Patient guide · Gastroenterology
Endoscopy, the modern menu - gastroscopy, colonoscopy, flexible sigmoidoscopy, capsule and enteroscopy.
Endoscopy uses a flexible camera to inspect the digestive tract. This guide covers the full menu - gastroscopy (upper GI), colonoscopy (large bowel), flexible sigmoidoscopy, capsule endoscopy and enteroscopy - and helps you choose the right test.
Why patients choose us
- 01
The right hands
A consultant gastroenterologist who scopes you and reports you - one clinician, one answer.
- 02
Often answers same-day
Findings are usually discussed immediately after the scope, with the written report to follow.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Key facts
Endoscopy at a glance.
The six things worth knowing before you scroll further - definition, menu, sedation, day-case status, therapeutic reach and who reports it.
- 01
Definition
A flexible camera examination of the digestive tract, performed by a consultant gastroenterologist.
- 02
Modalities
Gastroscopy, colonoscopy, flexible sigmoidoscopy, capsule endoscopy and enteroscopy.
- 03
Sedation options
Conscious sedation, or throat spray for gastroscopy - chosen with you before the test.
- 04
Day-case procedure
Home the same day. No overnight stay for the standard menu.
- 05
Diagnostic and therapeutic
The same scope can biopsy, remove polyps, dilate strictures and stop bleeding in one visit.
- 06
Reported by consultant
Every report is issued by a consultant gastroenterologist - never a trainee alone.
Preparation and pathway
From consultation to report - what happens, in order.
One consultant gastroenterologist from first appointment to structured report - usually within a week.
Phase 1 · Before your scope
Consultation, choice, preparation
Phase 2 · On the day
Sedation, scope, therapy
Phase 3 · After
Report and follow-up
- 01
Before
Gastroenterology consultation
A consultant reviews your symptoms, medications and prior imaging, and confirms whether endoscopy is the right step.
- 02
Before
Choose the modality
Gastroscopy, colonoscopy, flexi sig, capsule or enteroscopy - matched to the question that needs answering.
- 03
Before
Bowel prep or fasting
Bowel prep the day before for colonoscopy; six-hour clear-fluids fasting for gastroscopy. Written instructions provided.
- 04
On the day
Sedation or throat spray
Conscious sedation for most colonoscopies; throat spray or light sedation for gastroscopy - your choice, discussed on arrival.
- 05
On the day
Endoscopy performed
A flexible camera inspects the digestive tract. Typical scope time: 15–40 minutes depending on the modality.
- 06
On the day
Biopsy or polypectomy as needed
Tissue samples, polyp removal, dilatation or haemostasis performed in the same session where indicated.
- 07
After
Structured written report
A consultant-issued report with images, histology follow-up plan and clear next steps - usually within 48 hours.
Typical end-to-end: 3–7 days. Urgent cases: same week.
What it shows
What endoscopy can find, in one visit.
The presentations endoscopy is designed for - with the red-flag pathway called out separately.
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Oesophagitis, Barrett’s, hiatus hernia
Upper GI inflammation, columnar-lined oesophagus and hernia identified at gastroscopy.
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Peptic ulcer disease
Gastric and duodenal ulcers characterised, with biopsies for malignancy exclusion.
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H. pylori sample
CLO test or biopsy at gastroscopy for Helicobacter pylori detection.
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Coeliac disease (duodenal biopsy)
Duodenal biopsies confirm villous atrophy in suspected coeliac disease.
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Colon polyps and adenoma
Detected and removed at colonoscopy in the same session - the mainstay of colorectal cancer prevention.
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Colorectal cancer
Direct visualisation and biopsy of suspicious lesions in the large bowel.
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Inflammatory bowel disease
Crohn’s disease and ulcerative colitis diagnosed and staged, with biopsies for confirmation.
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Red flag: suspicious mass or high-grade lesion - 2-week-wait pathway
Any suspicious mass triggers immediate 2-week-wait cancer referral and MDT discussion.
Next steps
What happens after the endoscopy.
The eight most common next steps - from reassurance and PPI to polypectomy, dilatation, surgery and structured surveillance.
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Reassurance if normal
A normal endoscopy is meaningful - often the answer patients most need to hear.
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Polypectomy or EMR at scope
Polyps and early lesions removed at the same session - no second procedure needed.
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PPI for reflux or Barrett’s
Proton pump inhibitors for acid suppression, with structured surveillance for Barrett’s.
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Endoscopic haemostasis
Clips, adrenaline or thermal therapy to stop active GI bleeding at the same scope.
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Balloon dilatation
Endoscopic dilatation of oesophageal, pyloric or colonic strictures.
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Surgical referral for cancer
Immediate onward referral to colorectal or upper-GI surgery with MDT coordination.
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IBD MDT for Crohn’s or UC
Multidisciplinary team review with gastroenterology, radiology and specialist nurses.
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Structured surveillance
Post-polypectomy, Barrett’s and IBD surveillance intervals following BSG guidance.
Red flags
When endoscopy shouldn’t wait.
The nine situations that push endoscopy up the queue - and, in some cases, straight onto the 2-week-wait pathway.
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Suspicious mass
A mass at any level of the GI tract triggers 2-week-wait pathway and biopsy.
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Iron deficiency anaemia
Unexplained iron deficiency in adults warrants bidirectional endoscopy.
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GI bleed
Haematemesis, melaena or fresh rectal bleeding - urgent scope indication.
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Change in bowel habit
Persistent change over six weeks in the over-50s - colonoscopy indicated.
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Weight loss
Unintentional weight loss with GI symptoms - bidirectional endoscopy considered.
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Dysphagia
Difficulty swallowing - urgent gastroscopy is the first-line investigation.
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Barrett’s with dysplasia
Requires expert endoscopic assessment, mapping biopsies and MDT review.
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Lynch syndrome family history
Hereditary CRC risk warrants earlier and more frequent surveillance colonoscopy.
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Post-polypectomy bleed
Delayed bleeding after polyp removal - call the clinic urgently or attend A&E.
Reading your report
An endoscopy report can look intimidating. It isn’t.
Whatever the finding, the report keeps to the same four parts.
A quiet reminder
The report is written for your doctor, not for you - and that’s normal.
If you would like us to talk you through it before your follow-up, just ask.
- 01 Header
Indication and modality
Your details, the reason for endoscopy, and which modality (gastroscopy, colonoscopy, flexi sig, capsule or enteroscopy) was performed.
- 02 Technique
Sedation and extent
Sedation used, quality of preparation, extent reached (e.g. terminal ileum at colonoscopy) and completion status.
- 03 Findings
Segment-by-segment description
Segment-by-segment description of the mucosa, lesions found, biopsies taken and any therapy performed.
- 04 Impression
The conclusion - read this first
Diagnosis, histology awaited, and the concrete next step - surveillance interval, treatment or onward referral.
Recognised by major UK insurers
Cover depends on your policy and clinic; we confirm with your insurer before booking.
Frequently asked
Everything we get asked about endoscopy.
Quick answers on which modality, fasting, sedation, biopsies and how quickly results come back.
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What is endoscopy?
Endoscopy uses a thin, flexible camera to inspect the digestive tract. The menu includes gastroscopy (upper GI), colonoscopy (large bowel), flexible sigmoidoscopy (left colon), capsule endoscopy (small bowel via a swallowed capsule) and enteroscopy (deep small bowel).
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Which endoscopy do I need?
It depends on the symptoms. Reflux, dysphagia or upper-abdominal pain typically warrants gastroscopy; change in bowel habit, rectal bleeding or iron deficiency typically warrants colonoscopy; unexplained small-bowel bleeding after both may warrant capsule or enteroscopy. A gastroenterology consultation decides.
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Do I need to fast?
Yes. For gastroscopy, six hours no food and two hours no clear fluids. For colonoscopy, a bowel-prep regime the day before and clear fluids only. Written instructions are provided in advance.
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Is sedation used?
Usually. Conscious sedation (midazolam and fentanyl) is standard for colonoscopy. For gastroscopy, throat spray alone or light sedation is offered - your choice. You will need someone to take you home if sedated.
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When are biopsies taken?
Whenever the endoscopist sees suspicious mucosa, polyps or a red-flag lesion. Biopsies are painless and results usually return within one to two weeks, with a follow-up plan issued on receipt of histology.
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How quickly do I get results?
Verbal findings are discussed with you as soon as sedation wears off. A structured written report follows within 48 hours. Histology, if biopsies were taken, follows within one to two weeks.
Sources
The guidance behind this guide.
- British Society of Gastroenterology. Endoscopy guidelines.
- NICE. Colorectal cancer (NG151).
- European Society of Gastrointestinal Endoscopy. Clinical guidelines.
- American Society for Gastrointestinal Endoscopy. Practice guidelines.
Reviewed 2026-07-30 by Pulse Atlas Editorial Board, . Next review 2027-07-30. Estimated reading time 6 minutes.
Related tests
Looking for a different test?
-
Capsule endoscopy
Small-bowel visualisation with a swallowed camera capsule.
Learn more -
Enteroscopy
Deep small-bowel endoscopy for lesions beyond the duodenum.
Learn more -
Double-balloon enteroscopy
Advanced small-bowel access for diagnosis and therapy.
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All tests
Browse every test and procedure we arrange.
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Acid Reflux
Related condition guide.
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Crohns Disease
Related condition guide.
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Colectomy
Related treatment option.
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Cholecystectomy
Related treatment option.
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In practice, in London
Why private endoscopy moves differently in London
With endoscopy, the London question is usually about report turnaround and the radiologist reading it - not whether the scan is available. Public provision for endoscopy is competent but constrained by capacity. Private London clinics tend to have shorter diaries and longer appointment slots, so you get the same specialists with more time. For people who’ve been going round in circles with primary care, that first proper conversation is often what shifts things.
A private endoscopy pathway in London usually looks like this: an initial consultation, any diagnostics booked at a nearby facility (most within Zone 1 or 2), and a written report sent to you and your GP within a few days. The consultants we work with hold NHS posts alongside their private lists, which keeps the standards consistent across both settings. For endoscopy specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
The value of going through a concierge for endoscopy isn’t access - anyone with an insurer or a credit card can get a private appointment in London. The value is knowing which consultant reads this particular presentation best, which unit turns reports around fastest, and which pathway won’t hit a dead end if the findings point somewhere unexpected.