using Entonox® during your procedure in the endoscopy unit (PDF 95Kb).

    Do I need an escort? When can my escort pick me up from hospital?

    Yes, if you are having sedation or general anaesthetic you will need someone to pick you up after your procedure.

    You also need someone to stay with you at home for the next 24 hours.

    Due to the sedation, after the procedure, you will stay in recovery. Once it is safe to discharge you home, the nurse will call your escort.

    As we appreciate that your procedure and recovery might take some time, you are welcome to call your escort once in recovery to let them know that the procedure is finished.

    Discharge usually happens an hour afterwards, if no complications are present.

  • After my procedure

    Is there is anything I cannot do after my procedure?

    Within the first 24 hours if you have had sedation or anaesthetic you should not operate heavy machinery or drive, take care of children, sign any legal documents or drink any alcohol.

    When will I get my results?

    You will be given a paper report outlining your procedure on the day and if a biopsy has been taken.

    Results can take up to six weeks to be communicated with you and these will be done by the referring department – gastroenterology department, upper GI department or colorectal department – rather than endoscopy department. Results will usually be communicated in the form of a letter but sometimes the clinician may wish to see you for a face-to-face outpatient appointment, so someone from your referring department will contact you to arrange this if applicable.

    What does it mean on my endoscopy report by 'surgical virtual clinic' or 'gastro virtual clinic'?

    If you have had a biopsy taken or you are awaiting results, these will be reviewed by a consultant in a 'virtual clinic', which can take up to six weeks.

    In the 'virtual clinic' the consultant will decide on the next steps for you, which may be:

    • you are discharged back to the care of your GP or referring clinician
    • to bring you back for an outpatient clinic appointment
    • order for you to have further tests.

    If a biopsy has been taken the results will be communicated with you and your GP via letter.

    If six weeks have passed and you haven't received any communication please contact your GP, we are not allowed to give results over the phone.

    Your GP is also the point of contact to receive further copies of the report. 

    When should I restart taking my medication?

    This depends on the medication you are taking. The endoscopist should give advice on the day of your procedure. Otherwise please contact your GP.

    If I am unhappy with the service I have received how to I let someone know?

    If you are unhappy please raise your concern to the Patient Advice and Liaison Service (PALS).