Your Endoscopic Ultrasound (EUS) – see inside, find out what is wrong

This quick guide lists the key points you need to know before having an endoscopic ultrasound (EUS). For further information:

visit https://www.bradfordhospitals.nhs.uk/endoscopy

or call us for a more detailed patient information booklet to be sent to you in the post

What is an EUS?

A flexible camera tube with a small ultrasound probe at the tip is passed through your mouth. It uses ultrasound to get high-quality pictures of the organs around your gullet, stomach, and duodenum. Sometimes it is used to take a tissue sample or biopsy. This usually takes between 15 and 30 minutes.

Why have an EUS?

This procedure gives doctors extra information to find out what is wrong and evaluate or treat your condition or take a tissue sample. It can be more accurate than x-ray films or CT scans to determine the right treatment for you.

Who performs the procedure?

A doctor, an endoscopist, carries out the procedure. Trainees may watch or perform the procedure, but always under appropriate supervision. We will ask you if you are happy for them to watch or perform.

Is it painful?

Everyone is different but most people tolerate it well with the combination of throat spray, pain killer and sedation. EUS can be uncomfortable with some discomfort from trapped wind and bloating, but this rarely is severe and settles quickly afterwards. You may also have a sore throat, but this should settle within 24 to 48 hours. If it is too uncomfortable, we will always stop if you ask us to.

Most people feel fine within an hour.

Choosing pain relief

We recommend a combination of sedation, painkiller and throat spray for the procedure. We do not advise throat spray on its own because of the duration of the procedure.

Your options for pain relief

Getting ready

It is important to prepare well for your procedure. Having an empty stomach allows us to get good views and avoids the risk of vomiting during the test.

1. Telephone pre-assessment clinic
   About a week before a nurse will call you with instructions and answer any questions you may have.
2. Day of your procedure
   • Morning appointment? Do not eat anything after midnight. On the day of your procedure you can take your normal medicine with a small sip of water before 7.00am.
   • Afternoon appointment? You may have a light breakfast such as cereal or toast and take your normal medication before 7.00am. Do not eat or drink anything after this time.

On the day

1. You will be welcomed by our receptionist who will confirm your identity and give you a wristband.
2. We will have a quick chat to see if anything has changed since your pre-assessment appointment.
3. We will answer any questions you may have and ask you to sign a consent form.
4. You will be asked to change into a gown if needed.
5. A cannula will be placed in the back of your hand for your medications. You may also get an antibiotic dose through it.
6. You will be asked to lie comfortably on your left side on a trolley and a mouth guard will protect your teeth. Dentures will be removed.
7. A probe is placed on your finger to track your pulse and a small tube provides oxygen to your nostrils.
8. Tube glides down your throat as you take a small swallow.
9. Painless or pressure-only removal of tissue samples if needed.
10. Your procedure is complete, and the tube is removed.
11. You will then rest and recover in the recovery area.
12. A nurse will discuss your results with you and a family member if you wish.

How long will it take? 

Up to 4 hours to allow time for preparation, the procedure and recovery

Going home

Sedation – rest, snack, escorted home. You must have a responsible person stay with you overnight. No driving, machinery, alcohol, heights, sports, or signing legal documents for 24 hours.

Results

The results of the procedure and follow-up plans will be discussed with you before you leave, and you will get a written summary to take home. Any biopsy results will be sent to the hospital consultant who referred you for the test, usually within one month, but this can vary.

What are the risks?

An EUS is generally a safe procedure and there is always a good reason for doing it. It is common to have a sore throat for a day or so after the procedure. More serious complications occur in less than 1 in 100 cases and include:  

• A perforation or tear through the stomach wall or gullet that may require an operation to repair
• Bleeding
• Allergic reaction to the sedation or throat spray
• Damage to loose or crowned teeth
• Heart and breathing problems related to the sedation
• if a sample is taken there is a risk of infection or pancreatitis if the pancreas is sampled. Sometimes (less than 1in 15) the sample does not identify the cause of the problem

Very rarely (less than 1 in 12,000) a complication is so serious it is life threatening. If you are worried about complications or feel you are not fit enough, please let us know.

The decision to have an EUS is yours. There are alternative tests like a CT scan, but an EUS gives more detailed information required to plan the best treatment. These options can be discussed with your doctor.

Contact numbers

Questions about your procedure?
Tel: 01274 276393
Monday to Friday
8.30am to 5.30pm

Change your appointment
Tel: 01274 273073
Monday to Friday
8.00am to 4.00pm

If you are unwell after the procedure (inside office hours)
Tel: 01274 276393
Monday to Friday
8.30am to 5.30pm

If you are unwell after the procedure (outside office hours)
01274 364413 (Ward 5) or NHS 111 or Emergency Department
24 hours a day
7 days a week

Frequently asked questions

1. Will it hurt? Everyone is different and it will depend most on the length of your procedure. EUS can be uncomfortable, but it is rarely severe and settles quickly.
2. Why can’t I be put to sleep? To put you to sleep for a procedure involves giving a general anaesthetic. This is not available routinely and it increases the risk associated with the procedure. It is not required for most patients because the procedure is usually well tolerated with sedation.
3. How long will it take? This procedure takes 30 to 45 minutes, but expect to be at the unit for up to 4 hours to cover your full care.
4. When do I get my results? See results.
5. Do I need somebody with me afterwards? Yes, because we recommend sedation with throat spray.