What is gastrointestinal endoscopy? Why do many people choose sedation?

Gastrointestinal endoscopy is a technique that uses a flexible tube with a camera to directly examine the inside of the gastrointestinal tract, including the esophagus, stomach, duodenum, and colon. This method helps physicians detect gastrointestinal conditions at an early stage, such as inflammation, ulcers, polyps, gastrointestinal bleeding, or cancer.

In the past, endoscopy often caused anxiety because of sensations such as nausea, pain, or discomfort. Today, with the support of anesthesia and critical care, sedated gastrointestinal endoscopy allows patients to experience little to no discomfort, making it an increasingly preferred option.

What is sedated gastrointestinal endoscopy?

Sedated gastrointestinal endoscopy is an endoscopic procedure in which the patient receives short-acting sedative or anesthetic medication intravenously. The medication helps the patient sleep throughout the procedure and wake up after it is completed. This helps prevent discomfort, pain, and anxiety, allowing the physician to perform the procedure more accurately and safely.

1. Difference between conventional and sedated endoscopy

Conventional gastrointestinal endoscopy

The patient remains awake during the procedure and may experience nausea, a sensation of something in the throat, or abdominal bloating.

Sedated gastrointestinal endoscopy (sedation)

The patient sleeps during the procedure and experiences little to no pain or discomfort, and usually does not remember the procedure.

What is the purpose of sedated gastrointestinal endoscopy?

Sedated endoscopy is performed for the following main purposes:

Diagnosis: Detecting abnormalities in the gastrointestinal tract, such as inflammation, ulcers, polyps, tumors, bleeding, or other lesions without causing discomfort to the patient.

Treatment: Performing interventions such as polyp removal, hemostasis, dilation of strictures, foreign body removal, or stent placement during endoscopy.

Improving patient comfort: Helping patients avoid nausea, vomiting, or pain during endoscopy, particularly those with a low pain threshold, anxiety, or children.

Commonly used anesthetic and sedative medications

Several medications may be used for sedation or anesthesia during endoscopy, depending on the required level of sedation and the patient's health status. Common medications include:

Propofol: A commonly used intravenous anesthetic with rapid onset and short recovery time, providing a high level of comfort for patients.

Midazolam and fentanyl: Often used in combination to achieve moderate sedation (conscious sedation), helping patients relax while remaining able to respond to simple commands.

Other medications: In some cases, adjunctive medications such as diphenhydramine or droperidol may also be used.

Is sedated gastrointestinal endoscopy safe?

According to medical studies and recommendations, sedated gastrointestinal endoscopy is a safe procedure when performed with appropriate indications and according to established protocols. The rate of serious complications is very low (<1%) when patients are carefully screened and the procedure is performed at an appropriately equipped medical facility.

Sedative and anesthetic medications used during endoscopy temporarily reduce consciousness and pain perception. They have a short duration of action and rapid recovery. However, because these medications affect the central nervous system, they require careful administration and monitoring.

Throughout the endoscopic procedure:

• The patient's pulse, blood pressure, respiratory rate, and blood oxygen saturation are monitored.
• The anesthesiologist is always prepared to manage any abnormalities that may arise.

Who should consider sedated gastrointestinal endoscopy?

Patients who may consider sedated endoscopy include:

• People who are highly anxious or afraid of pain during endoscopy
• People with a strong gag reflex
• Older adults or people who may have difficulty cooperating during endoscopy
• Patients requiring biopsy or polyp removal during the procedure

How should you prepare for sedated gastrointestinal endoscopy?

To ensure safety and accurate results, patients should:

• Fast for at least 8 hours before upper gastrointestinal endoscopy.
• Stop drinking water approximately 2 hours before the procedure.
• For colonoscopy, complete bowel preparation with medication according to the instructions provided.

Inform your physician about:

• Existing medical conditions
• Medications taken regularly
• Any history of drug allergies or complications related to anesthesia, if applicable

What happens during sedated gastrointestinal endoscopy?

The sedated endoscopy process generally includes the following steps:

• The anesthesiologist receives the patient and performs a pre-anesthesia assessment.
• Anesthetic medication is administered intravenously.
• Endoscopy and any necessary interventions are performed.
• The patient is monitored during recovery after the procedure.

What should you do after sedated gastrointestinal endoscopy?

The patient's vital signs will be monitored in the recovery area, and the patient should rest for 1 hour until fully alert. A family member or responsible caregiver must accompany the patient home and provide care for at least 12–24 hours after the procedure.

Managing common side effects of anesthesia

Some mild side effects may occur after sedated endoscopy:

Drowsiness and fatigue: These may last for several hours or even throughout the day. This is normal due to the effects of the anesthetic medication.

Sore throat: This may occur after upper gastrointestinal endoscopy because the endoscope passes through the throat. It may be relieved by drinking warm water or sucking on lozenges.

Gas and abdominal bloating: This is caused by air introduced during the endoscopic procedure. It usually resolves on its own within a few hours.

Mild pain or discomfort at the procedure site: Over-the-counter pain relievers may be used according to the physician's instructions.

When should you seek immediate medical attention?

Seek urgent medical attention if you or your family member experiences any of the following signs:

• Initial symptoms, such as mild pain or bloating, do not improve or become worse after several days.
• Severe or progressively worsening abdominal pain, particularly with abdominal rigidity.
• High fever: temperature above 38°C.
• Persistent vomiting or vomiting blood, including material resembling coffee grounds.
• Black, tarry stools or fresh blood in the stool.
• Shortness of breath, rapid breathing, or chest pain.
• Dizziness, fainting, or severe weakness.
• Persistent swelling or redness at the intravenous injection site.

Strengths of University Medical Center Ho Chi Minh City in sedated endoscopy

University Medical Center Ho Chi Minh City (UMC) is one of the leading medical facilities, with notable strengths in sedated endoscopy, helping ensure optimal safety and effectiveness for patients.

1.1. Highly qualified medical team

UMC has a team of experienced physicians, anesthesiologists, critical care specialists, and nurses with specialized training in endoscopy and anesthesia. The medical team continuously updates its knowledge and techniques to ensure that procedures are performed accurately, safely, and professionally.

1.2. Modern equipment

The hospital is equipped with a new-generation, high-resolution endoscopy system, together with modern anesthesia and monitoring equipment, helping optimize diagnosis and treatment while ensuring maximum patient safety throughout sedated endoscopy and recovery.

1.3. Comprehensive care process

At UMC, patient care after sedated endoscopy follows a structured process, from preparation before the procedure and close monitoring during and after endoscopy in the recovery area to detailed home-care instructions. This helps minimize risks, improve patient comfort, and accelerate recovery.

Frequently asked questions (FAQ)

Can I drive myself home after sedated endoscopy?
Absolutely not. You should not drive, operate machinery, or make important decisions for 24 hours after sedated endoscopy. Anesthetic medications may affect your reaction time and cognitive function. You must have a family member or caregiver take you home.

What should I eat after sedated endoscopy?
It is recommended to start with liquids and easily digestible foods such as water, thin porridge, and soup. Avoid spicy or hot foods, high-fat foods, alcoholic beverages, and caffeine for at least the first 24 hours.

How long will discomfort after sedated endoscopy last?
Drowsiness, fatigue, bloating, or mild sore throat usually lasts for several hours. Most of these symptoms completely resolve within 24 hours.

When can I return to work or normal activities?
You should rest completely during the first 24 hours. After that, you can gradually resume light activities. For work and high-intensity physical activities, consult your physician to ensure that it is safe to resume them.

Does every endoscopy require sedation?
Not every endoscopic procedure requires sedation. In some cases, endoscopy can be performed without sedation or with only light sedation. However, sedation improves patient comfort and reduces anxiety, particularly during complex or prolonged procedures.

2. References

• [1] Murthy T. (2011). Sedation Guidelines for Gastro Intestinal Endoscopy. Med J Armed Forces India, 65(2), 161–165. Retrived: 2025-12-14.
• [2] Walke S. S., Chauhan S., Pandey V., Jadhav R., Chaudhari V., Vishwanathan D., Kolhe K., Ingle M. (2022). When to Discharge a Patient After Endoscopy: A Narrative Review. Clin Endosc, 55(1), 8–14. Retrived: 2025-12-14.
• [3] Lin O. S. (2017). Sedation for routine gastrointestinal endoscopic procedures: a review on efficacy, safety, efficiency, cost and satisfaction. Intest Res, 15(4), 456–466. Retrived: 2025-12-14.
• [4] Ahlawat R., Hoilat G. J., Ross A. B. (2023). Esophagogastroduodenoscopy. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Retrived: 2025-12-14.
• [5] Mayo Clinic. Upper endoscopy. https://www.mayoclinic.org/tests-procedures/endoscopy/about/pac-20395197. Retrived: 2025-12-14.

The information above is for reference purposes only and is not intended as medical advice. Please contact your doctor for detailed medical consultation.