Gastroenterology

Your Consultant or doctor has advised you to have an EUS (Endoscopic Ultrasound Examination).

What is a EUS?

You may be familiar with an ultrasound scan, one use of which is to look at babies in the womb of pregnant women by rolling a probe over the abdomen.  Endoscopic Ultrasound is a flexible telescope with tiny inbuilt ultrasound transducer at the tip. When this is advanced in it can be used to evaluate the lining of the gullet, stomach, early part of the small intestine and the rectum. The other advantage of EUS is it can be used to examine internal organs such as pancreas, liver, gallbladder, lungs and bile ducts in close quarters.

What are benefits of a EUS?

There are a variety of reasons why EUS might be used.  In some circumstances it is more sensitive than other tests such as CT scan to look at the area of interest.  In other cases it may be safer to use EUS to get more information as a preliminary test before moving onto tests that may have some higher degree of risk.

What are the risks of a EUS?

EUS is a very safe procedure.  The chance of any complication is minimal.

  • There is one in 1000 chance of making a tear (perforation) in the lining.
  • There is a small chance of a reaction to the drugs used for sedation or occasionally even from the throat spray. 
  • You may have a slightly sore throat from the procedure, which will usually wear off within 24 hours.

You must tell the nurse if you have any loose teeth, crowns or caps, as there is risk they could become dislodged.

Are there any alternatives to this procedure?

You have already had a number of tests to look at your problem and EUS is another way of getting further information.

What will happen if I don’t have this procedure done?

Your doctor may not be able to diagnose your problem and therefore will not be able to treat or advise you.

What anaesthetic or sedation will I be given?

You will be given sedation and a local anaesthetic throat spray. Sedation involves an injection given into your arm, which will make you slightly drowsy and relaxed.  You will not be unconscious.

The medicines used in sedation may affect your memory or concentration for up to 24 hours.  Many patients remember nothing about the procedure or even what the doctor has said to them afterwards. 

If you have sedation you must have a friend or relative collect you from the Gastroenterology Unit and we recommend they stay with you afterwards. 

A side effect of these medicines is that they can slow your breathing – this should not normally happen but sometimes patients can be oversensitive to the medicine. This is the main reason we do not give high doses of these drugs, we also give you oxygen during the test.

If you are worried about any of these risks, please speak to your Consultant or a member of their team before you are due to have this treatment.

Getting ready for your procedure

  • Do not have anything to eat or drink for at least six hours before your test. This is to make sure that we can have a clear view of your stomach.
  • However, if you routinely take medicines (including blood pressure medication) please continue to do so with the exceptions of the ones listed below. You may take your medication in the morning of your procedure with a very small amount of water.
  • You will be asked to remove any tight clothing, ties, dentures, spectacles and contact lenses.
  • Please do not bring large amounts of cash or valuables with you, as the Trust cannot be held responsible for them.
  • When you come to the department, please tell the doctor or nurse about any medicines you are taking and in particular, about any possible allergies or bad reactions in the past you may have had.

Your EUS procedure

In the endoscopy room you will be made comfortable lying on your left side; you will be given some oxygen through your nose.  The test involves passing a flexible telescope through the mouth and down into the oesophagus, stomach and duodenum. EUS is not a painful procedure but the sensations can be slightly unpleasant. 

The entire procedure lasts up to 25 minutes, so we always advise you to have sedation.

After your EUS procedure

You will need to lie on a trolley in the department to recover from the sedation for up to an hour. The nursing staff will monitor your blood pressure and pulse.

When you have recovered you will be transferred to the seated area for a drink and await your escort. Sometimes the doctor or nurse can let you know after the test what the results are. 

Sometimes biopsy, photography or other information is taken which may need to be assessed further and the result may not be available for a week or two.  In this case the results will be available to discuss with you during your next clinic appointment.

  • If you have had a local anaesthetic spray, you will be allowed to return to the ward following the test and you can then eat and drink once the effects of the throat spray has worn off.
  • If you have sedation, you will be made comfortable lying on your left side and returned to the ward and allowed to recover. You may also be given some oxygen and a nurse will record your blood pressure, pulse and in some cases your temperature. You will be allowed to eat and drink when you are fully awake.

Minor post procedure symptoms

You may or may not experience a sore throat. If you do, it can last for a couple of days but usually passes after a couple of hours.

Stomach ache is most likely due to the air inflated into your stomach during the procedure. This will pass in its own time.

Serious post procedure symptoms

Please tell the medical staff if you have severe pain in your neck, chest or stomach.

Cancellations

If you are unable to keep this appointment, please let us know as soon as possible on
Tel: 0151 706 2720. Text phone number: 18001 0151 706 2720.

We will be able to give your appointment to another patient, and arrange another for you.

Transport

  • Transport has not been arranged for this appointment so it will be necessary for you to make your own arrangements.
  • Parking for patients and visitors is available at the Q-Park multi-storey car park opposite the main hospital entrance on Prescot Street. The entrance by car is on Epworth Street off Erskine Street. The car park is open 24 hours a day, seven days a week.
  • This is a private car park and charges apply. The car park is continually monitored by parking hosts, and CCTV. There are disabled spaces throughout the car park. If you need help, please speak with a parking host at the car park entrance.
  • If you have been referred to us from clinic and usually have an ambulance to bring you for your appointment, please contact us on 0151 706 2720 as soon as possible.

Text phone number: 18001 0151 706 2720

  • If you have been referred to us by your family doctor (GP) and require an ambulance please contact their surgery.

Going home

Once you have completed the recovery stage, had a drink, your escort has arrived, you have been given information and the nurse has discharged you, you may go home.

For next 24 hours you must not

  • Travel alone
  • Drive any vehicle
  • Operate machinery (including domestic appliances such as a kettle)
  • Climb ladders
  • Make important decisions, sign any business or legal documents
  • Drink alcohol
  • Return to work within 12 hours of treatment. Your general health and any medicines you are taking may increase the time you need off work.

You should

  • Take it easy for the rest of the day, avoid strenuous activity
  • Take your medications as usual
  • Let someone else care for anyone you usually look after, such as children or elderly or sick relatives.

Further appointments

If you need a further appointment to be reviewed by the clinic that sent you for this test, this may be arranged at the end of the procedure and will either be given to you or sent to you in the post.

Important: If you have:

 
  1. Diabetes
  2. Are taking
  3. Anticoagulants:
 
  • Warfarin
  • Heparin/Low molecular weight heparin (including enoxaparin/dalteparin)
  • Dabigatran
  • Rivaroxiban
  • Sinthrome
 
  1. Antiplatelet therapy:
 
  • Clopidogrel (Plavix)
  • Prasugrel (Efient)
  • Ticagrelor (Brilique)
  • Dipyridamole (Persantin) and aspirin
 
  1. Are on dialysis
 
  1. Have suffered a heart attack within the last three months
You must contact the Gastroenterology Unit as soon as you receive this information leaflet.
Tel: 0151 706 2720
Text phone number: 18001 0151 706 2720

Feedback

Your feedback is important to us and helps us influence care in the future.

Following your discharge from hospital or attendance at your outpatient appointment you will receive a text asking if you would recommend our service to others. Please take the time to text back, you will not be charged for the text and can opt out at any point. Your co-operation is greatly appreciated.

Further information

If you have any questions or queries, please contact: The    Gastroenterology Unit during the following hours
 
Monday – Friday         1000 – 1700hrs Tel: 0151 706 2720
Saturday/Sunday/BH 0800 – 1600hrs Tel: 0151 706 2726
 
Text phone number: Monday – Friday 18001 0151 706 2720
Saturday/Sunday/BH 18001 0151 706 2726
Endoscopy appointment queries Tel: 0151 706 2720
Text phone number: 18001 0151 706 2720

 

The Emergency Department (A&E) is open 24 hours Tel: 0151 706 2049/2050.
Text phone number: 18001 0151 2049/2050
 
Hospital: Royal Liverpool hospital
Tel: 0151 706 2000
Text phone number: 18001 0151 706 2000
 
Author: Gastroenterology and Hepatology          
Review date: February 2029