ENDOSCOPY UNIT. Duodenum Stomach. Having an oesophageal stent. Patient information leaflet

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1 Trafford Hospitals ENDOSCOPY UNIT Gastroscope Oesophagus Lungs Duodenum Stomach Having an oesophageal stent Patient information leaflet If you are unable to keep your appointment, please telephone the Waiting List Office on as soon as possible. Your appointment can then be offered to someone else which helps to keep waiting lists shorter.

2 Introduction You may be having problems with swallowing caused by a narrowing of your gullet. Your doctor has suggested that a stent may help to improve this. What is an oesophageal stent? A stent is a tube made of a flexible mesh. It is passed by mouth into the gullet (oesophagus) and positioned through the narrowed area. It then gently expands to keep the narrowed part more widely open to allow fluids and food to pass into the stomach more easily. The stent is entirely internal and once in place you should not be able to feel it. Are there any alternatives to a stent? There are other methods to maintain your nutrition but these will not improve your swallowing. Your doctor or nurse specialist can discuss these with you. What happens if I decide not to have the stent? Your swallowing may become progressively worse and eventually you may not be able to eat or drink anything. How do I prepare for my stent insertion? If you are not already in hospital you will be admitted on the morning of the procedure. Please bring any medication you are taking with you. Your doctor/nurse Specialist will explain the test to you, including the risks and benefits. Your stomach needs to be empty so do not have anything to eat or drink from 7.00 am unless advised otherwise. You will be asked to sign a consent form before the procedure. If you take tablets to thin your blood, such as Warfarin or Sinthrome: Your dose may need to be adjusted for the test. Please make sure you contact your anticoagulant clinic. What are the risks? Oesophageal stent insertion is generally a safe procedure. There are, however some risks and complications that may arise: Minor bleeding can occur during the procedure. This generally stops without further treatment. Some people get heartburn and reflux afterwards. This can be controlled with simple measures or medicine. Rarely the stent may slip out of position and the procedure may need repeating. Occasionally it may not be possible to fit or place the stent for a variety of reasons. If this is the case your doctor will discuss possible alternative procedures with you

3 Very rarely inserting the stent causes a tear in the oesophagus. This is a serious complication and may need an operation or another stent inserted How is the stent inserted? The procedure takes place in the X-ray department. The stent is inserted by a doctor. A local anaesthetic is sprayed to numb the back of your throat before you lie down. You will then be given a sedative to make you sleepy and relaxed. This will be given through a small tube that has been placed in a vein (cannula). You will not be completely asleep. The oxygen level in your blood will be checked by attaching a small probe to your finger. Extra oxygen will be given through a small tube placed under or in your nostril. A nurse will remain close by to care for you throughout the procedure. A small plastic mouthpiece will be placed in your mouth to keep it open and protect your teeth/gums. A flexible tube (endoscope) is then passed gently through your mouth and down your oesophagus. A fine guide wire is then passed through the endoscope. The endoscope is then removed and the wire left in place. The stent is then passed over the wire and inserted via your mouth on the end of a thin delivery tube. X-rays will be taken to ensure it is in the correct position. Once in place the stent is released and will begin to expand outwards within the narrowed part of your gullet. The delivery tube is removed quickly and easily. Generally placing the stent does not take very long - around 20 minutes. You can expect to be in the X-ray department for a total of about 45 minutes. How will it feel when the stent is in place? You may have some chest discomfort for a short while afterwards as the stent gently expands into place but this can be controlled with pain relief medication. You may also have a mild sore throat for a day or two. Please tell the nurses if you feel any pain. What happens afterwards? You will be taken back to your ward on a trolley. The nursing staff will look after you and check your blood pressure and pulse. You will usually stay in bed for a few hours until you have recovered from the procedure and the sedation. You will be advised when you can start drinking and eating. A few hours afterwards you should be able to have sips of fluid. Soft food can be tried after about 24 hours. The Specialist Nurse or dietitian will generally see you before you go home to advise what sort of food to eat and to give suggestions to help you

4 When can I go home? You will normally stay in hospital overnight and go home when you are fully recovered and able to eat and drink comfortably. Your Nurse Specialist will telephone you at home to check that you are coping. Advice that may help Ensure tablets are broken, crushed or in liquid form. (Some tablets should not be crushed e.g. controlled release preparations. Ask your doctor or nurse if you are unsure). Sit upright in a high backed chair when eating or drinking. You can have any fluid or liquidised food. Solid food should be cut into small pieces and chewed thoroughly. Eat slowly. If you have dentures make sure you wear them to chew. Avoid foods that are difficult to chew (chunky, stringy, fibrous) as they may block the stent, e.g. citrus fruit segments, fruit skins, cereals such as muesli or shredded wheat, raw or stringy vegetables, meats and bread. Take plenty of fluids during your meal and have a fizzy drink afterwards to help keep your stent clear. If food begins to stick stop eating. Have a fizzy drink and walk about if you can. If the problem does not resolve contact your Specialist Nurse or local hospital for advice. If I have any further questions about the test, or need assistance afterwards, who should I contact? If you have any worries about your test, you can talk to your doctor or contact: Lynn Hughes, Upper GI Nurse Specialist The Endoscopy unit on , Monday to Friday 8.00 am-6.00 pm. Out of hour Switchboard , ask for Accident and Emergency. Further information can also be obtained via our website at or from Please make sure you fully understand the test and any possible treatments before signing your consent form. You may ask questions about anything you are unsure of. General Information Do not bring valuables to the hospital. We cannot be responsible for loss or damage to personal property

5 How to Get Here The hospital is situated on Moorside Road in Davyhulme. Parking is available at the front of the hospital and there are a few parking places at the front of the Endoscopy Unit. Parking is free of charge for the first three hours. Please note vehicles found illegally parked within the hospital grounds may be wheel clamped and subject to a release fee. Several buses serve the hospital. For up to date information on these bus routes, contact Transport for Greater Manchester on or visit For more information, visit and click on Plan Your Visit. No Smoking Policy The NHS has a responsibility for the nation s health. Protect yourself, patients, visitors and staff by adhering to our no smoking policy. Smoking is not permitted within any of our hospital buildings or grounds. You can contact the Trafford Stop Smoking Service on or by at stopsmoking.trafford@nhs.net. For some great information go to: Translation and Interpretation Service It is our policy that family, relatives or friends cannot interpret for patients. Should you require an interpreter ask a member of staff to arrange it for you. These translations say If you require an interpreter, or translation, please ask a member of our staff to arrange it for you. The languages translated, in order, are: Arabic, Urdu, Bengali, Polish, Somali and simplified Follow us on Facebook TIG: 151/13 Produced: December 2013 Review Date: December