Endoscopy

Offering a wide range of services for gastrointestinal disorders


Our state-of-the-art endoscopy unit at St Thomas' Hospital opened in 2013 to meet the growing demand of patients needing a variety of tests to examine and treat their digestive tract.

The endoscopy team currently cares for approximately 9,000 patients a year, and this is predicted to increase over the next five years. With separate changing and waiting areas for men and women, the endoscopy team hope that patients will feel comfortable and at ease before and after their procedure. 

Patients are referred to the unit for conditions such as anaemia, colitis, crohn's disease, ulcers, oesophagitis, cancer of the digestive tract, rectal bleeding, gallstones and liver disease.

  • We have a service on both the St Thomas' and Guy’s Hospital sites and book appointments at both hospitals, so please check which hospital you are due at before setting out.

Coming to your endoscopy appointment

  • How do patients get referred?

    Patients are referred to our service either from their GP, hospital clinic appointment or the Emergency Department (A&E).

  • Changing or cancelling your appointment

    If you need to change or cancel your appointment, please ring 020 7188 8887.

  • Do patients need to do anything before their appointment or bring anything with them?

    Please fill our health questionnaire form (Word) prior to your procedure.

    By filling it, you are helping us to minimise delays and improve your journey through our department. You can print it and bring it with you on the day of your procedure or email it to endoscopyhealthquestionnaire@gstt.nhs.uk.

    Please read our patient information leaflet (PDF 104Kb) about how to prepare for your procedure, which may involve fasting, laxatives or an enema. This leaflet will either be given to you when you hand in your referral letter or it will be sent in the post.

    All of our leaflets are available online. If your procedure involves an enema or laxatives and you have not received these five days prior to your procedure, please come to the Unit or give us a call.

    Please arrange for an escort and someone to stay with you at home for the next 24 hours if you choose to have sedation.   

    Some patients may require a pre-assessment appointment prior to their procedure to record your past medical history, request further tests and discuss the preparation for the procedure. If you need this, you will be informed at the reception desk when you hand in your referral letter or by the booking team, when they contact you regarding agreeing an appointment date. 

    Do not hesitate to contact us if you have further questions.

  • What can patients expect at the appointment?

    Most endoscopies are performed as day case procedures. The time you have been given is the time we need you in the department, not the time of the procedure.

    When you arrive at the Endoscopy Unit reception desk, you will be greeted by the receptionist. You will be asked to wait in the reception waiting area.

    You will be seen by an endoscopy nurse, who will ask you about your medical history, clarify any questions you may have and ask you to change into a gown.

    You will be then taken to a gender specific sub wait area. You may bring reading materials or movies on your tablet to help you pass the time. Most procedures take about 30 minutes but some can take 4 hours.

    Please leave any valuable jewellery at home, as we are not responsible for any valuables in the unit.

    The endoscopist will then explain more about the procedure and answer any questions you may still have as a part of the consent process. You should expect to have the risks and benefits of the procedure explained to you before you are asked to sign the consent. We have a range of clinicians who scope within the department including consultant physicians and surgeons, specialist registrars (independent and trainee status) and nurse endoscopists. You will be made aware of whom is doing your procedure during the consent.

    After the procedure you will be taken to the recovery area where your vital signs will be monitored. If you have not had sedation, you will be able to leave the hospital as soon as the staff have taken a set of observations and explained your report to you.

    If you have had sedation, you will need to rest quietly until the sedative has worn off (minimum 1 hour). The nurse will offer you a drink and biscuits. If you are wanting to have something more substantial such as a sandwich or fruit please bring with you.

  • Information for after their appointment

    The nurse will discuss with you the endoscopy results. You will be given a copy of it and an information sheet with further post discharge advice.

    If you had any biopsies taken during the procedure the results will generally be available within six weeks. Your GP and referring Dr will receive a letter with the results together with any recommendations for your care and treatment. Note that we cannot share the biopsy results with you over the phone. If you have not received it, please liaise with your GP.

  • Useful links

    CORE

    Guts UK's vision is a world where digestive disorders are better understood, better treated and everyone who lives with one gets the support they need.

    Tel: 020 7486 0341

    Email: info@corecharity.org.uk

    Website: https://gutscharity.org.uk/

    Crohn's and Colitis UK

    A charity providing information and support for those with inflammatory bowel disease.

    Tel: 01727 830 038

    Website: www.crohnsandcolitis.org.uk

Referrals for endoscopy

How to refer

Please send your referral to the service you require or the consultant gastroenterologist or surgeon, either by letter to the address at the top of this web page, or via NHS e-Referral. 

We aim to see urgent referrals within two weeks, and routine referrals within six weeks.  

Referrals from other hospitals must include a completed Inter-Provider Minimum Data Set or ensure that one is sent within 48 hours of referring a patient

For rectal bleeding clinic, please referrer to colorectal surgery referrals.

Urgent referrals

Please complete the two week wait proforma and fax to the two week wait office on 020 7188 0923. For further enquiries regarding two week waits please call 020 7188 0902.

Emergency referrals

If you need advice, an emergency patient review or to arrange an admission, please telephone the hospital switchboard on 020 7188 7188 and ask to speak to the on-call gastroenterology registrar

FAQ's

Before my procedure

  • I’ve been told I need an endoscopy 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 numbers for you.

    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.

  • I have agreed my endoscopy but I now want to change the date. Can I?

    You are only allowed to reschedule your procedure once and if you fail to attend your procedure you 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 as your referring clinician. 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.

  • Can I have my procedure if I am on my period?

    Yes this is fine and happens on a regular basis.

  • Can I have my procedure if I am ill (i.e. cold, cough)

    A cough or a cold is not impeditive of 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 the procedure.

  • Can I continue taking medication?

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

    Nevertheless, 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, may it be a medicine or simply 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.

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

    A colonoscopy is a routine test to examine the lining of your bowel, also called the large intestine or colon. This is done using an endoscope, which is a flexible tube, about the thickness of a (little) finger, which has a camera and light at one end. It is passed through the anus (back passage) and carefully moved around the large bowel by a specially trained doctor or nurse called an endoscopist.

    For further information, please read our having a colonoscopy (PDF 101 Kb) leaflet. It contains important information for the day of the procedure.

  • If I am having colonoscopy: do I have to take bowel prep?

    You will be given certain drugs by the nurse at your pre-assessment appointment. These usually work but sometimes, for various reasons, they fail to fully work – please, if you think they haven’t worked give us a call and we will advise you further. You may not be able to have your procedure on that day and may be rescheduled for another date.

    For further information, please read our diet advice and bowel preparation (bowel prep) for your colonoscopy (PDF 135Kb) leaflet.

  • I'm having an ERCP (endoscopic retrograde cholangio pancreatogram)- what do I need to know?

    An ERCP (endoscopic retrograde cholangio pancreatogram) is a type of x-ray and camera examination that enables your doctor to examine and/or treat conditions of the biliary system (liver, gall bladder, pancreas, pancreatic and bile ducts). 

    For further information, please read our having an ERCP (Endoscopic Retrograde Cholangio Pancreatogram) (PDF 304Kb) leaflet. It contains important information for the day of the procedure.

  • I'm having a flexible sigmoidoscopy - what do I need to know?

    A sigmoidoscopy is a routine test to examine the lining of your sigmoid colon. This is the lower part of your colon, also called your bowel or large intestine. The examination uses a endoscope, which is a flexible tube about the thickness of your little finger, with a camera and light at one end. It is passed through your anus (back passage) and carefully moved around your large bowel by a specially trained doctor or nurse, called an endoscopist. Sometimes biopsies (small tissue samples) of your bowel may be taken for analysis. 

    For further information, please read our having a flexible sigmoidoscopy (PDF 101Kb) leaflet. It contains important information for the day of the procedure.

  • I've been referred for the one-stop rectal bleed clinic, what happens - do I have a flexible sigmoidoscopy as well?

    At the one-stop rectal bleed clinic, you will have a consultation with a specialist nurse/doctor about your symptoms. You will then have a flexible sigmoidoscopy, where a soft, flexible tube with a camera at the end is passed through your anus (back passage) and up inside your bowel. This is done by a specially trained doctor or nurse (endoscopist), and will help to identify any causes for your symptoms. At the end of this test it may also be necessary to use a small instrument, called a proctoscope, to check for and treat haemorrhoids (piles), if necessary.

    For further information, please read our rectal bleeding clinic (flexible sigmoidoscopy) (PDF 140Kb). It contains important information for the day of the procedure.

  • How I can prepare for my Flexible Sig?

    You will need an enema, a solution passed through your back passage and placed in to your rectum that will clear the section of your bowel that will be examined during the test. We encourage you to have the enema in the comfort and privacy of your home, as this is proven to be more comfortable for you. It also helps us to avoid delays on the day of the procedure.

    The enema should have been given to you when your appointment was booked. If this has not happened, you can come to Endoscopy Unit at St. Thomas Hospital to collect it. Otherwise, we can post it to you, but this might take longer. If you live more than an hour away from the hospital or cannot have it at home, you can have it in the Unit, on the day of the procedure.

    For further information, please read our using a phosphate enema - preparing for your flexible sigmoidoscopy (PDF 67Kb) leaflet.

  • I'm having a gastroscopy (OGD) - what do I need to know?

    A gastroscopy is an examination that allows us to look directly at the upper part of the gastrointestinal tract; the oesophagus (tube that food passes down to reach the stomach); the stomach and around the first bend of the small intestine (duodenum).

    For further information, please read our having a gastroscopy (PDF 81 Kb) leaflet. It contains important information for the day of the procedure.

  • I'm having an intra-gastric balloon insertion, what do I need to know?

    An intra-gastric balloon is a soft silicone balloon that is placed into the stomach and filled with a sterile salt (saline) solution. The balloon partially fills the stomach, leading to a feeling of fullness. The intra-gastric balloon helps you to control your appetite and therefore the portion sizes when you eat. It can lead to weight loss when used alongside a good diet and changing some behaviours.

    For further information, please read our having an intra-gastric balloon insertion (PDF 263Kb) leaflet. It contains important information for the day of the procedure.

  • I having a video capsule endoscopy (VCE)

    The main reason for a video capsule endoscopy (VCE) is to examine the lining of the small intestine. This is an area which is difficult to examine with standard flexible endoscopes (devices used to look inside the body). Your doctor will explain why you are having a VCE.

    For further information, please read our video capsule endoscopy (PDF 128Kb leaflet. It contains important information for the day of the procedure.

  • I having a video capsule endoscopy (VCE) with capsocam

    The main reason for a video capsule endoscopy (VCE) is to examine the lining of the small intestine. This is an area which is difficult to examine with standard flexible endoscopes (devices used to look inside the body). Your doctor will explain why you are having a VCE.

    For further information, please read our video capsule endoscopy with capsocam (PDF 128Kb) leaflet. It contains important information for the day of the procedure.

On the day of the procedure

  • When should I arrive at reception? My appointment letter says a time on it (e.g. 8:30am) is this the time I need to arrive or is this the time of my procedure?

    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 5 minutes before the time 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?

    Please see these links for getting to St Thomas' Hospital and getting to Guy's Hospital we are based. We do not reimburse travel expenses except if we have unfortunately had to cancel your procedure on the day or at very short notice.

  • 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' 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 you will be in day surgery.

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

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

    At Guy's, 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’ you will carry your belongings around whilst at Guy’s your bag will be put in a locker.

    At Guy's 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.

  • I’ve taken my bowel prep and wonder if there will be toilets to use in the endoscopy unit?

    Both St Thomas’ and Guy's have toilets for use by patients.

  • How long does the procedure take?

    Gastroscopy and flexible sigmoidoscopy takes about 10 minutes, whilst colonoscopy takes about 30 minutes. ERCP is variable according to the procedure itself. These times are not static though; they might be longer according to the need of sedation, reason why the procedure is being done, findings of the procedure and patient himself. We aim however to minimise any impact that this might have.

  • 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 endoscopy may be completed by a consultant, registrar or one of our nurse endoscopists.

  • Does the procedure hurt?

    These procedures are usually not painful and we all aim to make you as comfortable as possible during the procedure. However, some patients experience some cramping pain and some discomfort. The endoscopist and the nurses in the room will reassure you through the procedure and are prepared to deal with this.

  • What pain relief will I have during my endoscopy procedure?

    There are several options regarding the use of pain relief. You may wish to use Entonox® gas, a mixture of 50% oxygen and 50% nitrous oxide, also known as ‘gas and air’. Otherwise, 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.

  • 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 him/her know that the procedure is finished. Discharge usually happens an hour after, if no complications are present.

After my procedure

  • If there is anything I cannot do after my procedure like fly?

    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. Thus, you can fly (as long you are not the pilot!)

  • 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 (i.e. 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 6 weeks to take place. In the "virtual clinic" the Consultant will decide on the next steps for you, which may be (a) you are discharged back to the care of your GP or referring clinician, (b) to bring you back for an outpatient clinic appointment, (c) 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 6 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 PALS department.