Can a Colonoscopy and
Gastroscopy Be Done Together?

Colonoscopy and gastroscopy are two common endoscopic procedures used for diagnostic and therapeutic purposes. These procedures can diagnose gastrointestinal (GI) symptoms like abdominal pain or unusual bowel movements. During these procedures, doctors can also collect samples to test for infections and abnormalities or remove polyps or precancerous growths as needed.

Patients sometimes wonder if both colonoscopy and gastroscopy can be performed simultaneously. This article will explore when such an approach may be recommended.

In certain cases, a bidirectional endoscopy can be performed, allowing for both colonoscopy and gastroscopy to be conducted during a single procedure. This approach is particularly beneficial when investigating conditions that may affect both the upper and lower gastrointestinal (GI) tracts, enabling a comprehensive evaluation and diagnosis.

During the combined procedure, sedation is administered to ensure patient comfort throughout the procedure. Separate scopes are utilised for each procedure to navigate the different areas of the GI tract effectively.

Combining gastroscopy and colonoscopy procedures offers several benefits for patients and doctors alike. These include:

• Saving Time: The combined procedure helps save valuable time for both patients and doctors, as they can address multiple gastrointestinal concerns in a single visit.
• No Multiple Sedation Sessions: Performing both procedures simultaneously reduces the need for additional sedation sessions, thereby reducing the associated risks.
• Faster Diagnosis: Doctors can examine upper and lower GI tract issues at the same time, providing a comprehensive view of the patient's digestive health. Should any abnormalities be detected during the examination, the doctor can immediately diagnose and manage the condition, eliminating the need for a follow-up procedure.

Doctors may recommend a combined procedure for individuals undergoing comprehensive health screenings. A bidirectional endoscopy may also be recommended for patients with alarming symptoms that affect both the upper and lower digestive tracts, such as:

• Persistent abdominal pain
• Unexplained weight loss
• Chronic diarrhoea or constipation
• Gastrointestinal bleeding

However, it is important to note that combined procedures are not routine and can only be carried out after a doctor has deemed it medically necessary.

To ensure optimal results and patient comfort, doctors typically provide guidelines on how to prepare for dual colonoscopy and gastroscopy procedures. These may include pre-procedure instructions like:

• Fasting: Refrain from eating or drinking for approximately 6-8 hours before the procedure to ensure the stomach is empty and facilitate better visibility during gastroscopy.
• Bowel Preparation: For a colonoscopy, take oral laxatives as prescribed to help cleanse the colon and ensure that the doctor can visualise the intestinal lining accurately.
• Medication Adjustment: Limit or discontinue the intake of specific medications, including proton pump inhibitors (PPIs), blood thinners, or constipating agents, about a week before the combined procedure to avoid complications.

Before the procedure, patients will receive a mild sedative to help them feel at ease and minimise any discomfort. A gastroscopy is performed first, where a gastroscope is passed down the back of the throat and into the oesophagus, stomach, and duodenum. The gastroscope does not interfere with normal breathing. Some patients may feel slight discomfort, but it is not painful.

After that, the patient will be asked to position themselves on their left side for a colonoscopy. The doctor will carefully introduce a colonoscope through the anal opening and into the rectum to examine the entire colon lining. The bowel will be gently inflated with air for better visibility and accuracy. Patients may experience a sensation of fullness or bloating, but there should not be any pain. If biopsies (tissue samples) need to be taken, the procedure may take longer.

The combined procedure usually takes around 45 minutes to an hour to complete, depending on the complexity of the examination and any findings requiring additional investigation. Throughout the procedure, doctors prioritise patient safety and comfort. Continuous monitoring of vital signs is standard practice, and sedation levels are adjusted to ensure a pain-free experience.

After the procedure, patients may encounter some common post-sedation symptoms, such as:

• Grogginess: Due to sedation, patients may feel drowsy or disoriented shortly after the procedure.
• Mild Throat Discomfort: After a gastroscopy, patients may have a sore throat, hoarseness, tickle, or dry cough as the tube passes through the throat.
• Bloating: Some patients may experience temporary bloating or stomach cramps due to air introduced during the procedure.

Most patients can resume normal activities the following day. In any case, it is advisable to avoid driving or operating heavy machinery for at least 24 hours post-sedation.

Patients should be aware of several symptoms that may warrant medical attention, including:

• Severe or lasting pain in the neck, chest, or abdomen
• Trouble breathing
• Vomiting
• Dizziness or weakness
• Unexplained fever

Combining gastroscopy and colonoscopy is a safe procedure. However, as with any procedure, there are some risks involved (although they are very minimal). These risks may include:

• Internal bleeding
• Perforation
• Bloody discharge from the rectum
• Adverse reactions to sedatives

Overall, undergoing a combined colonoscopy and gastroscopy can be a safe and effective way to assess gastrointestinal health. For patients experiencing symptoms affecting both the upper and lower digestive tracts, this approach offers advantages, including convenience, time savings, and comprehensive insights.

For more information on gastrointestinal health and whether a combined colonoscopy and gastroscopy is right for you, contact our clinic today.