Panendoscopy

A Panendoscopy is the term given to the endoscopic examination of the entirely

upper gastro-intestinal tract. The procedure is also commonly known as endoscopy or
gastroscopy. The investigation allows for the direct visual inspection of the entire upper
gastro-intestinal tract, namely pharynx, oesophagus, stomach and duodenum. Owing to its
high degree of accuracy, endoscopy has completely superseded Barium meal examination,
which has been rendered virtually obsolete.

Endoscopy is particularly valuable in the assessment of indigestion, heartburn,

dyspepsia, flatulence, post-prandial fullness, waterbrash, nausea, vomiting, upper
abdominal pain, and difficulties in swallowing.

Gastric biopsies are routinely performed to assess for the presence of Helicobacter
Pylori, a microorganism responsible for peptic ulceration, gastritis and associated with
stomach cancer. Biopsies of the distal second part of the duodenum are performed if
indicated, to assess for Coeliac disease.

Specific pathologies detected include:

Oesophagus: inflammation (graded I - IV), ulceration, polyps, strictures, tumours,

varices, hiatal hernia, gastro-oeosophageal reflux, Barretts oesophagus.
Stomach: ulceration, inflammation, erosions, polyps, benign and malignant tumours,
Helicobacter organism.
Duodenum: First and second parts assessed. Ulceration, inflammation, strictures,
tumours, and Coeliac disease.

The procedure allows for an excellent view of the gastro-intestinal tract by way of the
video endoscope, and also has the facility for biopsy, polypectomy, photography and
biopsies for the Helicobacter organism.

The Sydney Adventist Hospital has an outstanding Endoscopy Unit, with excellent
facilities, the best possible equipment, and staff who are specifically trained in these
procedures. Performed in such ideal circumstances, the procedure can be regarded as very
safe, with virtually no risk of injury to the gastrointestinal tract. In a personal series of 8000
panendoscopies, Dr Currer has not experienced any significant problems related to the
procedure.

Panendoscopy is performed usually as an Out-patient procedure, requiring a short, light,

general anaesthetic, and is usually experienced with minimal discomfort and distress by the
patient. The results of the endoscopy are discussed prior to leaving the hospital and the
patients are seen both before and after the investigation by Dr Currer.

The surgical procedures provided at the Centre for Digestive Diseases do not require
a general anaesthetic as intravenous sedation is given for these procedures. The Sedationist
will insert a small needle into a vein in the back of your hand or in your arm through which
the sedative will be injected. The injection may cause a local reaction. Bruising under the
skin may occur, but should not cause permanent damage and is usually not painful. If you
are having a gastroscopy procedure, your throat may be sprayed with an anaesthetic agent
and may feel numb for a short time.

What happens after the surgery?

After the procedure you may find your throat hurts. This should settle quickly with simple
painkillers such as paracetamol or ibuprofen.
You may have a stiff neck after the procedure. If there is a history of neck problems it is
important to let the surgeon know about this before the procedure.
After you have had time to recover from the anaesthetic and you are able to eat and
drink, you may go home. This will be discussed with you by the surgeon.
Take gentle exercise for a few days avoiding vigorous activities.
Depending on your job you may be advised to stay off work for a few days to rest your
throat.

What complications could occur?

These are very safe procedures and complications are rare.

The metal tube that is put down your throat may chip or loosen your front teeth as it is
passed. The surgeon uses a gum shield to help prevent this from happening. There is a
small risk of a tear in the lining of the gullet. If this happens you will need to stay in
hospital, until the problem settles. Rarely a leak may occur which would require surgery
to correct.
If you are not given an out patients appointment before leaving the ward one will be sent
to you. This will usually be about a week after your surgery, where the results of any
investigations will be discussed with you. It may be unnecessary for you to have a
further appointment. This will be discussed with you by the surgeon.

The procedures described above are considered to be safe. However, temporary

discomfort or pain may occur following introduction of air into the stomach or bowel. Major
complications are rare but can occur. These complications include perforation (puncture) of
the oesophagus, stomach or duodenum. Haemorrhage (bleeding) following removal of
polyps, infection, cardiac or respiratory arrest related to sedation / anaesthesia. If you wish
to discuss the potential risks or any issues regarding your procedure(s) in more detail,
please ask to speak with the Gastroenterologist.