OGD_FakeSet.csv

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"1","Hospital Number: O8583042 , Hospital: Random NHS Foundation Trust , DOB:  1903-05-10 , General Practitioner: Dr. Lutter, Carrie Nkaus Xwb  , Date of procedure:  2004-11-14Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Biopsies for H pylori FINDINGS: The patient has Barrett's oesophagus. It is a long segment. No loss of aceto-whitening  was also seen. Short segment only. There is a polyp in the third part of the duodenum which is stalked with an abnormal pit pattern. The mucosa surrounding the nodules is inflamed and edematous, with a granular appearance.The polyp was marked with a tattoo to aid in future surveillance endoscopy.. NA RECOMMENDATION: The patient should be informed of the diagnosis and the importance of adhering to the recommended treatment plan.  The patient may be prescribed medication to reduce the risk of developing more polyps. FOLLOW UP: The patient may be prescribed medication to manage any symptoms associated with the nodule, such as pain or discomfort.  The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and increase the risk of polyp growth."
"2","Hospital Number: H2587908 , Hospital: Random NHS Foundation Trust , DOB:  1933-11-14 , General Practitioner: Dr. Akhmedov, Shane  , Date of procedure:  2015-09-02Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known coeliac ch diarrhoea.Myelofibrosis on ruxolitinib and panobinostat FINDINGS: There is a polyp in the antrum which is sessile with an abnormal pit pattern. The polyp was marked with a tattoo to aid in future surveillance endoscopy..  NA  A repeat gastroscopy may be recommended in three to six months' time to assess the growth of the polyp.  The patient should be advised to avoid consuming caffeine, which can stimulate the production of stomach acid and increase the risk of polyp growth."
"3","Hospital Number: P9907275 , Hospital: Random NHS Foundation Trust , DOB:  1967-03-08 , General Practitioner: Dr. al-Tabet, Rawda  , Date of procedure:  2002-01-13Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG3  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known coeliac disease vomitting FINDINGS: The patient has inflammation in the second part of the duodenum which is mild. The mucosa appears reddened and swollen, with evidence of exudate present in some areas.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization.. There is inflammation in the body which is erosive. The gastric mucosa appears diffusely thickened with a cobblestone appearance and no ulcerations, suggestive of granulomatous gastritis.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. NA RECOMMENDATION: Endoscopic resection of the ulcer may be necessary for larger or more complex ulcers. RECOMMENDATION: The patient should avoid eating large meals and should instead eat smaller, more frequent meals throughout the day.  Further investigations such as a biopsy may be recommended to determine the underlying cause of the inflammation. FOLLOW UP: A blood test may be ordered to assess the patient's iron levels, as ulcers can cause bleeding in the stomach and intestines. FOLLOW UP: Further investigations, such as imaging studies and blood tests, may be required to determine the underlying cause of the stricture.  The patient may be prescribed a course of antibiotics to treat any underlying infection that may be causing the inflammation."
"4","Hospital Number: D9990587 , Hospital: Random NHS Foundation Trust , DOB:  1973-11-22 , General Practitioner: Dr. Garcia, Kyle  , Date of procedure:  2007-04-20Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  150mcg  , Midazolam  5mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"5","Hospital Number: K9010769 , Hospital: Random NHS Foundation Trust , DOB:  1968-04-13 , General Practitioner: Dr. el-Kaiser, Nuzha  , Date of procedure:  2016-01-12Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia   post oesophagectomy FINDINGS: There is an ulcer in the second part of the duodenum which is excavated.Forrest Ulcer classification: IIc.. Accompanied by white exudate and a yellowish base, the gastric ulcer presents with a cobblestone appearance.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. The base of the ulcer is covered in a yellowish fibrinous exudate.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. Oesophagus normal with no hiatus hernia.. NA  The patient should be instructed to avoid tight-fitting clothing to reduce pressure on the ulcer site.  The patient should be advised to avoid consuming alcohol, which can delay the healing of the ulcer and increase the risk of developing more ulcers."
"6","Hospital Number: U5728377 , Hospital: Random NHS Foundation Trust , DOB:  1904-06-03 , General Practitioner: Dr. Mielke, Aubrien  , Date of procedure:  2001-12-09Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  125mcg  , Midazolam  2mg  , Instrument:  FG3  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Therapeutic- Dilatation FINDINGS: Normal gastroscopy to the duodenum. "
"7","Hospital Number: Y3424765 , Hospital: Random NHS Foundation Trust , DOB:  1990-05-25 , General Practitioner: Dr. Winn, Victoria  , Date of procedure:  2005-06-20Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  100mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CHRONIC DIARRHOEA-biopsies needed FINDINGS: There is inflammation in the D1/D2 angle which is erosive.  RECOMMENDATION: The patient should avoid eating large meals and should instead eat smaller, more frequent meals throughout the day.  The patient should avoid NSAIDs and aspirin, which can irritate the lining of the stomach and exacerbate the inflammation. FOLLOW UP: The patient should be advised to chew their food thoroughly and to eat slowly to help prevent swallowing difficulties.  The patient should avoid lying down immediately after meals, as this can exacerbate the inflammation by increasing the risk of reflux."
"8","Hospital Number: S9335497 , Hospital: Random NHS Foundation Trust , DOB:  1954-01-06 , General Practitioner: Dr. Anderson, Stephany  , Date of procedure:  2007-11-21Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - Post caustic soda ingestion - assessment of healing FINDINGS: Normal gastroscopy to the duodenum. "
"9","Hospital Number: R3233951 , Hospital: Random NHS Foundation Trust , DOB:  1929-09-17 , General Practitioner: Dr. Garfio Portillo, Valeria  , Date of procedure:  2012-02-21Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG1  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Dysphagia/Odynophagia FINDINGS: The patient has a stricture in the third part of the duodenum which is HhpertrophiedTight stricture impassable with scope.. The stricture has a sharp and well-defined margin, suggesting a compressive etiology.During biopsy, it was noted that the lesion had a friable surface and bled easily.. Inflammatory changes seen in the oesophagus. NA"
"10","Hospital Number: Z3118534 , Hospital: Random NHS Foundation Trust , DOB:  1942-01-25 , General Practitioner: Dr. Bayar, Neely  , Date of procedure:  2005-01-17Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  100mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins weight loss. On warfarin and clopidogrel, FINDINGS: The mucosa of the oesophagus appears thickened and edematous.. There is a nodule in the D1/D2 angle which is sessile. NA  The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent further damage to the gastrointestinal tract.  The patient should be advised to seek emotional support from friends, family, or a counselor, as the diagnosis of cancer can be difficult to cope with."
"11","Hospital Number: G7303882 , Hospital: Random NHS Foundation Trust , DOB:  1903-01-03 , General Practitioner: Dr. al-Abdella, Waajida  , Date of procedure:  2014-08-17Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Epigastric pain. Previously on asprin for Cerebral infarction FINDINGS: There is a nodule in the antrum which is stalked. A nodular lesion with overlying mucosal ulceration is seen in the gastric fundus, suggestive of a gastric neuroendocrine tumor.Follow-up endoscopy with surveillance biopsies may be necessary for patients with a history of polyps or increased risk for malignancy..  NA RECOMMENDATION: The patient should be counseled on the risks and benefits of any potential treatments for their ulcer. RECOMMENDATION: The patient should be advised to avoid lifting heavy objects or engaging in strenuous physical activity, as this can increase the risk of bleeding in the gastrointestinal tract.  A repeat gastroscopy may be recommended in three to six months' time to assess the growth of the polyp. FOLLOW UP: The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and ulcer recurrence. FOLLOW UP: Further investigations, such as imaging studies and biopsy, may be required to determine the nature of the nodule.  The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and increase the risk of polyp growth."
"12","Hospital Number: B2496144 , Hospital: Random NHS Foundation Trust , DOB:  1972-12-12 , General Practitioner: Dr. Moncada, Kasandra  , Date of procedure:  2013-11-15Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG5  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Positive coeliac FINDINGS: There is an ulcer in the second part of the duodenum which is scarredIt is not bleeding. Accompanied by white exudate and a yellowish base, the gastric ulcer presents with a cobblestone appearance.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample.. The ulcer appears to be a chronic lesion, with signs of previous healing and scarring.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample.. There is a nodule in the body which is sessile. The nodular changes may represent early fundic gland polyps.The patient should be advised to avoid straining during bowel movements to reduce pressure on the ulcer site.. character(0) RECOMMENDATION: The patient should be advised to follow a soft diet and avoid spicy or acidic foods to reduce discomfort and promote healing. RECOMMENDATION: A follow-up appointment with the gastroenterologist should be scheduled for six months after the initial diagnosis to monitor the patient's progress.  The patient should avoid eating before bedtime, as this can increase the risk of reflux and polyp growth. FOLLOW UP: The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more ulcers. FOLLOW UP: The patient should avoid drinking alcohol, as this can increase the risk of bleeding in the gastrointestinal tract.  A colonoscopy may be ordered to assess for the presence of polyps in the colon and rectum."
"13","Hospital Number: J9928505 , Hospital: Random NHS Foundation Trust , DOB:  1953-12-07 , General Practitioner: Dr. Tisone, Hunter  , Date of procedure:  2007-04-08Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  25mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known EOE oesophgeal biopsies FINDINGS: No cervical inlet patch.. "
"14","Hospital Number: M7832839 , Hospital: Random NHS Foundation Trust , DOB:  1905-02-27 , General Practitioner: Dr. Malmsbury, Susan  , Date of procedure:  2010-11-14Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  25mcg  , Midazolam  3mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- RFA Therapeutic- EMR/ESD FINDINGS: Normal gastroscopy to the duodenum. "
"15","Hospital Number: C1538169 , Hospital: Random NHS Foundation Trust , DOB:  1988-03-14 , General Practitioner: Dr. Soto, Hortencia  , Date of procedure:  2008-04-25Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia post LTA FINDINGS: Normal gastroscopy to the duodenum. "
"16","Hospital Number: Q6090326 , Hospital: Random NHS Foundation Trust , DOB:  1987-10-15 , General Practitioner: Dr. Richardson, Kelly  , Date of procedure:  2013-08-14Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  25mcg  , Midazolam  7mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known coeliac ch diarrhoea.Myelofibrosis on ruxolitinib and panobinostat FINDINGS: Normal gastroscopy to the duodenum. "
"17","Hospital Number: X8881813 , Hospital: Random NHS Foundation Trust , DOB:  1981-06-11 , General Practitioner: Dr. Adams, Iysia  , Date of procedure:  2001-04-14Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  12.5mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia FINDINGS: There is inflammation in the D1/D2 angle which is erosive.  RECOMMENDATION: A follow-up appointment with the gastroenterologist should be scheduled for six months after the initial diagnosis to monitor the patient's progress.  A repeat gastroscopy may be recommended in six months' time to assess the response to treatment. FOLLOW UP: The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent reflux.  The patient should be advised to avoid consuming too much sugar, as this can exacerbate the inflammation by increasing the risk of bacterial overgrowth in the stomach."
"18","Hospital Number: E5760181 , Hospital: Random NHS Foundation Trust , DOB:  1985-04-25 , General Practitioner: Dr. el-Bina, Tamanna  , Date of procedure:  2009-11-30Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  150mcg  , Midazolam  1mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Advanced  pancreatic CA.  Now worsening jaundice FINDINGS: There is inflammation in the body which is severe. The gastric mucosa appears diffusely thickened with a cobblestone appearance and no ulcerations, suggestive of granulomatous gastritis.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization..  RECOMMENDATION: The patient should be counseled on the importance of taking any prescribed medications for ulcer healing and symptom control as directed. RECOMMENDATION: The patient should be advised to avoid eating acidic or spicy foods, as these can worsen GERD symptoms.  The patient may be referred to a gastroenterologist for further management of the inflammation. FOLLOW UP: Further investigations such as a biopsy may be recommended to determine the cause of the ulcer and assess the risk of cancer. FOLLOW UP: The patient should be informed of the diagnosis and the importance of adhering to the recommended treatment plan.  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and inflammation."
"19","Hospital Number: N3482935 , Hospital: Random NHS Foundation Trust , DOB:  1903-02-03 , General Practitioner: Dr. Vea, Alexandra  , Date of procedure:  2012-01-29Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins FINDINGS: Normal gastroscopy to the duodenum. "
"20","Hospital Number: V6466799 , Hospital: Random NHS Foundation Trust , DOB:  1906-02-04 , General Practitioner: Dr. Rodriguez, Jacqueline  , Date of procedure:  2013-05-07Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  25mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Haematemesis or Melaena/Blood PR FINDINGS: Normal gastroscopy to the duodenum. "
"21","Hospital Number: L2151400 , Hospital: Random NHS Foundation Trust , DOB:  1992-01-28 , General Practitioner: Dr. Skaggs, Nubci  , Date of procedure:  2001-04-18Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  150mcg  , Midazolam  2mg  , Instrument:  FG5  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Reflux-like Symptoms/Atypical Chest Pain FINDINGS: The patient has an ulcer in the second part of the duodenum which is necroticIt is not bleeding. The gastric ulcer exhibits signs of NSAID-induced injury, with a fibrous base and punched-out appearance.The ulcer was biopsied x8 for further analysis.. The surrounding mucosa appears hyperemic and erythematous, consistent with active inflammation.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. On retroflexion the wrap is in correct position, with no evidence of recurrent hiatus hernia.. character(0) RECOMMENDATION: The patient should be instructed to avoid tight-fitting clothing to reduce pressure on the ulcer site. RECOMMENDATION: If the stricture is causing symptoms such as difficulty swallowing, the patient may be referred to a speech therapist for swallowing therapy.  A consultation with a dietician may be beneficial to help the patient modify their diet to manage the inflammation. FOLLOW UP: The patient should be advised to avoid consuming dairy products, which can increase the production of stomach acid and delay the healing of the ulcer. FOLLOW UP: The patient should avoid eating before going to bed, as this can worsen reflux symptoms.  A repeat gastroscopy may be recommended in six months' time to assess the response to treatment."
"22","Hospital Number: A3080284 , Hospital: Random NHS Foundation Trust , DOB:  1998-09-29 , General Practitioner: Dr. Moreno, Lillian  , Date of procedure:  2008-01-19Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  25mcg  , Midazolam  5mg  , Instrument:  FG5  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Ongoing reflux symptoms. FINDINGS: There is a nodule in the body which is benign-looking. The gastric mucosa appears thickened with a nodular surface, suggestive of a diffuse lymphoid hyperplasia.The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools..   The patient should avoid smoking and drinking alcohol, as these habits can increase the risk of cancer.  The patient should avoid eating or drinking for at least six hours before any scheduled appointments."
"23","Hospital Number: I7491657 , Hospital: Random NHS Foundation Trust , DOB:  1909-12-23 , General Practitioner: Dr. Milenski, Mayra  , Date of procedure:  2005-11-28Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  150mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CT findings: . FINDINGS: There is inflammation in the antrum which is mild. The gastric inflammation is characterized by the presence of neutrophils and lymphocytes in the mucosal layer.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. LA Grade  D oesophagitis. There is significant narrowing of the oesophageal lumen due to stricture formation with areas of mucosal ulceration. The oesophageal mucosa is thickened and has a leathery appearance. The oesopahgitis is consistent with acid reflux. The gastric lesion appears malignant, with an irregular shape and size, and a raised edge.The ulcer was biopsied x8 for further analysis.. NA RECOMMENDATION: The patient should be advised to seek medical attention immediately if they experience symptoms of severe bleeding such as black tarry stools or vomiting blood. RECOMMENDATION: The patient should be advised to avoid eating foods that are difficult to swallow, such as hard or crunchy foods.  The patient should avoid eating before bedtime, as this can exacerbate the inflammation by increasing the risk of reflux. FOLLOW UP: The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more ulcers. FOLLOW UP: If the stricture is due to a medical condition such as gastroesophageal reflux disease (GERD), the patient may be prescribed medication to manage their symptoms.  The patient may be referred to a gastroenterologist for further management of the inflammation."
"24","Hospital Number: F8022001 , Hospital: Random NHS Foundation Trust , DOB:  1998-11-08 , General Practitioner: Dr. Shehadi, Gabrielle  , Date of procedure:  2004-10-08Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  125mcg  , Midazolam  1mg  , Instrument:  FG5  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal pain Other- previous ulcer FINDINGS: There is a polyp in the D1/D2 angle which is sessile with a normal pit pattern.  RECOMMENDATION: Follow-up with a primary care physician or gastroenterologist for ongoing management and symptom control is recommended.  A colonoscopy may be ordered to assess for the presence of polyps in the colon and rectum. FOLLOW UP:   Further investigations such as a biopsy may be recommended to determine the type of polyp and assess the risk of cancer."
"25","Hospital Number: T4904215 , Hospital: Random NHS Foundation Trust , DOB:  1944-02-26 , General Practitioner: Dr. Bell, Brianna  , Date of procedure:  2003-03-05Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  150mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known coeliac disease vomitting FINDINGS: There is a nodule in the GOJ which is stalked. A Paris IIb polypoid lesion was observed in the oesophagus during endoscopy, measuring 2.2 cm in diameter. The lesion had a nodular surface and appeared to be pedunculated.The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and inflammation..  character(0) RECOMMENDATION: The patient may be referred to a nutritionist to develop a diet plan that is easier to digest and that meets their nutritional needs. RECOMMENDATION: If the patient experiences chest pain or difficulty breathing, they should seek emergency medical attention immediately. RECOMMENDATION: The patient should be advised to avoid caffeine, which can stimulate the production of stomach acid and exacerbate the inflammation.   FOLLOW UP: The patient may be referred to a nutritionist to develop a diet plan that is easier to digest and that meets their nutritional needs. FOLLOW UP: The patient may be referred to a specialist for further evaluation and treatment, such as surgery to widen the esophagus. FOLLOW UP: The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and inflammation.  A repeat gastroscopy may be recommended in twelve months' time to assess the response to treatment."
"26","Hospital Number: W8932372 , Hospital: Random NHS Foundation Trust , DOB:  1952-10-01 , General Practitioner: Dr. Abachiche, Rorie  , Date of procedure:  2013-01-31Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  150mcg  , Midazolam  5mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- FINDINGS: OESOPHAGUS: Normal apart from small hiatus hernia.. "
"27","Hospital Number: O7967929 , Hospital: Random NHS Foundation Trust , DOB:  1989-12-06 , General Practitioner: Dr. Duskus, Alyssa  , Date of procedure:  2015-06-27Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  125mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: High Dysphagia further assessment of previoius diagnosed peptic stricture also recent eus and aspirat of bengn perigastric cyst FINDINGS: Barrett's is present. The pit pattern is normal. It is a long segment. "
"28","Hospital Number: H3844577 , Hospital: Random NHS Foundation Trust , DOB:  1940-11-22 , General Practitioner: Dr. Aviado II, Araseli  , Date of procedure:  2015-02-22Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Altered taste FINDINGS: There is inflammation in the third part of the duodenum which is severe. There are multiple erosions and ulcers noted in the duodenal mucosa, suggestive of ongoing inflammation.The biopsy was performed using a needle biopsy forceps, with the tissue samples sent for pathological analysis.. The endoscopic appearance of the oesophagus is suggestive of eosinophilic oesophagitis, with multiple linear furrows and white plaques.. character(0) RECOMMENDATION: The patient should be advised to avoid hot spices, sauces, and acidic foods to reduce discomfort and promote healing. RECOMMENDATION: A follow-up appointment with the gastroenterologist should be scheduled for six months after the initial diagnosis to monitor the patient's progress.  The patient may be prescribed a course of antibiotics to treat any underlying infection that may be causing the inflammation. FOLLOW UP: The patient should avoid consuming acidic foods and drinks, which can irritate the lining of the stomach and delay the healing of the ulcer. FOLLOW UP: The patient may be referred to a specialist for further evaluation and treatment, such as surgery to widen the esophagus.  The patient should be advised to avoid consuming too much sugar, as this can exacerbate the inflammation by increasing the risk of bacterial overgrowth in the stomach."
"29","Hospital Number: P4236233 , Hospital: Random NHS Foundation Trust , DOB:  1935-07-03 , General Practitioner: Dr. Ramirez, Janisa  , Date of procedure:  2002-05-22Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  150mcg  , Midazolam  5mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Maleana FINDINGS: The patient has a stricture in the third part of the duodenum which is contractedScope not held by stricture. The duodenal stricture has a smooth and regular contour, without any signs of ulceration or erosion.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. Inflammatory changes seen in the oesophagus. NA  Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) may be necessary for larger or more complex ulcers.  "
"30","Hospital Number: D4826904 , Hospital: Random NHS Foundation Trust , DOB:  1917-01-02 , General Practitioner: Dr. Childs, Elizabeth  , Date of procedure:  2004-04-26Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  125mcg  , Midazolam  4mg  , Instrument:  FG5  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Chronic cough?reflux FINDINGS: Normal gastroscopy to the duodenum. "
"31","Hospital Number: K8847627 , Hospital: Random NHS Foundation Trust , DOB:  1983-05-22 , General Practitioner: Dr. Chau, Chelsea  , Date of procedure:  2001-01-09Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Reflux-like Symptoms/Atypical Chest Pain FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"")."
"32","Hospital Number: U8525559 , Hospital: Random NHS Foundation Trust , DOB:  1988-02-21 , General Practitioner: Dr. el-Rassi, Aadila  , Date of procedure:  2003-12-25Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG3  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Therapeutic- Dilatation FINDINGS: LA Grade  D oesophagitis. Food present in the oesophagus The oesophageal mucosa appears pale and atrophic. There is a nodule in the stomach which is sessile. A nodular lesion with surrounding erythema and exudates is seen in the gastric fundus, suggestive of a malignant gastric neoplasm.A proton pump inhibitor medication may be prescribed to manage the inflammation.. character(0) RECOMMENDATION: The patient should be advised to report any new symptoms or changes in symptoms to their healthcare provider immediately. RECOMMENDATION: The patient should be advised to avoid wearing tight clothing around their waist, as this can put pressure on the stomach and worsen GERD symptoms.  The patient should follow a strict diet and avoid irritants that can exacerbate the inflammation. FOLLOW UP: The patient may be prescribed medication to reduce the size of the nodule and prevent it from growing. FOLLOW UP: The patient should be advised to maintain a healthy weight, as obesity can worsen the symptoms of GERD.  A repeat gastroscopy may be required in three to six months' time to monitor the progress of the inflammation."
"33","Hospital Number: Y5602439 , Hospital: Random NHS Foundation Trust , DOB:  1926-10-01 , General Practitioner: Dr. el-Guler, Shajee'a  , Date of procedure:  2007-03-02Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia . FINDINGS: There is inflammation in the GOJ which is mild. There are multiple raised, nodular areas of mucosa, suggestive of granulomatous inflammation.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization..  NA RECOMMENDATION: The patient should be advised to avoid wearing tight clothing around their waist, as this can put pressure on the stomach and worsen GERD symptoms.  The patient should avoid wearing tight clothing, as this can exacerbate the inflammation by increasing the pressure on the stomach. FOLLOW UP: The patient should be advised to avoid caffeine, as it can worsen reflux symptoms.  Further investigations such as a biopsy may be recommended to determine the underlying cause of the inflammation."
"34","Hospital Number: S6682774 , Hospital: Random NHS Foundation Trust , DOB:  1916-07-11 , General Practitioner: Dr. Chasse, Mckenzie  , Date of procedure:  2013-11-19Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow-up ULCER HEALING FINDINGS: The patient has a polyp in the stomach which is sessile.It has an abnormal pit pattern. The gastric polyp appears fundic with a smooth surface and no vascularization.ESD was performed to remove the polyp after lifting it with saline injection..  RECOMMENDATION: The patient should be counseled on the importance of taking any prescribed medications for ulcer healing and symptom control as directed.  The patient should avoid smoking and alcohol, which can increase the risk of developing more polyps. FOLLOW UP: The patient should be advised to avoid consuming dairy products, which can increase the production of stomach acid and delay the healing of the ulcer.  The patient should follow a healthy diet and lifestyle to reduce the risk of developing more polyps."
"35","Hospital Number: R6103760 , Hospital: Random NHS Foundation Trust , DOB:  1925-03-24 , General Practitioner: Dr. Ornelas, Monica  , Date of procedure:  2007-05-20Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  150mcg  , Midazolam  2mg  , Instrument:  FG6  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- EMR/ESD FINDINGS: The endoscopic findings reveal an ultra-short segment of the oesophagus affected by eosinophilic oesophagitis.. The patient has a 5mm nodule in the duodenal bulb which is stalked. character(0)  If the patient is experiencing symptoms such as vomiting or fever, they should contact their healthcare provider immediately.  The patient should avoid eating or drinking for at least six hours before any scheduled appointments."
"36","Hospital Number: Z1272661 , Hospital: Random NHS Foundation Trust , DOB:  1914-03-24 , General Practitioner: Dr. Dover, Caitlyn  , Date of procedure:  2014-12-25Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  50mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: ULCER CHECK. FINDINGS: The patient has a 4mm nodule in the body which is sessile. A nodular lesion with surrounding erythema and exudates is seen in the gastric fundus, suggestive of a malignant gastric neoplasm.A biopsy of the affected area may also be recommended to assess for any underlying pathology.. Small hiatus hernia.. character(0) RECOMMENDATION: The patient should be advised to maintain a healthy weight and exercise regularly to reduce the risk of recurrent ulcers.  The patient may be referred to a specialist for further evaluation and treatment, such as surgery to remove the nodule. FOLLOW UP: The patient should avoid consuming too much fat, as this can delay gastric emptying and delay the healing of the ulcer.  The patient may be prescribed medication to reduce the size of the nodule and prevent it from growing."
"37","Hospital Number: G2227671 , Hospital: Random NHS Foundation Trust , DOB:  1996-03-29 , General Practitioner: Dr. Young, Rachel  , Date of procedure:  2007-08-17Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  100mcg  , Midazolam  1mg  , Instrument:  FG2  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Altered taste FINDINGS: The patient has Barrett's oesophagus. No nodularity is present. Gastric mucosal prolapse seen. There is a nodule in the stomach which is stalked. A well-circumscribed, pedunculated nodule is observed in the gastric antrum, suggestive of a gastric fibroma.The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and increase the risk of polyp growth.. NA RECOMMENDATION: If the nodule is benign, the patient may not require any treatment, but may require monitoring with regular endoscopies.  The patient should avoid lying down immediately after meals, as this can increase the risk of reflux and polyp growth. FOLLOW UP:   The patient should be advised to eat slowly and chew their food thoroughly to aid digestion and reduce the risk of polyp growth."
"38","Hospital Number: B7082304 , Hospital: Random NHS Foundation Trust , DOB:  1960-06-20 , General Practitioner: Dr. Duran, Cyndee  , Date of procedure:  2006-03-09Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  12.5mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Weight Loss Anaemia/Low Iron or Vitamins FINDINGS: Small hiatus hernia.. "
"39","Hospital Number: J8000143 , Hospital: Random NHS Foundation Trust , DOB:  1951-08-16 , General Practitioner: Dr. Garlick, Shyanne  , Date of procedure:  2004-06-22Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  12.5mcg  , Midazolam  7mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known EOE oesophgeal biopsies FINDINGS: Normal gastroscopy to the duodenum. "
"40","Hospital Number: M2497777 , Hospital: Random NHS Foundation Trust , DOB:  1930-07-27 , General Practitioner: Dr. Vunguyen, Sophia  , Date of procedure:  2015-07-21Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: ULCER CHECK. FINDINGS: Normal gastroscopy to the duodenum.   Follow-up endoscopy with surveillance biopsies may be necessary for patients with a history of gastric ulcer or increased risk for malignancy.  The patient should avoid NSAIDs and aspirin, which can delay the healing of the ulcer and increase the risk of developing more ulcers."
"41","Hospital Number: C1910592 , Hospital: Random NHS Foundation Trust , DOB:  1942-09-30 , General Practitioner: Dr. Elahi, Alecia  , Date of procedure:  2010-07-19Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Dysphagia/Odynophagia FINDINGS: There is a nodule in the third part of the duodenum which is sessile.  NA  The patient may be referred to a specialist for further evaluation and treatment, such as surgery to remove the nodule.  Further investigations, such as imaging studies and biopsy, may be required to determine the nature of the nodule."
"42","Hospital Number: Q9535363 , Hospital: Random NHS Foundation Trust , DOB:  1990-11-01 , General Practitioner: Dr. Marshall, Alexis  , Date of procedure:  2003-11-18Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  100mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- RFA Therapeutic- EMR/ESD FINDINGS: Inflammatory changes seen in the oesophagus. Barrett's is present. The segment looks flat. character(0)"
"43","Hospital Number: X7857756 , Hospital: Random NHS Foundation Trust , DOB:  1906-04-27 , General Practitioner: Dr. Casillas, Karen  , Date of procedure:  2012-06-13Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  150mcg  , Midazolam  5mg  , Instrument:  FG2  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- PEG FINDINGS: Normal gastroscopy to the duodenum. "
"44","Hospital Number: E8303284 , Hospital: Random NHS Foundation Trust , DOB:  1907-08-17 , General Practitioner: Dr. Hermawan, Kiana  , Date of procedure:  2012-10-07Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Other- change in taste bile taste in mouth FINDINGS: LA Grade  A oesophagitis. The lower oesopahgeal sphincter looks widely patent  NA"
"45","Hospital Number: N5562828 , Hospital: Random NHS Foundation Trust , DOB:  1929-01-24 , General Practitioner: Dr. Platero, Alex  , Date of procedure:  2003-05-27Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Maleana FINDINGS: Normal gastroscopy to the duodenum. "
"46","Hospital Number: V8753920 , Hospital: Random NHS Foundation Trust , DOB:  1900-11-02 , General Practitioner: Dr. Rodriguez, Krista  , Date of procedure:  2001-06-30Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: On going epigastric pain FINDINGS: The patient has inflammation in the body which is erosive. The gastric mucosa appears diffusely thickened with a cobblestone appearance and no ulcerations, suggestive of granulomatous gastritis.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling..  RECOMMENDATION: Biopsy samples were taken from the ulcer base to rule out malignancy. The patient should follow up with their referring physician for results. RECOMMENDATION: The patient should be advised to maintain a healthy weight, as obesity can worsen the symptoms of GERD.  The patient should be informed of the diagnosis and provided with information on how to manage the inflammation. FOLLOW UP: The patient may be referred to a specialist in gastrointestinal disorders for further management of the ulcer. FOLLOW UP: The patient should avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as these can worsen GERD symptoms.  The patient should be advised to avoid acidic foods and drinks, which can irritate the lining of the stomach and exacerbate the inflammation."
"47","Hospital Number: L1479863 , Hospital: Random NHS Foundation Trust , DOB:  1988-03-28 , General Practitioner: Dr. Mcconnell, Aaliyah  , Date of procedure:  2004-12-09Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Weight Loss FINDINGS: There is inflammation in the third part of the duodenum which is erosive. Upon endoscopy, the duodenal mucosa appears edematous and inflamed.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling..  character(0) RECOMMENDATION: The patient should be informed of the diagnosis and the importance of adhering to the recommended treatment plan.  The patient should follow a strict diet and avoid irritants that can exacerbate the inflammation. FOLLOW UP: The patient may require additional endoscopies in the future to monitor the stricture and ensure that it is not progressing.  The patient should avoid lying down immediately after meals, as this can exacerbate the inflammation by increasing the risk of reflux."
"48","Hospital Number: A5218459 , Hospital: Random NHS Foundation Trust , DOB:  1982-02-07 , General Practitioner: Dr. Underwood, Claire  , Date of procedure:  2011-07-24Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow-up ULCER HEALING FINDINGS: The patient has a stricture in the body which is HhpertrophiedThere is very slight and non-restrcitve stricturing.. A gastric stricture with an overlying ulceration is seen in the antrum, suggestive of a peptic stricture.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. No inlet patch.. character(0)  The patient should be advised to avoid smoking, alcohol, and NSAIDs to reduce the risk of recurrent ulcers.  The patient should avoid lying down immediately after meals, as this can increase the risk of reflux and ulcer recurrence."
"49","Hospital Number: I2777268 , Hospital: Random NHS Foundation Trust , DOB:  1969-11-05 , General Practitioner: Dr. Lind, Jahcie  , Date of procedure:  2007-09-15Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  25mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Biopsies from duodenal stricture FINDINGS: Normal gastroscopy to the duodenum. "
"50","Hospital Number: F7726169 , Hospital: Random NHS Foundation Trust , DOB:  1946-06-07 , General Practitioner: Dr. al-Ayub, Aliyya  , Date of procedure:  2008-02-07Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  50mcg  , Midazolam  6mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Nausea and/or Vomiting FINDINGS: Lax cardia with small hiatus hernia. "
"51","Hospital Number: T1978921 , Hospital: Random NHS Foundation Trust , DOB:  1931-02-23 , General Practitioner: Dr. Duling, Hysendra  , Date of procedure:  2001-10-18Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Coeliac  and ? RCD FINDINGS: Columnar lined oesophagus is present. No loss of aceto-whitening  was also seen. Short segment only. No abnormal pit pattern is seen. The patient has a 10mm nodule in the duodenal bulb which is stalked. character(0)  The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent further damage to the gastrointestinal tract.  The patient should be advised to attend all scheduled appointments and follow the treatment plan recommended by their healthcare provider."
"52","Hospital Number: W8248560 , Hospital: Random NHS Foundation Trust , DOB:  1986-07-16 , General Practitioner: Dr. Fishburn, Daiszha  , Date of procedure:  2005-12-21Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG1  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - chronic cough ?GORD FINDINGS: The patient has a polyp in the duodenal bulb which is sessile with a normal pit pattern. The polyp did not lift on saline injection and was therefore not amenable to endoscopic resection..  character(0)  The patient should be informed of the diagnosis and provided with information on how to manage the polyp.  The patient may be referred to a specialist in gastrointestinal disorders for further management of the polyp."
"53","Hospital Number: O8592861 , Hospital: Random NHS Foundation Trust , DOB:  1995-12-07 , General Practitioner: Dr. Rucker, Daphne  , Date of procedure:  2016-05-29Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia FINDINGS: Normal gastroscopy to the duodenum. "
"54","Hospital Number: H1442477 , Hospital: Random NHS Foundation Trust , DOB:  1904-01-29 , General Practitioner: Dr. el-Mona, Hissa  , Date of procedure:  2015-04-19Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Weight Loss FINDINGS: No inlet patch  was also seen on narrow band imaging.. "
"55","Hospital Number: P1673382 , Hospital: Random NHS Foundation Trust , DOB:  1972-10-15 , General Practitioner: Dr. Rowe, Renee  , Date of procedure:  2013-02-23Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  12.5mcg  , Midazolam  7mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Previous multiple surgeries for reflux . FINDINGS: There is a polyp in the third part of the duodenum which is sessile with a normal pit pattern. The nodules are visualized using high-resolution endoscopy with narrow-band imaging technology.The polyp did not lift on saline injection and was therefore not amenable to endoscopic resection..  NA RECOMMENDATION: The patient should be advised to maintain a healthy weight, as obesity can increase the risk of cancer and other gastrointestinal diseases.  The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more polyps. FOLLOW UP: The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the nodule.  The patient should be advised to avoid hot, spicy foods, which can irritate the lining of the stomach and increase the risk of polyp growth."
"56","Hospital Number: D3953088 , Hospital: Random NHS Foundation Trust , DOB:  1984-04-18 , General Practitioner: Dr. el-Farman, Sajaa  , Date of procedure:  2002-01-11Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  50mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain FINDINGS: At 18cm two inlet patches were seen.. "
"57","Hospital Number: K5760664 , Hospital: Random NHS Foundation Trust , DOB:  1942-02-25 , General Practitioner: Dr. Hernandez, Sapphire  , Date of procedure:  2012-09-06Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG5  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Nausea and/or Vomiting Other- Early satiety FINDINGS: The patient has inflammation in the antrum which is erosive. The gastric mucosa appears thickened and edematous, with areas of ulceration and hemorrhage, suggestive of chronic atrophic gastritis.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. The patient has an ulcer in the body which is scarredForrest Ulcer classification: IIc.. The patient's medical history, along with the ulcer's rugose surface and flat appearance, suggest a chronic, long-standing condition.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. character(0) RECOMMENDATION: Follow-up with a primary care physician or gastroenterologist for ongoing management and symptom control is recommended. RECOMMENDATION: The patient should avoid smoking and drinking alcohol, as these habits can worsen GERD symptoms.  The patient should be advised to avoid acidic foods and drinks, which can irritate the lining of the stomach and exacerbate the inflammation. FOLLOW UP: The patient may be referred to a specialist in gastrointestinal disorders for further management of the ulcer. FOLLOW UP: The patient should be advised to elevate the head of their bed by six inches to help prevent reflux at night.  The patient should avoid eating before bedtime, as this can exacerbate the inflammation by increasing the risk of reflux."
"58","Hospital Number: U6704720 , Hospital: Random NHS Foundation Trust , DOB:  1991-03-21 , General Practitioner: Dr. Le, Paulina  , Date of procedure:  2007-07-06Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Dyspepsia FINDINGS: Normal gastroscopy to the duodenum. "
"59","Hospital Number: Y1451790 , Hospital: Random NHS Foundation Trust , DOB:  1981-07-17 , General Practitioner: Dr. el-Abood, Sumbula  , Date of procedure:  2003-01-29Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Abdominal Pain FINDINGS: LA Grade  B oesophagitis. Food present in the oesophagus There is significant ulceration and bleeding present in the oesophageal mucosa. The gastric lesion appears malignant with irregular borders and surrounding erythema.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. There is a polyp in the D1/D2 angle which is stalked.It has a normal pit pattern. NA RECOMMENDATION: Follow-up endoscopy with surveillance biopsies may be necessary for patients with a history of gastric ulcer or increased risk for malignancy.  A repeat gastroscopy may be recommended in twelve months' time to assess the response to treatment. FOLLOW UP: The patient should avoid lying down immediately after meals, as this can increase the risk of reflux and ulcer recurrence.  "
"60","Hospital Number: S9523253 , Hospital: Random NHS Foundation Trust , DOB:  1994-10-10 , General Practitioner: Dr. al-Sattar, Naaila  , Date of procedure:  2003-03-20Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Dilatation FINDINGS: Normal gastroscopy to the duodenum. "
"61","Hospital Number: R7817343 , Hospital: Random NHS Foundation Trust , DOB:  1996-03-28 , General Practitioner: Dr. Wood, Elizabeth  , Date of procedure:  2006-01-22Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known EOE oesophgeal biopsies FINDINGS: There is an ulcer in the D1/D2 angle which is exudativeIt has a visible vessel. The gastric ulcer exhibits signs of NSAID-induced injury, with a fibrous base and punched-out appearance.The biopsy was performed using a needle biopsy forceps, with the tissue samples sent for pathological analysis..   Referral to a gastroenterologist for further evaluation and management of the ulcer is recommended.  The patient should follow a healthy diet and lifestyle to reduce the risk of developing more ulcers."
"62","Hospital Number: Z7781233 , Hospital: Random NHS Foundation Trust , DOB:  1942-06-28 , General Practitioner: Dr. Toure, Keleshia  , Date of procedure:  2005-10-21Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Weight Loss FINDINGS: There is a polyp in the oesophagus at 24 cm which is sessile with a normal pit pattern. A sessile, nodular lesion is seen in the distal esophagus, suggestive of an esophageal papilloma.ESD was performed to remove the polyp after lifting it with saline injection.. There is a stricture in the fundus which is narrowedTight distal stricture which would not allow passage of scope.. The gastric stricture is likely due to fibrotic changes in the mucosa, rather than extrinsic compression.The ulcer was biopsied x8 for further analysis.. character(0) RECOMMENDATION: The patient should be advised to avoid aspirin or other blood thinners unless prescribed by a physician.  The patient should avoid smoking and alcohol, which can increase the risk of developing more polyps. FOLLOW UP: The patient should follow a healthy diet and lifestyle to reduce the risk of developing more ulcers.  The patient should be advised to avoid consuming caffeine, which can stimulate the production of stomach acid and increase the risk of polyp growth."
"63","Hospital Number: G7755694 , Hospital: Random NHS Foundation Trust , DOB:  1907-09-11 , General Practitioner: Dr. Becker, Hannah  , Date of procedure:  2012-09-03Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  100mcg  , Midazolam  3mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Abdominal Pain FINDINGS: Normal gastroscopy to the duodenum. "
"64","Hospital Number: B7780911 , Hospital: Random NHS Foundation Trust , DOB:  1937-08-09 , General Practitioner: Dr. Strascina-Dower, Mariah  , Date of procedure:  2009-07-14Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG5  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Family history of gastric cancer FINDINGS: The patient has a stricture in the fundus which is scarredIt is easily traversible.. A long-segment gastric stricture is noted in the body of the stomach, with a stenotic and irregular contour.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. Columnar lined oesophagus is present. No abnormal pit pattern is seen. The segment looks flat. Some areas of vascular abnormalities are seen. NA"
"65","Hospital Number: J8821698 , Hospital: Random NHS Foundation Trust , DOB:  1939-04-17 , General Practitioner: Dr. Awtrey, Ellen  , Date of procedure:  2005-02-01Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Reduced appetite early satiety FINDINGS: The patient has a 4mm nodule in the fundus which is stalked. A large, ulcerated nodule with central necrosis is seen in the gastric antrum, suggestive of a gastric adenocarcinoma.The patient should be advised to stay hydrated and eat small, frequent meals to help reduce inflammation and improve symptoms.. There is inflammation in the second part of the duodenum which is erosive. There is diffuse erythema and friability noted in the duodenal mucosa, with areas of active bleeding.The ulcer was biopsied x8 for further analysis.. character(0) RECOMMENDATION: Follow-up with a primary care physician or gastroenterologist for ongoing management and symptom control is recommended. RECOMMENDATION: The patient should be advised to avoid eating large meals or eating quickly, as this can increase the risk of reflux and further damage to the gastrointestinal tract. RECOMMENDATION: The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the stricture.  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and inflammation. FOLLOW UP: The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and delay the healing of the ulcer. FOLLOW UP: The patient should avoid smoking and drinking alcohol, as these habits can increase the risk of cancer. FOLLOW UP: The patient may be referred to a specialist for further evaluation and treatment, such as surgery to widen the esophagus.  A blood test may be ordered to assess the patient's iron levels, as chronic inflammation can cause anemia."
"66","Hospital Number: M8882071 , Hospital: Random NHS Foundation Trust , DOB:  1910-08-10 , General Practitioner: Dr. Cannell, Sasha  , Date of procedure:  2008-11-11Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  7mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Weight Loss FINDINGS: Normal gastroscopy to the duodenum. "
"67","Hospital Number: C4433311 , Hospital: Random NHS Foundation Trust , DOB:  1988-02-28 , General Practitioner: Dr. Thorpe, Tyanna  , Date of procedure:  2008-01-11Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  25mcg  , Midazolam  4mg  , Instrument:  FG7  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Nausea and/or Vomiting Weight Loss FINDINGS: The patient has a 3mm nodule in the third part of the duodenum which is benign-looking. Barrett's is present. No nodularity is present. It is a long segment. NA    The patient may be prescribed medication to reduce the size of the nodule and prevent it from growing."
"68","Hospital Number: Q1015837 , Hospital: Random NHS Foundation Trust , DOB:  1965-06-24 , General Practitioner: Dr. Gerlach, Krista  , Date of procedure:  2013-07-13Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG3  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Dyspepsia FINDINGS: There is a stricture in the GOJ which is stenoticTight stricture impassable with scope.. No evidence of bleeding or exudate is observed at the stricture site.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample.. The patient has a 3mm nodule in the oesophagus at 32 cm which is stalked. Inspection of the oesophageal ulcer reveals a diffusely inflamed and ulcerated mucosa with scattered areas of granulation tissue.A repeat gastroscopy may be recommended in six months' time to assess the response to treatment.. character(0) RECOMMENDATION: Follow-up with a primary care physician or gastroenterologist for ongoing management and symptom control is recommended.  The patient should be advised to maintain a healthy weight, as obesity can increase the risk of cancer and other gastrointestinal diseases. FOLLOW UP: The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and delay the healing of the ulcer.  The patient should be advised to avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as these can increase the risk of bleeding in the gastrointestinal tract."
"69","Hospital Number: X2594520 , Hospital: Random NHS Foundation Trust , DOB:  1990-01-15 , General Practitioner: Dr. Silcott, Kiyana  , Date of procedure:  2010-10-22Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Dysphagia/Odynophagia FINDINGS: Normal gastroscopy to the duodenum. "
"70","Hospital Number: E6158591 , Hospital: Random NHS Foundation Trust , DOB:  1943-08-30 , General Practitioner: Dr. Walker, Joleen  , Date of procedure:  2010-07-09Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  12.5mcg  , Midazolam  5mg  , Instrument:  FG7  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Therapeutic- Dilatation Therapeutic- NJ Tube/PEG/DPEJ FINDINGS: There is a polyp in the duodenal bulb which is stalked with a normal pit pattern. The nodules vary in size, with the largest measuring approximately 1 cm in diameter.The base of the polyp was cauterized with an argon plasma coagulator to prevent bleeding..  NA RECOMMENDATION: The patient should be informed of the diagnosis and the importance of adhering to the recommended treatment plan.  The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and increase the risk of polyp growth. FOLLOW UP: The patient should be advised to avoid lifting heavy objects or engaging in strenuous physical activity, as this can increase the risk of bleeding in the gastrointestinal tract.  The patient should be advised to avoid consuming caffeine, which can stimulate the production of stomach acid and increase the risk of polyp growth."
"71","Hospital Number: N9571333 , Hospital: Random NHS Foundation Trust , DOB:  1912-08-17 , General Practitioner: Dr. Starbird, Anna  , Date of procedure:  2009-01-17Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Gastric ucers with hy pylori. FINDINGS: Normal gastroscopy to the duodenum. "
"72","Hospital Number: V3328807 , Hospital: Random NHS Foundation Trust , DOB:  1965-05-29 , General Practitioner: Dr. Smith, Marlana  , Date of procedure:  2008-02-14Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Dysphagia/Odynophagia FINDINGS: Hiatus hernia .. "
"73","Hospital Number: L2721400 , Hospital: Random NHS Foundation Trust , DOB:  1920-07-25 , General Practitioner: Dr. Fushimi, Aimee  , Date of procedure:  2011-01-06Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Other- Early satiety FINDINGS: LA Grade  C oesophagitis. The oesophageal mucosa has a furrowed or corrugated appearance. Food present in the oesophagus The lower oesopahgeal sphincter looks widely patent  NA"
"74","Hospital Number: A9747574 , Hospital: Random NHS Foundation Trust , DOB:  1963-04-11 , General Practitioner: Dr. Godman, Samantha  , Date of procedure:  2015-05-10Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  150mcg  , Midazolam  5mg  , Instrument:  FG3  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: MelaenaEpigastric Pain FINDINGS: The patient has an ulcer in the oesophagus at 28 cm which is fibroticIt is bleeding. The gastric ulcer exhibits signs of NSAID-induced injury, with a fibrous base and punched-out appearance.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. Upon inspection, the oesophageal ulcer appears to be a raised, erythematous area with a central crater.The ulcer was biopsied x8 for further analysis..  character(0)  The patient should be counseled on the importance of taking any prescribed medications for ulcer healing and symptom control as directed.  The patient should avoid eating before bedtime, as this can increase the risk of reflux and ulcer recurrence."
"75","Hospital Number: I9081757 , Hospital: Random NHS Foundation Trust , DOB:  1952-08-16 , General Practitioner: Dr. Gaddis, Lily  , Date of procedure:  2010-06-11Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  100mcg  , Midazolam  7mg  , Instrument:  FG6  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss . FINDINGS: Barrett's is present. Some areas of vascular abnormalities are seen. Short segment only. "
"76","Hospital Number: F6090839 , Hospital: Random NHS Foundation Trust , DOB:  1932-12-09 , General Practitioner: Dr. Tohtsonie, Samantha  , Date of procedure:  2003-10-22Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  100mcg  , Midazolam  7mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Eosinophilic oesophatitis assessment FINDINGS: There is inflammation in the stomach which is erosive. Focal areas of erythema and hemorrhage are seen in the gastric fundus, suggestive of mild gastritis.The ulcer was biopsied x8 for further analysis.. There is a polyp in the third part of the duodenum which is stalked with an abnormal pit pattern. The mucosa surrounding the nodules is inflamed and edematous, with a granular appearance.The polyp was marked with a tattoo to aid in future surveillance endoscopy.. character(0) RECOMMENDATION: The patient should be counseled on the risks and benefits of any potential treatments for their ulcer. RECOMMENDATION: The patient should avoid drinking alcohol, as this can increase the risk of bleeding in the gastrointestinal tract. RECOMMENDATION: If the stricture is causing symptoms such as difficulty swallowing, the patient may be referred to a speech therapist for swallowing therapy. RECOMMENDATION: A barium swallow study may be ordered to assess the extent of the inflammation.  The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and increase the risk of polyp growth. FOLLOW UP: The patient should follow a healthy diet and lifestyle to reduce the risk of developing more ulcers. FOLLOW UP: The patient should be advised to avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as these can increase the risk of bleeding in the gastrointestinal tract. FOLLOW UP: The patient should avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as these can worsen GERD symptoms. FOLLOW UP: The patient should avoid consuming large meals, as this can exacerbate the inflammation.  A colonoscopy may be ordered to assess for the presence of polyps in the colon and rectum."
"77","Hospital Number: T7480285 , Hospital: Random NHS Foundation Trust , DOB:  1954-09-07 , General Practitioner: Dr. Chan, Lily Clare  , Date of procedure:  2006-11-15Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Eosinophilic oesophatitis assessment FINDINGS: The patient has a stricture in the duodenal bulb which is fibroticThere is very slight and non-restrcitve stricturing.. The stricture is located at the third part of the duodenum, and it appears to be eccentric in nature.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. There is a polyp in the third part of the duodenum which is stalked with an abnormal pit pattern. The mucosa surrounding the nodules is inflamed and edematous, with a granular appearance.The polyp was marked with a tattoo to aid in future surveillance endoscopy.. NA RECOMMENDATION:   The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and increase the risk of polyp growth. FOLLOW UP: The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent further damage to the gastrointestinal tract.  The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and increase the risk of polyp growth."
"78","Hospital Number: W2054819 , Hospital: Random NHS Foundation Trust , DOB:  1939-12-25 , General Practitioner: Dr. Belcher, Brittany  , Date of procedure:  2004-01-11Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  100mcg  , Midazolam  5mg  , Instrument:  FG5  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - Post caustic soda ingestion - assessment of healing FINDINGS: There is an ulcer in the second part of the duodenum which is induratedCLO test  was also taken.. The gastric lesion exhibits an irregular shape and size, with a raised edge and depth greater than 5 mm.The biopsy was performed using a needle biopsy forceps, with the tissue samples sent for pathological analysis.. The surrounding mucosa appears to be friable and prone to bleeding upon contact.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. There is inflammation in the D1/D2 angle which is erosive. NA RECOMMENDATION: The patient should be instructed to avoid caffeine and carbonated beverages to reduce discomfort and promote healing. RECOMMENDATION: The patient should be advised to avoid wearing tight clothing around their waist, as this can put pressure on the stomach and worsen GERD symptoms.  The patient should be advised to avoid consuming too much sugar, as this can exacerbate the inflammation by increasing the risk of bacterial overgrowth in the stomach. FOLLOW UP: The patient should be advised to avoid consuming caffeine, which can stimulate the production of stomach acid and delay the healing of the ulcer. FOLLOW UP: The patient should avoid drinking carbonated beverages, as these can worsen reflux symptoms.  "
"79","Hospital Number: O8834134 , Hospital: Random NHS Foundation Trust , DOB:  1935-06-30 , General Practitioner: Dr. Romero, Jayda  , Date of procedure:  2002-09-30Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Haematemesis or Melaena/Blood PR FINDINGS: Inflammatory changes seen in the oesophagus.  character(0)"
"80","Hospital Number: H6820128 , Hospital: Random NHS Foundation Trust , DOB:  1969-05-23 , General Practitioner: Dr. Holbrook, Kenia Yulissa  , Date of procedure:  2007-12-14Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  12.5mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Polypectomy FINDINGS: The patient has Barrett's oesophagus. It is a long segment. Short segment only.  NA  The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and increase the risk of polyp growth.  The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools."
"81","Hospital Number: P4350826 , Hospital: Random NHS Foundation Trust , DOB:  1912-04-27 , General Practitioner: Dr. Roberts, Reiana  , Date of procedure:  2014-02-08Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG2  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: ULCER CHECK. FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"").  Follow-up endoscopy should be performed in 4-6 weeks to assess for healing and to repeat biopsies if necessary.  The patient should avoid consuming too much fat, as this can delay gastric emptying and delay the healing of the ulcer."
"82","Hospital Number: D5429386 , Hospital: Random NHS Foundation Trust , DOB:  1955-02-22 , General Practitioner: Dr. Potluri, Hea Jeen  , Date of procedure:  2006-12-25Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia  post radiation stricture FINDINGS: There is a polyp in the stomach which is sessile with an abnormal pit pattern. A gastric polyp with a polypoid shape is seen in the cardia, with a smooth and rounded surface.Under endoscopic visualization, the polyp was removed using EMR..   The patient should be advised to avoid eating too much fiber, as this can irritate the lining of the stomach and increase the risk of polyp growth.  The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and increase the risk of polyp growth."
"83","Hospital Number: K5870127 , Hospital: Random NHS Foundation Trust , DOB:  1985-08-26 , General Practitioner: Dr. Stafford, Randi  , Date of procedure:  2012-11-07Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  50mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Nausea and/or Vomiting Reflux-like Symptoms/Atypical Chest Pain Weight Loss FINDINGS: Columnar lined oesophagus is present. It is a long segment. There is a stricture in the second part of the duodenum which is obliterativeThe endoscope passed through the stricture with resistance. The narrowing of the duodenal lumen is accompanied by a slight mucosal fold thickening.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. NA"
"84","Hospital Number: U3081246 , Hospital: Random NHS Foundation Trust , DOB:  1990-01-10 , General Practitioner: Dr. Parent, Der  , Date of procedure:  2008-05-19Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG1  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Anaemia/Low Iron or Vitamins FINDINGS: The patient has a polyp in the antrum which is sessile.It has an abnormal pit pattern. The gastric polyp appears fundic with a smooth surface and regular shape, suggestive of a benign process.The base of the polyp was fulgurated with an electrocautery device to prevent future bleeding or regrowth..  NA  The patient may be prescribed medication to reduce the risk of developing more polyps.  The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and increase the risk of polyp growth."
"85","Hospital Number: Y1506215 , Hospital: Random NHS Foundation Trust , DOB:  1980-07-23 , General Practitioner: Dr. al-Islam, Mawzoona  , Date of procedure:  2004-01-15Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  75mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CT findings: . FINDINGS: The patient has inflammation in the third part of the duodenum which is severe. There are multiple erosions and ulcers seen throughout the duodenal mucosa, suggestive of ongoing inflammation.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization..  character(0) RECOMMENDATION: The patient should be instructed to chew food thoroughly and eat slowly to reduce the risk of further irritation to the ulcer. RECOMMENDATION: If the stricture is due to a medical condition such as gastroesophageal reflux disease (GERD), the patient may be prescribed medication to manage their symptoms.  The patient should avoid smoking and alcohol, which can worsen the inflammation. FOLLOW UP: Further investigations such as a biopsy may be recommended to determine the cause of the ulcer and assess the risk of cancer. FOLLOW UP: The patient should be advised to elevate the head of their bed by six inches to help prevent reflux at night.  The patient should be advised to avoid acidic foods and drinks, which can irritate the lining of the stomach and exacerbate the inflammation."
"86","Hospital Number: S7145991 , Hospital: Random NHS Foundation Trust , DOB:  1920-11-06 , General Practitioner: Dr. Irick, Ashley  , Date of procedure:  2004-02-21Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Dysphagia/Odynophagia FINDINGS: The patient has a polyp in the D1/D2 angle which is sessile.It has a normal pit pattern.   A blood test may be ordered to assess the patient's iron levels, as polyps can cause bleeding in the stomach and intestines.  "
"87","Hospital Number: R9404908 , Hospital: Random NHS Foundation Trust , DOB:  1993-09-22 , General Practitioner: Dr. Duff, Ashley  , Date of procedure:  2010-06-12Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG4  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Abdominal Pain Haematemesis or Melaena/Blood PR FINDINGS: There is a polyp in the third part of the duodenum which is sessile with a normal pit pattern. The nodules are seen in the context of underlying inflammatory bowel disease, including Crohn's disease and ulcerative colitis.The polyp did not lift on saline injection and was therefore not amenable to endoscopic resection.. Small hiatus hernia only.. NA RECOMMENDATION: H. pylori testing and treatment may be necessary to prevent recurrence of the ulcer. RECOMMENDATION: The patient should be advised to avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as these can increase the risk of bleeding in the gastrointestinal tract.  The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more polyps. FOLLOW UP: The patient should be advised to eat slowly and chew their food thoroughly to aid digestion and reduce the risk of ulcer recurrence. FOLLOW UP: The patient may require additional endoscopies in the future to monitor the nodule and ensure that it is not progressing.  The patient should be advised to avoid consuming alcohol, which can increase the risk of developing more polyps."
"88","Hospital Number: Z6151451 , Hospital: Random NHS Foundation Trust , DOB:  1940-12-13 , General Practitioner: Dr. Davidson, Sadyan  , Date of procedure:  2001-01-08Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain x1 hematemesis Crohns colitis FINDINGS: At 18cm two inlet patches were seen.. "
"89","Hospital Number: G1498153 , Hospital: Random NHS Foundation Trust , DOB:  1931-07-21 , General Practitioner: Dr. Natividad-Gonzalez, Alyssah  , Date of procedure:  2008-04-21Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG5  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia post LTA FINDINGS: Normal gastroscopy to the duodenum. "
"90","Hospital Number: B8969666 , Hospital: Random NHS Foundation Trust , DOB:  1900-07-28 , General Practitioner: Dr. Shepherd, Seline  , Date of procedure:  2016-08-16Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  125mcg  , Midazolam  2mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain previous ogd attempt food residue FINDINGS: At 18cm two inlet patches were seen.. "
"91","Hospital Number: J1819477 , Hospital: Random NHS Foundation Trust , DOB:  1943-04-26 , General Practitioner: Dr. Judkins, Stephanie  , Date of procedure:  2012-09-11Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss FINDINGS: Normal gastroscopy to the duodenum. "
"92","Hospital Number: M8863036 , Hospital: Random NHS Foundation Trust , DOB:  1985-08-21 , General Practitioner: Dr. el-Ben, Fidda  , Date of procedure:  2006-09-20Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  12.5mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- FINDINGS: The patient has a stricture in the stomach which is unyieldingScope not held by stricture. A gastric stricture with a smooth and nodular surface is observed in the cardia, suggestive of a malignant lesion.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. "
"93","Hospital Number: C4021112 , Hospital: Random NHS Foundation Trust , DOB:  1931-07-26 , General Practitioner: Dr. Schermer, Stephanie  , Date of procedure:  2002-09-08Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Dyspepsia FINDINGS: Normal gastroscopy to the duodenum. "
"94","Hospital Number: Q8222665 , Hospital: Random NHS Foundation Trust , DOB:  1908-01-19 , General Practitioner: Dr. Kim, Juliette  , Date of procedure:  2008-03-15Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Previous gastric ulcer. repeat scope after 8 weeks. FINDINGS: There is inflammation in the duodenal bulb which is erosive. There is diffuse erythema and friability noted in the duodenal mucosa, with areas of active bleeding.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample..  character(0) RECOMMENDATION: Follow-up imaging such as CT or MRI may be necessary to assess for potential complications or to guide management decisions. RECOMMENDATION: The patient should avoid drinking carbonated beverages, as these can worsen reflux symptoms.  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and inflammation. FOLLOW UP: The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and delay the healing of the ulcer. FOLLOW UP: The patient may require additional endoscopies in the future to monitor the stricture and ensure that it is not progressing.  The patient should avoid smoking and alcohol, which can worsen the inflammation."
"95","Hospital Number: X5836068 , Hospital: Random NHS Foundation Trust , DOB:  1951-06-14 , General Practitioner: Dr. Begay, Brittany  , Date of procedure:  2012-01-16Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG1  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Positive coeliac serology FINDINGS: The patient has inflammation in the antrum which is mild. The gastric inflammation is characterized by the presence of neutrophils and lymphocytes in the mucosal layer.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. The patient has a stricture in the stomach which is scleroticThe endoscope passed through the stricture with resistance. Despite the impression of extrinsic compression, the gastric stricture is likely the result of fibrotic changes in the mucosa.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. character(0) RECOMMENDATION: The patient should be advised to elevate the head of their bed by six inches to help prevent reflux at night.  Further investigations such as a biopsy may be recommended to determine the underlying cause of the inflammation. FOLLOW UP: The patient should be advised to avoid caffeine, as it can worsen reflux symptoms.  The patient should be advised to avoid consuming too much sugar, as this can exacerbate the inflammation by increasing the risk of bacterial overgrowth in the stomach."
"96","Hospital Number: E8902521 , Hospital: Random NHS Foundation Trust , DOB:  1989-04-06 , General Practitioner: Dr. Schneider, Picabo  , Date of procedure:  2013-01-30Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  125mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Post oesophagectomy for Pagets FINDINGS: The patient has a 5mm nodule in the stomach which is benign-looking. A well-circumscribed, firm nodule is seen in the gastric body, suggestive of a gastrointestinal stromal tumor (GIST).The patient should be advised to avoid hot spices, sauces, and acidic foods to reduce discomfort and promote healing.. NA  The patient should be advised to avoid lifting heavy objects or engaging in strenuous physical activity, as this can increase the risk of bleeding in the gastrointestinal tract.  "
"97","Hospital Number: N7405188 , Hospital: Random NHS Foundation Trust , DOB:  1913-10-17 , General Practitioner: Dr. Perryman, Brandy  , Date of procedure:  2004-07-22Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  12.5mcg  , Midazolam  5mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Weight Loss Reflux-like Symptoms/Atypical Chest Pain FINDINGS: There is a nodule in the third part of the duodenum which is stalked. The patient has an ulcer in the body which is induratedForrest Ulcer classification: IIc.. Accompanied by white exudate and a cobblestone appearance, the gastric ulcer is likely caused by Helicobacter pylori infection.The lesion was biopsied using a standard forceps.. NA RECOMMENDATION: Endoscopic resection of the ulcer may be necessary for larger or more complex ulcers.  The patient should avoid drinking alcohol, as this can increase the risk of bleeding in the gastrointestinal tract. FOLLOW UP: A repeat gastroscopy may be recommended in six to twelve months' time to assess the response to treatment.  If the patient is experiencing symptoms such as vomiting or fever, they should contact their healthcare provider immediately."
"98","Hospital Number: V9378773 , Hospital: Random NHS Foundation Trust , DOB:  1987-09-08 , General Practitioner: Dr. Barton, Allie  , Date of procedure:  2007-10-10Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG4  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Other- Early satiety FINDINGS: Normal gastroscopy to the duodenum. "
"99","Hospital Number: L6117442 , Hospital: Random NHS Foundation Trust , DOB:  1926-04-27 , General Practitioner: Dr. Nolting, Tarah  , Date of procedure:  2009-02-27Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- liver abscesses FINDINGS: The patient has inflammation in the second part of the duodenum which is mild. There are areas of nodularity seen throughout the duodenal mucosa, suggestive of chronic inflammation.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. Columnar lined oesophagus is present. Gastric mucosal prolapse seen. No loss of aceto-whitening  was also seen. The segment looks flat. NA RECOMMENDATION:   A barium swallow study may be ordered to assess the extent of the inflammation. FOLLOW UP: The patient may be prescribed an H2 blocker to reduce stomach acid production and prevent reflux.  The patient should avoid smoking and alcohol, which can worsen the inflammation."
"100","Hospital Number: A3669324 , Hospital: Random NHS Foundation Trust , DOB:  1989-02-14 , General Practitioner: Dr. Tamura, Christine  , Date of procedure:  2004-04-10Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Small hiatus hernia only.. "
"101","Hospital Number: O8583042 , Hospital: Random NHS Foundation Trust , DOB:  1974-06-12 , General Practitioner: Dr. Rodriguez, Leana  , Date of procedure:  2014-01-12Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- RFA Therapeutic- EMR/ESD FINDINGS: No inlet patch  was also seen on narrow band imaging.. "
"102","Hospital Number: H2587908 , Hospital: Random NHS Foundation Trust , DOB:  1903-05-22 , General Practitioner: Dr. Graham, Samantha  , Date of procedure:  2001-06-10Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  12.5mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Therapeutic- Dilatation FINDINGS: Normal gastroscopy to the duodenum. "
"103","Hospital Number: P9907275 , Hospital: Random NHS Foundation Trust , DOB:  1988-11-15 , General Practitioner: Dr. al-Nagi, Musheera  , Date of procedure:  2012-08-04Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  125mcg  , Midazolam  2mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Nausea and/or Vomiting FINDINGS: The patient has an ulcer in the second part of the duodenum which is hemorrhagicIt has a visible vessel. The ulceration's irregular shape and size, along with a yellowish base, suggest a possible malignant process.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. The ulcer appears to be a solitary lesion, with no evidence of multiple or diffuse involvement.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization.. There is a polyp in the body which is stalked.It has an abnormal pit pattern. The gastric polyp appears fundic with a smooth surface and no vascularization.Due to its large size, the polyp was not able to be resected during the current endoscopic session.. character(0) RECOMMENDATION: Surgical intervention may be necessary in the event of complications such as perforation or obstruction.  The patient should be informed of the diagnosis and provided with information on how to manage the polyp. FOLLOW UP:   "
"104","Hospital Number: D9990587 , Hospital: Random NHS Foundation Trust , DOB:  1963-02-23 , General Practitioner: Dr. Solomon, Faith  , Date of procedure:  2005-10-24Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  150mcg  , Midazolam  5mg  , Instrument:  FG5  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Achalasia FINDINGS: Normal gastroscopy to the duodenum. "
"105","Hospital Number: K9010769 , Hospital: Random NHS Foundation Trust , DOB:  1941-08-09 , General Practitioner: Dr. el-Ramin, Sumbula  , Date of procedure:  2005-10-12Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Food bolus/foreign body removal FINDINGS: There is a polyp in the D1/D2 angle which is stalked.It has a normal pit pattern.   The patient should be informed of the diagnosis and provided with information on how to manage the polyp.  The patient should avoid lying down immediately after meals, as this can increase the risk of reflux and polyp growth."
"106","Hospital Number: U5728377 , Hospital: Random NHS Foundation Trust , DOB:  1931-08-10 , General Practitioner: Dr. Shen, Yoo  , Date of procedure:  2006-06-24Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Previous multiple surgeries for reflux . FINDINGS: Normal gastroscopy to the duodenum. "
"107","Hospital Number: Y3424765 , Hospital: Random NHS Foundation Trust , DOB:  1988-12-21 , General Practitioner: Dr. al-Fadel, Yaasmeen  , Date of procedure:  2010-02-09Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG6  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Ongoing reflux symptoms. FINDINGS: The patient has inflammation in the fundus which is erosive. Erythematous and edematous mucosa is observed in the gastric antrum, with no distinct ulcerations, suggestive of antral gastritis.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. The patient has a polyp in the GOJ which is stalked.It has an abnormal pit pattern. Upon endoscopic examination of the oesophagus, a 2 cm Paris IIa/c polypoid lesion was observed. The lesion had a smooth surface and appeared to be pedunculated.Under endoscopic visualization, the polyp was removed using EMR.. NA RECOMMENDATION: The patient should be counseled on the importance of maintaining good oral hygiene to prevent oral bacteria from entering the ulcer site. RECOMMENDATION: The patient should be advised to avoid eating acidic or spicy foods, as these can worsen GERD symptoms. RECOMMENDATION: The patient should be advised to avoid acidic foods and drinks, which can irritate the lining of the stomach and exacerbate the inflammation.  The patient should be advised to avoid NSAIDs and aspirin, which can increase the risk of developing more polyps. FOLLOW UP: The patient may be referred to a specialist in gastrointestinal disorders for further management of the ulcer. FOLLOW UP: The patient should be advised to avoid eating foods that are difficult to swallow, such as hard or crunchy foods. FOLLOW UP: A repeat gastroscopy may be required in three to six months' time to monitor the progress of the inflammation.  The patient should be advised to avoid eating too much fiber, as this can irritate the lining of the stomach and increase the risk of polyp growth."
"108","Hospital Number: S9335497 , Hospital: Random NHS Foundation Trust , DOB:  1976-10-20 , General Practitioner: Dr. Tran, Mira  , Date of procedure:  2005-11-27Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  25mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Grade D oesophagitis healing. Previous duodenal ulcer FINDINGS: There is a stricture in the body which is contractedIt is easily traversible.. A gastric stricture with a smooth and nodular surface is observed in the cardia, suggestive of a malignant lesion.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. character(0)  The patient should be counseled on the importance of taking any prescribed medications for ulcer healing and symptom control as directed.  The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools."
"109","Hospital Number: R3233951 , Hospital: Random NHS Foundation Trust , DOB:  1915-09-07 , General Practitioner: Dr. Wright, Emanii  , Date of procedure:  2008-05-30Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  12.5mcg  , Midazolam  7mg  , Instrument:  FG7  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Reflux-like Symptoms/Atypical Chest Pain Abdominal Pain FINDINGS: Normal gastroscopy to the duodenum. "
"110","Hospital Number: Z3118534 , Hospital: Random NHS Foundation Trust , DOB:  1935-12-04 , General Practitioner: Dr. al-Molla, Shafaaa  , Date of procedure:  2004-08-27Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  12.5mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - VCE placement (previous gastric bypass)Anaemia/Low Iron or Vitamins FINDINGS: LA Grade  B oesophagitis. The gastroesophageal junction appears normal, but there is diffuse erythema of the distal oesophagus. There is diffuse erythema and friability throughout the oesophagus. The oesophageal mucosa is thickened and has a cobblestone appearance. The patient has a stricture in the stomach which is obliterativeIt is easily traversible.. The gastric stricture is located in the body of the stomach, with a smooth surface and concentric narrowing of the lumen.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. character(0)"
"111","Hospital Number: G7303882 , Hospital: Random NHS Foundation Trust , DOB:  1914-11-27 , General Practitioner: Dr. Ware, Raina  , Date of procedure:  2011-12-14Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Small Bowel Biopsy FINDINGS: The patient has a stricture in the third part of the duodenum which is scleroticThe endoscope passed through the stricture with resistance. The narrowing of the lumen is more pronounced during end-inspiration.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. There is a nodule in the second part of the duodenum which is sessile. character(0)  If the nodule is benign, the patient may not require any treatment, but may require monitoring with regular endoscopies.  If the nodule is benign, the patient may not require any treatment, but may require monitoring with regular endoscopies."
"112","Hospital Number: B2496144 , Hospital: Random NHS Foundation Trust , DOB:  1971-08-10 , General Practitioner: Dr. Yi, Alicia  , Date of procedure:  2011-08-22Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Dysphagia/Odynophagia FINDINGS: Normal gastroscopy to the duodenum. "
"113","Hospital Number: J9928505 , Hospital: Random NHS Foundation Trust , DOB:  1912-01-12 , General Practitioner: Dr. Pope, Sandi  , Date of procedure:  2003-09-03Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  50mcg  , Midazolam  3mg  , Instrument:  FG1  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia large hiatus hernia FINDINGS: The patient has a 4mm nodule in the antrum which is benign-looking. A small, solid nodule is observed in the gastric body, suggestive of a gastric carcinoid tumor.-----------------------------------------------------------------FD_Nodule_Recommendations. Columnar lined oesophagus is present. No nodularity is present. No loss of aceto-whitening  was also seen. NA    The patient may be referred to a specialist for further evaluation and treatment, such as surgery to remove the nodule."
"114","Hospital Number: M7832839 , Hospital: Random NHS Foundation Trust , DOB:  1968-05-09 , General Practitioner: Dr. Balkenbush, Danielle  , Date of procedure:  2014-12-18Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  150mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Abdominal Pain FINDINGS: The patient has a stricture in the fundus which is narrowedTight distal stricture which would not allow passage of scope.. A gastric stricture with a smooth surface and displaced mucosal folds is noted in the antrum, suggestive of a benign lesion.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization.. The patient has a polyp in the oesophagus at 41 cm which is sessile.It has an abnormal pit pattern. During endoscopy, a 1.8 cm nodular lesion was detected in the oesophagus, located approximately 8 cm from the incisors. The lesion appeared to be sessile and had a regular nodular appearance.The polyp was grasped with a snare and cut with a hot biopsy forceps for removal.. A large, ulcerated lesion is noted in the distal esophagus, with surrounding erythema and exudates, suggestive of a malignant esophageal neoplasm.The ulcer was biopsied x8 for further analysis.. character(0) RECOMMENDATION: The patient should be advised to avoid hot spices, sauces, and acidic foods to reduce discomfort and promote healing.  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and polyp growth. FOLLOW UP:   The patient should avoid consuming too much fat, as this can delay gastric emptying and increase the risk of reflux and polyp growth."
"115","Hospital Number: C1538169 , Hospital: Random NHS Foundation Trust , DOB:  1931-09-02 , General Practitioner: Dr. al-Zaidi, Marwa  , Date of procedure:  2015-07-13Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  25mcg  , Midazolam  5mg  , Instrument:  FG3  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins . FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"")."
"116","Hospital Number: Q6090326 , Hospital: Random NHS Foundation Trust , DOB:  1994-02-25 , General Practitioner: Dr. Ballesteros Ramos, Krystal  , Date of procedure:  2009-10-23Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  12.5mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia post LTA FINDINGS: There is a nodule in the GOJ which is benign-looking. At the gastro-oesophageal junction, there is visible erythema and loss of vascular pattern.Further investigations such as a biopsy may be recommended to determine the cause of the ulcer and assess the risk of cancer..  character(0) RECOMMENDATION: Repeat endoscopy with surveillance biopsies is recommended every 3-5 years for patients with a history of gastric ulcer to monitor for recurrence or malignancy.   FOLLOW UP: The patient should be advised to avoid consuming dairy products, which can increase the production of stomach acid and delay the healing of the ulcer.  If the patient is experiencing symptoms such as vomiting or fever, they should contact their healthcare provider immediately."
"117","Hospital Number: X8881813 , Hospital: Random NHS Foundation Trust , DOB:  1953-05-22 , General Practitioner: Dr. el-Obeid, Naaila  , Date of procedure:  2007-07-24Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins FINDINGS: LA Grade  D oesophagitis. The oesophageal mucosa is thickened and has a cobblestone appearance. The distal oesophagus appears normal, but there is diffuse erythema and friability in the mid and proximal oesophagus.  character(0)"
"118","Hospital Number: E5760181 , Hospital: Random NHS Foundation Trust , DOB:  1940-08-23 , General Practitioner: Dr. Adams, Crystal  , Date of procedure:  2013-12-10Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Eosinophilic oesophatitis assessment FINDINGS: There is inflammation in the body which is mild. The gastric mucosa appears diffusely erythematous with no distinct erosions, suggestive of superficial gastritis.During biopsy, it was noted that the lesion had a friable surface and bled easily..  RECOMMENDATION: The patient may be prescribed medication to reduce the production of stomach acid and prevent reflux.  The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools. FOLLOW UP: The patient may be prescribed an H2 blocker to reduce stomach acid production and prevent reflux.  The patient should avoid lying down immediately after meals, as this can exacerbate the inflammation by increasing the risk of reflux."
"119","Hospital Number: N3482935 , Hospital: Random NHS Foundation Trust , DOB:  1935-05-20 , General Practitioner: Dr. Guerra, Katlin  , Date of procedure:  2015-12-06Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  150mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- FINDINGS: There is a polyp in the stomach which is sessile.It has a normal pit pattern. A gastric polyp with a broad-based attachment and lobulated surface is observed in the antrum, suggestive of an adenomatous lesion.The polyp was marked with a tattoo to aid in future surveillance endoscopy.. The patient has a polyp in the fundus which is stalked with a normal pit pattern. The gastric polyp appears as a sessile growth on the mucosal surface, with a smooth and regular contour.Due to its large size, the polyp was not able to be resected during the current endoscopic session.. character(0)  A blood test may be ordered to assess the patient's iron levels, as polyps can cause bleeding in the stomach and intestines.  The patient should be advised to avoid hot, spicy foods, which can irritate the lining of the stomach and increase the risk of polyp growth."
"120","Hospital Number: V6466799 , Hospital: Random NHS Foundation Trust , DOB:  1901-07-23 , General Practitioner: Dr. Guevara, Selena  , Date of procedure:  2008-03-08Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  125mcg  , Midazolam  1mg  , Instrument:  FG1  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - VCE placement (previous gastric bypass)Anaemia/Low Iron or Vitamins FINDINGS: Normal gastroscopy to the duodenum. "
"121","Hospital Number: L2151400 , Hospital: Random NHS Foundation Trust , DOB:  1928-06-27 , General Practitioner: Dr. al-Begum, Lutfiyya  , Date of procedure:  2005-08-05Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG3  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CHRONIC DIARRHOEA-biopsies needed FINDINGS: There is a nodule in the body which is stalked. A nodular lesion is observed in the gastric cardia, with surrounding erythema and nodularity of the overlying mucosa, suggestive of a malignant gastric neoplasm.Follow-up endoscopy with surveillance biopsies may be necessary for patients with a history of polyps or increased risk for malignancy..  RECOMMENDATION: The patient should be advised to attend all scheduled appointments and follow the treatment plan recommended by their healthcare provider.  The patient is advised to return for a follow-up appointment in four to six weeks' time to discuss the findings and plan for further management. FOLLOW UP: The patient should be advised to attend all scheduled appointments and follow the treatment plan recommended by their healthcare provider.  The patient should be informed of the diagnosis and provided with information on how to manage the polyp."
"122","Hospital Number: A3080284 , Hospital: Random NHS Foundation Trust , DOB:  1955-02-12 , General Practitioner: Dr. Uribe, Veronica  , Date of procedure:  2010-03-14Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Abdominal Pain FINDINGS: Normal gastroscopy to the duodenum. "
"123","Hospital Number: I7491657 , Hospital: Random NHS Foundation Trust , DOB:  1978-04-25 , General Practitioner: Dr. Palmer, Cherokee  , Date of procedure:  2014-03-07Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG2  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Anaemia/Low Iron or Vitamins FINDINGS: Normal gastroscopy to the duodenum. "
"124","Hospital Number: F8022001 , Hospital: Random NHS Foundation Trust , DOB:  1995-05-29 , General Practitioner: Dr. Darnell, Matia  , Date of procedure:  2013-08-09Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  125mcg  , Midazolam  2mg  , Instrument:  FG5  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - VCE placement (previous gastric bypass)Anaemia/Low Iron or Vitamins FINDINGS: The patient has a 10mm nodule in the duodenal bulb which is benign-looking.  character(0)  If the nodule is benign, the patient may not require any treatment, but may require monitoring with regular endoscopies.  The patient should be advised to attend all scheduled appointments and follow the treatment plan recommended by their healthcare provider."
"125","Hospital Number: T4904215 , Hospital: Random NHS Foundation Trust , DOB:  1908-10-31 , General Practitioner: Dr. Fitts, Lauren  , Date of procedure:  2012-07-21Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  100mcg  , Midazolam  4mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Dilatation FINDINGS: The patient has a 3mm nodule in the oesophagus at 32 cm which is stalked. Inspection of the oesophageal ulcer reveals a diffusely inflamed and ulcerated mucosa with scattered areas of granulation tissue.A repeat gastroscopy may be recommended in six months' time to assess the response to treatment.. There is a nodule in the body which is sessile. The nodular changes may represent early fundic gland polyps.The patient should be advised to avoid straining during bowel movements to reduce pressure on the ulcer site.. character(0) RECOMMENDATION: The patient should be advised to avoid smoking, alcohol, and NSAIDs to reduce the risk of recurrent ulcers. RECOMMENDATION: The patient may be referred to a surgeon for a minimally invasive procedure to remove the nodule.  The patient may be referred to a specialist in gastrointestinal disorders for further management of the polyp. FOLLOW UP: The patient may be prescribed medication to protect the stomach lining and reduce the risk of developing more ulcers. FOLLOW UP: The patient should avoid drinking alcohol, as this can increase the risk of bleeding in the gastrointestinal tract.  Further investigations such as a biopsy may be recommended to determine the type of polyp and assess the risk of cancer."
"126","Hospital Number: W8932372 , Hospital: Random NHS Foundation Trust , DOB:  1972-07-15 , General Practitioner: Dr. Jackson, Caitlin  , Date of procedure:  2001-01-18Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG1  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Nausea and/or Vomiting Reflux-like Symptoms/Atypical Chest Pain Weight Loss FINDINGS: Normal gastroscopy to the duodenum. "
"127","Hospital Number: O7967929 , Hospital: Random NHS Foundation Trust , DOB:  1997-10-11 , General Practitioner: Dr. Ngo, Alexandra  , Date of procedure:  2012-03-08Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  125mcg  , Midazolam  3mg  , Instrument:  FG5  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Small Bowel Biopsy Positive coeliac serology FINDINGS: There is a stricture in the duodenal bulb which is unyieldingThere is very slight and non-restrcitve stricturing.. The narrowing of the lumen is more pronounced during end-inspiration.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. There is a stricture in the fundus which is stiffTight distal stricture which would not allow passage of scope.. A gastric stricture with a smooth and nodular surface is observed in the cardia, suggestive of a malignant lesion.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. NA"
"128","Hospital Number: H3844577 , Hospital: Random NHS Foundation Trust , DOB:  1976-02-06 , General Practitioner: Dr. el-Tamer, Ramziyya  , Date of procedure:  2009-06-11Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  150mcg  , Midazolam  7mg  , Instrument:  FG2  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- FINDINGS: Normal gastroscopy to the duodenum. "
"129","Hospital Number: P4236233 , Hospital: Random NHS Foundation Trust , DOB:  1910-06-06 , General Practitioner: Dr. el-Dib, Aqeela  , Date of procedure:  2004-07-21Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Maleana FINDINGS: The patient has an ulcer in the GOJ which is deep which is bleeding. The gastric lesion exhibits an irregular shape and size, with a raised edge and depth greater than 5 mm.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. Upon endoscopic examination, the oesophageal ulcer appears to be a superficial erosion with minimal surrounding inflammation.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization..  character(0) RECOMMENDATION: Follow-up imaging such as CT or MRI may be necessary to assess for potential complications or to guide management decisions. RECOMMENDATION: The patient should be advised to elevate the head of their bed by six inches to help prevent reflux at night.  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and inflammation. FOLLOW UP: The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more ulcers. FOLLOW UP: If the stricture is causing symptoms such as difficulty swallowing, the patient may be referred to a speech therapist for swallowing therapy.  The patient should be advised to avoid caffeine, which can stimulate the production of stomach acid and exacerbate the inflammation."
"130","Hospital Number: D4826904 , Hospital: Random NHS Foundation Trust , DOB:  1944-06-02 , General Practitioner: Dr. Smoote'-Caesar, Joann  , Date of procedure:  2007-07-12Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  125mcg  , Midazolam  5mg  , Instrument:  FG3  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Eosinophilic oesophatitis assessment FINDINGS: Barrett's is present. Some areas of vascular abnormalities are seen. "
"131","Hospital Number: K8847627 , Hospital: Random NHS Foundation Trust , DOB:  1915-10-15 , General Practitioner: Dr. Chester, Tabitha  , Date of procedure:  2006-04-05Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Coeliac folllow up abd pain  bloating diarhoea FINDINGS: Normal gastroscopy to the duodenum. "
"132","Hospital Number: U8525559 , Hospital: Random NHS Foundation Trust , DOB:  1976-03-08 , General Practitioner: Dr. Eberhart, Danika  , Date of procedure:  2013-02-28Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Ongoing dyspepsia FINDINGS: Normal gastroscopy to the duodenum. "
"133","Hospital Number: Y5602439 , Hospital: Random NHS Foundation Trust , DOB:  1969-04-06 , General Practitioner: Dr. Ciesco, Kara  , Date of procedure:  2012-06-27Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  12.5mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - chronic cough ?GORD FINDINGS: LA Grade  D oesophagitis. There is significant narrowing of the oesophageal lumen due to stricture formation with areas of mucosal ulceration. The oesophageal mucosa is thickened and has a leathery appearance. The oesopahgitis is consistent with acid reflux. The gastric lesion appears malignant, with an irregular shape and size, and a raised edge.The ulcer was biopsied x8 for further analysis..  NA  The patient should be instructed to avoid caffeine and carbonated beverages to reduce discomfort and promote healing.  "
"134","Hospital Number: S6682774 , Hospital: Random NHS Foundation Trust , DOB:  1936-10-17 , General Practitioner: Dr. Mondine, Victoria  , Date of procedure:  2004-06-03Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  150mcg  , Midazolam  5mg  , Instrument:  FG5  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Therapeutic- Dilatation FINDINGS: Normal gastroscopy to the duodenum. "
"135","Hospital Number: R6103760 , Hospital: Random NHS Foundation Trust , DOB:  1966-01-19 , General Practitioner: Dr. Hoffman, Elizabeth  , Date of procedure:  2011-08-28Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Anaemia/Low Iron or Vitamins FINDINGS: The patient has an ulcer in the GOJ which is hemorrhagicIt has a visible vessel. The gastric lesion appears malignant, accompanied by active bleeding and a punched-out appearance.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. Examination of the oesophageal ulcer reveals a deep, necrotic base with surrounding granulation tissue.The lesion was biopsied using a standard forceps.. There is an ulcer in the antrum which is scarredIt has rolled edges. Accompanied by white exudate and a cobblestone appearance, the gastric ulcer is likely caused by Helicobacter pylori infection.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. NA  The patient should be advised to seek medical attention immediately if they experience symptoms of severe bleeding such as black tarry stools or vomiting blood.  The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and delay the healing of the ulcer."
"136","Hospital Number: Z1272661 , Hospital: Random NHS Foundation Trust , DOB:  1905-03-12 , General Practitioner: Dr. Adams, Tamia  , Date of procedure:  2007-02-03Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Abdominal Pain Haematemesis or Melaena/Blood PR FINDINGS: There is a nodule in the third part of the duodenum which is benign-looking. The endoscopic appearance of the oesophagus shows a friable mucosa with a fine white stippling, which is highly suggestive of eosinophilic oesophagitis.. character(0)  The patient should be advised to avoid lifting heavy objects or engaging in strenuous physical activity, as this can increase the risk of bleeding in the gastrointestinal tract.  The patient should avoid eating fried or fatty foods, as these can increase the risk of reflux and further damage to the gastrointestinal tract."
"137","Hospital Number: G2227671 , Hospital: Random NHS Foundation Trust , DOB:  1978-09-26 , General Practitioner: Dr. Cottonwood, Victoria  , Date of procedure:  2005-10-04Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow up oesophageal stricture dysphagia for recurrent dilatation FINDINGS: Normal gastroscopy to the duodenum. NA"
"138","Hospital Number: B7082304 , Hospital: Random NHS Foundation Trust , DOB:  1946-12-06 , General Practitioner: Dr. Parkhill, Jazmine  , Date of procedure:  2015-11-23Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Coeliac folllow up abd pain  bloating diarhoea FINDINGS: The patient has a polyp in the D1/D2 angle which is sessile.It has an abnormal pit pattern.   The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and increase the risk of polyp growth.  The patient should avoid eating before bedtime, as this can increase the risk of reflux and polyp growth."
"139","Hospital Number: J8000143 , Hospital: Random NHS Foundation Trust , DOB:  1902-03-21 , General Practitioner: Dr. Chmelka, Tanisha  , Date of procedure:  2010-06-01Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  25mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Weight Loss FINDINGS: Normal gastroscopy to the duodenum. "
"140","Hospital Number: M2497777 , Hospital: Random NHS Foundation Trust , DOB:  1987-06-14 , General Practitioner: Dr. Sathe, Lisa  , Date of procedure:  2016-06-19Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  100mcg  , Midazolam  5mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss FINDINGS: There is inflammation in the third part of the duodenum which is erosive. There is diffuse erythema and loss of vascularity noted in the duodenal mucosa.The ulcer was biopsied x8 for further analysis.. The patient has a polyp in the stomach which is stalked with an abnormal pit pattern. The hyperplastic gastric polyp presents with a smooth surface and regular shape, suggestive of a non-cancerous process.ESD was performed to remove the polyp after lifting it with saline injection.. character(0) RECOMMENDATION: Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) may be necessary for larger or more complex ulcers. RECOMMENDATION: The patient should be advised to avoid lying down for at least three hours after eating to help prevent reflux. RECOMMENDATION: The patient should be advised to avoid caffeine, which can stimulate the production of stomach acid and exacerbate the inflammation.  A repeat gastroscopy may be recommended in twelve months' time to assess the response to treatment. FOLLOW UP: The patient should be advised to avoid consuming dairy products, which can increase the production of stomach acid and delay the healing of the ulcer. FOLLOW UP: The patient should avoid drinking carbonated beverages, as these can worsen reflux symptoms. FOLLOW UP: The patient should avoid eating too much fat, as this can exacerbate the inflammation by delaying gastric emptying and increasing the risk of reflux.  The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and increase the risk of polyp growth."
"141","Hospital Number: C1910592 , Hospital: Random NHS Foundation Trust , DOB:  1944-03-27 , General Practitioner: Dr. el-Waheed, Widdad  , Date of procedure:  2011-12-17Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  150mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - chronic cough ?GORD FINDINGS: OESOPHAGUS: small hiatus hernia.. "
"142","Hospital Number: Q9535363 , Hospital: Random NHS Foundation Trust , DOB:  1922-03-28 , General Practitioner: Dr. Kim, Julia  , Date of procedure:  2002-09-29Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  125mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Dysphagia/Odynophagia FINDINGS: The patient has a polyp in the oesophagus at 41 cm which is sessile.It has an abnormal pit pattern. During endoscopy, a 1.8 cm nodular lesion was detected in the oesophagus, located approximately 8 cm from the incisors. The lesion appeared to be sessile and had a regular nodular appearance.The polyp was grasped with a snare and cut with a hot biopsy forceps for removal.. A large, ulcerated lesion is noted in the distal esophagus, with surrounding erythema and exudates, suggestive of a malignant esophageal neoplasm.The ulcer was biopsied x8 for further analysis..  NA RECOMMENDATION: The patient should be counseled on the importance of taking any prescribed medications for ulcer healing and symptom control as directed.  The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and increase the risk of polyp growth. FOLLOW UP: The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and delay the healing of the ulcer.  A repeat gastroscopy may be recommended in three to six months' time to assess the growth of the polyp."
"143","Hospital Number: X7857756 , Hospital: Random NHS Foundation Trust , DOB:  1973-06-11 , General Practitioner: Dr. Cave, Ashlyn  , Date of procedure:  2010-05-25Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Weight Loss FINDINGS: Normal gastroscopy to the duodenum. "
"144","Hospital Number: E8303284 , Hospital: Random NHS Foundation Trust , DOB:  1922-12-14 , General Practitioner: Dr. Campbell, Christina  , Date of procedure:  2005-05-01Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins FINDINGS: Trachealisation of the oesophagus is observed.. There is a polyp in the antrum which is sessile.It has a normal pit pattern. The gastric polyp appears adenomatous with a villous or tubular structure and high-grade dysplasia.The polyp was removed with a combination of snare and forceps, and hemostasis was achieved with an endoscopic clip.. NA  The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools.  The patient should be advised to avoid consuming alcohol, which can increase the risk of developing more polyps."
"145","Hospital Number: N5562828 , Hospital: Random NHS Foundation Trust , DOB:  1943-06-04 , General Practitioner: Dr. Harriman, Alexis  , Date of procedure:  2007-09-14Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Dysphagia/Odynophagia FINDINGS: The patient has a stricture in the D1/D2 angle which is circumferential.Tight distal stricture which would not allow passage of scope.. "
"146","Hospital Number: V8753920 , Hospital: Random NHS Foundation Trust , DOB:  1957-08-31 , General Practitioner: Dr. al-Saade, Maisara  , Date of procedure:  2003-09-22Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  25mcg  , Midazolam  4mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- PEG FINDINGS: The patient has an ulcer in the D1/D2 angle which is induratedIt has a visible vessel. Characterized by a distinct loss of mucosal tissue and surrounded by erythema, the severe ulceration presents with a nodular surface.The ulcer was biopsied x8 for further analysis..   The patient should be advised to eat smaller, more frequent meals to reduce pressure on the ulcer site and promote healing.  The patient should avoid eating before bedtime, as this can increase the risk of reflux and ulcer recurrence."
"147","Hospital Number: L1479863 , Hospital: Random NHS Foundation Trust , DOB:  1935-08-22 , General Practitioner: Dr. Khoshnam, Monina  , Date of procedure:  2008-02-21Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Weight Loss Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"148","Hospital Number: A5218459 , Hospital: Random NHS Foundation Trust , DOB:  1909-11-11 , General Practitioner: Dr. Srinivasan, Yoonji Jennifer  , Date of procedure:  2005-03-28Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  50mcg  , Midazolam  5mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia   post oesophagectomy FINDINGS: Normal gastroscopy to the duodenum. NA"
"149","Hospital Number: I2777268 , Hospital: Random NHS Foundation Trust , DOB:  1937-03-28 , General Practitioner: Dr. Boyd, Brittney  , Date of procedure:  2008-11-08Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  25mcg  , Midazolam  4mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Nausea and/or Vomiting Other- Early satiety FINDINGS: Small hiatus hernia.. "
"150","Hospital Number: F7726169 , Hospital: Random NHS Foundation Trust , DOB:  1964-09-20 , General Practitioner: Dr. Mowry, Samantha  , Date of procedure:  2007-03-04Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  12.5mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Achalasia FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"")."
"151","Hospital Number: T1978921 , Hospital: Random NHS Foundation Trust , DOB:  1973-06-21 , General Practitioner: Dr. Chun, Kaelene  , Date of procedure:  2006-09-23Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  125mcg  , Midazolam  1mg  , Instrument:  FG5  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Hb drop ?GI bleed previous gastric surgery FINDINGS: The patient has a polyp in the stomach which is stalked with an abnormal pit pattern. The gastric polyp appears adenomatous with a villous or tubular structure and high-grade dysplasia.Using a snare, the polyp was excised and retrieved for pathologic analysis..   A blood test may be ordered to assess the patient's iron levels, as polyps can cause bleeding in the stomach and intestines.  A blood test may be ordered to assess the patient's iron levels, as polyps can cause bleeding in the stomach and intestines."
"152","Hospital Number: W8248560 , Hospital: Random NHS Foundation Trust , DOB:  1998-01-26 , General Practitioner: Dr. al-Mitri, Arwa  , Date of procedure:  2004-03-21Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Abdominal Pain FINDINGS: Lax cardia with small hiatus hernia. "
"153","Hospital Number: O8592861 , Hospital: Random NHS Foundation Trust , DOB:  1915-01-05 , General Practitioner: Dr. Schadegg, Lauren  , Date of procedure:  2001-08-27Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Abdominal Pain FINDINGS: There is inflammation in the antrum which is severe. The gastric inflammation appears to be associated with the use of proton pump inhibitors (PPIs), with the presence of rebound hypergastrinemia.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. Likely paraoesophageal hernia present. NA RECOMMENDATION:   A repeat gastroscopy may be recommended in six months' time to assess the response to treatment. FOLLOW UP: The patient may be referred to a psychologist to help manage any anxiety or stress that may be contributing to their symptoms.  A proton pump inhibitor medication may be prescribed to manage the inflammation."
"154","Hospital Number: H1442477 , Hospital: Random NHS Foundation Trust , DOB:  1958-07-21 , General Practitioner: Dr. Charles, Ebony  , Date of procedure:  2013-04-16Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  100mcg  , Midazolam  5mg  , Instrument:  FG2  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Previous chemo rad. rpt dilation. FINDINGS: The patient has an ulcer in the duodenal bulb which is scarredIt has rolled edges. The patient's medical history and the ulcer's rugose surface suggest a chronic inflammatory process.During biopsy, it was noted that the lesion had a friable surface and bled easily.. The ulcer measures approximately 1 cm in diameter and has a sharply defined border.Following the biopsy of the lesion, there was bleeding, which was promptly managed..  character(0)  The patient should be advised to maintain a healthy weight and exercise regularly to reduce the risk of recurrent ulcers.  "
"155","Hospital Number: P1673382 , Hospital: Random NHS Foundation Trust , DOB:  1927-11-08 , General Practitioner: Dr. Moore, Raen  , Date of procedure:  2012-01-07Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR FINDINGS: The patient has a stricture in the D1/D2 angle which is scleroticThere is very slight and non-restrcitve stricturing.. "
"156","Hospital Number: D3953088 , Hospital: Random NHS Foundation Trust , DOB:  1925-01-23 , General Practitioner: Dr. Lerew, Alexis  , Date of procedure:  2007-12-26Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Dysphagia/Odynophagia Vaters syndrome astric pull-up surgery FINDINGS: Normal gastroscopy to the duodenum. "
"157","Hospital Number: K5760664 , Hospital: Random NHS Foundation Trust , DOB:  1910-06-29 , General Practitioner: Dr. Krien, Breanna  , Date of procedure:  2002-10-02Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  50mcg  , Midazolam  6mg  , Instrument:  FG1  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Dysphagia/Odynophagia FINDINGS: Columnar lined oesophagus is present. The pit pattern is normal. Short segment only.  character(0)"
"158","Hospital Number: U6704720 , Hospital: Random NHS Foundation Trust , DOB:  1904-11-26 , General Practitioner: Dr. Odollil, Seo Weon  , Date of procedure:  2012-03-16Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Therapeutic- Dilatation Therapeutic- NJ Tube/PEG/DPEJ FINDINGS: There is inflammation in the GOJ which is erosive. There is erythema and mild edema of the oesophageal mucosa, with scattered small ulcers and exudate, suggestive of chemical oesophagitis.The ulcer was biopsied x8 for further analysis.. LA Grade  D oesophagitis. There are scattered erosions present in the oesophageal mucosa. character(0) RECOMMENDATION: Endoscopic resection of the ulcer may be necessary for larger or more complex ulcers. RECOMMENDATION: The patient should avoid eating large meals late at night, as this can worsen reflux symptoms.  The patient may be referred to a gastroenterologist for further management of the inflammation. FOLLOW UP: The patient should be advised to eat slowly and chew their food thoroughly to aid digestion and reduce the risk of ulcer recurrence. FOLLOW UP: The patient should avoid eating before going to bed, as this can worsen reflux symptoms.  The patient may be prescribed a course of antibiotics to treat any underlying infection that may be causing the inflammation."
"159","Hospital Number: Y1451790 , Hospital: Random NHS Foundation Trust , DOB:  1993-12-18 , General Practitioner: Dr. al-Musa, Mushtaaqa  , Date of procedure:  2001-11-23Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Weight Loss FINDINGS: There is inflammation in the stomach which is severe. Erythematous and edematous mucosa is observed in the gastric antrum, with no distinct ulcerations, suggestive of antral gastritis.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury..  character(0) RECOMMENDATION: The patient should be instructed to avoid tight-fitting clothing to reduce pressure on the ulcer site. RECOMMENDATION: The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the stricture.  The patient should be informed of the diagnosis and provided with information on how to manage the inflammation. FOLLOW UP: The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and delay the healing of the ulcer. FOLLOW UP:   A repeat gastroscopy may be recommended in six months' time to assess the response to treatment."
"160","Hospital Number: S9523253 , Hospital: Random NHS Foundation Trust , DOB:  1961-08-11 , General Practitioner: Dr. Graves, Aliyah  , Date of procedure:  2015-06-29Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  12.5mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia   post oesophagectomy FINDINGS: Normal gastroscopy to the duodenum. NA"
"161","Hospital Number: R7817343 , Hospital: Random NHS Foundation Trust , DOB:  1989-01-05 , General Practitioner: Dr. Ibarra Hernandez, Elizabeth  , Date of procedure:  2003-01-11Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  100mcg  , Midazolam  4mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow-up oesophagitis healing FINDINGS: Normal gastroscopy to the duodenum. NA"
"162","Hospital Number: Z7781233 , Hospital: Random NHS Foundation Trust , DOB:  1914-06-12 , General Practitioner: Dr. al-Nasir, Kareema  , Date of procedure:  2001-11-14Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  25mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Altered taste FINDINGS: There is a nodule in the GOJ which is stalked. During endoscopic examination of the oesophagus, a Paris IIa nodular lesion was observed, measuring 0.5 cm in diameter. The lesion appeared to be sessile and had a regular nodular appearance.If inflammation is related to an autoimmune condition such as Crohn's disease, the patient may need referral to a specialist for further evaluation and treatment.. There is inflammation in the duodenal bulb which is erosive. There is diffuse erythema and friability noted in the duodenal mucosa, with areas of active bleeding.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. NA RECOMMENDATION: The patient may be referred to a nutritionist to develop a diet plan that is easier to digest and that meets their nutritional needs. RECOMMENDATION: The patient should be advised to maintain a healthy weight, as obesity can worsen the symptoms of GERD.   FOLLOW UP: If the nodule is suspicious for cancer, the patient may be referred to an oncologist for further evaluation and treatment. FOLLOW UP: If the patient is experiencing symptoms such as vomiting or fever, they should contact their healthcare provider immediately.  A repeat gastroscopy may be required in three to six months' time to monitor the progress of the inflammation."
"163","Hospital Number: G7755694 , Hospital: Random NHS Foundation Trust , DOB:  1980-01-19 , General Practitioner: Dr. el-Rahmani, Maisara  , Date of procedure:  2005-12-09Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  50mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known coeliac disease vomitting FINDINGS: The patient has inflammation in the D1/D2 angle which is mild.  RECOMMENDATION: The patient should be advised to avoid lying down immediately after eating, as this can worsen reflux symptoms.  The patient should be advised to avoid carbonated drinks, which can exacerbate the inflammation by increasing the production of gas. FOLLOW UP: If the stricture is due to a medical condition such as gastroesophageal reflux disease (GERD), the patient may be prescribed medication to manage their symptoms.  The patient should avoid NSAIDs and aspirin, which can irritate the lining of the stomach and exacerbate the inflammation."
"164","Hospital Number: B7780911 , Hospital: Random NHS Foundation Trust , DOB:  1992-09-01 , General Practitioner: Dr. Eltagonde, Lorrie  , Date of procedure:  2007-09-16Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG1  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Other-assess stents FINDINGS: Normal gastroscopy to the duodenum. "
"165","Hospital Number: J8821698 , Hospital: Random NHS Foundation Trust , DOB:  1975-11-15 , General Practitioner: Dr. Ortega, Anehely  , Date of procedure:  2002-12-24Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  100mcg  , Midazolam  5mg  , Instrument:  FG2  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Abdominal Pain FINDINGS: Normal gastroscopy to the duodenum. "
"166","Hospital Number: M8882071 , Hospital: Random NHS Foundation Trust , DOB:  1911-01-22 , General Practitioner: Dr. Khaliq, Sela  , Date of procedure:  2002-05-21Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  150mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- FINDINGS: Normal gastroscopy to the duodenum. "
"167","Hospital Number: C4433311 , Hospital: Random NHS Foundation Trust , DOB:  1911-06-14 , General Practitioner: Dr. Higgins, Morgan  , Date of procedure:  2013-05-22Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG1  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Previous gastric ulcer. repeat scope after 8 weeks. FINDINGS: Barrett's is present. It is a long segment.   Referral to a registered dietitian may be helpful in providing guidance on a healthy, ulcer-friendly diet.  The patient should be advised to avoid consuming dairy products, which can increase the production of stomach acid and delay the healing of the ulcer."
"168","Hospital Number: Q1015837 , Hospital: Random NHS Foundation Trust , DOB:  1903-01-02 , General Practitioner: Dr. al-Arif, Naadiya  , Date of procedure:  2007-01-31Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  150mcg  , Midazolam  5mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Nausea and/or Vomiting Other- diarrhoea FINDINGS: There is an ulcer in the body which is induratedIt has a visible vessel. The patient's medical history and the ulcer's rugose surface suggest a chronic inflammatory process.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape..   The patient should be advised to avoid aspirin or other blood thinners unless prescribed by a physician.  The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and delay the healing of the ulcer."
"169","Hospital Number: X2594520 , Hospital: Random NHS Foundation Trust , DOB:  1911-11-01 , General Practitioner: Dr. Davis, Rochelle  , Date of procedure:  2013-08-05Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  125mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Other- candidiasis FINDINGS: The patient has a 7mm nodule in the duodenal bulb which is stalked. There is a polyp in the antrum which is sessile.It has a normal pit pattern. The gastric polyp appears adenomatous with a villous or tubular structure and high-grade dysplasia.The polyp was removed with a combination of snare and forceps, and hemostasis was achieved with an endoscopic clip.. NA RECOMMENDATION: The patient may be referred to a specialist for further evaluation and treatment, such as surgery to remove the nodule.   FOLLOW UP: The patient should be advised to seek emotional support from friends, family, or a counselor, as the diagnosis of cancer can be difficult to cope with.  A blood test may be ordered to assess the patient's iron levels, as polyps can cause bleeding in the stomach and intestines."
"170","Hospital Number: E6158591 , Hospital: Random NHS Foundation Trust , DOB:  1905-03-21 , General Practitioner: Dr. Cirka, Brianna  , Date of procedure:  2005-02-21Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  100mcg  , Midazolam  7mg  , Instrument:  FG1  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- persumed per DU managed conservativelyPrevious persumed DU ulcer managed conservatively. FINDINGS: There is a stricture in the second part of the duodenum which is obliterativeThe endoscope passed through the stricture with resistance. The narrowing of the duodenal lumen is accompanied by a slight mucosal fold thickening.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding..  NA  The patient should be advised to eat smaller, more frequent meals to reduce pressure on the ulcer site and promote healing.  The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and delay the healing of the ulcer."
"171","Hospital Number: N9571333 , Hospital: Random NHS Foundation Trust , DOB:  1910-11-29 , General Practitioner: Dr. Clark, Zoe  , Date of procedure:  2014-11-05Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia   post oesophagectomy FINDINGS: There is a nodule in the stomach which is benign-looking. The gastric mucosa appears thickened with a nodular surface, suggestive of a diffuse lymphoid hyperplasia.. NA  The patient may be prescribed medication to reduce the size of the nodule and prevent it from growing.  The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the nodule."
"172","Hospital Number: V3328807 , Hospital: Random NHS Foundation Trust , DOB:  1974-06-26 , General Practitioner: Dr. Brown, Dana  , Date of procedure:  2011-09-09Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG5  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Previous chemo rad. rpt dilation. FINDINGS: The patient has a stricture in the D1/D2 angle which is inflexibleScope not held by stricture. "
"173","Hospital Number: L2721400 , Hospital: Random NHS Foundation Trust , DOB:  1905-05-02 , General Practitioner: Dr. Gilmore, Taylor  , Date of procedure:  2006-01-13Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known EOE oesophgeal biopsies FINDINGS: Multiple whitish plaques are noted in the oesophagus that may be suggestive of eosinophilic oesophagitis or Candida esophagitis.. There is an ulcer in the D1/D2 angle which is crateredIt has a visible vessel. Surrounded by erythema and exhibiting a nodular surface, the severe ulceration presents with a distinct loss of mucosal tissue.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. NA  Referral to a registered dietitian may be helpful in providing guidance on a healthy, ulcer-friendly diet.  The patient should be informed of the diagnosis and provided with information on how to manage the ulcer."
"174","Hospital Number: A9747574 , Hospital: Random NHS Foundation Trust , DOB:  1979-01-30 , General Practitioner: Dr. Marshall, Julia  , Date of procedure:  2003-04-03Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG3  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Coeliac  and ? RCD FINDINGS: No inlet patch.. "
"175","Hospital Number: I9081757 , Hospital: Random NHS Foundation Trust , DOB:  1911-10-30 , General Practitioner: Dr. King, Lanette  , Date of procedure:  2003-08-22Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - Post caustic soda ingestion - assessment of healing FINDINGS: The patient has a 6mm nodule in the GOJ which is benign-looking. The oesophageal mucosa appears thickened and friable, with diffuse erosions and ulcerations.Referral to a registered dietitian may be helpful in providing guidance on a healthy, polyp-friendly diet.. The patient has a polyp in the fundus which is stalked with a normal pit pattern. The gastric polyp appears as a sessile growth on the mucosal surface, with a smooth and regular contour.Due to its large size, the polyp was not able to be resected during the current endoscopic session.. NA RECOMMENDATION: Follow-up endoscopy with surveillance biopsies may be necessary for patients with a history of gastric ulcer or increased risk for malignancy. RECOMMENDATION: The patient should avoid drinking alcohol, as this can increase the risk of bleeding in the gastrointestinal tract.  The patient should avoid consuming too much fat, as this can delay gastric emptying and increase the risk of reflux and polyp growth. FOLLOW UP: The patient should avoid lying down immediately after meals, as this can increase the risk of reflux and ulcer recurrence. FOLLOW UP: The patient should avoid eating or drinking for at least six hours before any scheduled appointments.  A repeat gastroscopy may be recommended in three to six months' time to assess the growth of the polyp."
"176","Hospital Number: F6090839 , Hospital: Random NHS Foundation Trust , DOB:  1975-03-20 , General Practitioner: Dr. Bentley, Letyraial  , Date of procedure:  2011-06-16Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG1  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR FINDINGS: There is a stricture in the antrum which is roughThere is very slight and non-restrcitve stricturing.. Despite the impression of extrinsic compression, the gastric stricture is likely the result of fibrotic changes in the mucosa.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. LA Grade  A oesophagitis. There is significant ulceration and bleeding present in the oesophageal mucosa. The oesophageal mucosa appears pale and atrophic. Surrounded by erythema and exhibiting a nodular surface, the severe ulceration presents with a distinct loss of mucosal tissue.The lesion was biopsied using a standard forceps.. character(0)  The patient should be counseled on the importance of taking any prescribed medications for ulcer healing and symptom control as directed.  Further investigations such as a biopsy may be recommended to determine the cause of the ulcer and assess the risk of cancer."
"177","Hospital Number: T7480285 , Hospital: Random NHS Foundation Trust , DOB:  1915-09-08 , General Practitioner: Dr. Trevino, Mitzi  , Date of procedure:  2006-08-04Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  150mcg  , Midazolam  4mg  , Instrument:  FG1  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR FINDINGS: Normal gastroscopy to the duodenum. "
"178","Hospital Number: W2054819 , Hospital: Random NHS Foundation Trust , DOB:  1950-09-21 , General Practitioner: Dr. el-Salahuddin, Naqiyya  , Date of procedure:  2005-06-17Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Coeliac  and ? RCD FINDINGS: Normal gastroscopy to the duodenum. "
"179","Hospital Number: O8834134 , Hospital: Random NHS Foundation Trust , DOB:  1979-09-06 , General Practitioner: Dr. el-Sadri, Shareefa  , Date of procedure:  2008-01-25Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG1  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Dyspepsia FINDINGS: The patient has a polyp in the third part of the duodenum which is sessile.It has a normal pit pattern. Under endoscopic visualization, the polyp was removed using EMR.. The patient has a 9mm nodule in the stomach which is benign-looking. A nodular lesion with surrounding erythema and nodularity of the overlying mucosa is observed in the gastric cardia, suggestive of a malignant gastric neoplasm.The patient may require additional endoscopies in the future to monitor the nodule and ensure that it is not progressing.. character(0) RECOMMENDATION: The patient should avoid drinking alcohol, as this can increase the risk of bleeding in the gastrointestinal tract.  A repeat gastroscopy may be recommended in three to six months' time to assess the growth of the polyp. FOLLOW UP: If the nodule is benign, the patient may not require any treatment, but may require monitoring with regular endoscopies.  The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools."
"180","Hospital Number: H6820128 , Hospital: Random NHS Foundation Trust , DOB:  1949-12-25 , General Practitioner: Dr. Smith, Tyieshia  , Date of procedure:  2015-11-15Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CHRONIC DIARRHOEA-biopsies needed FINDINGS: Columnar lined oesophagus is present. No loss of aceto-whitening was seen. No nodularity is present. The patient has a polyp in the fundus which is stalked with an abnormal pit pattern. A hyperplastic gastric polyp is seen in the cardia, with a serrated and folded surface.Endoscopic mucosal resection was performed to remove the polyp in its entirety.. NA  The patient should be advised to avoid NSAIDs and aspirin, which can increase the risk of developing more polyps.  The patient is advised to return for a follow-up appointment in four to six weeks' time to discuss the findings and plan for further management."
"181","Hospital Number: P4350826 , Hospital: Random NHS Foundation Trust , DOB:  1986-08-04 , General Practitioner: Dr. Jennis, Essence  , Date of procedure:  2001-04-02Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  150mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Reflux-like Symptoms/Atypical Chest Pain FINDINGS: There is a stricture in the fundus which is irregularTight distal stricture which would not allow passage of scope.. The impression of extrinsic compression is present, but the gastric stricture is likely due to mucosal changes.The ulcer was biopsied x8 for further analysis..  character(0)  Follow-up endoscopy with surveillance biopsies may be necessary for patients with a history of gastric ulcer or increased risk for malignancy.  The patient may be prescribed medication to protect the stomach lining and reduce the risk of developing more ulcers."
"182","Hospital Number: D5429386 , Hospital: Random NHS Foundation Trust , DOB:  1929-11-11 , General Practitioner: Dr. Oliva, Keri  , Date of procedure:  2008-03-14Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  100mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Gastric ucers with hy pylori. FINDINGS: The patient has a polyp in the fundus which is sessile.It has an abnormal pit pattern. A gastric polyp is seen in the pylorus, with a tubular and elongated shape and a smooth surface.The polyp was grasped with a snare and cut with a hot biopsy forceps for removal.. Barrett's is present. No nodularity is present. It is a long segment. NA  The patient is advised to return for a follow-up appointment in four to six weeks' time to discuss the findings and plan for further management.  The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and increase the risk of polyp growth."
"183","Hospital Number: K5870127 , Hospital: Random NHS Foundation Trust , DOB:  1929-08-12 , General Practitioner: Dr. Murphy, Maeselle  , Date of procedure:  2006-05-08Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  125mcg  , Midazolam  1mg  , Instrument:  FG6  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Weight Loss Anaemia/Low Iron or Vitamins FINDINGS: The patient has Barrett's oesophagus. Gastric mucosal prolapse seen. Some areas of vascular abnormalities are seen. The segment looks flat. There is a nodule in the stomach which is stalked. The gastric mucosa appears irregularly thickened with a nodular appearance, suggestive of diffuse gastric carcinoma.The patient should be advised to follow a soft diet and avoid spicy or acidic foods to reduce discomfort and promote healing.. character(0)  The patient should be advised to maintain a healthy weight, as obesity can increase the risk of cancer and other gastrointestinal diseases.  The patient should be informed of the diagnosis and the importance of adhering to the recommended treatment plan."
"184","Hospital Number: U3081246 , Hospital: Random NHS Foundation Trust , DOB:  1922-07-10 , General Practitioner: Dr. Roy, Madisen  , Date of procedure:  2010-10-27Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain FINDINGS: There is inflammation in the GOJ which is severe. Upon examination, there appears to be diffuse erythema and friability of the oesophageal mucosa, consistent with a diagnosis of oesophagitis.Following the biopsy of the lesion, there was bleeding, which was promptly managed..  character(0) RECOMMENDATION: If the patient is experiencing symptoms such as vomiting or fever, they should contact their healthcare provider immediately.  The patient should avoid lying down immediately after meals, as this can exacerbate the inflammation by increasing the risk of reflux. FOLLOW UP: The patient may be prescribed an H2 blocker to reduce stomach acid production and prevent reflux.  A repeat gastroscopy may be required in three to six months' time to monitor the progress of the inflammation."
"185","Hospital Number: Y1506215 , Hospital: Random NHS Foundation Trust , DOB:  1955-08-30 , General Practitioner: Dr. Navarro, Myrriah  , Date of procedure:  2003-05-26Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  50mcg  , Midazolam  3mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Positive coeliac FINDINGS: The patient has a 4mm nodule in the second part of the duodenum which is stalked. LA Grade  C oesophagitis. Gastric mucosal prolapse also seen NA  The patient should be advised to attend all scheduled appointments and follow the treatment plan recommended by their healthcare provider.  The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent further damage to the gastrointestinal tract."
"186","Hospital Number: S7145991 , Hospital: Random NHS Foundation Trust , DOB:  1933-05-17 , General Practitioner: Dr. Miller, Larae  , Date of procedure:  2007-09-17Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG2  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Dilatation FINDINGS: No evidence of inlet patch on careful inspection.. "
"187","Hospital Number: R9404908 , Hospital: Random NHS Foundation Trust , DOB:  1932-01-31 , General Practitioner: Dr. Ford, Jaela  , Date of procedure:  2015-07-30Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  50mcg  , Midazolam  5mg  , Instrument:  FG3  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Weight Loss FINDINGS: There is a stricture in the stomach which is fibroticIt is easily traversible.. Despite the impression of extrinsic compression, the gastric stricture is likely the result of inflammatory changes in the mucosa.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample.. "
"188","Hospital Number: Z6151451 , Hospital: Random NHS Foundation Trust , DOB:  1985-10-10 , General Practitioner: Dr. Siren, Vidya  , Date of procedure:  2016-11-10Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Weight Loss FINDINGS: Normal gastroscopy to the duodenum. "
"189","Hospital Number: G1498153 , Hospital: Random NHS Foundation Trust , DOB:  1980-04-26 , General Practitioner: Dr. Ahmed, Asianna  , Date of procedure:  2006-11-02Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  50mcg  , Midazolam  3mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Early satiety FINDINGS: Hiatus hernia.. "
"190","Hospital Number: B8969666 , Hospital: Random NHS Foundation Trust , DOB:  1984-04-24 , General Practitioner: Dr. Prochazka, Courtney  , Date of procedure:  2010-04-02Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Haematemesisor Melaena/Blood PR FINDINGS: There is inflammation in the fundus which is mild. The gastric inflammation appears to be associated with the presence of Helicobacter pylori bacteria.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. The patient has a stricture in the D1/D2 angle which is thickenedThe endoscope passed through the stricture with resistance. NA RECOMMENDATION: The patient should be advised to maintain a healthy weight, as obesity can worsen the symptoms of GERD.  The patient should be advised to avoid consuming too much sugar, as this can exacerbate the inflammation by increasing the risk of bacterial overgrowth in the stomach. FOLLOW UP: The patient may be prescribed medication to reduce the production of stomach acid and prevent reflux.  The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools."
"191","Hospital Number: J1819477 , Hospital: Random NHS Foundation Trust , DOB:  1985-03-19 , General Practitioner: Dr. Hemlock, Alyssa  , Date of procedure:  2010-10-13Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  150mcg  , Midazolam  7mg  , Instrument:  FG6  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Weight Loss FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"")."
"192","Hospital Number: M8863036 , Hospital: Random NHS Foundation Trust , DOB:  1901-10-03 , General Practitioner: Dr. Kobayashi, Nicole  , Date of procedure:  2002-10-30Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss FINDINGS: Normal gastroscopy to the duodenum. "
"193","Hospital Number: C4021112 , Hospital: Random NHS Foundation Trust , DOB:  1958-12-01 , General Practitioner: Dr. Linkenheil, Taylor  , Date of procedure:  2015-07-15Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Maleana FINDINGS: Columnar lined oesophagus is present. Some areas of vascular abnormalities are seen. Short segment only. The pit pattern is normal. The patient has a 7mm nodule in the duodenal bulb which is sessile. NA  The patient should be informed of the diagnosis and the importance of adhering to the recommended treatment plan.  The patient should avoid eating fried or fatty foods, as these can increase the risk of reflux and further damage to the gastrointestinal tract."
"194","Hospital Number: Q8222665 , Hospital: Random NHS Foundation Trust , DOB:  1918-02-17 , General Practitioner: Dr. el-Ashraf, Sahla  , Date of procedure:  2013-10-21Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG6  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- RFA Other GAVE FINDINGS: There is a polyp in the oesophagus at 27 cm which is sessile.It has an abnormal pit pattern. A small, submucosal nodule is observed in the distal esophagus, suggestive of an esophageal lipoma.Endoscopic mucosal resection was performed to remove the polyp in its entirety..  NA RECOMMENDATION: The patient may require additional endoscopies in the future to monitor the nodule and ensure that it is not progressing.  The patient may be referred to a specialist in gastrointestinal disorders for further management of the polyp. FOLLOW UP:   The patient should be advised to avoid acidic foods and drinks, which can irritate the lining of the stomach and increase the risk of developing more polyps."
"195","Hospital Number: X5836068 , Hospital: Random NHS Foundation Trust , DOB:  1933-06-10 , General Practitioner: Dr. el-Moghaddam, Ghaaziya  , Date of procedure:  2008-12-02Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  125mcg  , Midazolam  3mg  , Instrument:  FG1  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Weight Loss Mother has gastric cancer FINDINGS: There is a cervical inlet patch of dubious significance.. "
"196","Hospital Number: E8902521 , Hospital: Random NHS Foundation Trust , DOB:  1925-08-24 , General Practitioner: Dr. Palmier, Antoinette  , Date of procedure:  2013-10-25Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG2  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Achalasia FINDINGS: The patient has a polyp in the antrum which is stalked.It has an abnormal pit pattern. The hyperplastic gastric polyp presents with a regular shape and no signs of atypical cells.The polyp was removed with a combination of snare and forceps, and hemostasis was achieved with an endoscopic clip.. Hiatus Hernia- Small.. character(0)  The patient is advised to return for a follow-up appointment in four to six weeks' time to discuss the findings and plan for further management.  A repeat gastroscopy may be recommended in twelve months' time to assess the response to treatment."
"197","Hospital Number: N7405188 , Hospital: Random NHS Foundation Trust , DOB:  1951-04-25 , General Practitioner: Dr. Carson, Megan  , Date of procedure:  2015-10-13Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  12.5mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - chronic cough ?GORD FINDINGS: The patient has a 6mm nodule in the stomach which is sessile. A nodular lesion is observed in the gastric cardia, with surrounding erythema and nodularity of the overlying mucosa, suggestive of a malignant gastric neoplasm.The patient should be advised to eat smaller, more frequent meals to reduce pressure on the ulcer site and promote healing..  RECOMMENDATION: The patient should be advised to maintain a healthy weight and exercise regularly to reduce the risk of recurrent ulcers.  The patient should be advised to avoid lifting heavy objects or engaging in strenuous physical activity, as this can increase the risk of bleeding in the gastrointestinal tract. FOLLOW UP: The patient should avoid consuming too much fat, as this can delay gastric emptying and delay the healing of the ulcer.  The patient should be advised to avoid eating spicy or acidic foods, as these can irritate the gastrointestinal tract and worsen symptoms."
"198","Hospital Number: V9378773 , Hospital: Random NHS Foundation Trust , DOB:  1932-01-10 , General Practitioner: Dr. Mao, Nhung  , Date of procedure:  2013-11-30Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  125mcg  , Midazolam  4mg  , Instrument:  FG2  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Family history of gastric cancer FINDINGS: OESOPHAGUS: Normal apart from small hiatus hernia.. "
"199","Hospital Number: L6117442 , Hospital: Random NHS Foundation Trust , DOB:  1901-07-22 , General Practitioner: Dr. Link, Janishka  , Date of procedure:  2006-08-26Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Hb drop ?GI bleed previous gastric surgery FINDINGS: Barrett's is present. The segment looks flat. It is a long segment. The pit pattern is normal. "
"200","Hospital Number: A3669324 , Hospital: Random NHS Foundation Trust , DOB:  1990-11-04 , General Practitioner: Dr. Babbitt, Samantha  , Date of procedure:  2004-05-07Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG6  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain x1 hematemesis Crohns colitis FINDINGS: The patient has an ulcer in the duodenal bulb which is fibroticIt has a visible vessel. The ulceration exhibits a cobblestone appearance and a yellowish base, suggestive of Helicobacter pylori infection.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. The ulcer appears to be a chronic lesion, with signs of previous healing and scarring.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample.. There is inflammation in the stomach which is severe. The gastric inflammation appears to be associated with the use of proton pump inhibitors (PPIs), with the presence of rebound hypergastrinemia.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. character(0) RECOMMENDATION: Repeat endoscopy with surveillance biopsies is recommended every 3-5 years for patients with a history of gastric ulcer to monitor for recurrence or malignancy. RECOMMENDATION:   The patient should avoid eating before bedtime, as this can exacerbate the inflammation by increasing the risk of reflux. FOLLOW UP: The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more ulcers. FOLLOW UP: If the stricture is causing symptoms such as difficulty swallowing, the patient may be referred to a speech therapist for swallowing therapy.  The patient should be advised to avoid carbonated drinks, which can exacerbate the inflammation by increasing the production of gas."
"201","Hospital Number: O8583042 , Hospital: Random NHS Foundation Trust , DOB:  1967-03-24 , General Practitioner: Dr. Palovich, Caitlyn  , Date of procedure:  2009-06-29Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  25mcg  , Midazolam  4mg  , Instrument:  FG2  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Epigastric pain. Previously on asprin for Cerebral infarction FINDINGS: The patient has a 10mm nodule in the oesophagus at 41 cm which is benign-looking. A large, lobulated mass is observed in the mid-esophagus, suggestive of a leiomyosarcoma.The patient should be advised to follow a soft diet and avoid spicy or acidic foods to reduce discomfort and promote healing.. The patient has a polyp in the duodenal bulb which is stalked with a normal pit pattern. The nodules are distributed throughout the duodenal bulb and descending duodenum.The base of the polyp was fulgurated with an electrocautery device to prevent future bleeding or regrowth.. NA RECOMMENDATION:    FOLLOW UP: The patient should avoid eating fried or fatty foods, as these can increase the risk of reflux and further damage to the gastrointestinal tract.  A blood test may be ordered to assess the patient's iron levels, as polyps can cause bleeding in the stomach and intestines."
"202","Hospital Number: H2587908 , Hospital: Random NHS Foundation Trust , DOB:  1930-08-11 , General Practitioner: Dr. Saxe, Alexandra  , Date of procedure:  2014-10-13Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG3  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins weight loss. On warfarin and clopidogrel, FINDINGS: There is a stricture in the stomach which is inflamedIt is easily traversible.. A gastric stricture with an overlying ulceration is seen in the antrum, suggestive of a peptic stricture.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. There is a nodule in the second part of the duodenum which is sessile. character(0) RECOMMENDATION: The patient should be advised to avoid straining during bowel movements to reduce pressure on the ulcer site.  The patient may be prescribed medication to manage any symptoms associated with the nodule, such as pain or discomfort. FOLLOW UP: The patient may be prescribed medication to reduce the acidity of the stomach and promote healing of the ulcer.  The patient should avoid drinking alcohol, as this can increase the risk of bleeding in the gastrointestinal tract."
"203","Hospital Number: P9907275 , Hospital: Random NHS Foundation Trust , DOB:  1975-05-29 , General Practitioner: Dr. al-Ibrahim, Tahleela  , Date of procedure:  2005-12-23Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  75mcg  , Midazolam  7mg  , Instrument:  FG3  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Weight Loss Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"204","Hospital Number: D9990587 , Hospital: Random NHS Foundation Trust , DOB:  1941-06-13 , General Practitioner: Dr. Mcbride, Leah  , Date of procedure:  2009-06-14Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  100mcg  , Midazolam  1mg  , Instrument:  FG5  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Other- Early satiety FINDINGS: LA Grade  B oesophagitis. Food present in the oesophagus The oesophageal mucosa is friable and edematous. There is significant ulceration and bleeding present in the oesophageal mucosa. Surrounded by erythema and exhibiting a nodular surface, the severe ulceration presents with a distinct loss of mucosal tissue.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample..  character(0)  Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) may be necessary for larger or more complex ulcers.  The patient should be advised to avoid consuming caffeine, which can stimulate the production of stomach acid and delay the healing of the ulcer."
"205","Hospital Number: K9010769 , Hospital: Random NHS Foundation Trust , DOB:  1973-03-10 , General Practitioner: Dr. Chavarria, Morgann  , Date of procedure:  2015-09-15Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  12.5mcg  , Midazolam  7mg  , Instrument:  FG3  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Therapeutic- Dilatation Therapeutic- NJ Tube/PEG/DPEJ FINDINGS: LA Grade  D oesophagitis. There is significant narrowing of the oesophageal lumen due to stricture formation with areas of mucosal ulceration. The gastric lesion appears malignant with irregular borders and surrounding erythema.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. Barrett's is present. No abnormal pit pattern is seen. character(0)  Follow-up imaging such as CT or MRI may be necessary to assess for potential complications or to guide management decisions.  The patient is advised to return for a follow-up appointment in two to four weeks' time to discuss the findings and plan for further management."
"206","Hospital Number: U5728377 , Hospital: Random NHS Foundation Trust , DOB:  1964-12-30 , General Practitioner: Dr. Abeyta, Olivia  , Date of procedure:  2009-07-08Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins FINDINGS: The patient has a stricture in the body which is hyperemicIt will not allow the scope to pass.. The gastric stricture is likely due to fibrotic changes in the mucosa, rather than extrinsic compression.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. "
"207","Hospital Number: Y3424765 , Hospital: Random NHS Foundation Trust , DOB:  1906-06-15 , General Practitioner: Dr. Carter, Justine  , Date of procedure:  2012-06-20Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia oesophageal stricture post chemorad for scc oesophagus FINDINGS: There is a polyp in the third part of the duodenum which is sessile with a normal pit pattern. The nodules are visualized using high-resolution endoscopy with narrow-band imaging technology.The polyp did not lift on saline injection and was therefore not amenable to endoscopic resection.. No evidence of inlet patch on careful inspection.. character(0) RECOMMENDATION: The patient may be referred to a nutritionist to develop a diet plan that is easier to digest and that meets their nutritional needs.  The patient should be advised to avoid hot, spicy foods, which can irritate the lining of the stomach and increase the risk of polyp growth. FOLLOW UP: The patient should be informed of the diagnosis and the importance of adhering to the recommended treatment plan.  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and polyp growth."
"208","Hospital Number: S9335497 , Hospital: Random NHS Foundation Trust , DOB:  1940-01-25 , General Practitioner: Dr. Saye, Jasmine  , Date of procedure:  2007-12-12Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  25mcg  , Midazolam  4mg  , Instrument:  FG1  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- RFA Other GAVE FINDINGS: Inflammatory changes seen in the oesophagus. There is a stricture in the D1/D2 angle which is unyieldingThere is very slight and non-restrcitve stricturing.. NA"
"209","Hospital Number: R3233951 , Hospital: Random NHS Foundation Trust , DOB:  1947-07-23 , General Practitioner: Dr. Garcia, Daijaniea  , Date of procedure:  2012-05-25Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Positive coeliac serology FINDINGS: There is an ulcer in the body which is fibroticForrest Ulcer classification: IIc.. The gastric lesion appears malignant with irregular borders and surrounding erythema.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding..   The patient should be instructed to chew food thoroughly and eat slowly to reduce the risk of further irritation to the ulcer.  The patient may be referred to a specialist in gastrointestinal disorders for further management of the ulcer."
"210","Hospital Number: Z3118534 , Hospital: Random NHS Foundation Trust , DOB:  1926-07-28 , General Practitioner: Dr. Runningbear-Paul, Brooklyn  , Date of procedure:  2002-12-05Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"211","Hospital Number: G7303882 , Hospital: Random NHS Foundation Trust , DOB:  1931-09-17 , General Practitioner: Dr. Dinneen, Taylor  , Date of procedure:  2009-11-04Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  75mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia oesophageal stricture post chemorad for scc oesophagus FINDINGS: There is a nodule in the GOJ which is sessile. In the oesophagus, a Paris IIa/c polypoid lesion was observed during endoscopy, measuring 0.7 cm in diameter. The lesion had a nodular surface and appeared to be sessile.The patient is advised to return for a follow-up appointment in two to four weeks' time to discuss the findings and plan for further management..  NA RECOMMENDATION: Further investigations, such as imaging studies and biopsy, may be required to determine the nature of the nodule.  The patient is advised to return for a follow-up appointment in four to six weeks' time to discuss the findings and plan for further management. FOLLOW UP: The patient may be referred to a surgeon for a minimally invasive procedure to remove the nodule.  A colonoscopy may be ordered to assess for the presence of polyps in the colon and rectum."
"212","Hospital Number: B2496144 , Hospital: Random NHS Foundation Trust , DOB:  1908-07-03 , General Practitioner: Dr. Brooks, Kaci  , Date of procedure:  2015-01-10Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Abdominal Pain Haematemesis or Melaena/Blood PR FINDINGS: There is a polyp in the stomach which is sessile with an abnormal pit pattern. The gastric polyp exhibits an adenomatous morphology with tubular and villous growth patterns.The polyp was grasped with a snare and cut with a hot biopsy forceps for removal..     The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more polyps."
"213","Hospital Number: J9928505 , Hospital: Random NHS Foundation Trust , DOB:  1938-05-10 , General Practitioner: Dr. Menchaca Arellano, Monica  , Date of procedure:  2002-05-28Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  50mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Gastric ucers with hy pylori. FINDINGS: Normal gastroscopy to the duodenum. "
"214","Hospital Number: M7832839 , Hospital: Random NHS Foundation Trust , DOB:  1935-12-10 , General Practitioner: Dr. O'Leary, Melanie  , Date of procedure:  2003-08-10Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  125mcg  , Midazolam  5mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Nausea and/or Vomiting FINDINGS: Normal gastroscopy to the duodenum. "
"215","Hospital Number: C1538169 , Hospital: Random NHS Foundation Trust , DOB:  1962-08-13 , General Practitioner: Dr. Crowell, Karishma  , Date of procedure:  2010-12-26Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG5  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Varices/Vascular FINDINGS: Normal gastroscopy to the duodenum. "
"216","Hospital Number: Q6090326 , Hospital: Random NHS Foundation Trust , DOB:  1938-11-30 , General Practitioner: Dr. Neitenbach, Kelsey  , Date of procedure:  2003-07-06Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  12.5mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Abdominal Pain FINDINGS: The patient has a polyp in the fundus which is stalked with an abnormal pit pattern. A hyperplastic gastric polyp is seen in the cardia, with a serrated and folded surface.Endoscopic mucosal resection was performed to remove the polyp in its entirety.. There is a nodule in the stomach which is sessile. A large, lobulated nodule is observed in the gastric body, suggestive of a gastrointestinal autonomic nerve tumor (GANT).They should also be instructed to report any new or worsening symptoms to their healthcare provider promptly.. NA RECOMMENDATION: The patient should avoid drinking alcohol, as this can increase the risk of bleeding in the gastrointestinal tract.  The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and increase the risk of polyp growth. FOLLOW UP: The patient should be advised to avoid lifting heavy objects or engaging in strenuous physical activity, as this can increase the risk of bleeding in the gastrointestinal tract.  The patient may be prescribed medication to reduce the risk of developing more polyps."
"217","Hospital Number: X8881813 , Hospital: Random NHS Foundation Trust , DOB:  1904-05-11 , General Practitioner: Dr. Hall, Zanelle  , Date of procedure:  2005-05-08Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  50mcg  , Midazolam  5mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal bloating chest discomfort reflux.Known fibromyalgia RA FINDINGS: Inflammatory changes seen in the oesophagus.  NA"
"218","Hospital Number: E5760181 , Hospital: Random NHS Foundation Trust , DOB:  1960-10-16 , General Practitioner: Dr. Doremus, Felicia  , Date of procedure:  2007-02-14Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss . FINDINGS: There is inflammation in the stomach which is severe. The gastric inflammation is diffuse and characterized by the presence of plasma cells in the mucosal layer.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury..  RECOMMENDATION: The patient should be advised to avoid caffeine, as it can worsen reflux symptoms.  The patient should be advised to avoid acidic foods and drinks, which can irritate the lining of the stomach and exacerbate the inflammation. FOLLOW UP: The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent reflux.  The patient should be advised to avoid consuming too much sugar, as this can exacerbate the inflammation by increasing the risk of bacterial overgrowth in the stomach."
"219","Hospital Number: N3482935 , Hospital: Random NHS Foundation Trust , DOB:  1918-10-16 , General Practitioner: Dr. Ponce, Mercy  , Date of procedure:  2005-12-06Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - chronic cough ?GORD FINDINGS: The patient has a 3mm nodule in the stomach which is stalked. A nodular lesion is seen in the gastric fundus, with a central umbilication and surrounding erythema, suggestive of a gastric leiomyoma.If inflammation is severe or has led to complications such as bleeding, hospitalization may be necessary for further evaluation and management..  NA RECOMMENDATION: The patient should avoid eating or drinking for at least six hours before any scheduled appointments. RECOMMENDATION: The patient should avoid drinking carbonated beverages, as these can worsen reflux symptoms.  The patient should be advised to avoid hot, spicy foods, which can irritate the lining of the stomach and exacerbate the inflammation. FOLLOW UP: The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the nodule. FOLLOW UP: The patient may be referred to a nutritionist to develop a diet plan that is easier to swallow and that meets their nutritional needs.  The patient should be encouraged to maintain a healthy weight to reduce the risk of developing inflammation in the future."
"220","Hospital Number: V6466799 , Hospital: Random NHS Foundation Trust , DOB:  1927-07-20 , General Practitioner: Dr. Henry, Ashlee  , Date of procedure:  2001-08-25Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Post oesophagectomy for Pagets FINDINGS: There is an ulcer in the D1/D2 angle which is induratedCLO test  was also taken.. The gastric ulcer presents with an irregular border and a fibrous base, suggestive of NSAID-induced injury.The ulcer was biopsied x8 for further analysis.. NA  The patient should be counseled on the importance of maintaining good oral hygiene to prevent oral bacteria from entering the ulcer site.  The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools."
"221","Hospital Number: L2151400 , Hospital: Random NHS Foundation Trust , DOB:  1970-04-03 , General Practitioner: Dr. Seth, Amanda  , Date of procedure:  2010-10-05Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  150mcg  , Midazolam  7mg  , Instrument:  FG5  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Small Bowel Biopsy Positive coeliac serology FINDINGS: Normal gastroscopy to the duodenum. "
"222","Hospital Number: A3080284 , Hospital: Random NHS Foundation Trust , DOB:  1936-09-21 , General Practitioner: Dr. Berg, Kelsie  , Date of procedure:  2009-09-26Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG2  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Positive coeliac FINDINGS: Normal gastroscopy to the duodenum. "
"223","Hospital Number: I7491657 , Hospital: Random NHS Foundation Trust , DOB:  1972-07-19 , General Practitioner: Dr. Crow, Alexandra  , Date of procedure:  2014-09-24Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  100mcg  , Midazolam  1mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain x1 hematemesis Crohns colitis FINDINGS: LA Grade  B oesophagitis. The distal oesophagus appears normal, but there is diffuse erythema and friability in the mid and proximal oesophagus. There are scattered erosions present in the oesophageal mucosa. There are multiple areas of oesophageal mucosal breaks with overlying fibrin and purulent exudates. The patient had crepe paper-like appearance of the oesophageal mucosa on endoscopy, suggestive of eosinophilic oesophagitis. There is a nodule in the fundus which is benign-looking. A well-circumscribed, firm nodule is seen in the gastric body, suggestive of a gastrointestinal stromal tumor (GIST).The patient should avoid consuming too much fat, as this can delay gastric emptying and increase the risk of reflux and polyp growth.. NA RECOMMENDATION: The patient may be referred to a surgeon for a minimally invasive procedure to remove the nodule.  The patient should be advised to avoid acidic foods and drinks, which can irritate the lining of the stomach and increase the risk of developing more polyps. FOLLOW UP: The patient should be informed of the diagnosis and the importance of adhering to the recommended treatment plan.  The patient should avoid eating before bedtime, as this can increase the risk of reflux and polyp growth."
"224","Hospital Number: F8022001 , Hospital: Random NHS Foundation Trust , DOB:  1947-12-14 , General Practitioner: Dr. Rodenburg, Carly  , Date of procedure:  2011-07-18Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Nausea and/or Vomiting FINDINGS: Normal gastroscopy to the duodenum. "
"225","Hospital Number: T4904215 , Hospital: Random NHS Foundation Trust , DOB:  1979-09-16 , General Practitioner: Dr. Rivers, Macie  , Date of procedure:  2015-05-27Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"226","Hospital Number: W8932372 , Hospital: Random NHS Foundation Trust , DOB:  1937-05-21 , General Practitioner: Dr. Abeyta, Ashley  , Date of procedure:  2010-11-12Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  100mcg  , Midazolam  1mg  , Instrument:  FG1  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Post oesophagectomy for Pagets FINDINGS: As an incidental finding she also has a cervical inlet patch.. character(0)"
"227","Hospital Number: O7967929 , Hospital: Random NHS Foundation Trust , DOB:  1952-04-04 , General Practitioner: Dr. Tran, Anh  , Date of procedure:  2011-06-03Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG2  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain FINDINGS: Small hiatus hernia only.. "
"228","Hospital Number: H3844577 , Hospital: Random NHS Foundation Trust , DOB:  1912-06-19 , General Practitioner: Dr. Davis, Chelsea  , Date of procedure:  2014-10-03Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Coeliac folllow up abd pain  bloating diarhoea FINDINGS: The patient has an ulcer in the duodenal bulb which is necroticIt has rolled edges. The ulceration's irregular shape and size, along with a yellowish base, suggest a possible malignant process.The ulcer was biopsied x8 for further analysis.. The edges of the ulcer appear to be undermined, which may indicate ongoing tissue destruction.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample..  NA  Endoscopic therapy with injection of epinephrine and/or placement of hemostatic clips may be necessary to achieve hemostasis in the event of active bleeding.  The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and delay the healing of the ulcer."
"229","Hospital Number: P4236233 , Hospital: Random NHS Foundation Trust , DOB:  1964-03-23 , General Practitioner: Dr. Martinez, Jurea  , Date of procedure:  2009-08-11Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Achalasia FINDINGS: Normal gastroscopy to the duodenum. "
"230","Hospital Number: D4826904 , Hospital: Random NHS Foundation Trust , DOB:  1929-07-30 , General Practitioner: Dr. el-Shakir, Maleeka  , Date of procedure:  2002-07-05Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  75mcg  , Midazolam  4mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Previous Polyps/Metaplasia etc. FINDINGS: Oesophagus normal with no hiatus hernia..   The patient may be prescribed medication to reduce the risk of developing more polyps.  "
"231","Hospital Number: K8847627 , Hospital: Random NHS Foundation Trust , DOB:  1940-12-08 , General Practitioner: Dr. Castanon-Gonzalez, Natalie  , Date of procedure:  2003-03-08Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  150mcg  , Midazolam  7mg  , Instrument:  FG3  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Previous gastric ulcer. repeat scope after 8 weeks. FINDINGS: LA Grade  D oesophagitis. There are scattered erosions present in the oesophageal mucosa. There is a polyp in the D1/D2 angle which is sessile.It has an abnormal pit pattern. character(0) RECOMMENDATION: Endoscopic resection of the ulcer may be necessary for larger or more complex ulcers.   FOLLOW UP: The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and delay the healing of the ulcer.  The patient should avoid consuming too much fat, as this can delay gastric emptying and increase the risk of reflux and polyp growth."
"232","Hospital Number: U8525559 , Hospital: Random NHS Foundation Trust , DOB:  1913-05-15 , General Practitioner: Dr. Cook, Savanna  , Date of procedure:  2003-04-29Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG4  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - exclude Lynch and coeliac FINDINGS: Normal gastroscopy to the duodenum. "
"233","Hospital Number: Y5602439 , Hospital: Random NHS Foundation Trust , DOB:  1904-09-28 , General Practitioner: Dr. Parado Irby, Cassandra  , Date of procedure:  2002-08-05Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  100mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins FINDINGS: Pull sign was demonstrated.. Rings were noted throughout the esophagusconsistent with eosinophilic oesophagitis.  character(0)"
"234","Hospital Number: S6682774 , Hospital: Random NHS Foundation Trust , DOB:  1985-02-20 , General Practitioner: Dr. Xiong, Vanessa  , Date of procedure:  2013-12-07Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- RFA FINDINGS: The patient has a 4mm nodule in the D1/D2 angle which is stalked.   If the nodule is benign, the patient may not require any treatment, but may require monitoring with regular endoscopies.  The patient should be advised to seek emotional support from friends, family, or a counselor, as the diagnosis of cancer can be difficult to cope with."
"235","Hospital Number: R6103760 , Hospital: Random NHS Foundation Trust , DOB:  1950-01-02 , General Practitioner: Dr. Smith, Rebecca  , Date of procedure:  2011-07-13Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CD FINDINGS: The patient has a stricture in the GOJ which is narrowedThe endoscope passed through the stricture with resistance. The severe narrowing of the oesophageal lumen at the stricture site is visible, and only a small-caliber endoscope can be passed through.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. Oesophagus normal with no hiatus hernia.. NA"
"236","Hospital Number: Z1272661 , Hospital: Random NHS Foundation Trust , DOB:  1969-02-17 , General Practitioner: Dr. Mose, Andrissa  , Date of procedure:  2003-11-13Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: High Dysphagia further assessment of previoius diagnosed peptic stricture also recent eus and aspirat of bengn perigastric cyst FINDINGS: Lax cardia with small hiatus hernia. "
"237","Hospital Number: G2227671 , Hospital: Random NHS Foundation Trust , DOB:  1953-05-15 , General Practitioner: Dr. Tu, Mariah  , Date of procedure:  2007-05-25Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  125mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Nausea and/or Vomiting FINDINGS: Hiatus Hernia- Large.. "
"238","Hospital Number: B7082304 , Hospital: Random NHS Foundation Trust , DOB:  1936-07-14 , General Practitioner: Dr. Choe, Michelle  , Date of procedure:  2008-09-02Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  100mcg  , Midazolam  3mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain previous ogd attempt food residue FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"")."
"239","Hospital Number: J8000143 , Hospital: Random NHS Foundation Trust , DOB:  1918-01-09 , General Practitioner: Dr. Butcher, Caitlin  , Date of procedure:  2011-09-03Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Other- Early satiety FINDINGS: There is an ulcer in the second part of the duodenum which is necroticForrest Ulcer classification: IIc.. Accompanied by white exudate and a cobblestone appearance, the gastric ulcer is likely caused by Helicobacter pylori infection.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. Upon endoscopic examination, a duodenal ulcer is visible at the angle of the duodenum.The biopsy was performed using a needle biopsy forceps, with the tissue samples sent for pathological analysis.. The endoscopic appearance of the oesophagus is suggestive of eosinophilic oesophagitis, with multiple linear furrows and white plaques.. character(0)  The patient should be counseled on the importance of taking any prescribed medications for ulcer healing and symptom control as directed.  The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and delay the healing of the ulcer."
"240","Hospital Number: M2497777 , Hospital: Random NHS Foundation Trust , DOB:  1931-08-29 , General Practitioner: Dr. Luna, Jessica  , Date of procedure:  2015-11-11Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Nausea and/or Vomiting Weight Loss FINDINGS: There is inflammation in the fundus which is mild. The gastric inflammation is diffuse and characterized by the presence of plasma cells in the mucosal layer.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample..  character(0) RECOMMENDATION: The patient should avoid drinking carbonated beverages, as these can worsen reflux symptoms.  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and inflammation. FOLLOW UP: If the stricture is due to a medical condition such as gastroesophageal reflux disease (GERD), the patient may be prescribed medication to manage their symptoms.  A consultation with a dietician may be beneficial to help the patient modify their diet to manage the inflammation."
"241","Hospital Number: C1910592 , Hospital: Random NHS Foundation Trust , DOB:  1921-06-02 , General Practitioner: Dr. al-Baluch, Najeeba  , Date of procedure:  2014-06-19Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG1  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- EMR/ESD FINDINGS: No evidence of inlet patch on careful inspection.. "
"242","Hospital Number: Q9535363 , Hospital: Random NHS Foundation Trust , DOB:  1961-06-01 , General Practitioner: Dr. al-Assad, Ruwaida  , Date of procedure:  2004-07-08Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG1  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss . FINDINGS: Normal gastroscopy to the duodenum. "
"243","Hospital Number: X7857756 , Hospital: Random NHS Foundation Trust , DOB:  1938-05-11 , General Practitioner: Dr. Beckwith, Kathryn  , Date of procedure:  2002-07-03Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  100mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Nausea and/or Vomiting FINDINGS: There is a nodule in the fundus which is benign-looking. A well-circumscribed, firm nodule is seen in the gastric body, suggestive of a gastrointestinal stromal tumor (GIST).The patient should avoid consuming too much fat, as this can delay gastric emptying and increase the risk of reflux and polyp growth..  NA RECOMMENDATION: The patient should avoid smoking and drinking alcohol, as these habits can increase the risk of cancer.  The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and increase the risk of polyp growth. FOLLOW UP: The patient may be prescribed medication to manage any symptoms associated with the nodule, such as pain or discomfort.  The patient should avoid lying down immediately after meals, as this can increase the risk of reflux and polyp growth."
"244","Hospital Number: E8303284 , Hospital: Random NHS Foundation Trust , DOB:  1904-09-02 , General Practitioner: Dr. Mueller, Malisse  , Date of procedure:  2009-09-02Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Dysphagia/Odynophagia Nausea and/orVomiting FINDINGS: Normal gastroscopy to the duodenum. "
"245","Hospital Number: N5562828 , Hospital: Random NHS Foundation Trust , DOB:  1982-06-19 , General Practitioner: Dr. Ruiz, Jessica  , Date of procedure:  2008-09-08Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting FINDINGS: There is a nodule in the third part of the duodenum which is stalked. There is a nodule in the D1/D2 angle which is stalked. NA  The patient should be informed of the diagnosis and the importance of adhering to the recommended treatment plan.  The patient should be advised to attend all scheduled appointments and follow the treatment plan recommended by their healthcare provider."
"246","Hospital Number: V8753920 , Hospital: Random NHS Foundation Trust , DOB:  1992-11-17 , General Practitioner: Dr. Harper, Tiyessha  , Date of procedure:  2007-05-12Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  50mcg  , Midazolam  3mg  , Instrument:  FG3  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Previous gastric ulcer. repeat scope after 8 weeks. FINDINGS: The patient has an ulcer in the third part of the duodenum which is superficial.Forrest Ulcer classification: IIc.. The ulceration's irregular shape and size, along with a yellowish base, suggest a possible malignant process.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. The surrounding mucosa appears hyperemic and erythematous, consistent with active inflammation.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. Barrett's is present. Gastric mucosal prolapse seen. NA RECOMMENDATION: The patient should be advised to avoid aspirin or other blood thinners unless prescribed by a physician. RECOMMENDATION: The patient may require additional endoscopies in the future to monitor the stricture and ensure that it is not progressing.  The patient should avoid eating too quickly, as this can exacerbate the inflammation by increasing the risk of reflux and indigestion. FOLLOW UP: The patient should avoid consuming acidic foods and drinks, which can irritate the lining of the stomach and delay the healing of the ulcer. FOLLOW UP: Further investigations, such as imaging studies and blood tests, may be required to determine the underlying cause of the stricture.  The patient should be advised to avoid carbonated drinks, which can exacerbate the inflammation by increasing the production of gas."
"247","Hospital Number: L1479863 , Hospital: Random NHS Foundation Trust , DOB:  1939-08-15 , General Practitioner: Dr. Carter, Natasha  , Date of procedure:  2001-02-01Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: dypepsia FINDINGS: The lumen is found to be tight, with a degree of stenosis noted.. OGD revealed the presence of longitudinal furrows in the distal esophagus, consistent with eosinophilic oesophagitis. The esophageal mucosa appeared to be friable on endoscopic examination. The patient had crepe paper-like appearance of the oesophageal mucosa on endoscopy, suggestive of eosinophilic oesophagitis.  NA"
"248","Hospital Number: A5218459 , Hospital: Random NHS Foundation Trust , DOB:  1964-02-15 , General Practitioner: Dr. Rivera, Vanessa  , Date of procedure:  2004-04-17Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Early satiety FINDINGS: No inlet patch  was also seen.. "
"249","Hospital Number: I2777268 , Hospital: Random NHS Foundation Trust , DOB:  1922-01-15 , General Practitioner: Dr. Summerlin, Naomi  , Date of procedure:  2011-11-14Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Dysphagia/Odynophagia FINDINGS: Columnar lined oesophagus is present. No loss of aceto-whitening was seen. Some areas of vascular abnormalities are seen. Gastric mucosal prolapse seen.  NA"
"250","Hospital Number: F7726169 , Hospital: Random NHS Foundation Trust , DOB:  1948-04-08 , General Practitioner: Dr. Pollard, Jeana Brinae  , Date of procedure:  2013-05-14Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG3  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow-up oesophagitis healing FINDINGS: As an incidental finding she also has a cervical inlet patch.. NA"
"251","Hospital Number: T1978921 , Hospital: Random NHS Foundation Trust , DOB:  1995-12-12 , General Practitioner: Dr. Stone, Sabrina  , Date of procedure:  2002-05-02Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia oesophageal stricture post chemorad for scc oesophagus FINDINGS: The patient has an ulcer in the antrum which is necroticCLO test was taken.. The patient's medical history, along with the ulcer's rugose surface and irregular border, suggest a chronic inflammatory process.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization.. The patient has an ulcer in the third part of the duodenum which is induratedForrest Ulcer classification:II B.. The severe ulceration presents with a depth greater than 5 mm and an irregular border.The lesion was biopsied using a standard forceps.. The margins of the ulcer appear to be slightly raised, with a central depression.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. NA  The patient should be counseled on the importance of maintaining good oral hygiene to prevent oral bacteria from entering the ulcer site.  The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and delay the healing of the ulcer."
"252","Hospital Number: W8248560 , Hospital: Random NHS Foundation Trust , DOB:  1936-04-29 , General Practitioner: Dr. Gomez-Garza, Denis  , Date of procedure:  2012-04-11Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  125mcg  , Midazolam  1mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- EMR/ESD FINDINGS: The oesophagus is mildly dilated and shows signs of crepe paper appearance.. OGD revealed the presence of longitudinal furrows in the distal esophagus, consistent with eosinophilic oesophagitis. Endoscopy showed mild trachealisation of the esophagus, which may be consistent with EoE. The esophageal mucosa was noted to be edematous and inflamed on endoscopic evaluation.  NA"
"253","Hospital Number: O8592861 , Hospital: Random NHS Foundation Trust , DOB:  1913-11-09 , General Practitioner: Dr. el-Farrah, Haakima  , Date of procedure:  2015-11-20Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Altered taste FINDINGS: Normal gastroscopy to the duodenum. "
"254","Hospital Number: H1442477 , Hospital: Random NHS Foundation Trust , DOB:  1931-04-09 , General Practitioner: Dr. Woodie, Chloe  , Date of procedure:  2009-01-19Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Nausea and/or Vomiting Dysphagia/Odynophagia FINDINGS: LA Grade  A oesophagitis. The lower oesopahgeal sphincter looks widely patent  NA"
"255","Hospital Number: P1673382 , Hospital: Random NHS Foundation Trust , DOB:  1916-07-27 , General Practitioner: Dr. Lord, Clarissa  , Date of procedure:  2011-04-07Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  50mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Polypectomy FINDINGS: There is a polyp in the second part of the duodenum which is stalked.It has an abnormal pit pattern. The nodules are distributed throughout the duodenal bulb and descending duodenum.The polyp did not lift on saline injection and was therefore not amenable to endoscopic resection.. The patient has Barrett's oesophagus. Gastric mucosal prolapse seen. The pit pattern is normal. character(0) RECOMMENDATION: If the patient is experiencing symptoms such as vomiting or fever, they should contact their healthcare provider immediately.  The patient should avoid smoking and alcohol, which can increase the risk of developing more polyps. FOLLOW UP: If the nodule is benign, the patient may not require any treatment, but may require monitoring with regular endoscopies.  "
"256","Hospital Number: D3953088 , Hospital: Random NHS Foundation Trust , DOB:  1938-04-30 , General Practitioner: Dr. Weinmeister, Breanne  , Date of procedure:  2013-03-17Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known EOE oesophgeal biopsies FINDINGS: There is inflammation in the body which is erosive. The gastric inflammation is characterized by the presence of eosinophils and mast cells in the mucosal layer.During biopsy, it was noted that the lesion had a friable surface and bled easily..  RECOMMENDATION: If the stricture is causing symptoms such as difficulty swallowing, the patient may be referred to a speech therapist for swallowing therapy.  The patient should avoid eating too much fat, as this can exacerbate the inflammation by delaying gastric emptying and increasing the risk of reflux. FOLLOW UP: The patient may require additional endoscopies in the future to monitor the stricture and ensure that it is not progressing.  A consultation with a dietician may be beneficial to help the patient modify their diet to manage the inflammation."
"257","Hospital Number: K5760664 , Hospital: Random NHS Foundation Trust , DOB:  1944-02-10 , General Practitioner: Dr. Romero, Sondra  , Date of procedure:  2015-12-20Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - Post caustic soda ingestion - assessment of healing FINDINGS: Normal gastroscopy to the duodenum. "
"258","Hospital Number: U6704720 , Hospital: Random NHS Foundation Trust , DOB:  1940-12-17 , General Practitioner: Dr. Valdez-Dever, Natali  , Date of procedure:  2002-11-28Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Nausea and/or Vomiting FINDINGS: No inlet patch was seen.. "
"259","Hospital Number: Y1451790 , Hospital: Random NHS Foundation Trust , DOB:  1906-01-06 , General Practitioner: Dr. Santorno, Kylee  , Date of procedure:  2004-05-27Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia oesophageal stricture post chemorad for scc oesophagus FINDINGS: The patient has an ulcer in the third part of the duodenum which is hemorrhagicForrest Ulcer classification: IIc.. Signs of NSAID-induced injury are evident in the gastric ulcer, which appears to have a punched-out appearance.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. The base of the ulcer is covered in a yellowish fibrinous exudate.During biopsy, it was noted that the lesion had a friable surface and bled easily.. The patient has an ulcer in the antrum which is scarredForrest Ulcer classification: IIc.. Characterized by a distinct loss of mucosal tissue, the severe ulceration presents with a nodular surface.The ulcer was biopsied x8 for further analysis.. character(0)  The patient should be advised to avoid straining during bowel movements to reduce pressure on the ulcer site.  The patient is advised to return for a follow-up appointment in two to four weeks' time to discuss the findings and plan for further management."
"260","Hospital Number: S9523253 , Hospital: Random NHS Foundation Trust , DOB:  1964-12-28 , General Practitioner: Dr. el-Rais, Waleeda  , Date of procedure:  2008-09-29Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins weight loss. On warfarin and clopidogrel, FINDINGS: Normal gastroscopy to the duodenum. "
"261","Hospital Number: R7817343 , Hospital: Random NHS Foundation Trust , DOB:  1973-05-19 , General Practitioner: Dr. Crank, Madison  , Date of procedure:  2008-12-31Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  25mcg  , Midazolam  4mg  , Instrument:  FG1  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia FINDINGS: The patient had crepe paper oesophagitis. Whitish exudates  were also seen in the esophagus during endoscopy, suggestive of eosinophilic oesophagitis. The patient has a 4mm nodule in the fundus which is stalked. A large, ulcerated nodule with central necrosis is seen in the gastric antrum, suggestive of a gastric adenocarcinoma.The patient should be advised to stay hydrated and eat small, frequent meals to help reduce inflammation and improve symptoms.. character(0) RECOMMENDATION: The patient should be advised to avoid smoking, alcohol, and NSAIDs to reduce the risk of recurrent ulcers. RECOMMENDATION: The patient should be advised to avoid eating spicy or acidic foods, as these can irritate the gastrointestinal tract and worsen symptoms. RECOMMENDATION: If the stricture is due to a medical condition such as gastroesophageal reflux disease (GERD), the patient may be prescribed medication to manage their symptoms.  The patient should avoid lying down immediately after meals, as this can exacerbate the inflammation by increasing the risk of reflux. FOLLOW UP: The patient should be informed of the diagnosis and provided with information on how to manage the ulcer. FOLLOW UP: The patient may require additional endoscopies in the future to monitor the nodule and ensure that it is not progressing. FOLLOW UP: The patient should be advised to elevate the head of their bed by six inches to help prevent reflux at night.  The patient should be informed of the diagnosis and provided with information on how to manage the inflammation."
"262","Hospital Number: Z7781233 , Hospital: Random NHS Foundation Trust , DOB:  1995-11-09 , General Practitioner: Dr. Zhang Cheung, Joanna  , Date of procedure:  2010-06-06Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  100mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Barretts FINDINGS: The patient has inflammation in the second part of the duodenum which is erosive. There are multiple erosions and ulcers seen throughout the duodenal mucosa, suggestive of ongoing inflammation.The lesion was biopsied using a standard forceps.. There is a stricture in the stomach which is unyieldingTight stricture impassable with scope.. A gastric stricture with extramucosal compression is noted in the cardia, with a displaced and distorted appearance.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. character(0) RECOMMENDATION: The patient should be counseled on the risks and benefits of any potential treatments for their ulcer. RECOMMENDATION: The patient should be advised to avoid eating acidic or spicy foods, as these can worsen GERD symptoms.  The patient should avoid NSAIDs and aspirin, which can irritate the lining of the stomach and exacerbate the inflammation. FOLLOW UP: The patient should avoid smoking and alcohol, which can delay the healing of the ulcer and increase the risk of developing more ulcers. FOLLOW UP: The patient should be advised to avoid caffeine, as it can worsen reflux symptoms.  A repeat gastroscopy may be required in three to six months' time to monitor the progress of the inflammation."
"263","Hospital Number: G7755694 , Hospital: Random NHS Foundation Trust , DOB:  1991-11-18 , General Practitioner: Dr. Escalante-Ibarra, Jennie  , Date of procedure:  2006-09-29Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG1  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Abdominal Pain FINDINGS: Inflammatory changes seen in the oesophagus.  NA"
"264","Hospital Number: B7780911 , Hospital: Random NHS Foundation Trust , DOB:  1939-05-13 , General Practitioner: Dr. Garcia, Chase  , Date of procedure:  2003-06-13Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  125mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- EMR/ESD Oesophagus- Dysplasia FINDINGS: The patient has a 7mm nodule in the antrum which is stalked. The nodules have an abnormal pit pattern and may represent an early gastric cancer.The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the stricture.. LA Grade  D oesophagitis. The oesophageal mucosa is friable and edematous. There are scattered erosions present in the oesophageal mucosa. There is significant ulceration and bleeding present in the oesophageal mucosa. Accompanied by white exudate and a yellowish base, the gastric ulcer presents with a cobblestone appearance.During biopsy, it was noted that the lesion had a friable surface and bled easily.. character(0) RECOMMENDATION: The patient should be advised to follow a soft diet and avoid spicy or acidic foods to reduce discomfort and promote healing.  The patient should be informed of the diagnosis and the importance of adhering to the recommended treatment plan. FOLLOW UP: The patient may be prescribed medication to protect the stomach lining and reduce the risk of developing more ulcers.  If the nodule is found to be cancerous, the patient may require further imaging studies and biopsies to determine the stage of the cancer and the appropriate treatment."
"265","Hospital Number: J8821698 , Hospital: Random NHS Foundation Trust , DOB:  1973-10-13 , General Practitioner: Dr. Xiong, Eri  , Date of procedure:  2016-04-26Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  150mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow up oesophageal stricture dysphagia for recurrent dilatation FINDINGS: Columnar lined oesophagus is present. It is a long segment. There is a nodule in the fundus which is benign-looking. A well-circumscribed, firm nodule is seen in the gastric body, suggestive of a gastrointestinal stromal tumor (GIST).The patient should avoid consuming too much fat, as this can delay gastric emptying and increase the risk of reflux and polyp growth.. character(0) RECOMMENDATION: The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the nodule.  The patient may be referred to a specialist in gastrointestinal disorders for further management of the polyp. FOLLOW UP:   Further investigations such as a biopsy may be recommended to determine the type of polyp and assess the risk of cancer."
"266","Hospital Number: M8882071 , Hospital: Random NHS Foundation Trust , DOB:  1964-05-07 , General Practitioner: Dr. Okubo, Kari  , Date of procedure:  2011-09-22Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  100mcg  , Midazolam  4mg  , Instrument:  FG7  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia FINDINGS: There is a nodule in the GOJ which is benign-looking. During endoscopy, a 1.8 cm nodular lesion was detected in the oesophagus, located approximately 8 cm from the incisors. The lesion appeared to be sessile and had a regular nodular appearance.They should also be advised to avoid any nonsteroidal anti-inflammatory drugs (NSAIDs) or other medications that may irritate the esophagus..  NA  If the nodule is found to be cancerous, the patient may require further imaging studies and biopsies to determine the stage of the cancer and the appropriate treatment.  "
"267","Hospital Number: C4433311 , Hospital: Random NHS Foundation Trust , DOB:  1911-10-31 , General Practitioner: Dr. Garcia, Arissa  , Date of procedure:  2007-12-24Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  150mcg  , Midazolam  4mg  , Instrument:  FG7  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Reflux-like Symptoms/Atypical Chest Pain Abdominal Pain FINDINGS: There is a stricture in the third part of the duodenum which is fibroticTight distal stricture which would not allow passage of scope.. The duodenal stricture has a smooth and regular contour, without any signs of ulceration or erosion.The biopsy was performed using a needle biopsy forceps, with the tissue samples sent for pathological analysis.. The patient has an ulcer in the body which is scarredForrest Ulcer classification: IIc.. The patient's medical history, along with the ulcer's rugose surface and flat appearance, suggest a chronic, long-standing condition.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. NA  Endoscopic therapy with injection of epinephrine and/or placement of hemostatic clips may be necessary to achieve hemostasis in the event of active bleeding.  The patient may be prescribed medication to reduce the acidity of the stomach and promote healing of the ulcer."
"268","Hospital Number: Q1015837 , Hospital: Random NHS Foundation Trust , DOB:  1934-02-22 , General Practitioner: Dr. Carter, Chinwendu  , Date of procedure:  2005-05-13Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia low iron normal HBAnaemia/Low Iron or Vitamins FINDINGS: The patient has an ulcer in the oesophagus at 38 cm which is excavated.CLO test was taken.. The gastric lesion appears malignant with irregular borders and surrounding erythema.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. Inspection of the oesophageal ulcer reveals a diffusely inflamed and ulcerated mucosa with scattered areas of granulation tissue.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. There is a stricture in the fundus which is stiffTight distal stricture which would not allow passage of scope.. A gastric stricture with a smooth and nodular surface is observed in the cardia, suggestive of a malignant lesion.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. character(0)  The patient should be counseled on the importance of maintaining good oral hygiene to prevent oral bacteria from entering the ulcer site.  The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and delay the healing of the ulcer."
"269","Hospital Number: X2594520 , Hospital: Random NHS Foundation Trust , DOB:  1937-09-27 , General Practitioner: Dr. Nevarez Flores, Tiffani  , Date of procedure:  2016-12-17Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  150mcg  , Midazolam  7mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Bloating FINDINGS: Small hiatus hernia only. "
"270","Hospital Number: E6158591 , Hospital: Random NHS Foundation Trust , DOB:  1926-04-02 , General Practitioner: Dr. el-Khalili, Tayyiba  , Date of procedure:  2003-09-16Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"271","Hospital Number: N9571333 , Hospital: Random NHS Foundation Trust , DOB:  1917-05-22 , General Practitioner: Dr. al-Karam, Hamna  , Date of procedure:  2016-09-23Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  75mcg  , Midazolam  4mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"272","Hospital Number: V3328807 , Hospital: Random NHS Foundation Trust , DOB:  1966-11-14 , General Practitioner: Dr. Suriwong, Jessica  , Date of procedure:  2005-02-17Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  12.5mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Positive coeliac FINDINGS: There is a polyp in the antrum which is sessile.It has a normal pit pattern. The gastric polyp appears adenomatous with a villous or tubular structure and high-grade dysplasia.The polyp was removed with a combination of snare and forceps, and hemostasis was achieved with an endoscopic clip.. OESOPHAGUS: Normal apart from small hiatus hernia.. NA  The patient should avoid smoking and alcohol, which can increase the risk of developing more polyps.  "
"273","Hospital Number: L2721400 , Hospital: Random NHS Foundation Trust , DOB:  1946-01-31 , General Practitioner: Dr. Romero, Sylvia  , Date of procedure:  2008-10-30Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG1  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Epigastric pain. Previously on asprin for Cerebral infarction FINDINGS: There is an ulcer in the third part of the duodenum which is crateredIt has a visible vessel. Accompanied by white exudate and a cobblestone appearance, the gastric ulcer is likely caused by Helicobacter pylori infection.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. Upon endoscopic examination, a duodenal ulcer is visible at the angle of the duodenum.The biopsy was performed using a needle biopsy forceps, with the tissue samples sent for pathological analysis..  character(0)  Surgical intervention may be necessary in the event of complications such as perforation or obstruction.  The patient should be advised to avoid consuming caffeine, which can stimulate the production of stomach acid and delay the healing of the ulcer."
"274","Hospital Number: A9747574 , Hospital: Random NHS Foundation Trust , DOB:  1917-08-06 , General Practitioner: Dr. Pan, Poulami  , Date of procedure:  2001-03-25Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  25mcg  , Midazolam  4mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Endoscopic ultrasound findings: Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"275","Hospital Number: I9081757 , Hospital: Random NHS Foundation Trust , DOB:  1928-09-18 , General Practitioner: Dr. Sanchez, Cynthia  , Date of procedure:  2011-03-02Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"276","Hospital Number: F6090839 , Hospital: Random NHS Foundation Trust , DOB:  1994-10-12 , General Practitioner: Dr. al-Abu, Laaiqa  , Date of procedure:  2012-09-08Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Gastric ucers with hy pylori. FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"")."
"277","Hospital Number: T7480285 , Hospital: Random NHS Foundation Trust , DOB:  1909-05-31 , General Practitioner: Dr. Merchant, Marquise  , Date of procedure:  2003-04-16Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  125mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Weight Loss Anaemia/Low Iron or Vitamins FINDINGS: The patient has a 8mm nodule in the second part of the duodenum which is sessile. OESOPHAGUS: small hiatus hernia.. NA  The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent further damage to the gastrointestinal tract.  The patient may be prescribed medication to reduce the size of the nodule and prevent it from growing."
"278","Hospital Number: W2054819 , Hospital: Random NHS Foundation Trust , DOB:  1991-02-03 , General Practitioner: Dr. Seeber, Rachelle  , Date of procedure:  2016-04-15Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Dyspepsia FINDINGS: LA Grade  C oesophagitis. The oesophageal mucosa is friable and edematous. Gastric mucosal prolapse also seen severe oesophagitis with ulceration. Signs of NSAID-induced injury are evident in the gastric ulcer, which appears to have a punched-out appearance.During biopsy, it was noted that the lesion had a friable surface and bled easily.. There is a polyp in the D1/D2 angle which is stalked.It has a normal pit pattern. character(0) RECOMMENDATION: The patient should be counseled on the importance of maintaining good oral hygiene to prevent oral bacteria from entering the ulcer site.  Further investigations such as a biopsy may be recommended to determine the type of polyp and assess the risk of cancer. FOLLOW UP: Further investigations such as a biopsy may be recommended to determine the cause of the ulcer and assess the risk of cancer.  The patient should be informed of the diagnosis and provided with information on how to manage the polyp."
"279","Hospital Number: O8834134 , Hospital: Random NHS Foundation Trust , DOB:  1923-09-10 , General Practitioner: Dr. Dominguez, Alicia  , Date of procedure:  2003-02-25Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG6  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Other-assess stents FINDINGS: Normal gastroscopy to the duodenum. "
"280","Hospital Number: H6820128 , Hospital: Random NHS Foundation Trust , DOB:  1931-01-02 , General Practitioner: Dr. Ball, Ashlyn  , Date of procedure:  2003-07-24Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Eosinophilic oesophatitis assessment FINDINGS: Oesophagus normal with no hiatus hernia.. "
"281","Hospital Number: P4350826 , Hospital: Random NHS Foundation Trust , DOB:  1931-12-11 , General Practitioner: Dr. Lopez, Chelsea  , Date of procedure:  2002-04-17Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  125mcg  , Midazolam  1mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Other-BloatingAbdominal Pain FINDINGS: LA Grade  A oesophagitis. The oesophageal mucosa is friable and edematous.  NA"
"282","Hospital Number: D5429386 , Hospital: Random NHS Foundation Trust , DOB:  1996-09-04 , General Practitioner: Dr. Reddy, Chau  , Date of procedure:  2003-04-19Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG1  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia   post oesophagectomy FINDINGS: Columnar lined oesophagus is present. No abnormal pit pattern is seen. Some areas of vascular abnormalities are seen.  NA"
"283","Hospital Number: K5870127 , Hospital: Random NHS Foundation Trust , DOB:  1916-01-28 , General Practitioner: Dr. Deguire, Caitlyn  , Date of procedure:  2002-11-22Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Gastric ucers with hy pylori. FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"")."
"284","Hospital Number: U3081246 , Hospital: Random NHS Foundation Trust , DOB:  1923-11-07 , General Practitioner: Dr. Cha, Grace  , Date of procedure:  2013-04-26Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Abdominal Pain FINDINGS: Columnar lined oesophagus is present. No loss of aceto-whitening  was also seen. The patient has a polyp in the second part of the duodenum which is stalked with a normal pit pattern. The nodular lesions are noted to have a pale appearance on narrow-band imaging, consistent with lymphoid tissue.The base of the polyp was fulgurated with an electrocautery device to prevent future bleeding or regrowth.. NA  A repeat gastroscopy may be recommended in twelve months' time to assess the response to treatment.  The patient should be advised to avoid consuming alcohol, which can increase the risk of developing more polyps."
"285","Hospital Number: Y1506215 , Hospital: Random NHS Foundation Trust , DOB:  1992-11-02 , General Practitioner: Dr. Mahat, Gabriella  , Date of procedure:  2004-10-24Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  150mcg  , Midazolam  2mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - exclude Lynch and coeliac FINDINGS: Lax cardia with small hiatus hernia. "
"286","Hospital Number: S7145991 , Hospital: Random NHS Foundation Trust , DOB:  1967-11-12 , General Practitioner: Dr. Peil, Samantha  , Date of procedure:  2001-10-12Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia . FINDINGS: Normal gastroscopy to the duodenum. "
"287","Hospital Number: R9404908 , Hospital: Random NHS Foundation Trust , DOB:  1970-09-21 , General Practitioner: Dr. al-Salman, Urwa  , Date of procedure:  2011-04-08Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  150mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Early satiety FINDINGS: Normal gastroscopy to the duodenum. "
"288","Hospital Number: Z6151451 , Hospital: Random NHS Foundation Trust , DOB:  1979-04-17 , General Practitioner: Dr. Suarez, Kristen  , Date of procedure:  2013-07-16Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia RegurgitationReflux-like Symptoms/Atypical Chest Pain FINDINGS: There is a polyp in the stomach which is sessile with a normal pit pattern. Multiple gastric polyps are seen in the antrum, with a clustered distribution and variable surface contour.The polyp was removed with minimal thermal injury to surrounding tissue using a cold snare technique.. Columnar lined oesophagus is present. No nodularity is present. It is a long segment. The segment looks flat. character(0)    The patient may be prescribed medication to reduce the risk of developing more polyps."
"289","Hospital Number: G1498153 , Hospital: Random NHS Foundation Trust , DOB:  1959-01-09 , General Practitioner: Dr. Parent, Rebecca  , Date of procedure:  2005-06-23Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG1  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Dilatation Nausea and/or Vomiting FINDINGS: There is a stricture in the stomach which is unyieldingTight stricture impassable with scope.. A gastric stricture with extramucosal compression is noted in the cardia, with a displaced and distorted appearance.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. "
"290","Hospital Number: B8969666 , Hospital: Random NHS Foundation Trust , DOB:  1979-02-18 , General Practitioner: Dr. Richardville, Jessica  , Date of procedure:  2013-11-22Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  125mcg  , Midazolam  5mg  , Instrument:  FG3  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia   post oesophagectomy FINDINGS: There is a cervical inlet patch of dubious significance.. character(0)"
"291","Hospital Number: J1819477 , Hospital: Random NHS Foundation Trust , DOB:  1915-10-06 , General Practitioner: Dr. Miao, Sara  , Date of procedure:  2005-11-19Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG1  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Barretts FINDINGS: There is inflammation in the stomach which is erosive. Erythematous patches with focal ulceration are noted in the gastric antrum, suggestive of acute erosive gastritis.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample..  character(0) RECOMMENDATION: Referral to a registered dietitian may be helpful in providing guidance on a healthy, ulcer-friendly diet. RECOMMENDATION:    FOLLOW UP: The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools. FOLLOW UP: The patient should avoid smoking and drinking alcohol, as these habits can worsen GERD symptoms.  Further investigations such as a biopsy may be recommended to determine the underlying cause of the inflammation."
"292","Hospital Number: M8863036 , Hospital: Random NHS Foundation Trust , DOB:  1980-08-07 , General Practitioner: Dr. Jobes, Inna  , Date of procedure:  2016-10-01Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Weight Loss FINDINGS: There is a polyp in the GOJ which is sessile.It has a normal pit pattern. A polypoid, solid lesion is observed in the mid-esophagus, suggestive of an esophageal adenoma.Under endoscopic visualization, the polyp was removed using EMR..  character(0)  The patient should be advised to eat slowly and chew their food thoroughly to aid digestion and reduce the risk of polyp growth.  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and polyp growth."
"293","Hospital Number: C4021112 , Hospital: Random NHS Foundation Trust , DOB:  1956-04-25 , General Practitioner: Dr. Foster, Daisha  , Date of procedure:  2001-09-26Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  150mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Abdominal Pain FINDINGS: There is inflammation in the oesophagus at 27 cm which is mild. There are multiple raised, nodular areas of mucosa, suggestive of granulomatous inflammation.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. There is an ulcer in the second part of the duodenum which is excavated.Forrest Ulcer classification: IIc.. Accompanied by white exudate and a yellowish base, the gastric ulcer presents with a cobblestone appearance.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. The base of the ulcer is covered in a yellowish fibrinous exudate.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. NA RECOMMENDATION: The patient should be advised to avoid straining during bowel movements to reduce pressure on the ulcer site. RECOMMENDATION: The patient should be advised to avoid wearing tight clothing around their waist, as this can put pressure on the stomach and worsen GERD symptoms.  The patient should avoid lying down immediately after meals, as this can exacerbate the inflammation by increasing the risk of reflux. FOLLOW UP: The patient should be informed of the diagnosis and provided with information on how to manage the ulcer. FOLLOW UP: The patient should avoid eating or drinking for at least six hours before any scheduled appointments.  The patient should avoid eating too quickly, as this can exacerbate the inflammation by increasing the risk of reflux and indigestion."
"294","Hospital Number: Q8222665 , Hospital: Random NHS Foundation Trust , DOB:  1911-02-25 , General Practitioner: Dr. Hill, Grace  , Date of procedure:  2011-07-01Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Longstanding history of IDA and high eosinophilis in blood. upper abdo pain /alternatin diarhoea/constipaton FINDINGS: There is an ulcer in the body which is deep with rolled edges. Signs of NSAID-induced injury are evident in the gastric ulcer, which appears to have a punched-out appearance.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample..   Close monitoring of the patient's blood pressure and fluid balance may be necessary in the event of significant bleeding from the ulcer.  The patient should be advised to avoid consuming caffeine, which can stimulate the production of stomach acid and delay the healing of the ulcer."
"295","Hospital Number: X5836068 , Hospital: Random NHS Foundation Trust , DOB:  1918-03-10 , General Practitioner: Dr. al-Samaan, Warda  , Date of procedure:  2005-07-04Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Post oesophagectomy for Pagets FINDINGS: There is a cervical inlet patch of dubious significance.. character(0)"
"296","Hospital Number: E8902521 , Hospital: Random NHS Foundation Trust , DOB:  1991-03-12 , General Practitioner: Dr. Jordan, Madisen  , Date of procedure:  2009-08-17Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG5  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - VCE placement (previous gastric bypass)Anaemia/Low Iron or Vitamins FINDINGS: Normal gastroscopy to the duodenum. "
"297","Hospital Number: N7405188 , Hospital: Random NHS Foundation Trust , DOB:  1975-07-18 , General Practitioner: Dr. Howe, Allegra  , Date of procedure:  2008-07-02Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia FINDINGS: There is a polyp in the D1/D2 angle which is sessile.It has an abnormal pit pattern.   The patient should avoid smoking and alcohol, which can increase the risk of developing more polyps.  The patient should be advised to avoid acidic foods and drinks, which can irritate the lining of the stomach and increase the risk of developing more polyps."
"298","Hospital Number: V9378773 , Hospital: Random NHS Foundation Trust , DOB:  1957-05-08 , General Practitioner: Dr. Smith, Kayla  , Date of procedure:  2008-07-19Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG6  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- RFA Therapeutic- EMR/ESD FINDINGS: LA Grade  C oesophagitis. Gastric mucosal prolapse also seen The patient has a stricture in the fundus which is ulceratedTight distal stricture which would not allow passage of scope.. The gastric lesion exhibits an irregular shape and size, with a raised edge and depth greater than 5 mm.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. The gastric stricture is located in the body of the stomach, causing narrowing of the lumen.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. character(0)  The patient should be instructed to avoid hot beverages and foods to prevent further irritation to the ulcer.  The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools."
"299","Hospital Number: L6117442 , Hospital: Random NHS Foundation Trust , DOB:  1968-08-23 , General Practitioner: Dr. el-Mattar, Amaani  , Date of procedure:  2011-08-03Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  12.5mcg  , Midazolam  5mg  , Instrument:  FG3  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Haematemesis or Melaena/Blood PR FINDINGS: No evidence of inlet patch on careful inspection.. "
"300","Hospital Number: A3669324 , Hospital: Random NHS Foundation Trust , DOB:  1996-02-01 , General Practitioner: Dr. Weiss, Tisa  , Date of procedure:  2012-03-31Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Post oesophagectomy for Pagets FINDINGS: Normal gastroscopy to the duodenum. NA"
"301","Hospital Number: O8583042 , Hospital: Random NHS Foundation Trust , DOB:  1915-08-28 , General Practitioner: Dr. Shuler, Brejona  , Date of procedure:  2016-08-15Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  25mcg  , Midazolam  3mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow up oesophageal stricture dysphagia for recurrent dilatation FINDINGS: Normal gastroscopy to the duodenum. character(0)"
"302","Hospital Number: H2587908 , Hospital: Random NHS Foundation Trust , DOB:  1948-10-06 , General Practitioner: Dr. al-Badour, Raabia  , Date of procedure:  2008-10-03Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG2  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"")."
"303","Hospital Number: P9907275 , Hospital: Random NHS Foundation Trust , DOB:  1949-02-16 , General Practitioner: Dr. al-El-Sayed, Mujaahida  , Date of procedure:  2012-09-14Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  25mcg  , Midazolam  5mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Dyspepsia FINDINGS: The patient has an ulcer in the stomach which is induratedIt has rolled edges. The flat surface with no elevation and thickened border of the ulcer suggests a chronic, long-standing condition.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding..   The patient should be counseled on the importance of maintaining good oral hygiene to prevent oral bacteria from entering the ulcer site.  "
"304","Hospital Number: D9990587 , Hospital: Random NHS Foundation Trust , DOB:  1911-12-03 , General Practitioner: Dr. Gaonkar, Kaitlin  , Date of procedure:  2010-04-11Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Dyspepsia FINDINGS: Barrett's is present. No abnormal pit pattern is seen. The segment looks flat. "
"305","Hospital Number: K9010769 , Hospital: Random NHS Foundation Trust , DOB:  1930-10-19 , General Practitioner: Dr. Parker, Calli  , Date of procedure:  2011-02-27Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  25mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss FINDINGS: Normal gastroscopy to the duodenum. "
"306","Hospital Number: U5728377 , Hospital: Random NHS Foundation Trust , DOB:  1922-08-10 , General Practitioner: Dr. al-Younan, Tharwa  , Date of procedure:  2001-09-12Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  125mcg  , Midazolam  4mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain x1 hematemesis Crohns colitis FINDINGS: There is an ulcer in the oesophagus at 35 cm which is exudativeIt has a visible vessel. Accompanied by white exudate and a yellowish base, the gastric ulcer presents with a cobblestone appearance.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. The oesophageal ulcer exhibits a punched-out appearance, suggestive of a peptic ulcer disease etiology.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. There is a stricture in the duodenal bulb which is unyieldingThe endoscope passed through the stricture with resistance. The stricture appears to be extraluminal in nature, with no evidence of intraluminal obstruction.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. character(0)  The patient should be advised to avoid aspirin or other blood thinners unless prescribed by a physician.  The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and delay the healing of the ulcer."
"307","Hospital Number: Y3424765 , Hospital: Random NHS Foundation Trust , DOB:  1965-01-18 , General Practitioner: Dr. Quint, Rylie  , Date of procedure:  2015-06-03Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  100mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Dysphagia/Odynophagia Nausea and/orVomiting FINDINGS: There is inflammation in the body which is severe. The gastric inflammation is accompanied by hyperemia and petechiae on the mucosal surface.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury..  RECOMMENDATION: The patient should be advised to avoid lying down for at least three hours after eating to help prevent reflux.   FOLLOW UP: The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the stricture.  The patient should be informed of the diagnosis and provided with information on how to manage the inflammation."
"308","Hospital Number: S9335497 , Hospital: Random NHS Foundation Trust , DOB:  1991-12-01 , General Practitioner: Dr. Hanratty, Carina  , Date of procedure:  2005-11-21Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Longstanding history of IDA and high eosinophilis in blood. upper abdo pain /alternatin diarhoea/constipaton FINDINGS: There is a stricture in the body which is fibroticTight distal stricture which would not allow passage of scope.. A circumferential gastric stricture with an overlying mucosal lesion is seen in the fundus, suggestive of a malignant tumor.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample.. The patient has a stricture in the stomach which is OedematousScope not held by stricture. A gastric stricture with a smooth and nodular surface is observed in the cardia, suggestive of a malignant lesion.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization.. NA"
"309","Hospital Number: R3233951 , Hospital: Random NHS Foundation Trust , DOB:  1985-05-31 , General Practitioner: Dr. al-Yasin, Faraah  , Date of procedure:  2011-11-21Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Altered taste FINDINGS: There is a nodule in the second part of the duodenum which is sessile. There is inflammation in the body which is severe. The gastric inflammation is accompanied by hyperemia and petechiae on the mucosal surface.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. NA RECOMMENDATION: A follow-up appointment with the gastroenterologist should be scheduled for six months after the initial diagnosis to monitor the patient's progress. RECOMMENDATION: The patient may be prescribed an H2 blocker to reduce stomach acid production and prevent reflux.  A proton pump inhibitor medication may be prescribed to manage the inflammation. FOLLOW UP: The patient may be referred to a nutritionist to develop a diet plan that is easier to digest and that meets their nutritional needs. FOLLOW UP: The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the stricture.  The patient should be advised to avoid consuming too much sugar, as this can exacerbate the inflammation by increasing the risk of bacterial overgrowth in the stomach."
"310","Hospital Number: Z3118534 , Hospital: Random NHS Foundation Trust , DOB:  1913-05-24 , General Practitioner: Dr. Rodriguez, Cindy  , Date of procedure:  2012-04-17Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Weight Loss Reflux-like Symptoms/Atypical Chest Pain FINDINGS: No evidence of inlet patch on careful inspection.. "
"311","Hospital Number: G7303882 , Hospital: Random NHS Foundation Trust , DOB:  1934-10-15 , General Practitioner: Dr. Bishop, Hana  , Date of procedure:  2013-11-29Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: dypepsia FINDINGS: The patient's oesophagus is noted to have linear furrowing.. The patient has an ulcer in the duodenal bulb which is scarredIt has a visible vessel. The gastric ulcer exhibits signs of NSAID-induced injury, with a fibrous base and punched-out appearance.The ulcer was biopsied x8 for further analysis.. The surrounding mucosa appears to be friable and prone to bleeding upon contact.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample.. character(0)  Follow-up endoscopy should be performed in 4-6 weeks to assess for healing and to repeat biopsies if necessary.  "
"312","Hospital Number: B2496144 , Hospital: Random NHS Foundation Trust , DOB:  1952-10-25 , General Practitioner: Dr. Garrett, Brandy  , Date of procedure:  2001-01-20Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Nausea and/or Vomiting FINDINGS: A large hiatus hernia is present. "
"313","Hospital Number: J9928505 , Hospital: Random NHS Foundation Trust , DOB:  1991-07-07 , General Practitioner: Dr. Miles, Sara  , Date of procedure:  2006-05-16Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG2  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CD FINDINGS: The patient has a 8mm nodule in the antrum which is stalked. A small, solid nodule is seen in the gastric antrum, suggestive of a gastric schwannoma.The patient should avoid eating large meals and should instead eat smaller, more frequent meals throughout the day.. The patient has a stricture in the third part of the duodenum which is scleroticIt will not allow the scope to pass.. The duodenal mucosa proximal to the stricture appears slightly erythematous, while the distal mucosa appears normal.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. character(0)    The patient should avoid eating fried or fatty foods, as these can increase the risk of reflux and further damage to the gastrointestinal tract."
"314","Hospital Number: M7832839 , Hospital: Random NHS Foundation Trust , DOB:  1938-03-16 , General Practitioner: Dr. Bost, Jewel  , Date of procedure:  2002-07-12Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  150mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Barretts FINDINGS: No inlet patch was seen on narrow band imaging.. "
"315","Hospital Number: C1538169 , Hospital: Random NHS Foundation Trust , DOB:  1966-11-28 , General Practitioner: Dr. Simpson, Desana  , Date of procedure:  2005-06-03Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Post oesophagectomy for Pagets FINDINGS: The patient has inflammation in the stomach which is erosive. The gastric mucosa appears thickened and edematous, with areas of ulceration and hemorrhage, suggestive of chronic atrophic gastritis.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. NA RECOMMENDATION: Follow-up endoscopy should be performed in 4-6 weeks to assess for healing and to repeat biopsies if necessary. RECOMMENDATION: If the stricture is due to a medical condition such as gastroesophageal reflux disease (GERD), the patient may be prescribed medication to manage their symptoms.  The patient may be referred to a gastroenterologist for further management of the inflammation. FOLLOW UP: The patient should avoid smoking and alcohol, which can delay the healing of the ulcer and increase the risk of developing more ulcers. FOLLOW UP: The patient should be advised to avoid wearing tight clothing around their waist, as this can put pressure on the stomach and worsen GERD symptoms.  The patient should follow a strict diet and avoid irritants that can exacerbate the inflammation."
"316","Hospital Number: Q6090326 , Hospital: Random NHS Foundation Trust , DOB:  1911-06-23 , General Practitioner: Dr. Moreno-Quezada, Jessica  , Date of procedure:  2012-01-02Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Gastric ucers with hy pylori. FINDINGS: Normal gastroscopy to the duodenum. "
"317","Hospital Number: X8881813 , Hospital: Random NHS Foundation Trust , DOB:  1947-11-17 , General Practitioner: Dr. el-Ebrahimi, Sitaara  , Date of procedure:  2015-10-18Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Weight Loss Reflux-like Symptoms/Atypical Chest Pain FINDINGS: The patient has a 6mm nodule in the GOJ which is stalked. The oesophageal ulcer is characterized by a fibrinous exudate overlying a deep, ulcerated base.The patient should be advised to avoid lifting heavy objects or engaging in strenuous physical activity, as this can increase the risk of bleeding in the gastrointestinal tract.. There is an ulcer in the oesophagus at 23 cm which is excavated with a visible vessel. The gastric ulcer presents with an irregular border and a fibrous base, suggestive of NSAID-induced injury.During biopsy, it was noted that the lesion had a friable surface and bled easily.. The oesophageal ulcer exhibits a friable, hemorrhagic surface with surrounding erythema and exudate, suggestive of an infectious process.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. NA RECOMMENDATION: Proton pump inhibitors may be prescribed to reduce gastric acid production and promote ulcer healing.  The patient should be advised to seek emotional support from friends, family, or a counselor, as the diagnosis of cancer can be difficult to cope with. FOLLOW UP: The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more ulcers.  If the nodule is benign, the patient may not require any treatment, but may require monitoring with regular endoscopies."
"318","Hospital Number: E5760181 , Hospital: Random NHS Foundation Trust , DOB:  1963-10-30 , General Practitioner: Dr. Dixit, Rebecca  , Date of procedure:  2007-12-25Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Ongoing reflux symptoms. FINDINGS: There is a nodule in the stomach which is sessile. A nodular lesion with surrounding erythema and exudates is seen in the gastric fundus, suggestive of a malignant gastric neoplasm.A proton pump inhibitor medication may be prescribed to manage the inflammation..  NA RECOMMENDATION:  RECOMMENDATION: If the patient is experiencing symptoms such as vomiting or fever, they should contact their healthcare provider immediately.  The patient should be informed of the diagnosis and provided with information on how to manage the inflammation. FOLLOW UP: The patient should avoid drinking alcohol, as this can increase the risk of bleeding in the gastrointestinal tract. FOLLOW UP: The patient should be advised to avoid wearing tight clothing around their waist, as this can put pressure on the stomach and worsen GERD symptoms.  A barium swallow study may be ordered to assess the extent of the inflammation."
"319","Hospital Number: N3482935 , Hospital: Random NHS Foundation Trust , DOB:  1968-07-17 , General Practitioner: Dr. al-Hammad, Sumbula  , Date of procedure:  2009-08-16Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  100mcg  , Midazolam  1mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow-up oesophagitis healing FINDINGS: Normal gastroscopy to the duodenum. character(0)"
"320","Hospital Number: V6466799 , Hospital: Random NHS Foundation Trust , DOB:  1949-12-27 , General Practitioner: Dr. Mendoza Rios, Emily  , Date of procedure:  2015-12-10Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Reduced appetite early satiety FINDINGS: Columnar lined oesophagus is present. No loss of aceto-whitening  was also seen. There is a nodule in the D1/D2 angle which is benign-looking. character(0)  The patient should avoid smoking and drinking alcohol, as these habits can increase the risk of cancer.  A follow-up appointment with the gastroenterologist should be scheduled for six months after the initial diagnosis to monitor the patient's progress."
"321","Hospital Number: L2151400 , Hospital: Random NHS Foundation Trust , DOB:  1986-07-08 , General Practitioner: Dr. Mestas, Erin  , Date of procedure:  2007-09-20Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Chemorad for scc middle third of oeosphagus - post treatment assessement FINDINGS: There is a polyp in the fundus which is sessile.It has a normal pit pattern. The gastric polyp appears as a sessile growth on the mucosal surface, with a smooth and regular contour.Endoscopic mucosal resection was performed to remove the polyp in its entirety.. No evidence of inlet patch on careful inspection.. character(0)  The patient may be prescribed medication to reduce the risk of developing more polyps.  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and polyp growth."
"322","Hospital Number: A3080284 , Hospital: Random NHS Foundation Trust , DOB:  1944-05-15 , General Practitioner: Dr. el-Azzam, Rashaa  , Date of procedure:  2007-04-28Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: High Dysphagia further assessment of previoius diagnosed peptic stricture also recent eus and aspirat of bengn perigastric cyst FINDINGS: There is inflammation in the stomach which is severe. The gastric inflammation appears to be associated with the use of proton pump inhibitors (PPIs), with the presence of rebound hypergastrinemia.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling..  RECOMMENDATION: The patient should be advised to avoid eating acidic or spicy foods, as these can worsen GERD symptoms.  The patient should be advised to avoid caffeine, which can stimulate the production of stomach acid and exacerbate the inflammation. FOLLOW UP: The patient should avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as these can worsen GERD symptoms.  The patient should avoid smoking and alcohol, which can worsen the inflammation."
"323","Hospital Number: I7491657 , Hospital: Random NHS Foundation Trust , DOB:  1932-12-02 , General Practitioner: Dr. Jain, Alexandra  , Date of procedure:  2003-05-09Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Nausea and/or Vomiting FINDINGS: The patient has a polyp in the duodenal bulb which is stalked with an abnormal pit pattern. The nodular lesions appear to be inflammatory in nature, without any features suggestive of neoplasia.The base of the polyp was fulgurated with an electrocautery device to prevent future bleeding or regrowth..  character(0)  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and polyp growth.  The patient should be advised to avoid acidic foods and drinks, which can irritate the lining of the stomach and increase the risk of developing more polyps."
"324","Hospital Number: F8022001 , Hospital: Random NHS Foundation Trust , DOB:  1916-05-27 , General Practitioner: Dr. el-Shaheed, Mufeeda  , Date of procedure:  2005-02-16Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abnormal Imaging FINDINGS: Normal gastroscopy to the duodenum. "
"325","Hospital Number: T4904215 , Hospital: Random NHS Foundation Trust , DOB:  1984-04-09 , General Practitioner: Dr. Mckay, Mariah  , Date of procedure:  2002-12-04Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss CHRONIC DIARRHOEA-biopsies needed Nausea and/or Vomiting FINDINGS: The patient has an ulcer in the body which is crateredCLO test  was also taken.. The severe ulceration presents with a depth greater than 5 mm and an irregular border.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding..   The patient should be instructed to avoid caffeine and carbonated beverages to reduce discomfort and promote healing.  "
"326","Hospital Number: W8932372 , Hospital: Random NHS Foundation Trust , DOB:  1924-03-25 , General Practitioner: Dr. Laner, Brandi  , Date of procedure:  2016-04-08Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  150mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Food bolus/foreign body removal FINDINGS: Normal gastroscopy to the duodenum. "
"327","Hospital Number: O7967929 , Hospital: Random NHS Foundation Trust , DOB:  1904-12-29 , General Practitioner: Dr. Williams, Jozlyn  , Date of procedure:  2013-06-20Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  125mcg  , Midazolam  1mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Anaemia/Low Iron or Vitamins FINDINGS: The patient has an ulcer in the third part of the duodenum which is hemorrhagicIt is bleeding. The gastric lesion appears malignant, accompanied by active bleeding and a punched-out appearance.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. Upon endoscopic examination, a duodenal ulcer is visible at the angle of the duodenum.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. There is a polyp in the fundus which is sessile with a normal pit pattern. A gastric polyp is noted in the cardia, with a thickened stalk and papillary surface.Using a snare, the polyp was excised and retrieved for pathologic analysis.. NA RECOMMENDATION: Follow-up endoscopy with surveillance biopsies may be necessary for patients with a history of gastric ulcer or increased risk for malignancy.   FOLLOW UP: The patient should be advised to avoid hot, spicy foods, which can irritate the lining of the stomach and delay the healing of the ulcer.  The patient should follow a healthy diet and lifestyle to reduce the risk of developing more polyps."
"328","Hospital Number: H3844577 , Hospital: Random NHS Foundation Trust , DOB:  1901-05-11 , General Practitioner: Dr. Robirds, Ashley  , Date of procedure:  2016-11-21Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Weight Loss FINDINGS: There is a polyp in the D1/D2 angle which is stalked.It has an abnormal pit pattern.   The patient should be informed of the diagnosis and provided with information on how to manage the polyp.  "
"329","Hospital Number: P4236233 , Hospital: Random NHS Foundation Trust , DOB:  1993-09-28 , General Practitioner: Dr. Stasinos, Amber  , Date of procedure:  2015-09-29Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Other-assess stents FINDINGS: Normal gastroscopy to the duodenum. "
"330","Hospital Number: D4826904 , Hospital: Random NHS Foundation Trust , DOB:  1981-10-09 , General Practitioner: Dr. Slaugh, Yeon  , Date of procedure:  2004-05-20Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Previous gastric ulcer. repeat scope after 8 weeks. FINDINGS: The oesophagus demonstrates concentric rings, as well as a corrugated, or feline appearance.. The patient has a polyp in the fundus which is stalked.It has a normal pit pattern. A solitary gastric polyp is noted in the body, with a sessile attachment and nodular surface.Using a snare, the polyp was excised and retrieved for pathologic analysis.. NA RECOMMENDATION: The patient should be advised to avoid hot spices, sauces, and acidic foods to reduce discomfort and promote healing.  The patient should be advised to avoid hot, spicy foods, which can irritate the lining of the stomach and increase the risk of polyp growth. FOLLOW UP: The patient should avoid consuming acidic foods and drinks, which can irritate the lining of the stomach and delay the healing of the ulcer.  "
"331","Hospital Number: K8847627 , Hospital: Random NHS Foundation Trust , DOB:  1977-10-16 , General Practitioner: Dr. Trower, Kimberly  , Date of procedure:  2015-07-28Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  150mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal bloating chest discomfort reflux.Known fibromyalgia RA FINDINGS: The patient has a 10mm nodule in the GOJ which is benign-looking. A small, solid nodule is seen in the proximal esophagus, suggestive of an esophageal schwannoma.The patient should be advised to avoid eating acidic or spicy foods, as these can worsen GERD symptoms.. The patient has Barrett's oesophagus. The pit pattern is normal. character(0)  Further investigations, such as imaging studies and biopsy, may be required to determine the nature of the nodule.  The patient should be advised to avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as these can increase the risk of bleeding in the gastrointestinal tract."
"332","Hospital Number: U8525559 , Hospital: Random NHS Foundation Trust , DOB:  1983-10-15 , General Practitioner: Dr. el-Nasir, Zubaida  , Date of procedure:  2013-10-05Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  25mcg  , Midazolam  7mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Grade D oesophagitis healing. Previous duodenal ulcer FINDINGS: No cervical inlet patch.. character(0)  Referral to a gastroenterologist for further evaluation and management of the ulcer is recommended.  The patient should follow a healthy diet and lifestyle to reduce the risk of developing more ulcers."
"333","Hospital Number: Y5602439 , Hospital: Random NHS Foundation Trust , DOB:  1952-11-01 , General Practitioner: Dr. Yang, Maya  , Date of procedure:  2010-01-19Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- RFA Other GAVE FINDINGS: Normal gastroscopy to the duodenum. "
"334","Hospital Number: S6682774 , Hospital: Random NHS Foundation Trust , DOB:  1931-09-15 , General Practitioner: Dr. Ngo, Kathryn  , Date of procedure:  2010-09-22Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  150mcg  , Midazolam  1mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: IDA FINDINGS: Normal gastroscopy to the duodenum. "
"335","Hospital Number: R6103760 , Hospital: Random NHS Foundation Trust , DOB:  1910-12-13 , General Practitioner: Dr. Weiss, Kendra  , Date of procedure:  2006-01-09Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG5  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- persumed per DU managed conservativelyPrevious persumed DU ulcer managed conservatively. FINDINGS: The patient has a polyp in the third part of the duodenum which is stalked with a normal pit pattern. The nodular lesions appear to be sessile, with a smooth surface and regular contour.Due to its large size, the polyp was not able to be resected during the current endoscopic session..  character(0) RECOMMENDATION: The patient should be instructed to avoid tight-fitting clothing to reduce pressure on the ulcer site.  A colonoscopy may be ordered to assess for the presence of polyps in the colon and rectum. FOLLOW UP:   The patient is advised to return for a follow-up appointment in four to six weeks' time to discuss the findings and plan for further management."
"336","Hospital Number: Z1272661 , Hospital: Random NHS Foundation Trust , DOB:  1984-12-24 , General Practitioner: Dr. Cifelli, Mia  , Date of procedure:  2007-01-06Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: High Dysphagia further assessment of previoius diagnosed peptic stricture also recent eus and aspirat of bengn perigastric cyst FINDINGS: There is inflammation in the second part of the duodenum which is erosive. The duodenal mucosa appears to have a rough and patchy surface, suggestive of inflammation.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. There is inflammation in the body which is mild. The gastric mucosa appears diffusely erythematous with no distinct erosions, suggestive of superficial gastritis.During biopsy, it was noted that the lesion had a friable surface and bled easily.. NA RECOMMENDATION: The patient should avoid smoking and drinking alcohol, as these habits can worsen GERD symptoms.   FOLLOW UP: The patient should be advised to chew their food thoroughly and to eat slowly to help prevent swallowing difficulties.  The patient should avoid eating before bedtime, as this can exacerbate the inflammation by increasing the risk of reflux."
"337","Hospital Number: G2227671 , Hospital: Random NHS Foundation Trust , DOB:  1945-06-04 , General Practitioner: Dr. Tidwell, Chloe  , Date of procedure:  2001-04-05Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  150mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Barretts FINDINGS: There is a cervical inlet patch of dubious significance.. "
"338","Hospital Number: B7082304 , Hospital: Random NHS Foundation Trust , DOB:  1901-10-11 , General Practitioner: Dr. Gardner, Kayla  , Date of procedure:  2001-01-12Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  12.5mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Eosinophilic oesophagitis assesment FINDINGS: Normal gastroscopy to the duodenum. character(0)"
"339","Hospital Number: J8000143 , Hospital: Random NHS Foundation Trust , DOB:  1993-02-23 , General Practitioner: Dr. Robison, Victoria  , Date of procedure:  2010-08-14Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG2  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain FINDINGS: The patient has a 3mm nodule in the fundus which is stalked. A large, lobulated nodule is observed in the gastric body, suggestive of a gastrointestinal autonomic nerve tumor (GANT).The patient should be monitored for signs of infection or other complications related to inflammation.. mild trachealization.. character(0) RECOMMENDATION:  RECOMMENDATION: The patient may require additional endoscopies in the future to monitor the stricture and ensure that it is not progressing.  The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and exacerbate the inflammation. FOLLOW UP: The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent further damage to the gastrointestinal tract. FOLLOW UP: The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the stricture.  The patient may be referred to a gastroenterologist for further management of the inflammation."
"340","Hospital Number: M2497777 , Hospital: Random NHS Foundation Trust , DOB:  1926-12-24 , General Practitioner: Dr. al-Zafar, Faraah  , Date of procedure:  2008-05-29Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  100mcg  , Midazolam  1mg  , Instrument:  FG5  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Hiatus Hernia- Small.. "
"341","Hospital Number: C1910592 , Hospital: Random NHS Foundation Trust , DOB:  1949-07-04 , General Practitioner: Dr. Edmunds, Zalena  , Date of procedure:  2005-10-17Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  25mcg  , Midazolam  7mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other-  Check for angiodysplasia FINDINGS: A large hiatus hernia is present. "
"342","Hospital Number: Q9535363 , Hospital: Random NHS Foundation Trust , DOB:  1996-03-18 , General Practitioner: Dr. Bryan, Kayla  , Date of procedure:  2001-11-08Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Nausea and/or Vomiting FINDINGS: LA Grade  A oesophagitis. The oesophageal mucosa is hyperemic and has a granular appearance with areas of erosion and exudate. The patient has inflammation in the stomach which is mild. The gastric inflammation is characterized by the presence of lymphoid aggregates in the mucosal layer.The ulcer was biopsied x8 for further analysis.. NA RECOMMENDATION: The patient should be counseled on the risks and benefits of any potential treatments for their ulcer. RECOMMENDATION: The patient may be referred to a specialist for further evaluation and treatment, such as surgery to widen the esophagus.  The patient should be advised to avoid hot, spicy foods, which can irritate the lining of the stomach and exacerbate the inflammation. FOLLOW UP: The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more ulcers. FOLLOW UP: The patient should be advised to avoid eating acidic or spicy foods, as these can worsen GERD symptoms.  The patient should be advised to avoid consuming too much sugar, as this can exacerbate the inflammation by increasing the risk of bacterial overgrowth in the stomach."
"343","Hospital Number: X7857756 , Hospital: Random NHS Foundation Trust , DOB:  1955-02-08 , General Practitioner: Dr. Schell, Jasmine  , Date of procedure:  2006-07-11Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  12.5mcg  , Midazolam  7mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Biopsies for H pylori FINDINGS: The patient has an ulcer in the GOJ which is deep with rolled edges. Accompanied by white exudate and a cobblestone appearance, the gastric ulcer is likely caused by Helicobacter pylori infection.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. The oesophageal ulcer is characterized by a fibrinous exudate overlying a deep, ulcerated base.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape..  NA  Proton pump inhibitors may be prescribed to reduce gastric acid production and promote ulcer healing.  The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and delay the healing of the ulcer."
"344","Hospital Number: E8303284 , Hospital: Random NHS Foundation Trust , DOB:  1989-07-23 , General Practitioner: Dr. Barnett, Jashinda  , Date of procedure:  2001-03-06Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG1  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Reduced appetite early satiety FINDINGS: Normal gastroscopy to the duodenum. "
"345","Hospital Number: N5562828 , Hospital: Random NHS Foundation Trust , DOB:  1934-03-20 , General Practitioner: Dr. Oronia, Sara  , Date of procedure:  2002-07-19Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  25mcg  , Midazolam  3mg  , Instrument:  FG4  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Hb drop ?GI bleed previous gastric surgery FINDINGS: Normal gastroscopy to the duodenum. "
"346","Hospital Number: V8753920 , Hospital: Random NHS Foundation Trust , DOB:  1942-12-06 , General Practitioner: Dr. Marquez, Amanda  , Date of procedure:  2013-07-20Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  75mcg  , Midazolam  4mg  , Instrument:  FG7  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia oesophageal stricture post chemorad for scc oesophagus FINDINGS: OESOPHAGUS: Normal, no appreciable hiatus hernia.. NA"
"347","Hospital Number: L1479863 , Hospital: Random NHS Foundation Trust , DOB:  1975-04-12 , General Practitioner: Dr. Moore, Sydny  , Date of procedure:  2013-02-18Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  150mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia oesophageal stricture post chemorad for scc oesophagus FINDINGS: The patient has a polyp in the duodenal bulb which is sessile with an abnormal pit pattern. The nodules are located in the second and third portions of the duodenum, with sparing of the duodenal papilla.The polyp was removed with minimal thermal injury to surrounding tissue using a cold snare technique.. The patient has an ulcer in the D1/D2 angle which is induratedIt has a visible vessel. Characterized by a distinct loss of mucosal tissue and surrounded by erythema, the severe ulceration presents with a nodular surface.The ulcer was biopsied x8 for further analysis.. NA RECOMMENDATION: Endoscopic resection of the ulcer may be necessary for larger or more complex ulcers. RECOMMENDATION: If the nodule is suspicious for cancer, the patient may be referred to an oncologist for further evaluation and treatment.  The patient is advised to return for a follow-up appointment in four to six weeks' time to discuss the findings and plan for further management. FOLLOW UP:  FOLLOW UP: The patient should be advised to maintain a healthy weight, as obesity can increase the risk of cancer and other gastrointestinal diseases.  The patient should follow a healthy diet and lifestyle to reduce the risk of developing more polyps."
"348","Hospital Number: A5218459 , Hospital: Random NHS Foundation Trust , DOB:  1983-12-23 , General Practitioner: Dr. Poole, Shardae  , Date of procedure:  2014-07-29Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  100mcg  , Midazolam  1mg  , Instrument:  FG6  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain . FINDINGS: Normal gastroscopy to the duodenum. "
"349","Hospital Number: I2777268 , Hospital: Random NHS Foundation Trust , DOB:  1984-04-10 , General Practitioner: Dr. al-Shahidi, Khulood  , Date of procedure:  2010-09-01Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins FINDINGS: Normal gastroscopy to the duodenum. "
"350","Hospital Number: F7726169 , Hospital: Random NHS Foundation Trust , DOB:  1957-02-03 , General Practitioner: Dr. Kowynia, Kelsey  , Date of procedure:  2014-10-21Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  12.5mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Previous multiple surgeries for reflux . FINDINGS: The patient has inflammation in the body which is erosive. The gastric inflammation is characterized by the presence of lymphoid aggregates in the mucosal layer.During biopsy, it was noted that the lesion had a friable surface and bled easily..  RECOMMENDATION: If the stricture is due to a medical condition such as gastroesophageal reflux disease (GERD), the patient may be prescribed medication to manage their symptoms.  A stool test may be ordered to assess the patient's fecal occult blood levels, as inflammation can cause bleeding in the stomach and intestines. FOLLOW UP: The patient should be advised to elevate the head of their bed by six inches to help prevent reflux at night.  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and inflammation."
"351","Hospital Number: T1978921 , Hospital: Random NHS Foundation Trust , DOB:  1962-01-11 , General Practitioner: Dr. Romero, Jesseca  , Date of procedure:  2015-02-11Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG1  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain x1 hematemesis Crohns colitis FINDINGS: No inlet patch  was also seen.. "
"352","Hospital Number: W8248560 , Hospital: Random NHS Foundation Trust , DOB:  1957-02-07 , General Practitioner: Dr. Lor, Vy  , Date of procedure:  2002-08-10Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG3  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- EMR/ESD FINDINGS: There is a polyp in the second part of the duodenum which is sessile.It has an abnormal pit pattern. The nodules are distributed throughout the duodenal bulb and descending duodenum.The polyp was visualized and biopsied during upper endoscopy.. No inlet patch  was also seen on narrow band imaging.. character(0) RECOMMENDATION: The patient should be advised to seek emotional support from friends, family, or a counselor, as the diagnosis of cancer can be difficult to cope with.   FOLLOW UP: The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent further damage to the gastrointestinal tract.  The patient should be informed of the diagnosis and provided with information on how to manage the polyp."
"353","Hospital Number: O8592861 , Hospital: Random NHS Foundation Trust , DOB:  1907-02-02 , General Practitioner: Dr. Tran, Kayla  , Date of procedure:  2013-04-23Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  50mcg  , Midazolam  5mg  , Instrument:  FG1  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: ULCER CHECK. FINDINGS: Small hiatus hernia..   Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) may be necessary for larger or more complex ulcers.  A repeat gastroscopy may be required in eight to twelve weeks' time to monitor the healing of the ulcer."
"354","Hospital Number: H1442477 , Hospital: Random NHS Foundation Trust , DOB:  1919-01-01 , General Practitioner: Dr. Shepherd, Ashanee  , Date of procedure:  2012-05-26Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  100mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Therapeutic- Dilatation Therapeutic- NJ Tube/PEG/DPEJ FINDINGS: Normal gastroscopy to the duodenum. "
"355","Hospital Number: P1673382 , Hospital: Random NHS Foundation Trust , DOB:  1953-04-16 , General Practitioner: Dr. al-Hashim, Raihaana  , Date of procedure:  2004-09-29Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG5  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Other- Early satiety FINDINGS: Normal gastroscopy to the duodenum. "
"356","Hospital Number: D3953088 , Hospital: Random NHS Foundation Trust , DOB:  1998-08-19 , General Practitioner: Dr. al-Hosein, Kabeera  , Date of procedure:  2008-03-16Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Cancer- Oesophagus or Stomach FINDINGS: There is inflammation in the GOJ which is severe. The oesophageal mucosa appears to be diffusely inflamed with scattered erosions and petechiae, indicative of mild reflux oesophagitis.During biopsy, it was noted that the lesion had a friable surface and bled easily.. There is inflammation in the antrum which is severe. The gastric inflammation appears to be associated with the use of proton pump inhibitors (PPIs), with the presence of rebound hypergastrinemia.During biopsy, it was noted that the lesion had a friable surface and bled easily.. NA RECOMMENDATION: The patient should be advised to avoid eating acidic or spicy foods, as these can worsen GERD symptoms.  The patient should avoid consuming large meals, as this can exacerbate the inflammation. FOLLOW UP:   The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and inflammation."
"357","Hospital Number: K5760664 , Hospital: Random NHS Foundation Trust , DOB:  1942-03-27 , General Practitioner: Dr. Mcwilliams, Courtney  , Date of procedure:  2004-09-28Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  100mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Nausea and/or Vomiting Other- Early satiety FINDINGS: Small hiatus hernia only. "
"358","Hospital Number: U6704720 , Hospital: Random NHS Foundation Trust , DOB:  1946-02-21 , General Practitioner: Dr. Rikke, Heng  , Date of procedure:  2005-06-18Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  100mcg  , Midazolam  1mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: MelaenaEpigastric Pain FINDINGS: Normal gastroscopy to the duodenum. "
"359","Hospital Number: Y1451790 , Hospital: Random NHS Foundation Trust , DOB:  1977-01-07 , General Practitioner: Dr. Huynh, Medhavi  , Date of procedure:  2014-06-04Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG3  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Achalasia FINDINGS: Barrett's is present. No nodularity is present. It is a long segment. "
"360","Hospital Number: S9523253 , Hospital: Random NHS Foundation Trust , DOB:  1967-07-26 , General Practitioner: Dr. Dubus, Samantha  , Date of procedure:  2012-07-17Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  100mcg  , Midazolam  4mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known coeliac ch diarrhoea.Myelofibrosis on ruxolitinib and panobinostat FINDINGS: There is a nodule in the body which is stalked. A well-circumscribed, firm nodule is seen in the gastric body, suggestive of a gastrointestinal stromal tumor (GIST).The patient should be advised to avoid alcohol and tobacco, as these can worsen inflammation and increase the risk of complications..  RECOMMENDATION: The patient should avoid smoking and drinking alcohol, as these habits can increase the risk of cancer. RECOMMENDATION: The patient may be prescribed medication to reduce the production of stomach acid and prevent reflux.  The patient should be advised to avoid caffeine, which can stimulate the production of stomach acid and exacerbate the inflammation. FOLLOW UP: The patient may be prescribed medication to manage any symptoms associated with the nodule, such as pain or discomfort. FOLLOW UP: The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the stricture.  The patient should avoid smoking and alcohol, which can worsen the inflammation."
"361","Hospital Number: R7817343 , Hospital: Random NHS Foundation Trust , DOB:  1998-06-07 , General Practitioner: Dr. al-Allee, Kulthum  , Date of procedure:  2010-05-14Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Haematemesis or Melaena/Blood PR FINDINGS: The patient has an ulcer in the stomach which is excavated which is not bleeding. Signs of NSAID-induced injury are evident in the gastric ulcer, which appears to have a punched-out appearance.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample..   The patient should be instructed to avoid hot beverages and foods to prevent further irritation to the ulcer.  The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and delay the healing of the ulcer."
"362","Hospital Number: Z7781233 , Hospital: Random NHS Foundation Trust , DOB:  1962-10-03 , General Practitioner: Dr. Guardipee, Candance  , Date of procedure:  2014-01-05Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Dysphagia/Odynophagia Vaters syndrome astric pull-up surgery FINDINGS: There is an ulcer in the second part of the duodenum which is deep.CLO test was taken.. The gastric lesion appears malignant with irregular borders and surrounding erythema.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. The ulcer appears to be located on the first part of the duodenum, just distal to the pylorus.The ulcer was biopsied x8 for further analysis..  character(0)  The patient should be advised to follow a soft diet and avoid spicy or acidic foods to reduce discomfort and promote healing.  The patient should avoid consuming acidic foods and drinks, which can irritate the lining of the stomach and delay the healing of the ulcer."
"363","Hospital Number: G7755694 , Hospital: Random NHS Foundation Trust , DOB:  1997-10-29 , General Practitioner: Dr. el-Bangura, Mu'mina  , Date of procedure:  2003-10-20Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  12.5mcg  , Midazolam  7mg  , Instrument:  FG5  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Weight Loss FINDINGS: There is an ulcer in the stomach which is induratedCLO test was taken.. Characterized by a distinct loss of mucosal tissue and surrounded by erythema, the severe ulceration presents with a nodular surface.The biopsy was performed using a needle biopsy forceps, with the tissue samples sent for pathological analysis..   The patient should be advised to maintain a healthy weight and exercise regularly to reduce the risk of recurrent ulcers.  The patient should be advised to avoid hot, spicy foods, which can irritate the lining of the stomach and delay the healing of the ulcer."
"364","Hospital Number: B7780911 , Hospital: Random NHS Foundation Trust , DOB:  1973-01-20 , General Practitioner: Dr. Kennah, Elijah  , Date of procedure:  2010-04-10Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Dilatation Nausea and/or Vomiting FINDINGS: There is a stricture in the duodenal bulb which is inflamedIt will not allow the scope to pass.. The stricture has a sharp and well-defined margin, suggesting a compressive etiology.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. The patient has inflammation in the antrum which is severe. Diffuse erythema with erosions and exudates are seen in the antrum and body of the stomach, suggestive of acute erosive gastritis.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. character(0) RECOMMENDATION: The patient should avoid eating large meals and should instead eat smaller, more frequent meals throughout the day.  A barium swallow study may be ordered to assess the extent of the inflammation. FOLLOW UP: The patient should be advised to avoid lying down for at least three hours after eating to help prevent reflux.  The patient should avoid eating before bedtime, as this can exacerbate the inflammation by increasing the risk of reflux."
"365","Hospital Number: J8821698 , Hospital: Random NHS Foundation Trust , DOB:  1975-09-05 , General Practitioner: Dr. Heredia, Amber  , Date of procedure:  2006-05-04Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CHRONIC DIARRHOEA-biopsies needed FINDINGS: Normal gastroscopy to the duodenum. "
"366","Hospital Number: M8882071 , Hospital: Random NHS Foundation Trust , DOB:  1994-08-06 , General Practitioner: Dr. Snyder-Jones, Aimee  , Date of procedure:  2002-08-04Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG3  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain x1 hematemesis Crohns colitis FINDINGS: The patient has a polyp in the body which is stalked.It has an abnormal pit pattern. The hyperplastic gastric polyp presents with a smooth surface and no evidence of glandular dysplasia.The polyp was grasped with a snare and cut with a hot biopsy forceps for removal..   A blood test may be ordered to assess the patient's iron levels, as polyps can cause bleeding in the stomach and intestines.  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and polyp growth."
"367","Hospital Number: C4433311 , Hospital: Random NHS Foundation Trust , DOB:  1995-06-27 , General Practitioner: Dr. Aguon, Briana  , Date of procedure:  2003-05-05Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  125mcg  , Midazolam  5mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Previous Polyps/Metaplasia etc. FINDINGS: Normal gastroscopy to the duodenum.   The patient may be referred to a specialist in gastrointestinal disorders for further management of the polyp.  The patient may be prescribed medication to reduce the risk of developing more polyps."
"368","Hospital Number: Q1015837 , Hospital: Random NHS Foundation Trust , DOB:  1975-10-16 , General Practitioner: Dr. Bolton, Ariana  , Date of procedure:  2015-06-04Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Dysphagia/Odynophagia FINDINGS: There is inflammation in the body which is mild. Focal areas of erythema with no exudate are observed in the gastric antrum, suggestive of mild gastritis.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. The patient has inflammation in the D1/D2 angle which is severe. character(0) RECOMMENDATION: The patient should be informed of the diagnosis and the importance of adhering to the recommended treatment plan.  The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and exacerbate the inflammation. FOLLOW UP:   "
"369","Hospital Number: X2594520 , Hospital: Random NHS Foundation Trust , DOB:  1941-05-23 , General Practitioner: Dr. Peluso, Fazeela  , Date of procedure:  2016-08-14Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  150mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: dypepsia FINDINGS: The patient has Barrett's oesophagus. No nodularity is present. There is a polyp in the stomach which is sessile with an abnormal pit pattern. The gastric polyp exhibits an adenomatous morphology with tubular and villous growth patterns.The polyp was grasped with a snare and cut with a hot biopsy forceps for removal.. character(0)  The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and increase the risk of polyp growth.  A blood test may be ordered to assess the patient's iron levels, as polyps can cause bleeding in the stomach and intestines."
"370","Hospital Number: E6158591 , Hospital: Random NHS Foundation Trust , DOB:  1935-04-27 , General Practitioner: Dr. Lucas, Eritrea  , Date of procedure:  2004-08-25Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: MelaenaEpigastric Pain FINDINGS: The patient has a stricture in the GOJ which is contractedIt is easily traversible.. The severe narrowing of the oesophageal lumen at the stricture site is visible, and only a small-caliber endoscope can be passed through.The lesion was biopsied using a standard forceps.. There is a polyp in the second part of the duodenum which is stalked.It has an abnormal pit pattern. The nodules are distributed throughout the duodenal bulb and descending duodenum.The polyp did not lift on saline injection and was therefore not amenable to endoscopic resection.. NA RECOMMENDATION: The patient may be prescribed medication to manage any symptoms associated with the nodule, such as pain or discomfort.  The patient may be referred to a specialist in gastrointestinal disorders for further management of the polyp. FOLLOW UP: The patient may be referred to a specialist for further evaluation and treatment, such as surgery to remove the nodule.  The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and increase the risk of polyp growth."
"371","Hospital Number: N9571333 , Hospital: Random NHS Foundation Trust , DOB:  1911-12-30 , General Practitioner: Dr. Allen, Amber  , Date of procedure:  2015-01-20Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  150mcg  , Midazolam  5mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Weight Loss FINDINGS: Normal gastroscopy to the duodenum. "
"372","Hospital Number: V3328807 , Hospital: Random NHS Foundation Trust , DOB:  1906-01-07 , General Practitioner: Dr. Ehrenfelt, Nika  , Date of procedure:  2002-06-07Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  150mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CHRONIC DIARRHOEA-biopsies needed FINDINGS: Normal gastroscopy to the duodenum. "
"373","Hospital Number: L2721400 , Hospital: Random NHS Foundation Trust , DOB:  1975-04-09 , General Practitioner: Dr. Hamlin, Stevie  , Date of procedure:  2010-07-18Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG1  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Abdominal Pain FINDINGS: Normal gastroscopy to the duodenum. "
"374","Hospital Number: A9747574 , Hospital: Random NHS Foundation Trust , DOB:  1947-03-06 , General Practitioner: Dr. Morgan, Jasmine  , Date of procedure:  2001-09-27Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"375","Hospital Number: I9081757 , Hospital: Random NHS Foundation Trust , DOB:  1979-03-15 , General Practitioner: Dr. Selke, Pamella  , Date of procedure:  2005-02-26Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG1  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known coeliac ch diarrhoea.Myelofibrosis on ruxolitinib and panobinostat FINDINGS: There is inflammation in the duodenal bulb which is erosive. Upon endoscopy, the duodenal mucosa appears edematous and inflamed.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. The patient has an ulcer in the third part of the duodenum which is hemorrhagicForrest Ulcer classification: IIc.. Signs of NSAID-induced injury are evident in the gastric ulcer, which appears to have a punched-out appearance.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. The base of the ulcer is covered in a yellowish fibrinous exudate.During biopsy, it was noted that the lesion had a friable surface and bled easily.. NA RECOMMENDATION: The patient should be counseled on the importance of taking any prescribed medications for ulcer healing and symptom control as directed. RECOMMENDATION: The patient should be advised to avoid eating acidic or spicy foods, as these can worsen GERD symptoms.  The patient should avoid NSAIDs and aspirin, which can irritate the lining of the stomach and exacerbate the inflammation. FOLLOW UP: The patient may be referred to a specialist in gastrointestinal disorders for further management of the ulcer. FOLLOW UP: The patient should avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as these can worsen GERD symptoms.  The patient should avoid eating before bedtime, as this can exacerbate the inflammation by increasing the risk of reflux."
"376","Hospital Number: F6090839 , Hospital: Random NHS Foundation Trust , DOB:  1966-09-04 , General Practitioner: Dr. el-Momin, Tareefa  , Date of procedure:  2003-12-15Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG6  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Dilatation Nausea and/or Vomiting FINDINGS: Columnar lined oesophagus is present. No abnormal pit pattern is seen.  character(0)"
"377","Hospital Number: T7480285 , Hospital: Random NHS Foundation Trust , DOB:  1929-02-02 , General Practitioner: Dr. Goldscheitter, Tayla  , Date of procedure:  2012-03-26Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  125mcg  , Midazolam  4mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Biopsies from duodenal stricture FINDINGS: There is inflammation in the oesophagus at 28 cm which is mild. There is diffuse erythema of the oesophageal mucosa with prominent exudate and friability, suggestive of viral oesophagitis.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from..  character(0) RECOMMENDATION: The patient should be advised to chew their food thoroughly and to eat slowly to help prevent swallowing difficulties.  The patient should be informed of the diagnosis and provided with information on how to manage the inflammation. FOLLOW UP: The patient should be advised to avoid wearing tight clothing around their waist, as this can put pressure on the stomach and worsen GERD symptoms.  The patient should be advised to eat slowly and chew their food thoroughly to aid digestion and reduce the risk of inflammation."
"378","Hospital Number: W2054819 , Hospital: Random NHS Foundation Trust , DOB:  1906-11-16 , General Practitioner: Dr. Storm, Rachel  , Date of procedure:  2001-03-27Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Maleana FINDINGS: The patient has an ulcer in the antrum which is superficial s*It is bleeding. Signs of NSAID-induced injury are evident in the gastric ulcer, which appears to have a punched-out appearance.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. There is a nodule in the third part of the duodenum which is benign-looking. NA RECOMMENDATION: The patient should be instructed to avoid tight-fitting clothing to reduce pressure on the ulcer site.  The patient should be advised to seek emotional support from friends, family, or a counselor, as the diagnosis of cancer can be difficult to cope with. FOLLOW UP: The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and ulcer recurrence.  If the nodule is benign, the patient may not require any treatment, but may require monitoring with regular endoscopies."
"379","Hospital Number: O8834134 , Hospital: Random NHS Foundation Trust , DOB:  1959-04-04 , General Practitioner: Dr. Hollins, Zhaney  , Date of procedure:  2012-07-06Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  75mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow-up ULCER HEALING FINDINGS: The patient has a stricture in the antrum which is ulceratedThe endoscope passed through the stricture with resistance. The severe ulceration presents with a depth greater than 5 mm and an irregular border.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. The gastric stricture is located in the body of the stomach, with an irregular surface and circumferential narrowing of the lumen.The biopsy was performed using a needle biopsy forceps, with the tissue samples sent for pathological analysis.. The patient has a stricture in the third part of the duodenum which is HhpertrophiedThere is very slight and non-restrcitve stricturing.. The narrowing of the duodenal lumen at the stricture site is severe, allowing only a small-caliber endoscope to pass through.The ulcer was biopsied x8 for further analysis.. NA  Follow-up endoscopy should be performed in 4-6 weeks to assess for healing and to repeat biopsies if necessary.  The patient should avoid consuming acidic foods and drinks, which can irritate the lining of the stomach and delay the healing of the ulcer."
"380","Hospital Number: H6820128 , Hospital: Random NHS Foundation Trust , DOB:  1976-11-06 , General Practitioner: Dr. Gonzalez, Isabella  , Date of procedure:  2012-09-16Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  100mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CHRONIC DIARRHOEA-biopsies needed FINDINGS: There is a nodule in the third part of the duodenum which is benign-looking. The patient has a polyp in the antrum which is sessile.It has an abnormal pit pattern. The gastric polyp appears fundic with a smooth surface and regular shape, suggestive of a benign process.The base of the polyp was fulgurated with an electrocautery device to prevent future bleeding or regrowth.. character(0) RECOMMENDATION: The patient should be advised to report any new symptoms or changes in symptoms to their healthcare provider immediately.  The patient should avoid smoking and alcohol, which can increase the risk of developing more polyps. FOLLOW UP: If the nodule is found to be cancerous, the patient may require further imaging studies and biopsies to determine the stage of the cancer and the appropriate treatment.  The patient should avoid consuming too much fat, as this can delay gastric emptying and increase the risk of reflux and polyp growth."
"381","Hospital Number: P4350826 , Hospital: Random NHS Foundation Trust , DOB:  1990-07-11 , General Practitioner: Dr. al-Molla, Khaalida  , Date of procedure:  2003-06-05Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  150mcg  , Midazolam  7mg  , Instrument:  FG3  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Ongoing reflux symptoms. FINDINGS: Normal gastroscopy to the duodenum. "
"382","Hospital Number: D5429386 , Hospital: Random NHS Foundation Trust , DOB:  1934-12-10 , General Practitioner: Dr. Dawson, Morgan  , Date of procedure:  2002-03-28Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Nausea and/or Vomiting FINDINGS: The patient has inflammation in the second part of the duodenum which is mild. The duodenal mucosa appears to have a cobblestone appearance, with multiple areas of ulceration and inflammation.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. The patient has an ulcer in the GOJ which is fungatingIt has a visible vessel. The patient's medical history, along with the ulcer's rugose surface and flat appearance, suggest a chronic, long-standing condition.During biopsy, it was noted that the lesion had a friable surface and bled easily.. Examination of the oesophageal ulcer reveals a deep, necrotic base with surrounding granulation tissue.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization.. character(0) RECOMMENDATION: The patient should be advised to maintain a healthy weight and exercise regularly to reduce the risk of recurrent ulcers. RECOMMENDATION: The patient may require additional endoscopies in the future to monitor the stricture and ensure that it is not progressing.  The patient should be advised to avoid consuming too much sugar, as this can exacerbate the inflammation by increasing the risk of bacterial overgrowth in the stomach. FOLLOW UP: A repeat gastroscopy may be required in eight to twelve weeks' time to monitor the healing of the ulcer. FOLLOW UP: The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent reflux.  A stool test may be ordered to assess the patient's fecal occult blood levels, as inflammation can cause bleeding in the stomach and intestines."
"383","Hospital Number: K5870127 , Hospital: Random NHS Foundation Trust , DOB:  1939-11-10 , General Practitioner: Dr. al-Hasen, Adeeba  , Date of procedure:  2016-06-14Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known coeliac ch diarrhoea.Myelofibrosis on ruxolitinib and panobinostat FINDINGS: The patient has an ulcer in the stomach which is crateredIt has a visible vessel. The severe ulceration presents with a depth greater than 5 mm and an irregular border.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from..   The patient should be advised to avoid aspirin or other blood thinners unless prescribed by a physician.  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and ulcer recurrence."
"384","Hospital Number: U3081246 , Hospital: Random NHS Foundation Trust , DOB:  1938-04-04 , General Practitioner: Dr. Tran, Pearl  , Date of procedure:  2003-06-11Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Dyspepsia FINDINGS: The patient has a 5mm nodule in the duodenal bulb which is stalked.  character(0)  The patient should avoid eating or drinking for at least six hours before any scheduled appointments.  The patient should avoid smoking and drinking alcohol, as these habits can increase the risk of cancer."
"385","Hospital Number: Y1506215 , Hospital: Random NHS Foundation Trust , DOB:  1990-01-19 , General Practitioner: Dr. Luna, Nallely  , Date of procedure:  2011-01-21Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Dyspepsia FINDINGS: The patient had crepe paper oesophagitis. Endoscopy revealed the presence of concentric rings throughout the esophagus, suggestive of eosinophilic oesophagitis. Rings were noted throughout the esophagusconsistent with eosinophilic oesophagitis. OGD showed the presence of several white exudates in the mid and distal esophagus. A large hiatus hernia is present. character(0)"
"386","Hospital Number: S7145991 , Hospital: Random NHS Foundation Trust , DOB:  1915-11-01 , General Practitioner: Dr. Byrd, Kendell  , Date of procedure:  2006-10-28Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG5  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia Vomiting known hiatus hernia FINDINGS: The patient has an ulcer in the third part of the duodenum which is induratedForrest Ulcer classification:II B.. The severe ulceration presents with a depth greater than 5 mm and an irregular border.The lesion was biopsied using a standard forceps.. The margins of the ulcer appear to be slightly raised, with a central depression.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. Oesophagus normal with no hiatus hernia.. NA  Referral to a registered dietitian may be helpful in providing guidance on a healthy, ulcer-friendly diet.  A repeat gastroscopy may be required in eight to twelve weeks' time to monitor the healing of the ulcer."
"387","Hospital Number: R9404908 , Hospital: Random NHS Foundation Trust , DOB:  1949-10-21 , General Practitioner: Dr. Peters, Evangeline  , Date of procedure:  2006-03-26Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  25mcg  , Midazolam  4mg  , Instrument:  FG5  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Dilatation Nausea and/or Vomiting FINDINGS: The patient has a 9mm nodule in the stomach which is benign-looking. A nodular lesion with surrounding erythema and nodularity of the overlying mucosa is observed in the gastric cardia, suggestive of a malignant gastric neoplasm.The patient should be advised to avoid hot, spicy foods, which can irritate the lining of the stomach and delay the healing of the ulcer..  RECOMMENDATION: The patient should be counseled on the importance of maintaining good oral hygiene to prevent oral bacteria from entering the ulcer site.  The patient may be prescribed medication to manage any symptoms associated with the nodule, such as pain or discomfort. FOLLOW UP: The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and delay the healing of the ulcer.  The patient should be advised to avoid lifting heavy objects or engaging in strenuous physical activity, as this can increase the risk of bleeding in the gastrointestinal tract."
"388","Hospital Number: Z6151451 , Hospital: Random NHS Foundation Trust , DOB:  1940-07-18 , General Practitioner: Dr. Northrup, Holly  , Date of procedure:  2009-04-16Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  150mcg  , Midazolam  2mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Polypectomy FINDINGS: LA Grade  C oesophagitis. There are scattered erosions present in the oesophageal mucosa. The oesophageal mucosa has a furrowed or corrugated appearance. The patient has an ulcer in the third part of the duodenum which is exudativeCLO test  was also taken.. Characterized by a distinct loss of mucosal tissue, the severe ulceration presents with a nodular surface.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. The surrounding mucosa appears to be friable and prone to bleeding upon contact.The lesion was biopsied using a standard forceps.. character(0) RECOMMENDATION: Biopsy samples were taken from the ulcer base to rule out malignancy. The patient should follow up with their referring physician for results.  The patient may be prescribed medication to reduce the risk of developing more polyps. FOLLOW UP: The patient may be referred to a specialist in gastrointestinal disorders for further management of the ulcer.  "
"389","Hospital Number: G1498153 , Hospital: Random NHS Foundation Trust , DOB:  1916-03-15 , General Practitioner: Dr. Griffin, Nicole  , Date of procedure:  2007-07-09Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  125mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Positive coeliac serology FINDINGS: There is inflammation in the second part of the duodenum which is erosive. There is diffuse erythema and friability noted in the duodenal mucosa, with areas of active bleeding.The ulcer was biopsied x8 for further analysis.. The patient has Barrett's oesophagus. No nodularity is present. NA RECOMMENDATION: Follow-up imaging such as CT or MRI may be necessary to assess for potential complications or to guide management decisions. RECOMMENDATION: If the patient experiences chest pain or difficulty breathing, they should seek emergency medical attention immediately.  The patient is advised to return for a follow-up appointment in six weeks' time to evaluate the progress of the inflammation. FOLLOW UP: The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools. FOLLOW UP: The patient should avoid eating or drinking for at least six hours before any scheduled appointments.  The patient is advised to return for a follow-up appointment in six weeks' time to evaluate the progress of the inflammation."
"390","Hospital Number: B8969666 , Hospital: Random NHS Foundation Trust , DOB:  1944-10-04 , General Practitioner: Dr. Alexopoulos, Kelsey  , Date of procedure:  2006-11-07Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG3  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Hb drop ?GI bleed previous gastric surgery FINDINGS: Normal gastroscopy to the duodenum. "
"391","Hospital Number: J1819477 , Hospital: Random NHS Foundation Trust , DOB:  1908-05-20 , General Practitioner: Dr. Keith, Symphony  , Date of procedure:  2003-03-01Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- EMR/ESD FINDINGS: Normal gastroscopy to the duodenum. "
"392","Hospital Number: M8863036 , Hospital: Random NHS Foundation Trust , DOB:  1953-11-01 , General Practitioner: Dr. Carson, Madeleine  , Date of procedure:  2011-07-07Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins weight loss. On warfarin and clopidogrel, FINDINGS: Normal gastroscopy to the duodenum. "
"393","Hospital Number: C4021112 , Hospital: Random NHS Foundation Trust , DOB:  1989-06-24 , General Practitioner: Dr. el-Shaker, Shamaail  , Date of procedure:  2013-01-02Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  100mcg  , Midazolam  5mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Dyspepsia FINDINGS: Normal gastroscopy to the duodenum. "
"394","Hospital Number: Q8222665 , Hospital: Random NHS Foundation Trust , DOB:  1937-04-02 , General Practitioner: Dr. Cherven, Alyssa  , Date of procedure:  2008-04-23Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG2  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Previous Polyps/Metaplasia etc. FINDINGS: There is a nodule in the D1/D2 angle which is stalked.  RECOMMENDATION: The patient should be advised to maintain a healthy diet and lifestyle, as this may help prevent the growth of the nodule.  The patient may be prescribed medication to reduce the risk of developing more polyps. FOLLOW UP: The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the nodule.  The patient should be advised to eat slowly and chew their food thoroughly to aid digestion and reduce the risk of polyp growth."
"395","Hospital Number: X5836068 , Hospital: Random NHS Foundation Trust , DOB:  1958-06-15 , General Practitioner: Dr. Salazar, Falicity  , Date of procedure:  2002-12-02Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG5  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Other- candidiasis FINDINGS: There is inflammation in the antrum which is severe. The gastric inflammation appears to be associated with the use of proton pump inhibitors (PPIs), with the presence of rebound hypergastrinemia.During biopsy, it was noted that the lesion had a friable surface and bled easily.. The patient has an ulcer in the D1/D2 angle which is exudativeIt is not bleeding. The ulceration exhibits a cobblestone appearance and a yellowish base, suggestive of Helicobacter pylori infection.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. character(0) RECOMMENDATION: Follow-up imaging such as CT or MRI may be necessary to assess for potential complications or to guide management decisions. RECOMMENDATION: The patient may be referred to a nutritionist to develop a diet plan that is easier to swallow and that meets their nutritional needs.  The patient should be advised to avoid carbonated drinks, which can exacerbate the inflammation by increasing the production of gas. FOLLOW UP: The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more ulcers. FOLLOW UP: The patient should be advised to avoid eating foods that are difficult to swallow, such as hard or crunchy foods.  A repeat gastroscopy may be recommended in six months' time to assess the response to treatment."
"396","Hospital Number: E8902521 , Hospital: Random NHS Foundation Trust , DOB:  1983-08-09 , General Practitioner: Dr. Kim, Julia  , Date of procedure:  2010-09-27Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  100mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Anaemia/Low Iron or Vitamins FINDINGS: The patient has a polyp in the D1/D2 angle which is stalked.It has an abnormal pit pattern.   The patient should be informed of the diagnosis and provided with information on how to manage the polyp.  The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and increase the risk of polyp growth."
"397","Hospital Number: N7405188 , Hospital: Random NHS Foundation Trust , DOB:  1980-04-28 , General Practitioner: Dr. Sayeed, Julia  , Date of procedure:  2006-07-18Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG3  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins weight loss. On warfarin and clopidogrel, FINDINGS: Barrett's is present. No loss of aceto-whitening  was also seen. The segment looks flat. Short segment only. "
"398","Hospital Number: V9378773 , Hospital: Random NHS Foundation Trust , DOB:  1956-12-11 , General Practitioner: Dr. Reyes, Victoria  , Date of procedure:  2010-05-12Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  125mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other-  Check for angiodysplasia FINDINGS: LA Grade  B oesophagitis. The lower oesopahgeal sphincter looks widely patent Candida present. The patient has an ulcer in the duodenal bulb which is fibroticIt has a visible vessel. The ulceration exhibits a cobblestone appearance and a yellowish base, suggestive of Helicobacter pylori infection.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. The ulcer appears to be a chronic lesion, with signs of previous healing and scarring.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample.. character(0)  The patient should be instructed to avoid caffeine and carbonated beverages to reduce discomfort and promote healing.  The patient should avoid consuming too much fat, as this can delay gastric emptying and delay the healing of the ulcer."
"399","Hospital Number: L6117442 , Hospital: Random NHS Foundation Trust , DOB:  1945-08-17 , General Practitioner: Dr. Belmont Ramirez, Yubelli  , Date of procedure:  2011-12-11Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  25mcg  , Midazolam  3mg  , Instrument:  FG1  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow-up oesophagitis healing FINDINGS: mild trachealization.. character(0)"
"400","Hospital Number: A3669324 , Hospital: Random NHS Foundation Trust , DOB:  1935-01-18 , General Practitioner: Dr. Frost, Lynn  , Date of procedure:  2010-05-09Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  100mcg  , Midazolam  7mg  , Instrument:  FG6  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Early satiety FINDINGS: Normal gastroscopy to the duodenum. "
"401","Hospital Number: O8583042 , Hospital: Random NHS Foundation Trust , DOB:  1920-12-07 , General Practitioner: Dr. Romero, Ashley  , Date of procedure:  2013-11-12Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Grade D oesophagitis healing. Previous duodenal ulcer FINDINGS: Normal gastroscopy to the duodenum. NA  The patient should be advised to avoid hot spices, sauces, and acidic foods to reduce discomfort and promote healing.  "
"402","Hospital Number: H2587908 , Hospital: Random NHS Foundation Trust , DOB:  1924-07-28 , General Practitioner: Dr. Israel, Stephanie  , Date of procedure:  2013-09-14Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  100mcg  , Midazolam  3mg  , Instrument:  FG3  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow-up ULCER HEALING FINDINGS: Oesophagus- Hiatus hernia seen..   Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) may be necessary for larger or more complex ulcers.  The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools."
"403","Hospital Number: P9907275 , Hospital: Random NHS Foundation Trust , DOB:  1981-03-16 , General Practitioner: Dr. Tamblyn, Mariah  , Date of procedure:  2003-04-23Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia . FINDINGS: The patient has a stricture in the stomach which is constrictedThe endoscope passed through the stricture with resistance. A gastric stricture with an overlying ulceration is seen in the antrum, suggestive of a peptic stricture.During biopsy, it was noted that the lesion had a friable surface and bled easily.. LA Grade  A oesophagitis. There are scattered erosions present in the oesophageal mucosa. The gastroesophageal junction appears normal, but there is diffuse erythema of the distal oesophagus. NA  Close monitoring of the patient's blood pressure and fluid balance may be necessary in the event of significant bleeding from the ulcer.  The patient should be advised to eat slowly and chew their food thoroughly to aid digestion and reduce the risk of ulcer recurrence."
"404","Hospital Number: D9990587 , Hospital: Random NHS Foundation Trust , DOB:  1978-01-27 , General Practitioner: Dr. el-Habib, Wardiyya  , Date of procedure:  2008-05-23Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG5  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known coeliac ch diarrhoea.Myelofibrosis on ruxolitinib and panobinostat FINDINGS: Normal gastroscopy to the duodenum. "
"405","Hospital Number: K9010769 , Hospital: Random NHS Foundation Trust , DOB:  1910-01-10 , General Practitioner: Dr. Nguyen, Ryang Ah  , Date of procedure:  2014-11-21Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Previous Polyps/Metaplasia etc. FINDINGS: The patient has a polyp in the GOJ which is sessile.It has a normal pit pattern. Upon endoscopic examination of the oesophagus, a Paris IIa polypoid lesion was observed, measuring 1.3 cm in diameter. The lesion had a smooth surface and appeared to be pedunculated.Endoscopic mucosal resection was performed to remove the polyp in its entirety..  NA  The patient should avoid eating before bedtime, as this can increase the risk of reflux and polyp growth.  The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more polyps."
"406","Hospital Number: U5728377 , Hospital: Random NHS Foundation Trust , DOB:  1950-04-02 , General Practitioner: Dr. Ray, Heather  , Date of procedure:  2012-02-18Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  100mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Previous Polyps/Metaplasia etc. FINDINGS: The patient has inflammation in the second part of the duodenum which is erosive. The duodenal folds appear thickened and rigid, with erythema noted in the intervening mucosa.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. There is inflammation in the body which is severe. The gastric inflammation appears to be mild, with erythema and edema limited to the antrum of the stomach.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. character(0) RECOMMENDATION: If the stricture is causing symptoms such as difficulty swallowing, the patient may be referred to a speech therapist for swallowing therapy. RECOMMENDATION: The patient should follow a strict diet and avoid irritants that can exacerbate the inflammation.  The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more polyps. FOLLOW UP: The patient should avoid eating large meals and should instead eat smaller, more frequent meals throughout the day. FOLLOW UP: The patient should be advised to eat slowly and chew their food thoroughly to aid digestion and reduce the risk of inflammation.  The patient should be advised to avoid consuming caffeine, which can stimulate the production of stomach acid and increase the risk of polyp growth."
"407","Hospital Number: Y3424765 , Hospital: Random NHS Foundation Trust , DOB:  1964-08-05 , General Practitioner: Dr. Ingle, Brooke  , Date of procedure:  2015-08-19Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Chronic cough?reflux FINDINGS: Normal gastroscopy to the duodenum. "
"408","Hospital Number: S9335497 , Hospital: Random NHS Foundation Trust , DOB:  1993-03-14 , General Practitioner: Dr. Solis, Meghan  , Date of procedure:  2002-04-03Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Small Bowel Biopsy FINDINGS: The patient has a 5mm nodule in the oesophagus at 22 cm which is stalked. A nodular lesion is observed in the gastric cardia, with surrounding erythema and nodularity of the overlying mucosa, suggestive of a malignant gastric neoplasm.Further testing may be necessary to determine the underlying cause of the inflammation and to guide appropriate treatment..  character(0) RECOMMENDATION: If the nodule is found to be cancerous, the patient may require further imaging studies and biopsies to determine the stage of the cancer and the appropriate treatment. RECOMMENDATION: The patient may be prescribed medication to reduce the production of stomach acid and prevent reflux.  The patient should be advised to avoid consuming too much sugar, as this can exacerbate the inflammation by increasing the risk of bacterial overgrowth in the stomach. FOLLOW UP: The patient may be referred to a nutritionist to develop a diet plan that is easier to digest and that meets their nutritional needs. FOLLOW UP: The patient may be referred to a specialist for further evaluation and treatment, such as surgery to widen the esophagus.  The patient should avoid wearing tight clothing, as this can exacerbate the inflammation by increasing the pressure on the stomach."
"409","Hospital Number: R3233951 , Hospital: Random NHS Foundation Trust , DOB:  1949-03-05 , General Practitioner: Dr. Poss, Kaley  , Date of procedure:  2009-11-23Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Other-assess stents FINDINGS: Normal gastroscopy to the duodenum. "
"410","Hospital Number: Z3118534 , Hospital: Random NHS Foundation Trust , DOB:  1987-11-20 , General Practitioner: Dr. Roberts, Chamera  , Date of procedure:  2004-02-03Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG4  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Dyspepsia FINDINGS: There is a nodule in the second part of the duodenum which is benign-looking. The patient has an ulcer in the duodenal bulb which is superficial.Forrest Ulcer classification: IIc.. The patient's medical history, along with the ulcer's rugose surface and irregular border, suggest a chronic inflammatory process.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. The margins of the ulcer appear to be slightly raised, with a central depression.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. NA RECOMMENDATION: Biopsy samples were taken from the ulcer base to rule out malignancy. The patient should follow up with their referring physician for results.  The patient should be advised to avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as these can increase the risk of bleeding in the gastrointestinal tract. FOLLOW UP:   Further investigations, such as imaging studies and biopsy, may be required to determine the nature of the nodule."
"411","Hospital Number: G7303882 , Hospital: Random NHS Foundation Trust , DOB:  1900-04-08 , General Practitioner: Dr. Villalobos Macias, America  , Date of procedure:  2015-02-04Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Nausea and/or Vomiting FINDINGS: The patient has a 10mm nodule in the third part of the duodenum which is stalked. There is a polyp in the stomach which is stalked.It has an abnormal pit pattern. Multiple gastric polyps are seen in the antrum, with a clustered distribution and variable surface contour.Using a snare, the polyp was excised and retrieved for pathologic analysis.. character(0) RECOMMENDATION: The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent further damage to the gastrointestinal tract.  The patient should avoid consuming too much fat, as this can delay gastric emptying and increase the risk of reflux and polyp growth. FOLLOW UP: The patient should be advised to avoid eating large meals or eating quickly, as this can increase the risk of reflux and further damage to the gastrointestinal tract.  Further investigations such as a biopsy may be recommended to determine the type of polyp and assess the risk of cancer."
"412","Hospital Number: B2496144 , Hospital: Random NHS Foundation Trust , DOB:  1927-08-19 , General Practitioner: Dr. Vincent, Emma  , Date of procedure:  2004-07-12Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  25mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Therapeutic- Dilatation FINDINGS: Normal gastroscopy to the duodenum. "
"413","Hospital Number: J9928505 , Hospital: Random NHS Foundation Trust , DOB:  1962-01-06 , General Practitioner: Dr. Washington, Talawnna  , Date of procedure:  2016-01-10Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"414","Hospital Number: M7832839 , Hospital: Random NHS Foundation Trust , DOB:  1937-03-13 , General Practitioner: Dr. Payne, Deanna  , Date of procedure:  2016-10-18Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG5  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Weight Loss FINDINGS: Normal gastroscopy to the duodenum. "
"415","Hospital Number: C1538169 , Hospital: Random NHS Foundation Trust , DOB:  1910-07-07 , General Practitioner: Dr. Duran, Christina  , Date of procedure:  2011-11-19Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss CHRONIC DIARRHOEA-biopsies needed Nausea and/or Vomiting FINDINGS: There is a nodule in the GOJ which is sessile. The stricture appears to have a smooth, regular contour without any visible masses or ulcers.Encourage the patient to maintain a healthy diet and exercise regimen to improve overall health and reduce inflammation.. There is inflammation in the body which is severe. The gastric inflammation is characterized by the presence of lymphoid aggregates in the mucosal layer.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. character(0) RECOMMENDATION: Follow-up with a primary care physician or gastroenterologist for ongoing management and symptom control is recommended. RECOMMENDATION: The patient should be advised to avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as these can increase the risk of bleeding in the gastrointestinal tract. RECOMMENDATION: The patient may be prescribed medication to reduce the production of stomach acid and prevent reflux.  Further investigations such as a biopsy may be recommended to determine the underlying cause of the inflammation. FOLLOW UP: The patient is advised to return for a follow-up appointment in two to four weeks' time to discuss the findings and plan for further management. FOLLOW UP: The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent further damage to the gastrointestinal tract. FOLLOW UP: The patient should be advised to chew their food thoroughly and to eat slowly to help prevent swallowing difficulties.  The patient is advised to return for a follow-up appointment in six weeks' time to evaluate the progress of the inflammation."
"416","Hospital Number: Q6090326 , Hospital: Random NHS Foundation Trust , DOB:  1910-08-13 , General Practitioner: Dr. Hurtado, Maribel  , Date of procedure:  2002-05-14Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  125mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Hb drop ?GI bleed previous gastric surgery FINDINGS: Normal gastroscopy to the duodenum. "
"417","Hospital Number: X8881813 , Hospital: Random NHS Foundation Trust , DOB:  1925-03-31 , General Practitioner: Dr. Figueroa, Brittani  , Date of procedure:  2011-03-03Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Nausea and/or Vomiting Weight Loss FINDINGS: Normal gastroscopy to the duodenum. "
"418","Hospital Number: E5760181 , Hospital: Random NHS Foundation Trust , DOB:  1980-05-07 , General Practitioner: Dr. Hall, Cassidy  , Date of procedure:  2008-11-21Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  125mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: IDA FINDINGS: Normal gastroscopy to the duodenum. "
"419","Hospital Number: N3482935 , Hospital: Random NHS Foundation Trust , DOB:  1910-03-25 , General Practitioner: Dr. Gurzhiev, Jessie  , Date of procedure:  2011-12-27Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG1  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Positive coeliac FINDINGS: Normal gastroscopy to the duodenum. "
"420","Hospital Number: V6466799 , Hospital: Random NHS Foundation Trust , DOB:  1936-08-05 , General Practitioner: Dr. el-Mohammed, Sumaita  , Date of procedure:  2009-06-15Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  150mcg  , Midazolam  7mg  , Instrument:  FG2  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- PEG FINDINGS: The patient has inflammation in the fundus which is erosive. The gastric mucosa appears diffusely atrophic with a smooth surface and no erosions, suggestive of chronic gastritis with intestinal metaplasia.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. No inlet patch was seen.. NA RECOMMENDATION: The patient should avoid eating large meals late at night, as this can worsen reflux symptoms.   FOLLOW UP: Further investigations, such as imaging studies and blood tests, may be required to determine the underlying cause of the stricture.  The patient should avoid eating too quickly, as this can exacerbate the inflammation by increasing the risk of reflux and indigestion."
"421","Hospital Number: L2151400 , Hospital: Random NHS Foundation Trust , DOB:  1909-04-12 , General Practitioner: Dr. Chavez, Janessa  , Date of procedure:  2014-07-31Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia Vomiting known hiatus hernia FINDINGS: The endoscopic appearance of the oesophagus is suggestive of eosinophilic oesophagitis, with multiple linear furrows and white plaques..  NA"
"422","Hospital Number: A3080284 , Hospital: Random NHS Foundation Trust , DOB:  1961-09-08 , General Practitioner: Dr. Bonser, Chelsea  , Date of procedure:  2016-01-21Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG2  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain previous ogd attempt food residue FINDINGS: As an incidental finding she also has a cervical inlet patch.. "
"423","Hospital Number: I7491657 , Hospital: Random NHS Foundation Trust , DOB:  1905-08-25 , General Practitioner: Dr. Martinez, Summer  , Date of procedure:  2007-04-12Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- clips positioning to oesophageal lesion FINDINGS: The patient has a stricture in the third part of the duodenum which is scleroticIt will not allow the scope to pass.. The duodenal mucosa proximal to the stricture appears slightly erythematous, while the distal mucosa appears normal.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. The patient has inflammation in the second part of the duodenum which is mild. There are areas of nodularity seen throughout the duodenal mucosa, suggestive of chronic inflammation.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. character(0) RECOMMENDATION: The patient may be referred to a specialist for further evaluation and treatment, such as surgery to widen the esophagus.  The patient may be referred to a gastroenterologist for further management of the inflammation. FOLLOW UP: If the patient experiences chest pain or difficulty breathing, they should seek emergency medical attention immediately.  The patient should be advised to avoid acidic foods and drinks, which can irritate the lining of the stomach and exacerbate the inflammation."
"424","Hospital Number: F8022001 , Hospital: Random NHS Foundation Trust , DOB:  1933-12-08 , General Practitioner: Dr. Ly, Rachel  , Date of procedure:  2011-10-05Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  25mcg  , Midazolam  7mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Haematemesisor Melaena/Blood PR FINDINGS: There is a nodule in the antrum which is benign-looking. A small, solid nodule is observed in the gastric body, suggestive of a gastric carcinoid tumor.The patient should be advised to avoid carbonated beverages and caffeine as these may exacerbate symptoms.. The patient has inflammation in the D1/D2 angle which is mild. character(0) RECOMMENDATION: The patient should be advised to maintain a healthy weight, as obesity can increase the risk of cancer and other gastrointestinal diseases. RECOMMENDATION: The patient should be informed of the diagnosis and the importance of adhering to the recommended treatment plan.  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and inflammation. FOLLOW UP: The patient should be advised to report any new symptoms or changes in symptoms to their healthcare provider immediately. FOLLOW UP: The patient should be advised to avoid lying down for at least three hours after eating to help prevent reflux.  The patient should be encouraged to maintain a healthy weight to reduce the risk of developing inflammation in the future."
"425","Hospital Number: T4904215 , Hospital: Random NHS Foundation Trust , DOB:  1902-02-26 , General Practitioner: Dr. Ellis, Jessica  , Date of procedure:  2016-08-18Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Other- candidiasis FINDINGS: Inlet patch - Yes. "
"426","Hospital Number: W8932372 , Hospital: Random NHS Foundation Trust , DOB:  1997-10-06 , General Practitioner: Dr. Nelson, Ariel  , Date of procedure:  2001-11-05Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  50mcg  , Midazolam  5mg  , Instrument:  FG5  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like SymptomsAbdominal Pain FINDINGS: There is inflammation in the body which is severe. The gastric inflammation is diffuse and characterized by the presence of plasma cells in the mucosal layer.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from..  RECOMMENDATION: The patient should avoid eating large meals and should instead eat smaller, more frequent meals throughout the day.   FOLLOW UP: The patient should be advised to avoid eating foods that are difficult to swallow, such as hard or crunchy foods.  The patient should be advised to avoid consuming too much sugar, as this can exacerbate the inflammation by increasing the risk of bacterial overgrowth in the stomach."
"427","Hospital Number: O7967929 , Hospital: Random NHS Foundation Trust , DOB:  1992-04-09 , General Practitioner: Dr. Reeves, Salem  , Date of procedure:  2008-08-08Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  125mcg  , Midazolam  1mg  , Instrument:  FG1  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia post LTA FINDINGS: There is a polyp in the D1/D2 angle which is stalked with a normal pit pattern.   The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and polyp growth.  The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and increase the risk of polyp growth."
"428","Hospital Number: H3844577 , Hospital: Random NHS Foundation Trust , DOB:  1945-12-03 , General Practitioner: Dr. Byer, Michelle  , Date of procedure:  2011-09-11Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  125mcg  , Midazolam  5mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins weight loss. On warfarin and clopidogrel, FINDINGS: There is a polyp in the stomach which is stalked.It has an abnormal pit pattern. Multiple gastric polyps are seen in the antrum, with a clustered distribution and variable surface contour.Using a snare, the polyp was excised and retrieved for pathologic analysis.. There is inflammation in the duodenal bulb which is erosive. The duodenal mucosa appears edematous and congested, with evidence of exudate present in some areas.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. character(0) RECOMMENDATION: The patient should avoid eating before going to bed, as this can worsen reflux symptoms. RECOMMENDATION: The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools.  The patient should avoid smoking and alcohol, which can increase the risk of developing more polyps. FOLLOW UP: A follow-up appointment with the gastroenterologist should be scheduled for six months after the initial diagnosis to monitor the patient's progress. FOLLOW UP: The patient should avoid smoking and alcohol, which can worsen the inflammation.  A repeat gastroscopy may be recommended in three to six months' time to assess the growth of the polyp."
"429","Hospital Number: P4236233 , Hospital: Random NHS Foundation Trust , DOB:  1983-11-05 , General Practitioner: Dr. Carmona, Amanda  , Date of procedure:  2003-07-25Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG6  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia   post oesophagectomy FINDINGS: Normal gastroscopy to the duodenum. character(0)"
"430","Hospital Number: D4826904 , Hospital: Random NHS Foundation Trust , DOB:  1933-10-02 , General Practitioner: Dr. Larios, Amelia  , Date of procedure:  2012-07-07Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Coeliac folllow up abd pain  bloating diarhoea FINDINGS: Normal gastroscopy to the duodenum. "
"431","Hospital Number: K8847627 , Hospital: Random NHS Foundation Trust , DOB:  1902-12-29 , General Practitioner: Dr. el-Jafari, Laaiqa  , Date of procedure:  2014-09-20Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  12.5mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Other-BloatingAbdominal Pain FINDINGS: The patient's oesophagus is noted to have linear furrowing.. There is a nodule in the antrum which is stalked. A nodular lesion with overlying mucosal ulceration is seen in the gastric fundus, suggestive of a gastric neuroendocrine tumor.Follow-up endoscopy with surveillance biopsies may be necessary for patients with a history of polyps or increased risk for malignancy.. character(0) RECOMMENDATION: Follow-up endoscopy should be performed in 4-6 weeks to assess for healing and to repeat biopsies if necessary. RECOMMENDATION: If the nodule is benign, the patient may not require any treatment, but may require monitoring with regular endoscopies.  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and polyp growth. FOLLOW UP: The patient should be advised to avoid consuming caffeine, which can stimulate the production of stomach acid and delay the healing of the ulcer. FOLLOW UP: The patient should be advised to attend all scheduled appointments and follow the treatment plan recommended by their healthcare provider.  The patient should avoid consuming too much fat, as this can delay gastric emptying and increase the risk of reflux and polyp growth."
"432","Hospital Number: U8525559 , Hospital: Random NHS Foundation Trust , DOB:  1929-05-01 , General Practitioner: Dr. Hill, Amanda  , Date of procedure:  2010-11-22Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  75mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CD FINDINGS: There is a nodule in the GOJ which is sessile. There are multiple raised, nodular areas of mucosa, suggestive of granulomatous inflammation.The patient should be instructed to avoid caffeine and carbonated beverages to reduce discomfort and promote healing.. There is inflammation in the D1/D2 angle which is erosive. character(0) RECOMMENDATION: A follow-up appointment with the gastroenterologist should be scheduled for six months after the initial diagnosis to monitor the patient's progress. RECOMMENDATION: The patient should avoid eating or drinking for at least six hours before any scheduled appointments.   FOLLOW UP: The patient should be advised to avoid lifting heavy objects or engaging in strenuous physical activity, as this can increase the risk of bleeding in the gastrointestinal tract. FOLLOW UP: The patient should be advised to avoid eating foods that are difficult to swallow, such as hard or crunchy foods.  The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and exacerbate the inflammation."
"433","Hospital Number: Y5602439 , Hospital: Random NHS Foundation Trust , DOB:  1974-09-19 , General Practitioner: Dr. Robinson, Katelyn  , Date of procedure:  2014-09-23Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  100mcg  , Midazolam  7mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain FINDINGS: There is a stricture in the third part of the duodenum which is irregularScope not held by stricture. The duodenal stricture has a non-distensible appearance, suggestive of fibrosis.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. Hiatus Hernia- Large.. NA"
"434","Hospital Number: S6682774 , Hospital: Random NHS Foundation Trust , DOB:  1953-10-02 , General Practitioner: Dr. el-Shaheed, Naseeba  , Date of procedure:  2015-03-08Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  75mcg  , Midazolam  7mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: High Dysphagia further assessment of previoius diagnosed peptic stricture also recent eus and aspirat of bengn perigastric cyst FINDINGS: The patient has a polyp in the GOJ which is sessile with a normal pit pattern. Upon endoscopic examination of the oesophagus, a 2 cm Paris IIa/c polypoid lesion was observed. The lesion had a smooth surface and appeared to be pedunculated.Endoscopic mucosal resection was performed to remove the polyp in its entirety..  character(0)  The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and increase the risk of polyp growth.  The patient should avoid smoking and alcohol, which can increase the risk of developing more polyps."
"435","Hospital Number: R6103760 , Hospital: Random NHS Foundation Trust , DOB:  1957-08-01 , General Practitioner: Dr. Bough, Devon  , Date of procedure:  2004-11-08Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  12.5mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow up oesophageal stricture dysphagia for recurrent dilatation FINDINGS: There is a nodule in the oesophagus at 35 cm which is stalked. The oesophageal ulcer appears to be a linear, longitudinally oriented lesion with associated mucosal edema.The patient should avoid consuming too much fat, as this can delay gastric emptying and delay the healing of the ulcer..  NA RECOMMENDATION: The patient should be counseled on the importance of maintaining good oral hygiene to prevent oral bacteria from entering the ulcer site.  If the nodule is suspicious for cancer, the patient may be referred to an oncologist for further evaluation and treatment. FOLLOW UP: The patient should be informed of the diagnosis and provided with information on how to manage the ulcer.  The patient should avoid smoking and drinking alcohol, as these habits can increase the risk of cancer."
"436","Hospital Number: Z1272661 , Hospital: Random NHS Foundation Trust , DOB:  1937-10-09 , General Practitioner: Dr. Barragan, Siera  , Date of procedure:  2016-08-28Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Family history of gastric cancer FINDINGS: Normal gastroscopy to the duodenum. "
"437","Hospital Number: G2227671 , Hospital: Random NHS Foundation Trust , DOB:  1942-11-29 , General Practitioner: Dr. Pina, Amanda  , Date of procedure:  2010-12-22Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG1  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Chronic cough?reflux FINDINGS: The patient has a stricture in the second part of the duodenum which is inflexibleTight stricture impassable with scope.. The stricture is non-tapering and involves the entire circumference of the duodenal lumen.During biopsy, it was noted that the lesion had a friable surface and bled easily.. There is a nodule in the body which is sessile. The gastric mucosa appears thickened with multiple small nodules, suggestive of a lymphoproliferative disorder such as MALT lymphoma.Given the finding of a stricture, a referral to a gastroenterologist is recommended for further evaluation and management.. character(0)  The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent further damage to the gastrointestinal tract.  If the nodule is benign, the patient may not require any treatment, but may require monitoring with regular endoscopies."
"438","Hospital Number: B7082304 , Hospital: Random NHS Foundation Trust , DOB:  1962-12-01 , General Practitioner: Dr. Castillo, Marissa  , Date of procedure:  2013-11-07Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  100mcg  , Midazolam  4mg  , Instrument:  FG1  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia post LTA FINDINGS: There is inflammation in the stomach which is mild. The gastric inflammation appears to be diffuse and involves both the body and antrum of the stomach.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. LA Grade  A oesophagitis. The lower oesopahgeal sphincter looks widely patent character(0) RECOMMENDATION: The patient should be advised to elevate the head of their bed by six inches to help prevent reflux at night.  The patient should be advised to avoid acidic foods and drinks, which can irritate the lining of the stomach and exacerbate the inflammation. FOLLOW UP: If the patient experiences chest pain or difficulty breathing, they should seek emergency medical attention immediately.  The patient is advised to return for a follow-up appointment in six weeks' time to evaluate the progress of the inflammation."
"439","Hospital Number: J8000143 , Hospital: Random NHS Foundation Trust , DOB:  1976-10-16 , General Practitioner: Dr. Maxwell, Ladreshalek  , Date of procedure:  2008-07-22Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  150mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Abdominal Pain FINDINGS: There is a polyp in the GOJ which is stalked.It has an abnormal pit pattern. An oesophageal polyp was detected during endoscopy, located approximately 14 cm from the incisors. The lesion had a nodular surface and measured 1 cm in diameter.Under endoscopic visualization, the polyp was removed using EMR.. The patient has a 3mm nodule in the fundus which is stalked. A large, lobulated nodule is observed in the gastric body, suggestive of a gastrointestinal autonomic nerve tumor (GANT).The patient should be monitored for signs of infection or other complications related to inflammation.. NA RECOMMENDATION: The patient may be referred to a specialist for further evaluation and treatment, such as surgery to remove the nodule. RECOMMENDATION: The patient should avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as these can worsen GERD symptoms. RECOMMENDATION: The patient should avoid eating too much fat, as this can exacerbate the inflammation by delaying gastric emptying and increasing the risk of reflux.  The patient should avoid lying down immediately after meals, as this can increase the risk of reflux and polyp growth. FOLLOW UP: Further investigations, such as imaging studies and biopsy, may be required to determine the nature of the nodule. FOLLOW UP: The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent reflux. FOLLOW UP: The patient should avoid eating too quickly, as this can exacerbate the inflammation by increasing the risk of reflux and indigestion.  The patient should avoid lying down immediately after meals, as this can increase the risk of reflux and polyp growth."
"440","Hospital Number: M2497777 , Hospital: Random NHS Foundation Trust , DOB:  1996-12-14 , General Practitioner: Dr. Peter, Taryn  , Date of procedure:  2003-09-01Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  125mcg  , Midazolam  5mg  , Instrument:  FG1  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Coeliac folllow up abd pain  bloating diarhoea FINDINGS: There is a polyp in the third part of the duodenum which is stalked.It has an abnormal pit pattern. The mucosa surrounding the nodules is inflamed and edematous, with a granular appearance.The base of the polyp was cauterized with an argon plasma coagulator to prevent bleeding.. No inlet patch.. NA RECOMMENDATION: The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the nodule.  The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and increase the risk of polyp growth. FOLLOW UP: The patient should be advised to seek emotional support from friends, family, or a counselor, as the diagnosis of cancer can be difficult to cope with.  The patient should be advised to avoid consuming alcohol, which can increase the risk of developing more polyps."
"441","Hospital Number: C1910592 , Hospital: Random NHS Foundation Trust , DOB:  1985-07-02 , General Practitioner: Dr. Chacon, Allanna  , Date of procedure:  2001-02-08Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG4  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia  post radiation stricture FINDINGS: He had two visible vessels just distal to the GOJ, withina hiatus hernia.. There is inflammation in the stomach which is severe. The gastric inflammation is severe and involves ulceration and necrosis of the mucosa.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. character(0) RECOMMENDATION: Biopsy samples were taken from the ulcer base to rule out malignancy. The patient should follow up with their referring physician for results. RECOMMENDATION: The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the stricture.  The patient should avoid eating before bedtime, as this can exacerbate the inflammation by increasing the risk of reflux. FOLLOW UP: The patient should avoid lying down immediately after meals, as this can increase the risk of reflux and ulcer recurrence. FOLLOW UP: The patient should avoid eating large meals late at night, as this can worsen reflux symptoms.  The patient should be advised to avoid consuming too much sugar, as this can exacerbate the inflammation by increasing the risk of bacterial overgrowth in the stomach."
"442","Hospital Number: Q9535363 , Hospital: Random NHS Foundation Trust , DOB:  1936-09-19 , General Practitioner: Dr. Cody, Brittany  , Date of procedure:  2001-09-23Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia post transhiatal oesophagectomy FINDINGS: The patient has a 5mm nodule in the duodenal bulb which is sessile.  character(0)  The patient may be prescribed medication to manage any symptoms associated with the nodule, such as pain or discomfort.  The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the nodule."
"443","Hospital Number: X7857756 , Hospital: Random NHS Foundation Trust , DOB:  1926-04-29 , General Practitioner: Dr. al-Soliman, Rabdaa  , Date of procedure:  2005-08-06Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG5  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Haematemesis or Melaena/Blood PR FINDINGS: The patient has a stricture in the third part of the duodenum which is tight.Tight distal stricture which would not allow passage of scope.. Linear furrowing was observed in the mid and distal esophagus during endoscopy, which may indicate eosinophilic oesophagitis. OGD showed the presence of several white exudates in the mid and distal esophagus. The diameter of the duodenal lumen at the stricture site is significantly smaller than the diameter of the duodenum proximal and distal to the stricture.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample..  NA"
"444","Hospital Number: E8303284 , Hospital: Random NHS Foundation Trust , DOB:  1918-08-11 , General Practitioner: Dr. Singh, Alexis  , Date of procedure:  2003-11-22Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: ongoing diarhoea intermittent PR bleed. Previous RCD!. FINDINGS: There is a nodule in the duodenal bulb which is benign-looking. The patient has a stricture in the antrum which is unyieldingIt is easily traversible.. A gastric stricture with an overlying ulceration is seen in the antrum, suggestive of a peptic stricture.The ulcer was biopsied x8 for further analysis.. NA RECOMMENDATION: Biopsy samples were taken from the ulcer base to rule out malignancy. The patient should follow up with their referring physician for results.  The patient should avoid eating fried or fatty foods, as these can increase the risk of reflux and further damage to the gastrointestinal tract. FOLLOW UP:   The patient should avoid eating fried or fatty foods, as these can increase the risk of reflux and further damage to the gastrointestinal tract."
"445","Hospital Number: N5562828 , Hospital: Random NHS Foundation Trust , DOB:  1947-02-09 , General Practitioner: Dr. Pyles, Amina  , Date of procedure:  2003-06-17Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  125mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss . FINDINGS: Normal gastroscopy to the duodenum. "
"446","Hospital Number: V8753920 , Hospital: Random NHS Foundation Trust , DOB:  1928-06-24 , General Practitioner: Dr. Ballou, Jordyn  , Date of procedure:  2013-01-17Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG6  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Abdominal Pain FINDINGS: LA Grade  C oesophagitis. There is diffuse mucosal edema throughout the oesophagus. Candida present. There is diffuse erythema and friability throughout the oesophagus.  NA"
"447","Hospital Number: L1479863 , Hospital: Random NHS Foundation Trust , DOB:  1976-08-02 , General Practitioner: Dr. Mann, Lora  , Date of procedure:  2001-05-04Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG6  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - chronic cough ?GORD FINDINGS: Normal gastroscopy to the duodenum. "
"448","Hospital Number: A5218459 , Hospital: Random NHS Foundation Trust , DOB:  1912-02-22 , General Practitioner: Dr. Noel, Alyssa  , Date of procedure:  2013-02-07Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG2  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Abdominal Pain FINDINGS: There is a nodule in the D1/D2 angle which is benign-looking.   The patient should be informed of the diagnosis and the importance of adhering to the recommended treatment plan.  The patient should be advised to maintain a healthy diet and lifestyle, as this may help prevent the growth of the nodule."
"449","Hospital Number: I2777268 , Hospital: Random NHS Foundation Trust , DOB:  1936-01-26 , General Practitioner: Dr. al-Naim, Shaqeeqa  , Date of procedure:  2008-03-09Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG5  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"450","Hospital Number: F7726169 , Hospital: Random NHS Foundation Trust , DOB:  1975-08-12 , General Practitioner: Dr. el-Fares, Afnaan  , Date of procedure:  2006-05-05Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  100mcg  , Midazolam  7mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Chemorad for scc middle third of oeosphagus - post treatment assessement FINDINGS: No inlet patch.. "
"451","Hospital Number: T1978921 , Hospital: Random NHS Foundation Trust , DOB:  1972-01-15 , General Practitioner: Dr. Coca, Shanaya  , Date of procedure:  2015-04-22Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  25mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Anaemia/Low Iron or Vitamins FINDINGS: There is a stricture in the D1/D2 angle which is unyieldingThere is very slight and non-restrcitve stricturing.. "
"452","Hospital Number: W8248560 , Hospital: Random NHS Foundation Trust , DOB:  1970-09-06 , General Practitioner: Dr. Hansen, Brooke  , Date of procedure:  2004-01-03Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  125mcg  , Midazolam  3mg  , Instrument:  FG3  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia post LTA FINDINGS: There is inflammation in the body which is erosive. The gastric mucosa appears diffusely thickened with a cobblestone appearance and no ulcerations, suggestive of granulomatous gastritis.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from..  RECOMMENDATION: Endoscopic resection of the ulcer may be necessary for larger or more complex ulcers. RECOMMENDATION: The patient should be advised to avoid wearing tight clothing around their waist, as this can put pressure on the stomach and worsen GERD symptoms.   FOLLOW UP: The patient should avoid carbonated drinks, which can increase the production of gas and delay the healing of the ulcer. FOLLOW UP: The patient may be referred to a nutritionist to develop a diet plan that is easier to swallow and that meets their nutritional needs.  A repeat gastroscopy may be required in three to six months' time to monitor the progress of the inflammation."
"453","Hospital Number: O8592861 , Hospital: Random NHS Foundation Trust , DOB:  1943-01-17 , General Practitioner: Dr. Rioja Piedras, Alyssa  , Date of procedure:  2004-05-09Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  100mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia FINDINGS: Barrett's is present. No abnormal pit pattern is seen. "
"454","Hospital Number: H1442477 , Hospital: Random NHS Foundation Trust , DOB:  1920-05-20 , General Practitioner: Dr. Bonser, Mika  , Date of procedure:  2006-09-27Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG6  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow up oesophageal stricture dysphagia for recurrent dilatation FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"").
NA"
"455","Hospital Number: P1673382 , Hospital: Random NHS Foundation Trust , DOB:  1984-07-28 , General Practitioner: Dr. Lewis, Elberta  , Date of procedure:  2013-10-10Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  150mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins . FINDINGS: Normal gastroscopy to the duodenum. "
"456","Hospital Number: D3953088 , Hospital: Random NHS Foundation Trust , DOB:  1957-01-24 , General Practitioner: Dr. el-Anwar, Tayyiba  , Date of procedure:  2012-07-04Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG5  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: dypepsia FINDINGS: Normal gastroscopy to the duodenum. "
"457","Hospital Number: K5760664 , Hospital: Random NHS Foundation Trust , DOB:  1909-01-13 , General Practitioner: Dr. Blackmore, Mara  , Date of procedure:  2013-10-16Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Globus cough FINDINGS: There is a nodule in the GOJ which is stalked. A well-circumscribed, firm nodule is seen in the distal esophagus, suggestive of an esophageal gastrointestinal stromal tumor (GIST).Lifestyle modifications such as avoiding trigger foods and losing weight may help reduce inflammation.. The patient has inflammation in the D1/D2 angle which is severe. NA RECOMMENDATION: The patient should be advised to maintain a healthy diet and lifestyle, as this may help prevent the growth of the nodule. RECOMMENDATION: The patient may be referred to a psychologist to help manage any anxiety or stress that may be contributing to their symptoms.  The patient should avoid eating before bedtime, as this can exacerbate the inflammation by increasing the risk of reflux. FOLLOW UP: The patient may be referred to a surgeon for a minimally invasive procedure to remove the nodule. FOLLOW UP: The patient should avoid eating or drinking for at least six hours before any scheduled appointments.  The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and exacerbate the inflammation."
"458","Hospital Number: U6704720 , Hospital: Random NHS Foundation Trust , DOB:  1901-06-11 , General Practitioner: Dr. Walker, Erin  , Date of procedure:  2009-11-01Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG6  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: ongoing diarhoea intermittent PR bleed. Previous RCD!. FINDINGS: Multiple whitish plaques are noted in the oesophagus that may be suggestive of eosinophilic oesophagitis or Candida esophagitis..  character(0)"
"459","Hospital Number: Y1451790 , Hospital: Random NHS Foundation Trust , DOB:  1956-08-31 , General Practitioner: Dr. Denmon, Shelby  , Date of procedure:  2010-05-01Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Dyspepsia FINDINGS: There is a polyp in the D1/D2 angle which is sessile.It has an abnormal pit pattern.     The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more polyps."
"460","Hospital Number: S9523253 , Hospital: Random NHS Foundation Trust , DOB:  1959-11-19 , General Practitioner: Dr. Bear-Flores, Lydia  , Date of procedure:  2002-11-02Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Nausea and/or Vomiting Reflux-like Symptoms/Atypical Chest Pain Weight Loss FINDINGS: There is a stricture in the duodenal bulb which is unyieldingThe endoscope passed through the stricture with resistance. The stricture appears to be extraluminal in nature, with no evidence of intraluminal obstruction.Following the biopsy of the lesion, there was bleeding, which was promptly managed..  NA"
"461","Hospital Number: R7817343 , Hospital: Random NHS Foundation Trust , DOB:  1919-11-22 , General Practitioner: Dr. Trinh, Ruby  , Date of procedure:  2007-05-18Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Dyspepsia FINDINGS: The patient has Barrett's oesophagus. No abnormal pit pattern is seen. No nodularity is present. Some areas of vascular abnormalities are seen. The patient has inflammation in the second part of the duodenum which is mild. The duodenal mucosa appears to have a cobblestone appearance, with multiple areas of ulceration and inflammation.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. NA RECOMMENDATION: Follow-up endoscopy should be performed in 4-6 weeks to assess for healing and to repeat biopsies if necessary. RECOMMENDATION: The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the stricture.  The patient is advised to return for a follow-up appointment in six weeks' time to evaluate the progress of the inflammation. FOLLOW UP: The patient should avoid stress and maintain good mental health, as stress can delay the healing of the ulcer. FOLLOW UP:   "
"462","Hospital Number: Z7781233 , Hospital: Random NHS Foundation Trust , DOB:  1901-08-06 , General Practitioner: Dr. Lewis, Ladreshalek  , Date of procedure:  2005-07-27Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  12.5mcg  , Midazolam  5mg  , Instrument:  FG3  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CHRONIC DIARRHOEA-biopsies needed FINDINGS: Inflammatory changes seen in the oesophagus. There is a nodule in the D1/D2 angle which is stalked. NA  If the nodule is benign, the patient may not require any treatment, but may require monitoring with regular endoscopies.  The patient may be referred to a nutritionist to develop a diet plan that is easier to digest and that meets their nutritional needs."
"463","Hospital Number: G7755694 , Hospital: Random NHS Foundation Trust , DOB:  1904-04-30 , General Practitioner: Dr. Wood, Kimberly  , Date of procedure:  2005-01-30Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Weight Loss Mother has gastric cancer FINDINGS: Normal gastroscopy to the duodenum. "
"464","Hospital Number: B7780911 , Hospital: Random NHS Foundation Trust , DOB:  1991-10-18 , General Practitioner: Dr. el-Hana, Hilmiyya  , Date of procedure:  2006-07-03Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain x1 hematemesis Crohns colitis FINDINGS: There is an ulcer in the oesophagus at 23 cm which is fibroticIt has a visible vessel. The gastric ulcer exhibits signs of NSAID-induced injury, with a fibrous base and punched-out appearance.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. Upon endoscopic examination, the oesophageal ulcer appears to be a superficial erosion with minimal surrounding inflammation.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. There is inflammation in the antrum which is severe. The gastric inflammation appears to be associated with the use of proton pump inhibitors (PPIs), with the presence of rebound hypergastrinemia.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. character(0) RECOMMENDATION: Referral to a registered dietitian may be helpful in providing guidance on a healthy, ulcer-friendly diet. RECOMMENDATION: If the patient is experiencing symptoms such as vomiting or fever, they should contact their healthcare provider immediately.  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and inflammation. FOLLOW UP: The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more ulcers. FOLLOW UP: The patient should be advised to avoid wearing tight clothing around their waist, as this can put pressure on the stomach and worsen GERD symptoms.  The patient should avoid NSAIDs and aspirin, which can irritate the lining of the stomach and exacerbate the inflammation."
"465","Hospital Number: J8821698 , Hospital: Random NHS Foundation Trust , DOB:  1907-07-09 , General Practitioner: Dr. al-Zahra, Naseefa  , Date of procedure:  2014-09-07Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Ongoing reflux symptoms. FINDINGS: The patient has a polyp in the fundus which is sessile.It has an abnormal pit pattern. A large, irregular gastric polyp is noted in the body of the stomach, with a nodular and friable surface.The polyp did not lift on saline injection and was therefore not amenable to endoscopic resection..  NA  Further investigations such as a biopsy may be recommended to determine the type of polyp and assess the risk of cancer.  The patient may be prescribed medication to reduce the risk of developing more polyps."
"466","Hospital Number: M8882071 , Hospital: Random NHS Foundation Trust , DOB:  1972-10-02 , General Practitioner: Dr. Bol, Alexandrea  , Date of procedure:  2001-11-01Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  25mcg  , Midazolam  7mg  , Instrument:  FG7  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"467","Hospital Number: C4433311 , Hospital: Random NHS Foundation Trust , DOB:  1988-10-03 , General Practitioner: Dr. Goodrich, Sofia  , Date of procedure:  2010-04-19Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Positive coeliac serology FINDINGS: The patient has a polyp in the second part of the duodenum which is stalked.It has an abnormal pit pattern. The nodules are located in the second and third portions of the duodenum, with sparing of the duodenal papilla.The polyp was visualized and biopsied during upper endoscopy.. Barrett's is present. The pit pattern is normal. No loss of aceto-whitening  was also seen. Some areas of vascular abnormalities are seen. character(0) RECOMMENDATION: The patient should avoid eating fried or fatty foods, as these can increase the risk of reflux and further damage to the gastrointestinal tract.  The patient may be prescribed medication to reduce the risk of developing more polyps. FOLLOW UP: The patient should be advised to avoid eating spicy or acidic foods, as these can irritate the gastrointestinal tract and worsen symptoms.  The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more polyps."
"468","Hospital Number: Q1015837 , Hospital: Random NHS Foundation Trust , DOB:  1968-06-17 , General Practitioner: Dr. Dominguez, Christina  , Date of procedure:  2008-02-01Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  150mcg  , Midazolam  7mg  , Instrument:  FG7  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Other- candidiasis FINDINGS: The patient has a polyp in the second part of the duodenum which is stalked with a normal pit pattern. The nodules are seen in the context of underlying inflammatory bowel disease, including Crohn's disease and ulcerative colitis.The polyp did not lift on saline injection and was therefore not amenable to endoscopic resection.. Pull sign was demonstrated.. Rings were noted throughout the esophagusconsistent with eosinophilic oesophagitis. NA RECOMMENDATION: The patient should be counseled on the risks and benefits of any potential treatments for their ulcer. RECOMMENDATION: The patient should avoid eating or drinking for at least six hours before any scheduled appointments.  A repeat gastroscopy may be required in six months' time to monitor the growth of the polyp. FOLLOW UP: The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more ulcers. FOLLOW UP: If the nodule is found to be cancerous, the patient may require further imaging studies and biopsies to determine the stage of the cancer and the appropriate treatment.  The patient should be informed of the diagnosis and provided with information on how to manage the polyp."
"469","Hospital Number: X2594520 , Hospital: Random NHS Foundation Trust , DOB:  1973-01-03 , General Practitioner: Dr. Holmstrom, Courtney  , Date of procedure:  2014-04-30Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG6  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known EOE oesophgeal biopsies FINDINGS: There is a nodule in the body which is stalked. A small, submucosal nodule is observed in the gastric body, suggestive of a gastric lipoma.The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and increase the risk of polyp growth..  RECOMMENDATION: The patient should be advised to report any new symptoms or changes in symptoms to their healthcare provider immediately.  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and polyp growth. FOLLOW UP: The patient should avoid eating fried or fatty foods, as these can increase the risk of reflux and further damage to the gastrointestinal tract.  The patient should avoid consuming too much fat, as this can delay gastric emptying and increase the risk of reflux and polyp growth."
"470","Hospital Number: E6158591 , Hospital: Random NHS Foundation Trust , DOB:  1947-05-21 , General Practitioner: Dr. Walborn, Matea  , Date of procedure:  2007-02-24Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG1  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia FINDINGS: OESOPHAGUS: small hiatus hernia.. "
"471","Hospital Number: N9571333 , Hospital: Random NHS Foundation Trust , DOB:  1973-05-08 , General Practitioner: Dr. al-Qasim, Fikra  , Date of procedure:  2013-05-19Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow-up ULCER HEALING FINDINGS: There is inflammation in the antrum which is mild. Focal areas of erythema with no exudate are observed in the gastric antrum, suggestive of mild gastritis.The biopsy was performed using a needle biopsy forceps, with the tissue samples sent for pathological analysis.. There is a stricture in the duodenal bulb which is narrowedScope not held by stricture. The stricture has a fibrotic appearance, suggesting chronicity.The ulcer was biopsied x8 for further analysis.. character(0) RECOMMENDATION: Referral to a registered dietitian may be helpful in providing guidance on a healthy, ulcer-friendly diet. RECOMMENDATION: The patient should be advised to maintain a healthy weight, as obesity can worsen the symptoms of GERD.   FOLLOW UP: The patient should avoid eating before bedtime, as this can increase the risk of reflux and ulcer recurrence. FOLLOW UP: The patient should be advised to elevate the head of their bed by six inches to help prevent reflux at night.  A blood test may be ordered to assess the patient's iron levels, as chronic inflammation can cause anemia."
"472","Hospital Number: V3328807 , Hospital: Random NHS Foundation Trust , DOB:  1957-11-13 , General Practitioner: Dr. Hammond, Heather  , Date of procedure:  2006-04-08Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG5  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal bloating chest discomfort reflux.Known fibromyalgia RA FINDINGS: The patient has an ulcer in the GOJ which is excavated s*It is bleeding. The patient's medical history, along with the ulcer's rugose surface and irregular border, suggest a chronic inflammatory process.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample.. Inspection of the oesophageal ulcer reveals an elevated, nodular appearance, consistent with a malignancy.The lesion was biopsied using a standard forceps.. LA Grade  C oesophagitis. The oesophageal mucosa is friable and edematous. Gastric mucosal prolapse also seen severe oesophagitis with ulceration. Signs of NSAID-induced injury are evident in the gastric ulcer, which appears to have a punched-out appearance.During biopsy, it was noted that the lesion had a friable surface and bled easily.. character(0)  Follow-up endoscopy with surveillance biopsies may be necessary for patients with a history of gastric ulcer or increased risk for malignancy.  The patient may be referred to a specialist in gastrointestinal disorders for further management of the ulcer."
"473","Hospital Number: L2721400 , Hospital: Random NHS Foundation Trust , DOB:  1918-06-29 , General Practitioner: Dr. Reilly, Michelle  , Date of procedure:  2010-12-16Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  150mcg  , Midazolam  7mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Abdominal Pain FINDINGS: mild trachealization.. "
"474","Hospital Number: A9747574 , Hospital: Random NHS Foundation Trust , DOB:  1986-03-27 , General Practitioner: Dr. Cooksey, Kelsey  , Date of procedure:  2015-05-19Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  100mcg  , Midazolam  7mg  , Instrument:  FG6  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Other- Early satiety FINDINGS: Small hiatus hernia only. "
"475","Hospital Number: I9081757 , Hospital: Random NHS Foundation Trust , DOB:  1968-04-17 , General Practitioner: Dr. Harris, Eunmi  , Date of procedure:  2001-10-21Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  12.5mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known coeliac ch diarrhoea.Myelofibrosis on ruxolitinib and panobinostat FINDINGS: Normal gastroscopy to the duodenum. "
"476","Hospital Number: F6090839 , Hospital: Random NHS Foundation Trust , DOB:  1938-03-23 , General Practitioner: Dr. Rosales, Brenda  , Date of procedure:  2001-01-26Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia oesophageal stricture post chemorad for scc oesophagus FINDINGS: The patient has an ulcer in the antrum which is scarredIt is bleeding. The patient's medical history, along with the ulcer's rugose surface and irregular border, suggest a chronic inflammatory process.During biopsy, it was noted that the lesion had a friable surface and bled easily..  character(0)  The patient should be counseled on the importance of maintaining good oral hygiene to prevent oral bacteria from entering the ulcer site.  The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more ulcers."
"477","Hospital Number: T7480285 , Hospital: Random NHS Foundation Trust , DOB:  1969-04-26 , General Practitioner: Dr. al-Bari, Najaat  , Date of procedure:  2007-07-03Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Chemorad for scc middle third of oeosphagus - post treatment assessement FINDINGS: The patient has inflammation in the antrum which is severe. Diffuse erythema with erosions and exudates are seen in the antrum and body of the stomach, suggestive of acute erosive gastritis.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. The patient has an ulcer in the third part of the duodenum which is hemorrhagicIt is bleeding. Surrounded by erythema and exhibiting a nodular surface, the severe ulceration presents with a distinct loss of mucosal tissue.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization.. The ulcer appears to be a chronic lesion, with signs of previous healing and scarring.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. NA RECOMMENDATION: Follow-up imaging such as CT or MRI may be necessary to assess for potential complications or to guide management decisions. RECOMMENDATION: The patient should be advised to avoid wearing tight clothing around their waist, as this can put pressure on the stomach and worsen GERD symptoms.  A barium swallow study may be ordered to assess the extent of the inflammation. FOLLOW UP: The patient should avoid eating before bedtime, as this can increase the risk of reflux and ulcer recurrence. FOLLOW UP: The patient should avoid smoking and drinking alcohol, as these habits can worsen GERD symptoms.  The patient should be informed of the diagnosis and provided with information on how to manage the inflammation."
"478","Hospital Number: W2054819 , Hospital: Random NHS Foundation Trust , DOB:  1950-07-10 , General Practitioner: Dr. el-Jafri, Ghaada  , Date of procedure:  2012-02-29Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Previous Polyps/Metaplasia etc. FINDINGS: The patient has a stricture in the stomach which is hyperemicScope not held by stricture. The gastric stricture appears to involve the mucosa and submucosa layers, with a concentric narrowing of the lumen.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling..   The patient may be referred to a specialist in gastrointestinal disorders for further management of the polyp.  The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more polyps."
"479","Hospital Number: O8834134 , Hospital: Random NHS Foundation Trust , DOB:  1970-06-19 , General Practitioner: Dr. Fernandez, Acacia  , Date of procedure:  2002-11-14Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  150mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- RFA Therapeutic- EMR/ESD FINDINGS: There is a stricture in the stomach which is scarredScope not held by stricture. A gastric stricture with a smooth and tapered appearance is observed in the corpus, suggestive of a benign fibrotic process.The ulcer was biopsied x8 for further analysis..   Follow-up imaging such as CT or MRI may be necessary to assess for potential complications or to guide management decisions.  The patient should be advised to avoid consuming caffeine, which can stimulate the production of stomach acid and delay the healing of the ulcer."
"480","Hospital Number: H6820128 , Hospital: Random NHS Foundation Trust , DOB:  1979-03-12 , General Practitioner: Dr. al-Kabir, Sabeeka  , Date of procedure:  2005-11-22Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  12.5mcg  , Midazolam  2mg  , Instrument:  FG5  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain FINDINGS: The patient has inflammation in the antrum which is mild. The gastric inflammation is severe, with the presence of abscesses and granulomas in the mucosa.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample..  NA RECOMMENDATION: The patient should avoid smoking and drinking alcohol, as these habits can worsen GERD symptoms.  A repeat gastroscopy may be required in three to six months' time to monitor the progress of the inflammation. FOLLOW UP: The patient should be advised to avoid lying down for at least three hours after eating to help prevent reflux.  The patient should avoid lying down immediately after meals, as this can exacerbate the inflammation by increasing the risk of reflux."
"481","Hospital Number: P4350826 , Hospital: Random NHS Foundation Trust , DOB:  1989-03-01 , General Practitioner: Dr. Yocum, Victoria  , Date of procedure:  2014-01-31Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  25mcg  , Midazolam  5mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- RFA Other GAVE FINDINGS: Normal gastroscopy to the duodenum. "
"482","Hospital Number: D5429386 , Hospital: Random NHS Foundation Trust , DOB:  1903-08-26 , General Practitioner: Dr. Her, Brigitte  , Date of procedure:  2009-01-27Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  25mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Dyspepsia FINDINGS: Normal gastroscopy to the duodenum. "
"483","Hospital Number: K5870127 , Hospital: Random NHS Foundation Trust , DOB:  1912-02-16 , General Practitioner: Dr. Littlefield, Ciana  , Date of procedure:  2010-06-02Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Eosinophilic oesophagitis assesment FINDINGS: Normal gastroscopy to the duodenum. NA"
"484","Hospital Number: U3081246 , Hospital: Random NHS Foundation Trust , DOB:  1901-01-05 , General Practitioner: Dr. Mellon, Ariel  , Date of procedure:  2008-08-25Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia . FINDINGS: Normal gastroscopy to the duodenum. "
"485","Hospital Number: Y1506215 , Hospital: Random NHS Foundation Trust , DOB:  1901-05-08 , General Practitioner: Dr. Lim, Yen Nhi  , Date of procedure:  2007-03-19Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow-up ULCER HEALING FINDINGS: LA Grade  D oesophagitis. Gastric mucosal prolapse also seen The distal oesophagus appears normal, but there is diffuse erythema and friability in the mid and proximal oesophagus. The oesophageal mucosa is thickened and has a cobblestone appearance.  character(0)  The patient should be advised to follow a soft diet and avoid spicy or acidic foods to reduce discomfort and promote healing.  A repeat gastroscopy may be recommended in six to twelve months' time to assess the response to treatment."
"486","Hospital Number: S7145991 , Hospital: Random NHS Foundation Trust , DOB:  1942-01-05 , General Practitioner: Dr. Washington, Hailee  , Date of procedure:  2007-06-15Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  50mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Biopsies for H pylori FINDINGS: Normal gastroscopy to the duodenum. "
"487","Hospital Number: R9404908 , Hospital: Random NHS Foundation Trust , DOB:  1979-01-03 , General Practitioner: Dr. Mitchell, Olivia  , Date of procedure:  2012-05-21Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  100mcg  , Midazolam  3mg  , Instrument:  FG4  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Hb drop ?GI bleed previous gastric surgery FINDINGS: The patient has a 7mm nodule in the D1/D2 angle which is benign-looking.   The patient should be advised to maintain a healthy weight, as obesity can increase the risk of cancer and other gastrointestinal diseases.  The patient should be advised to maintain a healthy weight, as obesity can increase the risk of cancer and other gastrointestinal diseases."
"488","Hospital Number: Z6151451 , Hospital: Random NHS Foundation Trust , DOB:  1983-01-13 , General Practitioner: Dr. Whittington, Chadley  , Date of procedure:  2005-02-06Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  75mcg  , Midazolam  7mg  , Instrument:  FG2  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Chemorad for scc middle third of oeosphagus - post treatment assessement FINDINGS: The patient has a 5mm nodule in the D1/D2 angle which is sessile.   The patient should avoid eating or drinking for at least six hours before any scheduled appointments.  The patient may be referred to a surgeon for a minimally invasive procedure to remove the nodule."
"489","Hospital Number: G1498153 , Hospital: Random NHS Foundation Trust , DOB:  1981-03-31 , General Practitioner: Dr. el-Taheri, Radwa  , Date of procedure:  2013-02-02Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal pain Other- previous ulcer FINDINGS: Normal gastroscopy to the duodenum.   Surgical intervention may be necessary in the event of complications such as perforation or obstruction.  Further investigations such as a biopsy may be recommended to determine the cause of the ulcer and assess the risk of cancer."
"490","Hospital Number: B8969666 , Hospital: Random NHS Foundation Trust , DOB:  1993-07-23 , General Practitioner: Dr. Naylor, Chelsea  , Date of procedure:  2010-05-31Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG1  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Eosinophilic oesophatitis assessment FINDINGS: The patient has Barrett's oesophagus. Gastric mucosal prolapse seen. The pit pattern is normal. Lax cardia with small hiatus hernia. character(0)"
"491","Hospital Number: J1819477 , Hospital: Random NHS Foundation Trust , DOB:  1932-07-13 , General Practitioner: Dr. Hoffmann, Laura  , Date of procedure:  2015-04-13Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  125mcg  , Midazolam  5mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Endoscopic ultrasound findings: Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"492","Hospital Number: M8863036 , Hospital: Random NHS Foundation Trust , DOB:  1963-05-16 , General Practitioner: Dr. Hering, Tre  , Date of procedure:  2009-07-31Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  125mcg  , Midazolam  4mg  , Instrument:  FG2  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- liver abscesses FINDINGS: Normal gastroscopy to the duodenum. "
"493","Hospital Number: C4021112 , Hospital: Random NHS Foundation Trust , DOB:  1938-10-27 , General Practitioner: Dr. Ta, Gabriella  , Date of procedure:  2001-05-25Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG3  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Previous gastric ulcer. repeat scope after 8 weeks. FINDINGS: There is a nodule in the antrum which is sessile. A well-circumscribed, firm nodule is seen in the gastric body, suggestive of a gastrointestinal stromal tumor (GIST)..  character(0) RECOMMENDATION: The patient should be advised to seek medical attention immediately if they experience symptoms of severe bleeding such as black tarry stools or vomiting blood.  The patient may be referred to a specialist for further evaluation and treatment, such as surgery to remove the nodule. FOLLOW UP: Further investigations such as a biopsy may be recommended to determine the cause of the ulcer and assess the risk of cancer.  A follow-up appointment with the gastroenterologist should be scheduled for six months after the initial diagnosis to monitor the patient's progress."
"494","Hospital Number: Q8222665 , Hospital: Random NHS Foundation Trust , DOB:  1995-08-23 , General Practitioner: Dr. Muljadi, Alyssa  , Date of procedure:  2009-12-23Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG5  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like SymptomsAbdominal Pain FINDINGS: Barrett's is present. No abnormal pit pattern is seen. "
"495","Hospital Number: X5836068 , Hospital: Random NHS Foundation Trust , DOB:  1948-11-08 , General Practitioner: Dr. Suarez-Jaimes, Esmeralda  , Date of procedure:  2007-08-30Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG5  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow-up oesophagitis healing FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"").
character(0)"
"496","Hospital Number: E8902521 , Hospital: Random NHS Foundation Trust , DOB:  1988-09-09 , General Practitioner: Dr. Maass, Tynasia  , Date of procedure:  2005-11-17Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Varices/Vascular FINDINGS: Normal gastroscopy to the duodenum. "
"497","Hospital Number: N7405188 , Hospital: Random NHS Foundation Trust , DOB:  1922-03-03 , General Practitioner: Dr. Mow, Iris  , Date of procedure:  2004-02-05Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  150mcg  , Midazolam  4mg  , Instrument:  FG2  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow-up oesophagitis healing FINDINGS: There is a polyp in the antrum which is sessile with a normal pit pattern. With a round shape and no sign of dysplasia, the gastric polyp appears fundic.Endoscopic mucosal resection was performed to remove the polyp in its entirety..  character(0)  The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and increase the risk of polyp growth.  "
"498","Hospital Number: V9378773 , Hospital: Random NHS Foundation Trust , DOB:  1989-10-06 , General Practitioner: Dr. Lucier, Hannah  , Date of procedure:  2012-10-31Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia FINDINGS: There is inflammation in the D1/D2 angle which is mild.  RECOMMENDATION: The patient should be advised to avoid lying down for at least three hours after eating to help prevent reflux.  The patient should avoid consuming large meals, as this can exacerbate the inflammation. FOLLOW UP: The patient may require additional endoscopies in the future to monitor the stricture and ensure that it is not progressing.  The patient should avoid wearing tight clothing, as this can exacerbate the inflammation by increasing the pressure on the stomach."
"499","Hospital Number: L6117442 , Hospital: Random NHS Foundation Trust , DOB:  1981-09-25 , General Practitioner: Dr. Shrestha, Brittany  , Date of procedure:  2002-01-06Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG2  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - chronic cough ?GORD FINDINGS: Columnar lined oesophagus is present. No abnormal pit pattern is seen. The segment looks flat. Some areas of vascular abnormalities are seen. The patient has a stricture in the third part of the duodenum which is scleroticThe endoscope passed through the stricture with resistance. The narrowing of the lumen is more pronounced during end-inspiration.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. character(0)"
"500","Hospital Number: A3669324 , Hospital: Random NHS Foundation Trust , DOB:  1913-03-06 , General Practitioner: Dr. Misa, Ashley  , Date of procedure:  2005-06-08Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Eosinophilic oesophagitis assesment FINDINGS: There is an ulcer in the duodenal bulb which is superficial s*It is not bleeding. The flat surface with no elevation and thickened border of the ulcer suggests a chronic, long-standing condition.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample.. There are no visible signs of perforation or penetration into adjacent organs or tissues.During biopsy, it was noted that the lesion had a friable surface and bled easily.. The patient has inflammation in the body which is erosive. The gastric mucosa appears diffusely thickened with a cobblestone appearance and no ulcerations, suggestive of granulomatous gastritis.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. NA RECOMMENDATION: Referral to a gastroenterologist for further evaluation and management of the ulcer is recommended. RECOMMENDATION: The patient should avoid eating before going to bed, as this can worsen reflux symptoms.  The patient may be prescribed a course of antibiotics to treat any underlying infection that may be causing the inflammation. FOLLOW UP:  FOLLOW UP: The patient should be advised to maintain a healthy weight, as obesity can worsen the symptoms of GERD.  The patient should be advised to avoid consuming too much sugar, as this can exacerbate the inflammation by increasing the risk of bacterial overgrowth in the stomach."
"501","Hospital Number: O8583042 , Hospital: Random NHS Foundation Trust , DOB:  1958-04-12 , General Practitioner: Dr. al-Daoud, Shahaada  , Date of procedure:  2003-01-20Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  75mcg  , Midazolam  7mg  , Instrument:  FG6  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Weight Loss FINDINGS: Normal gastroscopy to the duodenum. "
"502","Hospital Number: H2587908 , Hospital: Random NHS Foundation Trust , DOB:  1996-03-21 , General Practitioner: Dr. Noris, Jasmine  , Date of procedure:  2014-01-02Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  25mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia . FINDINGS: Normal gastroscopy to the duodenum. "
"503","Hospital Number: P9907275 , Hospital: Random NHS Foundation Trust , DOB:  1943-12-10 , General Practitioner: Dr. Cusick, Alexis  , Date of procedure:  2004-06-23Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  150mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Previous gastric ulcer. repeat scope after 8 weeks. FINDINGS: Barrett's is present. Gastric mucosal prolapse seen. No abnormal pit pattern is seen. Short segment only.   The patient should be advised to seek medical attention immediately if they experience symptoms of severe bleeding such as black tarry stools or vomiting blood.  The patient is advised to return for a follow-up appointment in two to four weeks' time to discuss the findings and plan for further management."
"504","Hospital Number: D9990587 , Hospital: Random NHS Foundation Trust , DOB:  1986-12-26 , General Practitioner: Dr. Xiong, Grace  , Date of procedure:  2013-02-01Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  125mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia post LTA FINDINGS: There is a stricture in the second part of the duodenum which is obliterativeIt will not allow the scope to pass.. The narrowing of the duodenal lumen at the stricture site is severe, allowing only a small-caliber endoscope to pass through.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. Barrett's is present. Gastric mucosal prolapse seen. No abnormal pit pattern is seen. Short segment only. NA"
"505","Hospital Number: K9010769 , Hospital: Random NHS Foundation Trust , DOB:  1954-11-29 , General Practitioner: Dr. Medina, Ericka  , Date of procedure:  2001-11-12Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Nausea and/or Vomiting Weight Loss FINDINGS: Inflammatory changes seen in the oesophagus.  character(0)"
"506","Hospital Number: U5728377 , Hospital: Random NHS Foundation Trust , DOB:  1976-03-26 , General Practitioner: Dr. Mangisel, Gaochazhong  , Date of procedure:  2016-01-29Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known EOE oesophgeal biopsies FINDINGS: Normal gastroscopy to the duodenum. "
"507","Hospital Number: Y3424765 , Hospital: Random NHS Foundation Trust , DOB:  1972-12-06 , General Practitioner: Dr. Combs, Arnisha  , Date of procedure:  2007-07-20Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Chemorad for scc middle third of oeosphagus - post treatment assessement FINDINGS: The patient has a 4mm nodule in the second part of the duodenum which is sessile.  character(0)  The patient should be advised to avoid eating large meals or eating quickly, as this can increase the risk of reflux and further damage to the gastrointestinal tract.  The patient should be advised to avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as these can increase the risk of bleeding in the gastrointestinal tract."
"508","Hospital Number: S9335497 , Hospital: Random NHS Foundation Trust , DOB:  1961-08-26 , General Practitioner: Dr. Modi, Mary  , Date of procedure:  2004-08-06Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  25mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: MelaenaEpigastric Pain FINDINGS: Normal gastroscopy to the duodenum. "
"509","Hospital Number: R3233951 , Hospital: Random NHS Foundation Trust , DOB:  1979-06-16 , General Practitioner: Dr. Estrada, Cynthia  , Date of procedure:  2009-02-18Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain x1 hematemesis Crohns colitis FINDINGS: The patient has a polyp in the stomach which is stalked.It has a normal pit pattern. The gastric polyp presents with an irregular shape, ulceration, and invasive margins, suggestive of a malignant process.The polyp was visualized and biopsied during upper endoscopy.. The patient's medical history and the ulcer's rugose surface suggest a chronic inflammatory process.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample..  RECOMMENDATION: Biopsy samples were taken from the ulcer base to rule out malignancy. The patient should follow up with their referring physician for results.  A repeat gastroscopy may be recommended in three to six months' time to assess the growth of the polyp. FOLLOW UP: A repeat gastroscopy may be recommended in six to twelve months' time to assess the response to treatment.  The patient should be advised to avoid hot, spicy foods, which can irritate the lining of the stomach and increase the risk of polyp growth."
"510","Hospital Number: Z3118534 , Hospital: Random NHS Foundation Trust , DOB:  1938-11-16 , General Practitioner: Dr. Pena, Monica  , Date of procedure:  2010-07-05Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG2  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Previous multiple surgeries for reflux . FINDINGS: There is a nodule in the second part of the duodenum which is stalked.  character(0)    If the nodule is benign, the patient may not require any treatment, but may require monitoring with regular endoscopies."
"511","Hospital Number: G7303882 , Hospital: Random NHS Foundation Trust , DOB:  1961-12-17 , General Practitioner: Dr. Yazzie, Adrena  , Date of procedure:  2003-08-29Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - exclude Lynch and coeliac FINDINGS: There is a stricture in the D1/D2 angle which is inflamedIt will not allow the scope to pass.. "
"512","Hospital Number: B2496144 , Hospital: Random NHS Foundation Trust , DOB:  1998-12-11 , General Practitioner: Dr. Hall, Ashlee  , Date of procedure:  2009-05-06Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  150mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Hb drop ?GI bleed previous gastric surgery FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"")."
"513","Hospital Number: J9928505 , Hospital: Random NHS Foundation Trust , DOB:  1949-11-28 , General Practitioner: Dr. La, Kathleen  , Date of procedure:  2006-03-06Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  12.5mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia low iron normal HBAnaemia/Low Iron or Vitamins FINDINGS: The patient has inflammation in the second part of the duodenum which is mild. There are scattered areas of hemorrhage seen throughout the duodenal mucosa, indicative of inflammation.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. The patient has a polyp in the body which is stalked.It has a normal pit pattern. Characterized by an irregular surface and size, the gastric polyp appears malignant.Using a snare, the polyp was excised and retrieved for pathologic analysis.. NA RECOMMENDATION: The patient should avoid eating large meals and should instead eat smaller, more frequent meals throughout the day. RECOMMENDATION: The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools.  The patient should avoid eating before bedtime, as this can increase the risk of reflux and polyp growth. FOLLOW UP: The patient should be advised to avoid lying down immediately after eating, as this can worsen reflux symptoms. FOLLOW UP: The patient should be advised to avoid caffeine, which can stimulate the production of stomach acid and exacerbate the inflammation.  The patient should be advised to avoid consuming alcohol, which can increase the risk of developing more polyps."
"514","Hospital Number: M7832839 , Hospital: Random NHS Foundation Trust , DOB:  1902-08-26 , General Practitioner: Dr. Coney, Emilie  , Date of procedure:  2010-01-04Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal bloating chest discomfort reflux.Known fibromyalgia RA FINDINGS: The patient has a polyp in the body which is stalked.It has a normal pit pattern. Characterized by an irregular surface and size, the gastric polyp appears malignant.Using a snare, the polyp was excised and retrieved for pathologic analysis..   The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and increase the risk of polyp growth.  A colonoscopy may be ordered to assess for the presence of polyps in the colon and rectum."
"515","Hospital Number: C1538169 , Hospital: Random NHS Foundation Trust , DOB:  1985-06-08 , General Practitioner: Dr. Rosburg, Julia  , Date of procedure:  2013-05-27Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  25mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Dyspepsia FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"")."
"516","Hospital Number: Q6090326 , Hospital: Random NHS Foundation Trust , DOB:  1934-06-18 , General Practitioner: Dr. al-Rashed, Muneera  , Date of procedure:  2014-12-01Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG5  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Weight Loss FINDINGS: On retroflexion the wrap is in correct position, with no evidence of recurrent hiatus hernia.. "
"517","Hospital Number: X8881813 , Hospital: Random NHS Foundation Trust , DOB:  1980-01-17 , General Practitioner: Dr. Tabaldo, Kelly  , Date of procedure:  2008-12-25Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Other- change in taste bile taste in mouth FINDINGS: Normal gastroscopy to the duodenum. "
"518","Hospital Number: E5760181 , Hospital: Random NHS Foundation Trust , DOB:  1975-05-07 , General Practitioner: Dr. Williams, Cheyenne  , Date of procedure:  2006-04-29Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia  post radiation stricture FINDINGS: Hiatus Hernia- Large.. "
"519","Hospital Number: N3482935 , Hospital: Random NHS Foundation Trust , DOB:  1922-04-11 , General Practitioner: Dr. Palandeng, Anna  , Date of procedure:  2010-07-10Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  12.5mcg  , Midazolam  5mg  , Instrument:  FG7  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Worsening epigastric pain. constipatiom. suggest checking HP FINDINGS: The patient has a stricture in the third part of the duodenum which is inflexibleIt is easily traversible.. The narrowing of the lumen is more pronounced during end-inspiration.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization.. There is a nodule in the oesophagus at 26 cm which is sessile. Inspection of the oesophageal ulcer reveals an elevated, nodular appearance, consistent with a malignancy.The patient should be advised to seek medical attention immediately if they experience symptoms of severe bleeding such as black tarry stools or vomiting blood.. character(0) RECOMMENDATION: Referral to a registered dietitian may be helpful in providing guidance on a healthy, ulcer-friendly diet.  The patient should be advised to seek emotional support from friends, family, or a counselor, as the diagnosis of cancer can be difficult to cope with. FOLLOW UP: The patient should be advised to eat slowly and chew their food thoroughly to aid digestion and reduce the risk of ulcer recurrence.  The patient should avoid smoking and drinking alcohol, as these habits can increase the risk of cancer."
"520","Hospital Number: V6466799 , Hospital: Random NHS Foundation Trust , DOB:  1982-08-14 , General Practitioner: Dr. Sterett, Claire  , Date of procedure:  2003-04-05Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting FINDINGS: The patient has a stricture in the stomach which is OedematousScope not held by stricture. A gastric stricture with a smooth and nodular surface is observed in the cardia, suggestive of a malignant lesion.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization.. "
"521","Hospital Number: L2151400 , Hospital: Random NHS Foundation Trust , DOB:  1905-08-22 , General Practitioner: Dr. el-Yousef, Gaitha  , Date of procedure:  2001-01-04Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  100mcg  , Midazolam  7mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Weight Loss FINDINGS: There is a stricture in the third part of the duodenum which is thickenedThere is very slight and non-restrcitve stricturing.. The diameter of the duodenal lumen at the stricture site is significantly smaller than the diameter of the duodenum proximal and distal to the stricture.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding..  NA"
"522","Hospital Number: A3080284 , Hospital: Random NHS Foundation Trust , DOB:  1971-05-15 , General Practitioner: Dr. Witham, Hope  , Date of procedure:  2007-03-07Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Previous gastric ulcer. repeat scope after 8 weeks. FINDINGS: Normal gastroscopy to the duodenum.   Endoscopic therapy with injection of epinephrine and/or placement of hemostatic clips may be necessary to achieve hemostasis in the event of active bleeding.  The patient should follow a healthy diet and lifestyle to reduce the risk of developing more ulcers."
"523","Hospital Number: I7491657 , Hospital: Random NHS Foundation Trust , DOB:  1915-03-19 , General Practitioner: Dr. Lopez, Angelique  , Date of procedure:  2011-06-15Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  125mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Oesophagus- Dysplasia FINDINGS: There is a nodule in the third part of the duodenum which is sessile. The patient has an ulcer in the duodenal bulb which is superficial.Forrest Ulcer classification: IIc.. The patient's medical history, along with the ulcer's rugose surface and irregular border, suggest a chronic inflammatory process.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. The margins of the ulcer appear to be slightly raised, with a central depression.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. character(0) RECOMMENDATION: Follow-up with a primary care physician or gastroenterologist for ongoing management and symptom control is recommended.  The patient should avoid eating or drinking for at least six hours before any scheduled appointments. FOLLOW UP: The patient should avoid smoking and alcohol, which can delay the healing of the ulcer and increase the risk of developing more ulcers.  The patient may be prescribed medication to manage any symptoms associated with the nodule, such as pain or discomfort."
"524","Hospital Number: F8022001 , Hospital: Random NHS Foundation Trust , DOB:  1991-07-30 , General Practitioner: Dr. Turner, Aurora  , Date of procedure:  2004-07-17Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  50mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Nausea and/or Vomiting Reflux-like Symptoms/Atypical Chest Pain Weight Loss FINDINGS: Normal gastroscopy to the duodenum. "
"525","Hospital Number: T4904215 , Hospital: Random NHS Foundation Trust , DOB:  1988-09-02 , General Practitioner: Dr. el-Musa, Nada  , Date of procedure:  2012-05-06Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: anastomotic stricture post thoracoabdominal oesophagogastrecotmy for dilatation FINDINGS: The patient has a polyp in the stomach which is stalked.It has a normal pit pattern. The gastric polyp exhibits a fundic morphology with a pale surface and absence of glandular elements.The base of the polyp was fulgurated with an electrocautery device to prevent future bleeding or regrowth.. character(0)  A repeat gastroscopy may be recommended in three to six months' time to assess the growth of the polyp.  The patient should be advised to avoid consuming alcohol, which can increase the risk of developing more polyps."
"526","Hospital Number: W8932372 , Hospital: Random NHS Foundation Trust , DOB:  1966-03-19 , General Practitioner: Dr. Gutierrez, Demi  , Date of procedure:  2016-02-26Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  125mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Polypectomy FINDINGS: No evidence of inlet patch on careful inspection..   The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and increase the risk of polyp growth.  The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools."
"527","Hospital Number: O7967929 , Hospital: Random NHS Foundation Trust , DOB:  1916-01-01 , General Practitioner: Dr. al-Mahdavi, Nazeeha  , Date of procedure:  2007-05-27Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  50mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Small Bowel Biopsy FINDINGS: The patient has a stricture in the third part of the duodenum which is tight s*It is easily traversible.. The mucosa of the esophagus was noted to be thickened and white in color during endoscopy. The patient had crepe paper-like appearance of the oesophageal mucosa on endoscopy, suggestive of eosinophilic oesophagitis. The esophageal mucosa appeared to be friable on endoscopic examination. The diameter of the duodenal lumen at the stricture site is significantly smaller than the diameter of the duodenum proximal and distal to the stricture.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. OESOPHAGUS: Normal apart from small hiatus hernia.. NA"
"528","Hospital Number: H3844577 , Hospital: Random NHS Foundation Trust , DOB:  1971-03-24 , General Practitioner: Dr. Atkins, Courtney  , Date of procedure:  2006-11-30Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG3  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia FINDINGS: Normal gastroscopy to the duodenum. "
"529","Hospital Number: P4236233 , Hospital: Random NHS Foundation Trust , DOB:  1960-02-04 , General Practitioner: Dr. Sumual, Loan Mai  , Date of procedure:  2013-11-14Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  150mcg  , Midazolam  1mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Dyspepsia FINDINGS: The patient has inflammation in the antrum which is erosive. The gastric inflammation appears to be associated with the use of proton pump inhibitors (PPIs), with the presence of rebound hypergastrinemia.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. The patient has a polyp in the stomach which is stalked.It has a normal pit pattern. The gastric polyp exhibits a fundic morphology with a pale surface and absence of glandular elements.The base of the polyp was fulgurated with an electrocautery device to prevent future bleeding or regrowth.. NA RECOMMENDATION: The patient may be prescribed an H2 blocker to reduce stomach acid production and prevent reflux. RECOMMENDATION: The patient should avoid wearing tight clothing, as this can exacerbate the inflammation by increasing the pressure on the stomach.  The patient should be advised to avoid consuming alcohol, which can increase the risk of developing more polyps. FOLLOW UP: The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the stricture. FOLLOW UP: A repeat gastroscopy may be recommended in six months' time to assess the response to treatment.  The patient should be advised to eat slowly and chew their food thoroughly to aid digestion and reduce the risk of polyp growth."
"530","Hospital Number: D4826904 , Hospital: Random NHS Foundation Trust , DOB:  1914-08-17 , General Practitioner: Dr. Jordan, Serena  , Date of procedure:  2009-01-14Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG2  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Weight Loss Mother has gastric cancer FINDINGS: The patient has a polyp in the duodenal bulb which is sessile.It has a normal pit pattern. The nodules are monitored over time for any signs of growth or malignant transformation.Endoscopic mucosal resection was performed to remove the polyp in its entirety.. Small hiatus hernia only.. character(0) RECOMMENDATION: The patient may be referred to a nutritionist to develop a diet plan that is easier to digest and that meets their nutritional needs.  The patient is advised to return for a follow-up appointment in four to six weeks' time to discuss the findings and plan for further management. FOLLOW UP: The patient should be advised to report any new symptoms or changes in symptoms to their healthcare provider immediately.  A repeat gastroscopy may be required in six months' time to monitor the growth of the polyp."
"531","Hospital Number: K8847627 , Hospital: Random NHS Foundation Trust , DOB:  1931-02-08 , General Practitioner: Dr. Fifita, Anuzaya  , Date of procedure:  2015-09-26Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  125mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Ongoing reflux symptoms. FINDINGS: LA Grade  D oesophagitis. There are multiple areas of oesophageal mucosal breaks with overlying fibrin and purulent exudates severe oesophagitis with ulceration. The esophageal mucosa was noted to be edematous and inflamed on endoscopic evaluation. Endoscopy showed mild trachealisation of the esophagus, which may be consistent with EoE. The patient had crepe paper-like appearance of the oesophageal mucosa on endoscopy, suggestive of eosinophilic oesophagitis. The gastric lesion appears malignant, with an irregular shape and size, and a raised edge.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample..  character(0)  Proton pump inhibitors may be prescribed to reduce gastric acid production and promote ulcer healing.  The patient may be prescribed medication to reduce the acidity of the stomach and promote healing of the ulcer."
"532","Hospital Number: U8525559 , Hospital: Random NHS Foundation Trust , DOB:  1915-02-06 , General Practitioner: Dr. Waldo, Alexandra  , Date of procedure:  2014-05-02Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  100mcg  , Midazolam  3mg  , Instrument:  FG3  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: dypepsia FINDINGS: The patient has a stricture in the D1/D2 angle which is hyperemicThe endoscope passed through the stricture with resistance. "
"533","Hospital Number: Y5602439 , Hospital: Random NHS Foundation Trust , DOB:  1953-04-12 , General Practitioner: Dr. Freihoefer, Chealsey  , Date of procedure:  2011-01-02Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins weight loss. On warfarin and clopidogrel, FINDINGS: Columnar lined oesophagus is present. It is a long segment. OESOPHAGUS: Normal, no appreciable hiatus hernia.. NA"
"534","Hospital Number: S6682774 , Hospital: Random NHS Foundation Trust , DOB:  1962-11-13 , General Practitioner: Dr. Jaquez, Maria  , Date of procedure:  2008-05-08Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  100mcg  , Midazolam  5mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Dysphagia/Odynophagia Nausea and/orVomiting FINDINGS: The patient has an ulcer in the body which is scarredForrest Ulcer classification: IIc.. The patient's medical history, along with the ulcer's rugose surface and flat appearance, suggest a chronic, long-standing condition.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding..   Follow-up endoscopy with surveillance biopsies may be necessary for patients with a history of gastric ulcer or increased risk for malignancy.  The patient should avoid consuming too much fat, as this can delay gastric emptying and delay the healing of the ulcer."
"535","Hospital Number: R6103760 , Hospital: Random NHS Foundation Trust , DOB:  1964-01-20 , General Practitioner: Dr. Martinez, Megan  , Date of procedure:  2012-03-18Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Reflux-like Symptoms/Atypical Chest Pain FINDINGS: There is inflammation in the GOJ which is erosive. The oesophageal mucosa appears to be diffusely inflamed with scattered erosions and petechiae, indicative of mild reflux oesophagitis.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample.. There is a polyp in the stomach which is sessile with an abnormal pit pattern. The gastric polyp exhibits an adenomatous morphology with tubular and villous growth patterns.The polyp was grasped with a snare and cut with a hot biopsy forceps for removal.. NA RECOMMENDATION: The patient should avoid eating large meals and should instead eat smaller, more frequent meals throughout the day. RECOMMENDATION: The patient should avoid NSAIDs and aspirin, which can irritate the lining of the stomach and exacerbate the inflammation.  The patient should avoid consuming too much fat, as this can delay gastric emptying and increase the risk of reflux and polyp growth. FOLLOW UP: The patient should be advised to chew their food thoroughly and to eat slowly to help prevent swallowing difficulties. FOLLOW UP: The patient should follow a strict diet and avoid irritants that can exacerbate the inflammation.  The patient should avoid eating before bedtime, as this can increase the risk of reflux and polyp growth."
"536","Hospital Number: Z1272661 , Hospital: Random NHS Foundation Trust , DOB:  1969-09-07 , General Practitioner: Dr. Fox, Paris  , Date of procedure:  2004-07-28Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  25mcg  , Midazolam  4mg  , Instrument:  FG1  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR FINDINGS: The patient has an ulcer in the antrum which is scarredForrest Ulcer classification: IIc.. Characterized by a distinct loss of mucosal tissue, the severe ulceration presents with a nodular surface.The ulcer was biopsied x8 for further analysis.. The patient has a 10mm nodule in the duodenal bulb which is stalked. NA RECOMMENDATION: The patient should be instructed to avoid hot beverages and foods to prevent further irritation to the ulcer.  The patient may be prescribed medication to reduce the size of the nodule and prevent it from growing. FOLLOW UP: The patient should be informed of the diagnosis and provided with information on how to manage the ulcer.  The patient may be referred to a specialist for further evaluation and treatment, such as surgery to remove the nodule."
"537","Hospital Number: G2227671 , Hospital: Random NHS Foundation Trust , DOB:  1974-04-17 , General Practitioner: Dr. Miller, Amy  , Date of procedure:  2009-02-19Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  50mcg  , Midazolam  3mg  , Instrument:  FG7  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss FINDINGS: Normal gastroscopy to the duodenum. "
"538","Hospital Number: B7082304 , Hospital: Random NHS Foundation Trust , DOB:  1967-03-27 , General Practitioner: Dr. Fontenot, Shelby  , Date of procedure:  2012-11-17Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  125mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"539","Hospital Number: J8000143 , Hospital: Random NHS Foundation Trust , DOB:  1914-06-23 , General Practitioner: Dr. Matthews, Sarah  , Date of procedure:  2015-10-04Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  100mcg  , Midazolam  4mg  , Instrument:  FG7  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Nausea and/or Vomiting FINDINGS: The patient has a stricture in the GOJ which is thickenedIt is easily traversible.. The mucosal surface proximal to the stricture appears mildly ulcerated, while the distal mucosa is normal.Following the biopsy of the lesion, there was bleeding, which was promptly managed..  NA  The patient should be advised to avoid straining during bowel movements to reduce pressure on the ulcer site.  The patient may be prescribed medication to reduce the acidity of the stomach and promote healing of the ulcer."
"540","Hospital Number: M2497777 , Hospital: Random NHS Foundation Trust , DOB:  1938-02-04 , General Practitioner: Dr. Vela-Aguilar, Aime  , Date of procedure:  2016-03-25Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  12.5mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Previous gastric ulcer. repeat scope after 8 weeks. FINDINGS: No inlet patch..   The patient should be advised to seek medical attention immediately if they experience symptoms of severe bleeding such as black tarry stools or vomiting blood.  The patient should avoid stress and maintain good mental health, as stress can delay the healing of the ulcer."
"541","Hospital Number: C1910592 , Hospital: Random NHS Foundation Trust , DOB:  1960-10-07 , General Practitioner: Dr. Moeder, Emma  , Date of procedure:  2006-05-12Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Gastric ucers with hy pylori. FINDINGS: The patient has a stricture in the second part of the duodenum which is scarredThe endoscope passed through the stricture with resistance. The stricture has a fibrotic appearance, suggesting chronicity.During biopsy, it was noted that the lesion had a friable surface and bled easily.. There is an ulcer in the oesophagus at 34 cm which is fungatingIt has rolled edges. Helicobacter pylori infection is the likely cause of the ulcer, which exhibits a fibrous base and active bleeding.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. The oesophageal ulcer appears to be a well-demarcated, circular lesion with a central area of necrosis.The biopsy was performed using a needle biopsy forceps, with the tissue samples sent for pathological analysis.. NA  Endoscopic resection of the ulcer may be necessary for larger or more complex ulcers.  The patient should be advised to avoid hot, spicy foods, which can irritate the lining of the stomach and delay the healing of the ulcer."
"542","Hospital Number: Q9535363 , Hospital: Random NHS Foundation Trust , DOB:  1923-10-30 , General Practitioner: Dr. el-Bashara, Samraa  , Date of procedure:  2003-04-01Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  100mcg  , Midazolam  3mg  , Instrument:  FG3  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia post LTA FINDINGS: Normal gastroscopy to the duodenum. "
"543","Hospital Number: X7857756 , Hospital: Random NHS Foundation Trust , DOB:  1942-04-17 , General Practitioner: Dr. Deboer, Ashley  , Date of procedure:  2004-11-25Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  100mcg  , Midazolam  5mg  , Instrument:  FG4  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Nausea and/or Vomiting Other- diarrhoea FINDINGS: LA Grade  B oesophagitis. Candida present. There are multiple areas of oesophageal mucosal breaks with overlying fibrin and purulent exudates. A whitish exudate  was also seen in the esophagus on endoscopic examination, which may indicate eosinophilic oesophagitis. OGD revealed the presence of longitudinal furrows in the distal esophagus, consistent with eosinophilic oesophagitis. OGD showed the presence of several white exudates in the mid and distal esophagus. The patient has a 4mm nodule in the antrum which is benign-looking. A small, solid nodule is observed in the gastric body, suggestive of a gastric carcinoid tumor.-----------------------------------------------------------------FD_Nodule_Recommendations. NA  The patient should be advised to avoid eating spicy or acidic foods, as these can irritate the gastrointestinal tract and worsen symptoms.  The patient should be advised to avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as these can increase the risk of bleeding in the gastrointestinal tract."
"544","Hospital Number: E8303284 , Hospital: Random NHS Foundation Trust , DOB:  1988-11-09 , General Practitioner: Dr. Schalz, Stephanie  , Date of procedure:  2002-11-18Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  150mcg  , Midazolam  1mg  , Instrument:  FG2  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Dyspepsia FINDINGS: The patient has a 9mm nodule in the antrum which is sessile. A well-circumscribed, firm nodule is seen in the gastric body, suggestive of a gastrointestinal stromal tumor (GIST).The patient should be encouraged to maintain a healthy weight to reduce the risk of developing inflammation in the future.. mild trachealization.. NA RECOMMENDATION: The patient should avoid eating fried or fatty foods, as these can increase the risk of reflux and further damage to the gastrointestinal tract. RECOMMENDATION: The patient may be prescribed an H2 blocker to reduce stomach acid production and prevent reflux.  A blood test may be ordered to assess the patient's iron levels, as chronic inflammation can cause anemia. FOLLOW UP: The patient may be referred to a specialist for further evaluation and treatment, such as surgery to remove the nodule. FOLLOW UP:   A repeat gastroscopy may be required in three to six months' time to monitor the progress of the inflammation."
"545","Hospital Number: N5562828 , Hospital: Random NHS Foundation Trust , DOB:  1932-05-10 , General Practitioner: Dr. Valadez, Taylor  , Date of procedure:  2016-11-19Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- EMR/ESD FINDINGS: The patient has an ulcer in the duodenal bulb which is hemorrhagicForrest Ulcer classification:II B.. Characterized by a distinct loss of mucosal tissue and surrounded by erythema, the severe ulceration presents with a nodular surface.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. The surrounding mucosa appears to be friable and prone to bleeding upon contact.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding..  NA  Surgical intervention may be necessary in the event of complications such as perforation or obstruction.  The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and delay the healing of the ulcer."
"546","Hospital Number: V8753920 , Hospital: Random NHS Foundation Trust , DOB:  1912-02-26 , General Practitioner: Dr. Horst, Amber  , Date of procedure:  2011-12-23Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain previous ogd attempt food residue FINDINGS: mild trachealization.. "
"547","Hospital Number: L1479863 , Hospital: Random NHS Foundation Trust , DOB:  1965-11-17 , General Practitioner: Dr. Soto, Sabrina  , Date of procedure:  2006-09-16Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Ongoing dyspepsia FINDINGS: On retroflexion the wrap is in correct position, with no evidence of recurrent hiatus hernia.. "
"548","Hospital Number: A5218459 , Hospital: Random NHS Foundation Trust , DOB:  1919-12-31 , General Practitioner: Dr. Ortleb, Jestine  , Date of procedure:  2011-02-10Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Abdominal Pain FINDINGS: Normal gastroscopy to the duodenum. "
"549","Hospital Number: I2777268 , Hospital: Random NHS Foundation Trust , DOB:  1941-07-05 , General Practitioner: Dr. al-Adel, Warda  , Date of procedure:  2006-10-29Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  125mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal pain Other- previous ulcer FINDINGS: The patient has a 9mm nodule in the second part of the duodenum which is sessile. The patient has a polyp in the duodenal bulb which is sessile with a normal pit pattern. The polyp did not lift on saline injection and was therefore not amenable to endoscopic resection.. character(0) RECOMMENDATION: Biopsy samples were taken from the ulcer base to rule out malignancy. The patient should follow up with their referring physician for results. RECOMMENDATION: The patient should be advised to attend all scheduled appointments and follow the treatment plan recommended by their healthcare provider.  The patient is advised to return for a follow-up appointment in four to six weeks' time to discuss the findings and plan for further management. FOLLOW UP: A repeat gastroscopy may be recommended in six to twelve months' time to assess the response to treatment. FOLLOW UP: If the nodule is found to be cancerous, the patient may require further imaging studies and biopsies to determine the stage of the cancer and the appropriate treatment.  A blood test may be ordered to assess the patient's iron levels, as polyps can cause bleeding in the stomach and intestines."
"550","Hospital Number: F7726169 , Hospital: Random NHS Foundation Trust , DOB:  1974-01-29 , General Practitioner: Dr. Solorzano, Jordan  , Date of procedure:  2011-01-27Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Weight Loss FINDINGS: Normal gastroscopy to the duodenum. "
"551","Hospital Number: T1978921 , Hospital: Random NHS Foundation Trust , DOB:  1919-08-11 , General Practitioner: Dr. Smith, Kendra  , Date of procedure:  2016-02-02Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  125mcg  , Midazolam  5mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Oesophagus- Dysplasia FINDINGS: There is an ulcer in the second part of the duodenum which is necroticCLO test  was also taken.. The gastric lesion appears malignant, accompanied by active bleeding and a punched-out appearance.The ulcer was biopsied x8 for further analysis.. The ulcer appears to be a benign lesion, with no evidence of malignant transformation.During biopsy, it was noted that the lesion had a friable surface and bled easily.. LA Grade  A oesophagitis. The oesophageal mucosa is thickened and has a leathery appearance. NA  The patient should be advised to avoid aspirin or other blood thinners unless prescribed by a physician.  "
"552","Hospital Number: W8248560 , Hospital: Random NHS Foundation Trust , DOB:  1971-01-15 , General Practitioner: Dr. el-Rashed, Qamraaa  , Date of procedure:  2008-12-10Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Other- Early satiety FINDINGS: There is a polyp in the second part of the duodenum which is sessile.It has an abnormal pit pattern. The nodules are scattered throughout the duodenum, with a patchy distribution.Due to its large size, the polyp was not able to be resected during the current endoscopic session.. LA Grade  B oesophagitis. Food present in the oesophagus There is significant ulceration and bleeding present in the oesophageal mucosa. The gastric lesion appears malignant with irregular borders and surrounding erythema.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. character(0) RECOMMENDATION: The patient should be instructed to chew food thoroughly and eat slowly to reduce the risk of further irritation to the ulcer. RECOMMENDATION: The patient may be prescribed medication to reduce the size of the nodule and prevent it from growing.  The patient should be advised to avoid carbonated drinks, which can increase the risk of developing more polyps by increasing the production of gas. FOLLOW UP: The patient should avoid lying down immediately after meals, as this can increase the risk of reflux and ulcer recurrence. FOLLOW UP: The patient should avoid smoking and drinking alcohol, as these habits can increase the risk of cancer.  The patient should avoid lying down immediately after meals, as this can increase the risk of reflux and polyp growth."
"553","Hospital Number: O8592861 , Hospital: Random NHS Foundation Trust , DOB:  1989-09-09 , General Practitioner: Dr. Forsman, Nicole  , Date of procedure:  2005-12-12Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Dilatation FINDINGS: There is a nodule in the stomach which is stalked. The gastric mucosa appears irregularly thickened with a nodular appearance, suggestive of diffuse gastric carcinoma.The patient should be advised to follow a soft diet and avoid spicy or acidic foods to reduce discomfort and promote healing..   The patient may require additional endoscopies in the future to monitor the nodule and ensure that it is not progressing.  The patient should avoid eating or drinking for at least six hours before any scheduled appointments."
"554","Hospital Number: H1442477 , Hospital: Random NHS Foundation Trust , DOB:  1942-10-14 , General Practitioner: Dr. al-Sylla, Nadheera  , Date of procedure:  2015-11-05Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- RFA FINDINGS: The patient has a 3mm nodule in the body which is benign-looking. The gastric mucosa appears irregularly thickened with a nodular appearance, suggestive of diffuse gastric carcinoma.-----------------------------------------------------------------FD_Inflammation_Recommendations.  RECOMMENDATION: The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent further damage to the gastrointestinal tract. RECOMMENDATION: If the patient is experiencing symptoms such as vomiting or fever, they should contact their healthcare provider immediately.  The patient should avoid NSAIDs and aspirin, which can irritate the lining of the stomach and exacerbate the inflammation. FOLLOW UP: The patient should be advised to attend all scheduled appointments and follow the treatment plan recommended by their healthcare provider. FOLLOW UP: If the stricture is causing symptoms such as difficulty swallowing, the patient may be referred to a speech therapist for swallowing therapy.  The patient should avoid eating too much fat, as this can exacerbate the inflammation by delaying gastric emptying and increasing the risk of reflux."
"555","Hospital Number: P1673382 , Hospital: Random NHS Foundation Trust , DOB:  1921-01-31 , General Practitioner: Dr. al-Rahman, Hafsa  , Date of procedure:  2011-01-31Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Family history of gastric cancer FINDINGS: There is an ulcer in the oesophagus at 34 cm which is fungatingIt has rolled edges. Helicobacter pylori infection is the likely cause of the ulcer, which exhibits a fibrous base and active bleeding.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. The oesophageal ulcer appears to be a well-demarcated, circular lesion with a central area of necrosis.The biopsy was performed using a needle biopsy forceps, with the tissue samples sent for pathological analysis..  NA  Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) may be necessary for larger or more complex ulcers.  The patient should avoid consuming acidic foods and drinks, which can irritate the lining of the stomach and delay the healing of the ulcer."
"556","Hospital Number: D3953088 , Hospital: Random NHS Foundation Trust , DOB:  1902-11-14 , General Practitioner: Dr. Rock, Andrea  , Date of procedure:  2011-11-12Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Varices/Vascular FINDINGS: Normal gastroscopy to the duodenum. "
"557","Hospital Number: K5760664 , Hospital: Random NHS Foundation Trust , DOB:  1921-04-11 , General Practitioner: Dr. Sypher, Shiann  , Date of procedure:  2012-01-20Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  7mg  , Instrument:  FG3  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CHRONIC DIARRHOEA-biopsies needed FINDINGS: Normal gastroscopy to the duodenum. "
"558","Hospital Number: U6704720 , Hospital: Random NHS Foundation Trust , DOB:  1995-05-21 , General Practitioner: Dr. Kishi, Jobel  , Date of procedure:  2004-03-24Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG3  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Previous multiple surgeries for reflux . FINDINGS: Normal gastroscopy to the duodenum. "
"559","Hospital Number: Y1451790 , Hospital: Random NHS Foundation Trust , DOB:  1908-05-19 , General Practitioner: Dr. Christopher, Brittni  , Date of procedure:  2004-10-03Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  100mcg  , Midazolam  3mg  , Instrument:  FG7  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Previous Polyps/Metaplasia etc. FINDINGS: There is a polyp in the fundus which is sessile with a normal pit pattern. A gastric polyp is noted in the cardia, with a thickened stalk and papillary surface.Using a snare, the polyp was excised and retrieved for pathologic analysis..  NA  The patient should be advised to avoid consuming alcohol, which can increase the risk of developing more polyps.  "
"560","Hospital Number: S9523253 , Hospital: Random NHS Foundation Trust , DOB:  1989-12-12 , General Practitioner: Dr. al-Taheri, Radiyya  , Date of procedure:  2006-11-17Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG2  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CT findings: . FINDINGS: A large hiatus hernia is present. "
"561","Hospital Number: R7817343 , Hospital: Random NHS Foundation Trust , DOB:  1921-04-16 , General Practitioner: Dr. Hauert, Arnesha  , Date of procedure:  2007-08-06Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia FINDINGS: The patient has inflammation in the third part of the duodenum which is mild. The duodenal mucosa appears to have an uneven, cobblestone-like appearance due to inflammation.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. No evidence of inlet patch on careful inspection.. character(0) RECOMMENDATION: The patient should avoid eating or drinking for at least six hours before any scheduled appointments.   FOLLOW UP: The patient should be advised to maintain a healthy weight, as obesity can worsen the symptoms of GERD.  A blood test may be ordered to assess the patient's iron levels, as chronic inflammation can cause anemia."
"562","Hospital Number: Z7781233 , Hospital: Random NHS Foundation Trust , DOB:  1998-03-28 , General Practitioner: Dr. Mccarthy, Ariunzaya  , Date of procedure:  2016-05-17Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Dysphagia/Odynophagia Vaters syndrome astric pull-up surgery FINDINGS: There is a nodule in the stomach which is sessile. The gastric mucosa appears thickened with multiple small nodules, suggestive of a lymphoproliferative disorder such as MALT lymphoma.The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and ulcer recurrence..  RECOMMENDATION: The patient should be counseled on the importance of maintaining good oral hygiene to prevent oral bacteria from entering the ulcer site.  The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent further damage to the gastrointestinal tract. FOLLOW UP: The patient should avoid carbonated drinks, which can increase the production of gas and delay the healing of the ulcer.  "
"563","Hospital Number: G7755694 , Hospital: Random NHS Foundation Trust , DOB:  1951-12-23 , General Practitioner: Dr. Box, Valerie  , Date of procedure:  2002-08-03Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  12.5mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- PEG FINDINGS: The patient's oesophagus shows a ringed appearance, with a degree of narrowing noted.. The patient has a 10mm nodule in the D1/D2 angle which is sessile. NA  The patient should avoid eating or drinking for at least six hours before any scheduled appointments.  A follow-up appointment with the gastroenterologist should be scheduled for six months after the initial diagnosis to monitor the patient's progress."
"564","Hospital Number: B7780911 , Hospital: Random NHS Foundation Trust , DOB:  1948-01-17 , General Practitioner: Dr. Finley, Alexandrea  , Date of procedure:  2008-06-19Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  150mcg  , Midazolam  1mg  , Instrument:  FG1  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Haematemesis or Melaena/Blood PR FINDINGS: The patient has inflammation in the duodenal bulb which is severe. The mucosa appears granular and thickened in appearance, indicative of chronic inflammation.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. No inlet patch  was also seen on narrow band imaging.. NA RECOMMENDATION: The patient should be advised to avoid caffeine, as it can worsen reflux symptoms.  The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and exacerbate the inflammation. FOLLOW UP: The patient should be advised to avoid lying down for at least three hours after eating to help prevent reflux.  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and inflammation."
"565","Hospital Number: J8821698 , Hospital: Random NHS Foundation Trust , DOB:  1965-12-15 , General Practitioner: Dr. Bowerman, Brianca  , Date of procedure:  2013-09-23Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG2  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia oesophageal stricture post chemorad for scc oesophagus FINDINGS: The patient has a 10mm nodule in the D1/D2 angle which is sessile. NA  The patient should avoid drinking alcohol, as this can increase the risk of bleeding in the gastrointestinal tract.  The patient may be prescribed medication to reduce the size of the nodule and prevent it from growing."
"566","Hospital Number: M8882071 , Hospital: Random NHS Foundation Trust , DOB:  1960-10-03 , General Practitioner: Dr. al-Abood, Huda  , Date of procedure:  2011-08-06Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Biopsies from duodenal stricture FINDINGS: The patient has a polyp in the second part of the duodenum which is stalked with a normal pit pattern. The nodular lesions are noted to have a pale appearance on narrow-band imaging, consistent with lymphoid tissue.The base of the polyp was fulgurated with an electrocautery device to prevent future bleeding or regrowth.. The patient has Barrett's oesophagus. Gastric mucosal prolapse seen. Some areas of vascular abnormalities are seen. The segment looks flat. NA  The patient is advised to return for a follow-up appointment in four to six weeks' time to discuss the findings and plan for further management.  The patient should avoid smoking and alcohol, which can increase the risk of developing more polyps."
"567","Hospital Number: C4433311 , Hospital: Random NHS Foundation Trust , DOB:  1981-02-06 , General Practitioner: Dr. Navarrette, Esmeralda  , Date of procedure:  2002-05-13Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  100mcg  , Midazolam  3mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Food bolus/foreign body removal FINDINGS: The proximal oesophagus appears normal, with the appearance of white exudates in the mid to distal oesophagus.. Mild trachealization of the esophagus  was also noted on endoscopy. Rings  were also noted throughout the esophagusconsistent with eosinophilic oesophagitis. The esophageal mucosa appeared to be friable on endoscopic examination.  NA"
"568","Hospital Number: Q1015837 , Hospital: Random NHS Foundation Trust , DOB:  1909-01-02 , General Practitioner: Dr. Mestas, Veronica  , Date of procedure:  2007-05-05Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Cancer- Oesophagus or Stomach FINDINGS: The patient has an ulcer in the body which is induratedForrest Ulcer classification: IIc.. Accompanied by white exudate and a cobblestone appearance, the gastric ulcer is likely caused by Helicobacter pylori infection.The lesion was biopsied using a standard forceps..   Repeat endoscopy with surveillance biopsies is recommended every 3-5 years for patients with a history of gastric ulcer to monitor for recurrence or malignancy.  The patient should avoid consuming too much fat, as this can delay gastric emptying and delay the healing of the ulcer."
"569","Hospital Number: X2594520 , Hospital: Random NHS Foundation Trust , DOB:  1929-03-10 , General Practitioner: Dr. Davis, Shervanna  , Date of procedure:  2011-04-09Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss FINDINGS: Normal gastroscopy to the duodenum. "
"570","Hospital Number: E6158591 , Hospital: Random NHS Foundation Trust , DOB:  1998-07-01 , General Practitioner: Dr. Ramirez Carreon, Maricarmen  , Date of procedure:  2003-05-12Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  100mcg  , Midazolam  4mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Coeliac  and ? RCD FINDINGS: There is a nodule in the D1/D2 angle which is benign-looking.   The patient may require additional endoscopies in the future to monitor the nodule and ensure that it is not progressing.  The patient should be advised to avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as these can increase the risk of bleeding in the gastrointestinal tract."
"571","Hospital Number: N9571333 , Hospital: Random NHS Foundation Trust , DOB:  1980-03-31 , General Practitioner: Dr. Rieb, Joylensia  , Date of procedure:  2009-11-02Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  150mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- persumed per DU managed conservativelyPrevious persumed DU ulcer managed conservatively. FINDINGS: There is an ulcer in the duodenal bulb which is fibroticIt has rolled edges. The flat surface with no elevation and thickened border of the ulcer suggests a chronic, long-standing condition.The lesion was biopsied using a standard forceps.. The ulcer appears to be a benign lesion, with no evidence of malignant transformation.The lesion was biopsied using a standard forceps.. There is a nodule in the antrum which is sessile. A well-circumscribed, firm nodule is seen in the gastric body, suggestive of a gastrointestinal stromal tumor (GIST).. character(0) RECOMMENDATION: The patient should be instructed to avoid hot beverages and foods to prevent further irritation to the ulcer.  The patient should be advised to attend all scheduled appointments and follow the treatment plan recommended by their healthcare provider. FOLLOW UP: The patient should be advised to eat slowly and chew their food thoroughly to aid digestion and reduce the risk of ulcer recurrence.  If the patient is experiencing symptoms such as vomiting or fever, they should contact their healthcare provider immediately."
"572","Hospital Number: V3328807 , Hospital: Random NHS Foundation Trust , DOB:  1901-03-23 , General Practitioner: Dr. Martinez, Susana  , Date of procedure:  2013-09-13Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  125mcg  , Midazolam  5mg  , Instrument:  FG5  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain x1 hematemesis Crohns colitis FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"")."
"573","Hospital Number: L2721400 , Hospital: Random NHS Foundation Trust , DOB:  1924-12-11 , General Practitioner: Dr. Vue, Katie  , Date of procedure:  2001-05-08Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  12.5mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: IDA FINDINGS: The patient has a 7mm nodule in the duodenal bulb which is sessile. The patient has a polyp in the second part of the duodenum which is stalked with an abnormal pit pattern. Biopsies of the nodules reveal lymphoid hyperplasia with reactive germinal centers.The polyp was removed with a combination of snare and forceps, and hemostasis was achieved with an endoscopic clip.. character(0) RECOMMENDATION: The patient should avoid smoking and drinking alcohol, as these habits can increase the risk of cancer.  A colonoscopy may be ordered to assess for the presence of polyps in the colon and rectum. FOLLOW UP: The patient should be advised to avoid eating large meals or eating quickly, as this can increase the risk of reflux and further damage to the gastrointestinal tract.  The patient is advised to return for a follow-up appointment in four to six weeks' time to discuss the findings and plan for further management."
"574","Hospital Number: A9747574 , Hospital: Random NHS Foundation Trust , DOB:  1964-08-29 , General Practitioner: Dr. L'Hirondelle, Adinidiin  , Date of procedure:  2005-01-10Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Ongoing dyspepsia FINDINGS: There is a nodule in the second part of the duodenum which is sessile.  NA  The patient should be informed of the diagnosis and the importance of adhering to the recommended treatment plan.  If the nodule is suspicious for cancer, the patient may be referred to an oncologist for further evaluation and treatment."
"575","Hospital Number: I9081757 , Hospital: Random NHS Foundation Trust , DOB:  1985-08-09 , General Practitioner: Dr. Boon, Julia  , Date of procedure:  2002-10-04Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  125mcg  , Midazolam  2mg  , Instrument:  FG5  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Dyspepsia FINDINGS: There is a polyp in the duodenal bulb which is stalked with an abnormal pit pattern. The nodules are seen in the context of underlying inflammatory bowel disease, including Crohn's disease and ulcerative colitis.The base of the polyp was fulgurated with an electrocautery device to prevent future bleeding or regrowth..  character(0) RECOMMENDATION: Biopsy samples were taken from the ulcer base to rule out malignancy. The patient should follow up with their referring physician for results. RECOMMENDATION: The patient should be advised to maintain a healthy weight, as obesity can increase the risk of cancer and other gastrointestinal diseases.  The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more polyps. FOLLOW UP: The patient should follow a healthy diet and lifestyle to reduce the risk of developing more ulcers. FOLLOW UP: The patient should be advised to avoid eating large meals or eating quickly, as this can increase the risk of reflux and further damage to the gastrointestinal tract.  The patient may be referred to a specialist in gastrointestinal disorders for further management of the polyp."
"576","Hospital Number: F6090839 , Hospital: Random NHS Foundation Trust , DOB:  1939-10-12 , General Practitioner: Dr. Keys, Desiree  , Date of procedure:  2006-11-23Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  12.5mcg  , Midazolam  5mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Abdominal Pain FINDINGS: There is inflammation in the stomach which is severe. The gastric inflammation is severe and involves ulceration and necrosis of the mucosa.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from..  RECOMMENDATION: The patient should be advised to seek medical attention immediately if they experience symptoms of severe bleeding such as black tarry stools or vomiting blood. RECOMMENDATION: The patient may be prescribed medication to reduce the production of stomach acid and prevent reflux.  The patient should avoid wearing tight clothing, as this can exacerbate the inflammation by increasing the pressure on the stomach. FOLLOW UP: The patient should be informed of the diagnosis and provided with information on how to manage the ulcer. FOLLOW UP: The patient should be advised to avoid eating acidic or spicy foods, as these can worsen GERD symptoms.  The patient should be advised to avoid consuming too much sugar, as this can exacerbate the inflammation by increasing the risk of bacterial overgrowth in the stomach."
"577","Hospital Number: T7480285 , Hospital: Random NHS Foundation Trust , DOB:  1982-01-22 , General Practitioner: Dr. el-Majid, Rifqa  , Date of procedure:  2015-01-24Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  125mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Other-assess stents FINDINGS: mild trachealization.. "
"578","Hospital Number: W2054819 , Hospital: Random NHS Foundation Trust , DOB:  1954-07-08 , General Practitioner: Dr. Jaramillo, Lydia  , Date of procedure:  2008-09-03Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Weight Loss Mother has gastric cancer FINDINGS: Normal gastroscopy to the duodenum. "
"579","Hospital Number: O8834134 , Hospital: Random NHS Foundation Trust , DOB:  1908-01-28 , General Practitioner: Dr. Rico, Evelyn  , Date of procedure:  2005-12-22Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Ongoing reflux symptoms. FINDINGS: Normal gastroscopy to the duodenum. "
"580","Hospital Number: H6820128 , Hospital: Random NHS Foundation Trust , DOB:  1966-03-01 , General Practitioner: Dr. al-Qazi, Mawzoona  , Date of procedure:  2012-07-22Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  75mcg  , Midazolam  7mg  , Instrument:  FG1  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Nausea and/or Vomiting Other- Early satiety FINDINGS: Normal gastroscopy to the duodenum. "
"581","Hospital Number: P4350826 , Hospital: Random NHS Foundation Trust , DOB:  1903-08-10 , General Practitioner: Dr. Ramirez, Ariana  , Date of procedure:  2005-11-23Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Grade D oesophagitis healing. Previous duodenal ulcer FINDINGS: The patient has a 8mm nodule in the third part of the duodenum which is sessile.  character(0) RECOMMENDATION: The patient should be advised to avoid aspirin or other blood thinners unless prescribed by a physician.   FOLLOW UP: The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and delay the healing of the ulcer.  The patient should avoid eating or drinking for at least six hours before any scheduled appointments."
"582","Hospital Number: D5429386 , Hospital: Random NHS Foundation Trust , DOB:  1985-09-30 , General Practitioner: Dr. Bernal, Kashmir  , Date of procedure:  2011-05-18Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  150mcg  , Midazolam  7mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Therapeutic- Dilatation Therapeutic- NJ Tube/PEG/DPEJ FINDINGS: The patient has an ulcer in the duodenal bulb which is scarredIt has a visible vessel. The gastric ulcer exhibits signs of NSAID-induced injury, with a fibrous base and punched-out appearance.The ulcer was biopsied x8 for further analysis.. The surrounding mucosa appears to be friable and prone to bleeding upon contact.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample..  NA  The patient should be instructed to avoid hot beverages and foods to prevent further irritation to the ulcer.  The patient should be advised to eat slowly and chew their food thoroughly to aid digestion and reduce the risk of ulcer recurrence."
"583","Hospital Number: K5870127 , Hospital: Random NHS Foundation Trust , DOB:  1961-06-13 , General Practitioner: Dr. Lange, Melanie  , Date of procedure:  2004-06-30Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  125mcg  , Midazolam  3mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Previous gastric ulcer. repeat scope after 8 weeks. FINDINGS: There is a cervical inlet patch of dubious significance..   The patient should be advised to avoid hot spices, sauces, and acidic foods to reduce discomfort and promote healing.  The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and delay the healing of the ulcer."
"584","Hospital Number: U3081246 , Hospital: Random NHS Foundation Trust , DOB:  1923-04-17 , General Practitioner: Dr. York, Summer  , Date of procedure:  2002-04-06Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia post transhiatal oesophagectomy FINDINGS: Barrett's is present. The segment looks flat. No abnormal pit pattern is seen. NA"
"585","Hospital Number: Y1506215 , Hospital: Random NHS Foundation Trust , DOB:  1940-10-03 , General Practitioner: Dr. Finley Ponds, Natalie  , Date of procedure:  2002-04-23Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG5  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Abdominal Pain FINDINGS: There is a nodule in the duodenal bulb which is benign-looking. There is an ulcer in the second part of the duodenum which is necroticCLO test  was also taken.. The gastric lesion appears malignant, accompanied by active bleeding and a punched-out appearance.The ulcer was biopsied x8 for further analysis.. The ulcer appears to be a benign lesion, with no evidence of malignant transformation.During biopsy, it was noted that the lesion had a friable surface and bled easily.. character(0) RECOMMENDATION: The patient should be counseled on the importance of maintaining good oral hygiene to prevent oral bacteria from entering the ulcer site.  The patient may require additional endoscopies in the future to monitor the nodule and ensure that it is not progressing. FOLLOW UP:   The patient may require additional endoscopies in the future to monitor the nodule and ensure that it is not progressing."
"586","Hospital Number: S7145991 , Hospital: Random NHS Foundation Trust , DOB:  1959-08-08 , General Practitioner: Dr. Hohm, Audrey  , Date of procedure:  2015-03-13Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG6  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Reflux-like Symptoms/Atypical Chest Pain Abdominal Pain FINDINGS: The patient has a polyp in the stomach which is stalked.It has an abnormal pit pattern. Multiple polyps with variable size are seen throughout the gastric mucosa, suggestive of familial adenomatous polyposis.ESD was performed to remove the polyp after lifting it with saline injection..     A repeat gastroscopy may be recommended in three to six months' time to assess the growth of the polyp."
"587","Hospital Number: R9404908 , Hospital: Random NHS Foundation Trust , DOB:  1950-02-09 , General Practitioner: Dr. Todd, Sara  , Date of procedure:  2006-04-26Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  50mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Small Bowel Biopsy Positive coeliac serology FINDINGS: The patient has an ulcer in the third part of the duodenum which is induratedForrest Ulcer classification: IIc.. The gastric lesion appears malignant, accompanied by active bleeding and a punched-out appearance.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization.. The ulcer base appears to be necrotic and sloughing, with visible debris and exudate.During biopsy, it was noted that the lesion had a friable surface and bled easily.. OESOPHAGUS: small hiatus hernia.. NA  Referral to a gastroenterologist for further evaluation and management of the ulcer is recommended.  The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and delay the healing of the ulcer."
"588","Hospital Number: Z6151451 , Hospital: Random NHS Foundation Trust , DOB:  1949-05-07 , General Practitioner: Dr. Platt, Amanda  , Date of procedure:  2004-10-10Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  100mcg  , Midazolam  5mg  , Instrument:  FG3  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Other- Bloating FINDINGS: Normal gastroscopy to the duodenum. "
"589","Hospital Number: G1498153 , Hospital: Random NHS Foundation Trust , DOB:  1941-10-27 , General Practitioner: Dr. Caraveo, Rosangelica  , Date of procedure:  2009-02-16Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG3  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain . FINDINGS: The patient has inflammation in the second part of the duodenum which is erosive. The duodenal mucosa appears to have a rough and patchy surface, suggestive of inflammation.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. LA Grade  D oesophagitis. The oesophageal mucosa is hyperemic and has a granular appearance with areas of erosion and exudate. Candida present. The oesophageal mucosa has a furrowed or corrugated appearance. character(0) RECOMMENDATION: The patient may be prescribed medication to reduce the production of stomach acid and prevent reflux.  A consultation with a dietician may be beneficial to help the patient modify their diet to manage the inflammation. FOLLOW UP: The patient should be advised to avoid caffeine, as it can worsen reflux symptoms.  The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and exacerbate the inflammation."
"590","Hospital Number: B8969666 , Hospital: Random NHS Foundation Trust , DOB:  1955-11-25 , General Practitioner: Dr. Aguilar Molina, Brandie  , Date of procedure:  2013-02-19Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  25mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Dysphagia/Odynophagia FINDINGS: Normal gastroscopy to the duodenum. "
"591","Hospital Number: J1819477 , Hospital: Random NHS Foundation Trust , DOB:  1945-05-07 , General Practitioner: Dr. Cook-Nunn, Kalole  , Date of procedure:  2012-09-02Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain previous ogd attempt food residue FINDINGS: Normal gastroscopy to the duodenum. "
"592","Hospital Number: M8863036 , Hospital: Random NHS Foundation Trust , DOB:  1949-12-07 , General Practitioner: Dr. Darcy, Ivory  , Date of procedure:  2004-12-28Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG5  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Haematemesisor Melaena/Blood PR FINDINGS: There is inflammation in the third part of the duodenum which is erosive. There are areas of nodularity seen throughout the duodenal mucosa, suggestive of chronic inflammation.The lesion was biopsied using a standard forceps.. The patient has an ulcer in the duodenal bulb which is fibroticIt has a visible vessel. The ulceration exhibits a cobblestone appearance and a yellowish base, suggestive of Helicobacter pylori infection.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. The ulcer appears to be a chronic lesion, with signs of previous healing and scarring.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample.. character(0) RECOMMENDATION: Endoscopic therapy with injection of epinephrine and/or placement of hemostatic clips may be necessary to achieve hemostasis in the event of active bleeding. RECOMMENDATION: The patient may be prescribed an H2 blocker to reduce stomach acid production and prevent reflux.  The patient should be informed of the diagnosis and provided with information on how to manage the inflammation. FOLLOW UP: The patient is advised to return for a follow-up appointment in two to four weeks' time to discuss the findings and plan for further management. FOLLOW UP: The patient may be referred to a psychologist to help manage any anxiety or stress that may be contributing to their symptoms.  The patient should avoid consuming large meals, as this can exacerbate the inflammation."
"593","Hospital Number: C4021112 , Hospital: Random NHS Foundation Trust , DOB:  1942-10-27 , General Practitioner: Dr. Duran, Amber  , Date of procedure:  2004-02-26Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Maleana FINDINGS: There is a polyp in the D1/D2 angle which is stalked.It has a normal pit pattern.   The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and polyp growth.  The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools."
"594","Hospital Number: Q8222665 , Hospital: Random NHS Foundation Trust , DOB:  1936-12-10 , General Practitioner: Dr. Lam, Elyse  , Date of procedure:  2015-11-27Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  125mcg  , Midazolam  4mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Dyspepsia FINDINGS: The patient has a polyp in the GOJ which is sessile.It has an abnormal pit pattern. An oesophageal polyp was detected during endoscopy, located approximately 10 cm from the incisors. The lesion had a nodular surface and measured 1.5 cm in diameter.Under endoscopic visualization, the polyp was removed using EMR.. OESOPHAGUS: Normal, no appreciable hiatus hernia.. NA  A repeat gastroscopy may be recommended in twelve months' time to assess the response to treatment.  The patient should be advised to avoid NSAIDs and aspirin, which can increase the risk of developing more polyps."
"595","Hospital Number: X5836068 , Hospital: Random NHS Foundation Trust , DOB:  1901-08-07 , General Practitioner: Dr. Moore, Lindsay  , Date of procedure:  2003-11-23Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  125mcg  , Midazolam  2mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Other- change in taste bile taste in mouth FINDINGS: LA Grade  C oesophagitis. There are scattered erosions present in the oesophageal mucosa. There are multiple areas of oesophageal mucosal breaks with overlying fibrin and purulent exudates. Multiple white exudates were observed in the esophagus, which may indicate candida or food debris.  character(0)"
"596","Hospital Number: E8902521 , Hospital: Random NHS Foundation Trust , DOB:  1970-11-29 , General Practitioner: Dr. Harvin, Tatiyana  , Date of procedure:  2004-05-21Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: High Dysphagia further assessment of previoius diagnosed peptic stricture also recent eus and aspirat of bengn perigastric cyst FINDINGS: LA Grade  C oesophagitis. The oesopahgitis is consistent with acid reflux.  NA"
"597","Hospital Number: N7405188 , Hospital: Random NHS Foundation Trust , DOB:  1948-08-07 , General Practitioner: Dr. Lopez, Natalie  , Date of procedure:  2013-12-23Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR FINDINGS: The patient has a 4mm nodule in the fundus which is stalked. A large, lobulated nodule is observed in the gastric body, suggestive of a gastrointestinal autonomic nerve tumor (GANT).Monitor for side effects of prescribed medications and adjust therapy as necessary to balance benefits and risks.. There is a stricture in the second part of the duodenum which is obliterativeThe endoscope passed through the stricture with resistance. The narrowing of the duodenal lumen is accompanied by a slight mucosal fold thickening.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. character(0)  The patient should be advised to maintain a healthy diet and lifestyle, as this may help prevent the growth of the nodule.  The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the nodule."
"598","Hospital Number: V9378773 , Hospital: Random NHS Foundation Trust , DOB:  1950-08-29 , General Practitioner: Dr. Ruff, Jonni Lynn  , Date of procedure:  2005-12-18Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  25mcg  , Midazolam  7mg  , Instrument:  FG3  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Reflux-like Symptoms/Atypical Chest Pain Abdominal Pain FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"")."
"599","Hospital Number: L6117442 , Hospital: Random NHS Foundation Trust , DOB:  1984-09-26 , General Practitioner: Dr. al-Tariq, Kameela  , Date of procedure:  2015-12-07Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  12.5mcg  , Midazolam  5mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Small Bowel Biopsy Positive coeliac serology FINDINGS: Normal gastroscopy to the duodenum. "
"600","Hospital Number: A3669324 , Hospital: Random NHS Foundation Trust , DOB:  1997-09-12 , General Practitioner: Dr. Cue, Shelbee  , Date of procedure:  2007-07-27Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG5  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Positive coeliac serology FINDINGS: mild trachealization.. "
"601","Hospital Number: O8583042 , Hospital: Random NHS Foundation Trust , DOB:  1902-05-29 , General Practitioner: Dr. Zambrano, Francis  , Date of procedure:  2007-02-10Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Ongoing dyspepsia FINDINGS: Normal gastroscopy to the duodenum. "
"602","Hospital Number: H2587908 , Hospital: Random NHS Foundation Trust , DOB:  1924-07-13 , General Practitioner: Dr. al-Abu, Jasra  , Date of procedure:  2009-04-24Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  12.5mcg  , Midazolam  6mg  , Instrument:  FG1  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia . FINDINGS: There is a stricture in the third part of the duodenum which is obliterativeScope not held by stricture. The stricture has a sharp and well-defined margin, suggesting a compressive etiology.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. There is inflammation in the duodenal bulb which is erosive. There is diffuse erythema and friability noted in the duodenal mucosa, with areas of active bleeding.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. NA RECOMMENDATION: The patient should be advised to elevate the head of their bed by six inches to help prevent reflux at night.  A consultation with a dietician may be beneficial to help the patient modify their diet to manage the inflammation. FOLLOW UP: The patient should be informed of the diagnosis and the importance of adhering to the recommended treatment plan.  The patient should avoid eating too much fat, as this can exacerbate the inflammation by delaying gastric emptying and increasing the risk of reflux."
"603","Hospital Number: P9907275 , Hospital: Random NHS Foundation Trust , DOB:  1912-01-17 , General Practitioner: Dr. el-Abood, Firdaus  , Date of procedure:  2001-01-11Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG3  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia oesophageal stricture post chemorad for scc oesophagus FINDINGS: The patient has inflammation in the D1/D2 angle which is severe. NA RECOMMENDATION: The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the stricture.  The patient should be encouraged to maintain a healthy weight to reduce the risk of developing inflammation in the future. FOLLOW UP: Further investigations, such as imaging studies and blood tests, may be required to determine the underlying cause of the stricture.  The patient should be encouraged to maintain a healthy weight to reduce the risk of developing inflammation in the future."
"604","Hospital Number: D9990587 , Hospital: Random NHS Foundation Trust , DOB:  1961-12-03 , General Practitioner: Dr. Dawe, Reyana  , Date of procedure:  2005-08-25Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  150mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia Vomiting known hiatus hernia FINDINGS: Inflammatory changes seen in the oesophagus.  NA"
"605","Hospital Number: K9010769 , Hospital: Random NHS Foundation Trust , DOB:  1935-11-13 , General Practitioner: Dr. Packer, Jennifer  , Date of procedure:  2010-07-13Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  25mcg  , Midazolam  7mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Columnar lined oesophagus is present. The pit pattern is normal. No loss of aceto-whitening was seen. No abnormal pit pattern is seen. The patient has inflammation in the second part of the duodenum which is severe. The duodenal mucosa appears to have a rough and patchy surface, suggestive of inflammation.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. NA RECOMMENDATION: The patient should be advised to avoid eating acidic or spicy foods, as these can worsen GERD symptoms.  The patient should be informed of the diagnosis and provided with information on how to manage the inflammation. FOLLOW UP: The patient may be prescribed an H2 blocker to reduce stomach acid production and prevent reflux.  The patient is advised to return for a follow-up appointment in six weeks' time to evaluate the progress of the inflammation."
"606","Hospital Number: U5728377 , Hospital: Random NHS Foundation Trust , DOB:  1995-07-05 , General Practitioner: Dr. Mandakh, Sozan  , Date of procedure:  2014-02-14Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Abdominal Pain FINDINGS: Normal gastroscopy to the duodenum. "
"607","Hospital Number: Y3424765 , Hospital: Random NHS Foundation Trust , DOB:  1915-10-11 , General Practitioner: Dr. al-Amara, Kawkab  , Date of procedure:  2013-08-23Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Other-assess stents FINDINGS: Normal gastroscopy to the duodenum. "
"608","Hospital Number: S9335497 , Hospital: Random NHS Foundation Trust , DOB:  1954-10-12 , General Practitioner: Dr. el-Faraj, Haniyya  , Date of procedure:  2003-08-31Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Grade D oesophagitis healing. Previous duodenal ulcer FINDINGS: Normal gastroscopy to the duodenum. NA  Endoscopic therapy with injection of epinephrine and/or placement of hemostatic clips may be necessary to achieve hemostasis in the event of active bleeding.  The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and delay the healing of the ulcer."
"609","Hospital Number: R3233951 , Hospital: Random NHS Foundation Trust , DOB:  1953-08-23 , General Practitioner: Dr. Little, Camille  , Date of procedure:  2014-06-03Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  125mcg  , Midazolam  5mg  , Instrument:  FG4  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Bloating FINDINGS: There is a stricture in the GOJ which is stenoticIt will not allow the scope to pass.. The stricture located 22cm from the incisors appears to be a fixed, non-dilatable lesion.The biopsy was performed using a needle biopsy forceps, with the tissue samples sent for pathological analysis.. Likely paraoesophageal hernia present. NA"
"610","Hospital Number: Z3118534 , Hospital: Random NHS Foundation Trust , DOB:  1934-01-27 , General Practitioner: Dr. Martinez, Janelle  , Date of procedure:  2008-10-04Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Varices FINDINGS: Barrett's is present. No abnormal pit pattern is seen. Gastric mucosal prolapse seen. "
"611","Hospital Number: G7303882 , Hospital: Random NHS Foundation Trust , DOB:  1925-01-03 , General Practitioner: Dr. Compton, Lindsay  , Date of procedure:  2010-07-16Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG5  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Dyspepsia FINDINGS: The patient has a 8mm nodule in the third part of the duodenum which is sessile. Inflammatory changes seen in the oesophagus. character(0)  If the nodule is benign, the patient may not require any treatment, but may require monitoring with regular endoscopies.  The patient should avoid eating fried or fatty foods, as these can increase the risk of reflux and further damage to the gastrointestinal tract."
"612","Hospital Number: B2496144 , Hospital: Random NHS Foundation Trust , DOB:  1991-11-17 , General Practitioner: Dr. Rockwell, Chase  , Date of procedure:  2011-04-28Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Polypectomy FINDINGS: Normal gastroscopy to the duodenum.   The patient should be informed of the diagnosis and provided with information on how to manage the polyp.  The patient should avoid eating before bedtime, as this can increase the risk of reflux and polyp growth."
"613","Hospital Number: J9928505 , Hospital: Random NHS Foundation Trust , DOB:  1970-01-22 , General Practitioner: Dr. Schneider, Lilyanne  , Date of procedure:  2010-01-22Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CD FINDINGS: There is a polyp in the body which is stalked with an abnormal pit pattern. A large, irregular gastric polyp is noted in the body of the stomach, with a nodular and friable surface.ESD was performed to remove the polyp after lifting it with saline injection..   The patient should be advised to avoid acidic foods and drinks, which can irritate the lining of the stomach and increase the risk of developing more polyps.  A colonoscopy may be ordered to assess for the presence of polyps in the colon and rectum."
"614","Hospital Number: M7832839 , Hospital: Random NHS Foundation Trust , DOB:  1959-02-28 , General Practitioner: Dr. Yun, Kathryn  , Date of procedure:  2004-09-27Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  25mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow up oesophageal stricture dysphagia for recurrent dilatation FINDINGS: LA Grade  C oesophagitis. The oesophageal mucosa is thickened and has a cobblestone appearance. The oesopahgitis is consistent with acid reflux.  character(0)"
"615","Hospital Number: C1538169 , Hospital: Random NHS Foundation Trust , DOB:  1941-01-01 , General Practitioner: Dr. el-Alam, Kawthar  , Date of procedure:  2004-11-20Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Positive coeliac serology FINDINGS: There is a polyp in the stomach which is stalked.It has an abnormal pit pattern. A gastric polyp with a broad-based attachment and lobulated surface is observed in the antrum, suggestive of an adenomatous lesion.The polyp was marked with a tattoo to aid in future surveillance endoscopy..  character(0)  The patient should be advised to avoid carbonated drinks, which can increase the risk of developing more polyps by increasing the production of gas.  The patient should be advised to avoid consuming caffeine, which can stimulate the production of stomach acid and increase the risk of polyp growth."
"616","Hospital Number: Q6090326 , Hospital: Random NHS Foundation Trust , DOB:  1932-11-03 , General Practitioner: Dr. Smith, Cheyenne  , Date of procedure:  2001-03-08Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  50mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Epigastric pain. Previously on asprin for Cerebral infarction FINDINGS: The patient has a polyp in the third part of the duodenum which is sessile with a normal pit pattern. The nodules vary in size, with the largest measuring approximately 1 cm in diameter.The base of the polyp was fulgurated with an electrocautery device to prevent future bleeding or regrowth.. There is a nodule in the oesophagus at 35 cm which is stalked. The oesophageal ulcer appears to be a linear, longitudinally oriented lesion with associated mucosal edema.The patient should avoid consuming too much fat, as this can delay gastric emptying and delay the healing of the ulcer.. character(0) RECOMMENDATION: Surgical intervention may be necessary in the event of complications such as perforation or obstruction. RECOMMENDATION: The patient should avoid smoking and drinking alcohol, as these habits can increase the risk of cancer.  The patient is advised to return for a follow-up appointment in four to six weeks' time to discuss the findings and plan for further management. FOLLOW UP: The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools. FOLLOW UP: The patient should be advised to attend all scheduled appointments and follow the treatment plan recommended by their healthcare provider.  The patient should be advised to avoid acidic foods and drinks, which can irritate the lining of the stomach and increase the risk of developing more polyps."
"617","Hospital Number: X8881813 , Hospital: Random NHS Foundation Trust , DOB:  1917-04-07 , General Practitioner: Dr. Hansen, Jessica  , Date of procedure:  2010-01-14Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting FINDINGS: Normal gastroscopy to the duodenum. "
"618","Hospital Number: E5760181 , Hospital: Random NHS Foundation Trust , DOB:  1908-01-23 , General Practitioner: Dr. Burciaga-Munoz, Ruby  , Date of procedure:  2001-03-23Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  125mcg  , Midazolam  3mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Positive coeliac FINDINGS: Normal gastroscopy to the duodenum. "
"619","Hospital Number: N3482935 , Hospital: Random NHS Foundation Trust , DOB:  1955-03-02 , General Practitioner: Dr. Tromble, Kaitlyn  , Date of procedure:  2016-08-29Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  25mcg  , Midazolam  3mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Varices/Vascular FINDINGS: There is an ulcer in the fundus which is exudativeIt is bleeding. The patient's medical history, along with the ulcer's rugose surface and irregular border, suggest a chronic inflammatory process.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample..  character(0)  The patient should be advised to seek medical attention immediately if they experience symptoms of severe bleeding such as black tarry stools or vomiting blood.  The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and delay the healing of the ulcer."
"620","Hospital Number: V6466799 , Hospital: Random NHS Foundation Trust , DOB:  1944-04-18 , General Practitioner: Dr. el-Jamal, Nabeela  , Date of procedure:  2001-03-22Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  50mcg  , Midazolam  3mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Maleana FINDINGS: There is a polyp in the fundus which is sessile.It has a normal pit pattern. A well-defined, elevated gastric polyp is observed on the antral mucosa, with a nodular surface.The polyp was marked with a tattoo to aid in future surveillance endoscopy.. There is inflammation in the body which is mild. The gastric mucosa appears diffusely erythematous with no distinct erosions, suggestive of superficial gastritis.During biopsy, it was noted that the lesion had a friable surface and bled easily.. character(0) RECOMMENDATION: The patient should be advised to avoid eating acidic or spicy foods, as these can worsen GERD symptoms. RECOMMENDATION:   The patient may be referred to a specialist in gastrointestinal disorders for further management of the polyp. FOLLOW UP: If the patient experiences chest pain or difficulty breathing, they should seek emergency medical attention immediately. FOLLOW UP: A repeat gastroscopy may be required in three to six months' time to monitor the progress of the inflammation.  "
"621","Hospital Number: L2151400 , Hospital: Random NHS Foundation Trust , DOB:  1914-09-18 , General Practitioner: Dr. Herrera, Katherine  , Date of procedure:  2014-07-18Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  50mcg  , Midazolam  6mg  , Instrument:  FG4  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia FINDINGS: On retroflexion the wrap is in correct position, with no evidence of recurrent hiatus hernia.. "
"622","Hospital Number: A3080284 , Hospital: Random NHS Foundation Trust , DOB:  1966-09-06 , General Practitioner: Dr. Meyer, Megan  , Date of procedure:  2008-05-18Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: duodenal stent FINDINGS: The patient has a stricture in the GOJ which is HhpertrophiedThe endoscope passed through the stricture with resistance. Upon inspection, the mucosa proximal to the stricture shows a slightly erythematous appearance, whereas the distal mucosa appears normal.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. LA Grade  A oesophagitis. The lower oesopahgeal sphincter looks widely patent character(0)"
"623","Hospital Number: I7491657 , Hospital: Random NHS Foundation Trust , DOB:  1965-06-26 , General Practitioner: Dr. Lee, Brittany  , Date of procedure:  2008-08-04Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Abdominal Pain FINDINGS: Normal gastroscopy to the duodenum. "
"624","Hospital Number: F8022001 , Hospital: Random NHS Foundation Trust , DOB:  1954-10-27 , General Practitioner: Dr. al-Saade, Iffat  , Date of procedure:  2015-11-13Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - VCE placement (previous gastric bypass)Anaemia/Low Iron or Vitamins FINDINGS: Columnar lined oesophagus is present. No nodularity is present. No loss of aceto-whitening  was also seen.  NA"
"625","Hospital Number: T4904215 , Hospital: Random NHS Foundation Trust , DOB:  1942-08-25 , General Practitioner: Dr. Robinson, Katherine  , Date of procedure:  2002-11-12Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  150mcg  , Midazolam  4mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Chemorad for scc middle third of oeosphagus - post treatment assessement FINDINGS: As an incidental finding she also has a cervical inlet patch.. "
"626","Hospital Number: W8932372 , Hospital: Random NHS Foundation Trust , DOB:  1926-05-15 , General Practitioner: Dr. Sedillos, Reberta  , Date of procedure:  2002-07-14Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  125mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Grade D oesophagitis healing. Previous duodenal ulcer FINDINGS: Previous OGD showed LA grade C reflux oesophagitis above a hiatus hernia and gastroduodenitis.. The oesophageal mucosa is eroded with fibrinous exudates present. The esophagus appeared to have a corrugated or ridged appearance on endoscopic examination. Multiple white exudates  were also observed in the esophagus, which may indicate candida or food debris. The esophageal mucosa  was also noted to be edematous and inflamed on endoscopic evaluation.  NA  Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) may be necessary for larger or more complex ulcers.  The patient may be prescribed medication to protect the stomach lining and reduce the risk of developing more ulcers."
"627","Hospital Number: O7967929 , Hospital: Random NHS Foundation Trust , DOB:  1953-05-06 , General Practitioner: Dr. Rangel Valverde, Christina  , Date of procedure:  2016-10-09Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  12.5mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - VCE placement (previous gastric bypass)Anaemia/Low Iron or Vitamins FINDINGS: At 18cm two inlet patches  were also seen.. "
"628","Hospital Number: H3844577 , Hospital: Random NHS Foundation Trust , DOB:  1925-10-31 , General Practitioner: Dr. Breazell-Johnson, Oshanee  , Date of procedure:  2015-06-17Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known coeliac ch diarrhoea.Myelofibrosis on ruxolitinib and panobinostat FINDINGS: Normal gastroscopy to the duodenum. "
"629","Hospital Number: P4236233 , Hospital: Random NHS Foundation Trust , DOB:  1914-02-15 , General Practitioner: Dr. Shuler, Ashley  , Date of procedure:  2014-04-26Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia . FINDINGS: The patient has a stricture in the stomach which is obliterativeIt is easily traversible.. The gastric stricture is located in the body of the stomach, with a smooth surface and concentric narrowing of the lumen.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. "
"630","Hospital Number: D4826904 , Hospital: Random NHS Foundation Trust , DOB:  1979-01-21 , General Practitioner: Dr. el-Akbari, Afeefa  , Date of procedure:  2004-07-15Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG2  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: anastomotic stricture post thoracoabdominal oesophagogastrecotmy for dilatation FINDINGS: The patient has an ulcer in the second part of the duodenum which is fungatingForrest Ulcer classification:II B.. The patient's medical history and the ulcer's rugose surface suggest a chronic inflammatory process.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. There are no visible signs of perforation or penetration into adjacent organs or tissues.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. Inflammatory changes seen in the oesophagus. character(0)  The patient should be counseled on the risks and benefits of any potential treatments for their ulcer.  The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and delay the healing of the ulcer."
"631","Hospital Number: K8847627 , Hospital: Random NHS Foundation Trust , DOB:  1958-10-07 , General Practitioner: Dr. Kirn, Destiny  , Date of procedure:  2002-09-02Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR FINDINGS: Normal gastroscopy to the duodenum. "
"632","Hospital Number: U8525559 , Hospital: Random NHS Foundation Trust , DOB:  1995-12-05 , General Practitioner: Dr. Chan, Della  , Date of procedure:  2006-05-15Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  25mcg  , Midazolam  3mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- RFA FINDINGS: Normal gastroscopy to the duodenum. "
"633","Hospital Number: Y5602439 , Hospital: Random NHS Foundation Trust , DOB:  1950-05-25 , General Practitioner: Dr. al-Arif, Nuzha  , Date of procedure:  2003-10-14Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG6  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Nausea and/or Vomiting Weight Loss FINDINGS: Normal gastroscopy to the duodenum. "
"634","Hospital Number: S6682774 , Hospital: Random NHS Foundation Trust , DOB:  1913-05-23 , General Practitioner: Dr. Hsueh, Iona  , Date of procedure:  2002-09-05Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Haematemesis or Melaena/Blood PR FINDINGS: The patient has a polyp in the GOJ which is stalked.It has an abnormal pit pattern. Upon endoscopic examination of the oesophagus, a 2 cm Paris IIa/c polypoid lesion was observed. The lesion had a smooth surface and appeared to be pedunculated.Under endoscopic visualization, the polyp was removed using EMR..  character(0)  A colonoscopy may be ordered to assess for the presence of polyps in the colon and rectum.  The patient should be informed of the diagnosis and provided with information on how to manage the polyp."
"635","Hospital Number: R6103760 , Hospital: Random NHS Foundation Trust , DOB:  1963-09-06 , General Practitioner: Dr. Luke, Sabrina  , Date of procedure:  2004-06-29Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  150mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CD FINDINGS: There is a stricture in the D1/D2 angle which is roughTight distal stricture which would not allow passage of scope.. "
"636","Hospital Number: Z1272661 , Hospital: Random NHS Foundation Trust , DOB:  1953-04-23 , General Practitioner: Dr. Beg, Simran  , Date of procedure:  2009-05-09Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Melaena/Blood PR FINDINGS: The patient has an ulcer in the GOJ which is fibroticIt has a visible vessel. Accompanied by white exudate and a yellowish base, the gastric ulcer presents with a cobblestone appearance.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample.. The oesophageal ulcer appears to be a shallow, non-healing lesion with a diameter of approximately 1 cm.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. The patient has a stricture in the fundus which is scarredIt is easily traversible.. A long-segment gastric stricture is noted in the body of the stomach, with a stenotic and irregular contour.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. NA  Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) may be necessary for larger or more complex ulcers.  The patient should avoid lying down immediately after meals, as this can increase the risk of reflux and ulcer recurrence."
"637","Hospital Number: G2227671 , Hospital: Random NHS Foundation Trust , DOB:  1929-09-29 , General Practitioner: Dr. al-Ozer, Ilhaam  , Date of procedure:  2010-10-19Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  25mcg  , Midazolam  7mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Altered taste FINDINGS: There is a stricture in the duodenal bulb which is ulceratedThere is very slight and non-restrcitve stricturing.. Characterized by a distinct loss of mucosal tissue, the severe ulceration presents with a nodular surface.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. The stricture has a sharp and well-defined margin, suggesting a compressive etiology.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization.. There is inflammation in the fundus which is mild. The gastric inflammation is characterized by erythema and edema of the mucosa.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. NA RECOMMENDATION: The patient should be counseled on the importance of maintaining good oral hygiene to prevent oral bacteria from entering the ulcer site. RECOMMENDATION: The patient should be advised to avoid lying down immediately after eating, as this can worsen reflux symptoms.  The patient should be advised to avoid hot, spicy foods, which can irritate the lining of the stomach and exacerbate the inflammation. FOLLOW UP: The patient should avoid consuming acidic foods and drinks, which can irritate the lining of the stomach and delay the healing of the ulcer. FOLLOW UP: The patient may be prescribed an H2 blocker to reduce stomach acid production and prevent reflux.  The patient should avoid eating before bedtime, as this can exacerbate the inflammation by increasing the risk of reflux."
"638","Hospital Number: B7082304 , Hospital: Random NHS Foundation Trust , DOB:  1997-11-01 , General Practitioner: Dr. Mccaine, Taylor  , Date of procedure:  2003-01-12Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Other- candidiasis FINDINGS: There is inflammation in the D1/D2 angle which is severe.  RECOMMENDATION: The patient should be advised to avoid caffeine, as it can worsen reflux symptoms.  The patient should be advised to avoid consuming too much sugar, as this can exacerbate the inflammation by increasing the risk of bacterial overgrowth in the stomach. FOLLOW UP: The patient may be referred to a specialist for further evaluation and treatment, such as surgery to widen the esophagus.  Further investigations such as a biopsy may be recommended to determine the underlying cause of the inflammation."
"639","Hospital Number: J8000143 , Hospital: Random NHS Foundation Trust , DOB:  1936-03-04 , General Practitioner: Dr. Staton, Ventoria  , Date of procedure:  2013-08-26Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Previous Polyps/Metaplasia etc. FINDINGS: The patient has an ulcer in the antrum which is fibroticForrest Ulcer classification:II B.. Surrounded by erythema and exhibiting a nodular surface, the severe ulceration presents with a distinct loss of mucosal tissue.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. There is an ulcer in the second part of the duodenum which is necroticCLO test  was also taken.. The gastric lesion appears malignant, accompanied by active bleeding and a punched-out appearance.The ulcer was biopsied x8 for further analysis.. The ulcer appears to be a benign lesion, with no evidence of malignant transformation.During biopsy, it was noted that the lesion had a friable surface and bled easily.. NA RECOMMENDATION: Proton pump inhibitors may be prescribed to reduce gastric acid production and promote ulcer healing.  The patient should be advised to avoid carbonated drinks, which can increase the risk of developing more polyps by increasing the production of gas. FOLLOW UP: The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and delay the healing of the ulcer.  Further investigations such as a biopsy may be recommended to determine the type of polyp and assess the risk of cancer."
"640","Hospital Number: M2497777 , Hospital: Random NHS Foundation Trust , DOB:  1912-07-15 , General Practitioner: Dr. Brown, Nicole  , Date of procedure:  2001-10-16Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- FINDINGS: Normal gastroscopy to the duodenum. "
"641","Hospital Number: C1910592 , Hospital: Random NHS Foundation Trust , DOB:  1971-03-03 , General Practitioner: Dr. Mochal, Rene  , Date of procedure:  2016-11-05Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG1  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Other- Early satiety FINDINGS: The patient has a stricture in the stomach which is scleroticThe endoscope passed through the stricture with resistance. Despite the impression of extrinsic compression, the gastric stricture is likely the result of fibrotic changes in the mucosa.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. "
"642","Hospital Number: Q9535363 , Hospital: Random NHS Foundation Trust , DOB:  1916-11-30 , General Practitioner: Dr. el-Ahmad, Sumaita  , Date of procedure:  2014-02-28Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  12.5mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Weight Loss Anaemia/Low Iron or Vitamins FINDINGS: Normal gastroscopy to the duodenum. "
"643","Hospital Number: X7857756 , Hospital: Random NHS Foundation Trust , DOB:  1901-01-15 , General Practitioner: Dr. Lopez, Makayla  , Date of procedure:  2012-12-04Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Weight Loss Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"644","Hospital Number: E8303284 , Hospital: Random NHS Foundation Trust , DOB:  1996-11-18 , General Practitioner: Dr. Vidal, Rene  , Date of procedure:  2007-10-15Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Eosinophilic oesophagitis assesment FINDINGS: There is an ulcer in the oesophagus at 23 cm which is excavated with a visible vessel. The gastric ulcer presents with an irregular border and a fibrous base, suggestive of NSAID-induced injury.During biopsy, it was noted that the lesion had a friable surface and bled easily.. The oesophageal ulcer exhibits a friable, hemorrhagic surface with surrounding erythema and exudate, suggestive of an infectious process.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. The patient has inflammation in the second part of the duodenum which is mild. The mucosa appears reddened and swollen, with evidence of exudate present in some areas.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization.. character(0) RECOMMENDATION: The patient should be advised to avoid aspirin or other blood thinners unless prescribed by a physician. RECOMMENDATION: The patient should avoid drinking carbonated beverages, as these can worsen reflux symptoms.  The patient should be informed of the diagnosis and provided with information on how to manage the inflammation. FOLLOW UP: A repeat gastroscopy may be required in eight to twelve weeks' time to monitor the healing of the ulcer. FOLLOW UP: The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the stricture.  The patient is advised to return for a follow-up appointment in six weeks' time to evaluate the progress of the inflammation."
"645","Hospital Number: N5562828 , Hospital: Random NHS Foundation Trust , DOB:  1927-08-03 , General Practitioner: Dr. Sipan, Alyce  , Date of procedure:  2006-10-15Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal bloating chest discomfort reflux.Known fibromyalgia RA FINDINGS: Normal gastroscopy to the duodenum. "
"646","Hospital Number: V8753920 , Hospital: Random NHS Foundation Trust , DOB:  1985-06-19 , General Practitioner: Dr. Moline, Rebecca  , Date of procedure:  2013-08-18Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  25mcg  , Midazolam  5mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Positive coeliac FINDINGS: There is inflammation in the stomach which is severe. The gastric mucosa appears diffusely thickened with nodular lesions and areas of ulceration, suggestive of lymphocytic gastritis.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape..  RECOMMENDATION: The patient should be counseled on the importance of maintaining good oral hygiene to prevent oral bacteria from entering the ulcer site. RECOMMENDATION: The patient should be advised to avoid lying down for at least three hours after eating to help prevent reflux.  The patient should be advised to eat slowly and chew their food thoroughly to aid digestion and reduce the risk of inflammation. FOLLOW UP:  FOLLOW UP:   The patient should be advised to avoid consuming too much sugar, as this can exacerbate the inflammation by increasing the risk of bacterial overgrowth in the stomach."
"647","Hospital Number: L1479863 , Hospital: Random NHS Foundation Trust , DOB:  1959-08-23 , General Practitioner: Dr. Madera, Mackenzie  , Date of procedure:  2014-11-17Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: MelaenaEpigastric Pain FINDINGS: Normal gastroscopy to the duodenum. "
"648","Hospital Number: A5218459 , Hospital: Random NHS Foundation Trust , DOB:  1984-11-28 , General Practitioner: Dr. Renz, Nastashia  , Date of procedure:  2002-03-02Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  100mcg  , Midazolam  1mg  , Instrument:  FG2  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known coeliac ch diarrhoea.Myelofibrosis on ruxolitinib and panobinostat FINDINGS: LA Grade  D oesophagitis. The oesophageal mucosa is hyperemic and has a granular appearance with areas of erosion and exudate. Candida present. The oesophageal mucosa has a furrowed or corrugated appearance.  character(0)"
"649","Hospital Number: I2777268 , Hospital: Random NHS Foundation Trust , DOB:  1949-09-21 , General Practitioner: Dr. Wicks, Katrice  , Date of procedure:  2012-08-31Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Positive coeliac FINDINGS: Hiatus Hernia- Large.. "
"650","Hospital Number: F7726169 , Hospital: Random NHS Foundation Trust , DOB:  1913-03-21 , General Practitioner: Dr. Archuleta, Elizabeth  , Date of procedure:  2011-12-10Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: anastomotic stricture post thoracoabdominal oesophagogastrecotmy for dilatation FINDINGS: There is inflammation in the oesophagus at 27 cm which is severe. Upon examination, there appears to be diffuse erythema and friability of the oesophageal mucosa, consistent with a diagnosis of oesophagitis.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. There is inflammation in the second part of the duodenum which is erosive. The duodenal mucosa appears to have a rough and patchy surface, suggestive of inflammation.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. NA RECOMMENDATION: The patient should be advised to avoid wearing tight clothing around their waist, as this can put pressure on the stomach and worsen GERD symptoms.  The patient may be referred to a gastroenterologist for further management of the inflammation. FOLLOW UP: The patient should avoid smoking and drinking alcohol, as these habits can worsen GERD symptoms.  The patient may be referred to a gastroenterologist for further management of the inflammation."
"651","Hospital Number: T1978921 , Hospital: Random NHS Foundation Trust , DOB:  1908-10-21 , General Practitioner: Dr. al-Asad, Tasneem  , Date of procedure:  2011-07-16Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Nausea and/or Vomiting Weight Loss FINDINGS: The patient has a polyp in the GOJ which is stalked with a normal pit pattern. In the oesophagus, a Paris IIa/c polypoid lesion was detected during endoscopy, measuring 1 cm in diameter. The lesion had a nodular surface and appeared to be sessile.The polyp was removed with a combination of snare and forceps, and hemostasis was achieved with an endoscopic clip.. There is inflammation in the third part of the duodenum which is mild. The mucosa is ulcerated and friable, with evidence of pus and exudate present in some areas.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. character(0) RECOMMENDATION: Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) may be necessary for larger or more complex ulcers. RECOMMENDATION: If the stricture is due to a medical condition such as gastroesophageal reflux disease (GERD), the patient may be prescribed medication to manage their symptoms. RECOMMENDATION: The patient should avoid eating too quickly, as this can exacerbate the inflammation by increasing the risk of reflux and indigestion.   FOLLOW UP: The patient may be referred to a specialist in gastrointestinal disorders for further management of the ulcer. FOLLOW UP: The patient should avoid eating or drinking for at least six hours before any scheduled appointments. FOLLOW UP: The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and inflammation.  The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and increase the risk of polyp growth."
"652","Hospital Number: W8248560 , Hospital: Random NHS Foundation Trust , DOB:  1989-07-07 , General Practitioner: Dr. Yee, Nicole  , Date of procedure:  2007-01-11Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  100mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - chronic cough ?GORD FINDINGS: The patient has inflammation in the oesophagus at 26 cm which is mild. A patchy distribution of erythema and friability is noted in the distal oesophagus.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. The patient has a stricture in the D1/D2 angle which is unyieldingTight stricture impassable with scope.. NA RECOMMENDATION: A follow-up appointment with the gastroenterologist should be scheduled for six months after the initial diagnosis to monitor the patient's progress.  The patient should avoid NSAIDs and aspirin, which can irritate the lining of the stomach and exacerbate the inflammation. FOLLOW UP: The patient may require additional endoscopies in the future to monitor the stricture and ensure that it is not progressing.  The patient should be advised to eat slowly and chew their food thoroughly to aid digestion and reduce the risk of inflammation."
"653","Hospital Number: O8592861 , Hospital: Random NHS Foundation Trust , DOB:  1982-05-25 , General Practitioner: Dr. Cawdrey, Andrea  , Date of procedure:  2003-03-02Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Ongoing reflux symptoms. FINDINGS: Multiple whitish plaques are noted in the oesophagus that may be suggestive of eosinophilic oesophagitis or Candida esophagitis..  character(0)"
"654","Hospital Number: H1442477 , Hospital: Random NHS Foundation Trust , DOB:  1965-10-15 , General Practitioner: Dr. Schubert, Haileigh  , Date of procedure:  2010-03-25Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  100mcg  , Midazolam  5mg  , Instrument:  FG5  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Previous Polyps/Metaplasia etc. FINDINGS: There is a stricture in the third part of the duodenum which is narrowedThere is very slight and non-restrcitve stricturing.. The duodenal stricture is non-peristaltic and exhibits limited mobility upon insufflation.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. OESOPHAGUS: small hiatus hernia.. character(0)  The patient may be prescribed medication to reduce the risk of developing more polyps.  The patient should avoid lying down immediately after meals, as this can increase the risk of reflux and polyp growth."
"655","Hospital Number: P1673382 , Hospital: Random NHS Foundation Trust , DOB:  1915-01-12 , General Practitioner: Dr. Mckeon, Jenell  , Date of procedure:  2011-11-08Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Endoscopic ultrasound findings: Reflux-like Symptoms/Atypical Chest Pain FINDINGS: There is a nodule in the second part of the duodenum which is sessile. The patient has a stricture in the third part of the duodenum which is inflexibleIt is easily traversible.. The narrowing of the lumen is more pronounced during end-inspiration.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization.. character(0)  The patient should be advised to attend all scheduled appointments and follow the treatment plan recommended by their healthcare provider.  "
"656","Hospital Number: D3953088 , Hospital: Random NHS Foundation Trust , DOB:  1970-10-16 , General Practitioner: Dr. Espinoza, Alejandra  , Date of procedure:  2016-08-27Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  25mcg  , Midazolam  7mg  , Instrument:  FG7  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia Vomiting known hiatus hernia FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"")."
"657","Hospital Number: K5760664 , Hospital: Random NHS Foundation Trust , DOB:  1955-12-24 , General Practitioner: Dr. Black, Athena  , Date of procedure:  2002-03-12Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: IDA FINDINGS: OESOPHAGUS: Normal, no appreciable hiatus hernia.. "
"658","Hospital Number: U6704720 , Hospital: Random NHS Foundation Trust , DOB:  1983-04-01 , General Practitioner: Dr. al-Ghattas, Aqeela  , Date of procedure:  2002-11-01Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia post LTA FINDINGS: Normal gastroscopy to the duodenum. "
"659","Hospital Number: Y1451790 , Hospital: Random NHS Foundation Trust , DOB:  1924-10-22 , General Practitioner: Dr. Nwankwo, Vater  , Date of procedure:  2005-08-22Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  50mcg  , Midazolam  3mg  , Instrument:  FG5  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Weight Loss FINDINGS: Normal gastroscopy to the duodenum. "
"660","Hospital Number: S9523253 , Hospital: Random NHS Foundation Trust , DOB:  1976-12-23 , General Practitioner: Dr. Yeros, Dawna  , Date of procedure:  2014-10-14Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG2  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: ongoing diarhoea intermittent PR bleed. Previous RCD!. FINDINGS: Previous OGD showed LA grade C reflux oesophagitis above a hiatus hernia and gastroduodenitis.. There is significant ulceration and bleeding present in the oesophageal mucosa. Gastric mucosal prolapse also seen The oesophageal mucosa is hyperemic and has a granular appearance with areas of erosion and exudate. The gastric lesion appears malignant, accompanied by active bleeding and a punched-out appearance.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling..  NA  Follow-up endoscopy should be performed in 4-6 weeks to assess for healing and to repeat biopsies if necessary.  The patient should avoid smoking and alcohol, which can delay the healing of the ulcer and increase the risk of developing more ulcers."
"661","Hospital Number: R7817343 , Hospital: Random NHS Foundation Trust , DOB:  1940-09-15 , General Practitioner: Dr. Sharma, Rachel  , Date of procedure:  2005-07-28Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG1  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - VCE placement (previous gastric bypass)Anaemia/Low Iron or Vitamins FINDINGS: Normal gastroscopy to the duodenum. "
"662","Hospital Number: Z7781233 , Hospital: Random NHS Foundation Trust , DOB:  1914-11-10 , General Practitioner: Dr. Bryson, Amari  , Date of procedure:  2015-01-04Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG6  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia post LTA FINDINGS: There is an ulcer in the D1/D2 angle which is crateredIt has a visible vessel. Surrounded by erythema and exhibiting a nodular surface, the severe ulceration presents with a distinct loss of mucosal tissue.Following the biopsy of the lesion, there was bleeding, which was promptly managed..   The patient should be instructed to avoid caffeine and carbonated beverages to reduce discomfort and promote healing.  A repeat gastroscopy may be required in eight to twelve weeks' time to monitor the healing of the ulcer."
"663","Hospital Number: G7755694 , Hospital: Random NHS Foundation Trust , DOB:  1953-10-22 , General Practitioner: Dr. el-Bilal, Firdaus  , Date of procedure:  2005-05-19Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG5  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Abdominal Pain FINDINGS: The patient has inflammation in the stomach which is severe. The gastric inflammation is severe, with a diffuse and confluent pattern throughout the body of the stomach.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury..  RECOMMENDATION:   The patient should avoid lying down immediately after meals, as this can exacerbate the inflammation by increasing the risk of reflux. FOLLOW UP: The patient may be referred to a nutritionist to develop a diet plan that is easier to swallow and that meets their nutritional needs.  The patient should avoid lying down immediately after meals, as this can exacerbate the inflammation by increasing the risk of reflux."
"664","Hospital Number: B7780911 , Hospital: Random NHS Foundation Trust , DOB:  1901-08-10 , General Practitioner: Dr. Ros, Ashley  , Date of procedure:  2005-12-01Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  100mcg  , Midazolam  3mg  , Instrument:  FG3  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Altered taste FINDINGS: There is a polyp in the fundus which is stalked.It has an abnormal pit pattern. A gastric polyp with a broad, flat surface is observed in the pylorus, with a smooth and regular contour.The polyp was removed with a combination of snare and forceps, and hemostasis was achieved with an endoscopic clip.. There is inflammation in the body which is severe. The gastric inflammation is accompanied by hyperemia and petechiae on the mucosal surface.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. NA RECOMMENDATION: The patient should avoid smoking and drinking alcohol, as these habits can worsen GERD symptoms. RECOMMENDATION: The patient should avoid wearing tight clothing, as this can exacerbate the inflammation by increasing the pressure on the stomach.  The patient should be informed of the diagnosis and provided with information on how to manage the polyp. FOLLOW UP: The patient may be prescribed medication to reduce the production of stomach acid and prevent reflux. FOLLOW UP: A proton pump inhibitor medication may be prescribed to manage the inflammation.  The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more polyps."
"665","Hospital Number: J8821698 , Hospital: Random NHS Foundation Trust , DOB:  1986-05-14 , General Practitioner: Dr. Richardson, Theresa  , Date of procedure:  2014-03-18Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  25mcg  , Midazolam  7mg  , Instrument:  FG6  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Positive coeliac FINDINGS: Small hiatus hernia only. "
"666","Hospital Number: M8882071 , Hospital: Random NHS Foundation Trust , DOB:  1908-03-25 , General Practitioner: Dr. Gomez, Alexzandria  , Date of procedure:  2006-07-04Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- persumed per DU managed conservativelyPrevious persumed DU ulcer managed conservatively. FINDINGS: Normal gastroscopy to the duodenum.   The patient should be advised to avoid straining during bowel movements to reduce pressure on the ulcer site.  The patient is advised to return for a follow-up appointment in two to four weeks' time to discuss the findings and plan for further management."
"667","Hospital Number: C4433311 , Hospital: Random NHS Foundation Trust , DOB:  1941-01-30 , General Practitioner: Dr. Naylor, Nikoma  , Date of procedure:  2015-12-24Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG3  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known coeliac ch diarrhoea.Myelofibrosis on ruxolitinib and panobinostat FINDINGS: Normal gastroscopy to the duodenum. "
"668","Hospital Number: Q1015837 , Hospital: Random NHS Foundation Trust , DOB:  1914-09-15 , General Practitioner: Dr. Plascencia, Jennefer  , Date of procedure:  2004-10-01Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG6  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Ongoing reflux symptoms. FINDINGS: There is an ulcer in the third part of the duodenum which is superficial s*It is not bleeding. The severe ulceration presents with a depth greater than 5 mm and an irregular border.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. The surrounding mucosa appears hyperemic and erythematous, consistent with active inflammation.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. Barrett's is present. Gastric mucosal prolapse seen. No loss of aceto-whitening was seen. Short segment only. NA RECOMMENDATION: The patient should be advised to avoid smoking, alcohol, and NSAIDs to reduce the risk of recurrent ulcers. RECOMMENDATION: The patient should be advised to elevate the head of their bed by six inches to help prevent reflux at night.  The patient should avoid lying down immediately after meals, as this can exacerbate the inflammation by increasing the risk of reflux. FOLLOW UP: The patient should avoid carbonated drinks, which can increase the production of gas and delay the healing of the ulcer. FOLLOW UP: The patient should be advised to maintain a healthy weight, as obesity can worsen the symptoms of GERD.  The patient should avoid eating too much fat, as this can exacerbate the inflammation by delaying gastric emptying and increasing the risk of reflux."
"669","Hospital Number: X2594520 , Hospital: Random NHS Foundation Trust , DOB:  1966-08-31 , General Practitioner: Dr. Guzman, Zaira  , Date of procedure:  2003-05-02Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  150mcg  , Midazolam  5mg  , Instrument:  FG3  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: anastomotic stricture post thoracoabdominal oesophagogastrecotmy for dilatation FINDINGS: The patient has an ulcer in the duodenal bulb which is superficial.Forrest Ulcer classification: IIc.. The patient's medical history, along with the ulcer's rugose surface and irregular border, suggest a chronic inflammatory process.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. The margins of the ulcer appear to be slightly raised, with a central depression.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample..  NA  The patient should be advised to avoid straining during bowel movements to reduce pressure on the ulcer site.  "
"670","Hospital Number: E6158591 , Hospital: Random NHS Foundation Trust , DOB:  1972-01-07 , General Practitioner: Dr. Whitebull-Delgado, Kaitlyn  , Date of procedure:  2006-01-24Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG1  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Polypectomy FINDINGS: The patient has a polyp in the fundus which is stalked with a normal pit pattern. The gastric polyp appears as a sessile growth on the mucosal surface, with a smooth and regular contour.Due to its large size, the polyp was not able to be resected during the current endoscopic session..  NA  The patient should be advised to avoid eating too much fiber, as this can irritate the lining of the stomach and increase the risk of polyp growth.  The patient should be advised to avoid hot, spicy foods, which can irritate the lining of the stomach and increase the risk of polyp growth."
"671","Hospital Number: N9571333 , Hospital: Random NHS Foundation Trust , DOB:  1923-08-09 , General Practitioner: Dr. al-Aydin, Husniyya  , Date of procedure:  2008-08-02Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  75mcg  , Midazolam  7mg  , Instrument:  FG1  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: anastomotic stricture post thoracoabdominal oesophagogastrecotmy for dilatation FINDINGS: The patient has a polyp in the stomach which is stalked with an abnormal pit pattern. The gastric polyp exhibits an adenomatous morphology with tubular and villous growth patterns.The polyp was removed with minimal thermal injury to surrounding tissue using a cold snare technique.. NA  The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and increase the risk of polyp growth.  The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more polyps."
"672","Hospital Number: V3328807 , Hospital: Random NHS Foundation Trust , DOB:  1976-06-04 , General Practitioner: Dr. Deherrera, Mayra  , Date of procedure:  2006-05-11Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  100mcg  , Midazolam  3mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Endoscopic ultrasound findings: Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"673","Hospital Number: L2721400 , Hospital: Random NHS Foundation Trust , DOB:  1971-03-06 , General Practitioner: Dr. al-Salih, Tahaani  , Date of procedure:  2008-06-11Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  150mcg  , Midazolam  1mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- RFA Other GAVE FINDINGS: Columnar lined oesophagus is present. Some areas of vascular abnormalities are seen. No nodularity is present. It is a long segment. There is a nodule in the GOJ which is sessile. There are multiple raised, nodular areas of mucosa, suggestive of granulomatous inflammation.The patient should be instructed to avoid caffeine and carbonated beverages to reduce discomfort and promote healing.. character(0) RECOMMENDATION: The patient should be advised to avoid eating large meals or eating quickly, as this can increase the risk of reflux and further damage to the gastrointestinal tract. RECOMMENDATION: The patient should avoid drinking carbonated beverages, as these can worsen reflux symptoms.  A consultation with a dietician may be beneficial to help the patient modify their diet to manage the inflammation. FOLLOW UP: The patient may be referred to a nutritionist to develop a diet plan that is easier to digest and that meets their nutritional needs. FOLLOW UP: The patient should avoid eating large meals late at night, as this can worsen reflux symptoms.  The patient should avoid NSAIDs and aspirin, which can irritate the lining of the stomach and exacerbate the inflammation."
"674","Hospital Number: A9747574 , Hospital: Random NHS Foundation Trust , DOB:  1913-11-14 , General Practitioner: Dr. Lebsock, Natalie  , Date of procedure:  2003-11-19Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG1  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Reflux-like Symptoms/Atypical Chest Pain FINDINGS: There is a polyp in the D1/D2 angle which is stalked.It has an abnormal pit pattern.   The patient should avoid smoking and alcohol, which can increase the risk of developing more polyps.  A repeat gastroscopy may be required in six months' time to monitor the growth of the polyp."
"675","Hospital Number: I9081757 , Hospital: Random NHS Foundation Trust , DOB:  1924-03-27 , General Practitioner: Dr. Pacheco, Alexandra  , Date of procedure:  2005-11-20Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia large hiatus hernia FINDINGS: There is an ulcer in the oesophagus at 31 cm which is deep.It has rolled edges. The gastric ulcer presents with an irregular border and a fibrous base, suggestive of NSAID-induced injury.The lesion was biopsied using a standard forceps.. The oesophageal ulcer presents as a sharply demarcated lesion with smooth borders and a clean base.The lesion was biopsied using a standard forceps..  character(0)  The patient should be advised to avoid smoking, alcohol, and NSAIDs to reduce the risk of recurrent ulcers.  The patient should avoid smoking and alcohol, which can delay the healing of the ulcer and increase the risk of developing more ulcers."
"676","Hospital Number: F6090839 , Hospital: Random NHS Foundation Trust , DOB:  1994-02-27 , General Practitioner: Dr. Rodriguez, Abigail  , Date of procedure:  2015-04-24Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG5  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Barretts FINDINGS: Normal gastroscopy to the duodenum. "
"677","Hospital Number: T7480285 , Hospital: Random NHS Foundation Trust , DOB:  1948-03-02 , General Practitioner: Dr. el-Ismael, Khaleela  , Date of procedure:  2008-05-12Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  150mcg  , Midazolam  2mg  , Instrument:  FG3  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Abdominal Pain FINDINGS: There is inflammation in the fundus which is mild. The gastric inflammation is characterized by erythema and edema of the mucosa.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. The patient has an ulcer in the third part of the duodenum which is induratedForrest Ulcer classification: IIc.. The gastric lesion appears malignant, accompanied by active bleeding and a punched-out appearance.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization.. The ulcer base appears to be necrotic and sloughing, with visible debris and exudate.During biopsy, it was noted that the lesion had a friable surface and bled easily.. NA RECOMMENDATION: H. pylori testing and treatment may be necessary to prevent recurrence of the ulcer. RECOMMENDATION: The patient should avoid eating or drinking for at least six hours before any scheduled appointments.  A barium swallow study may be ordered to assess the extent of the inflammation. FOLLOW UP: The patient should avoid eating before bedtime, as this can increase the risk of reflux and ulcer recurrence. FOLLOW UP: The patient should be advised to avoid caffeine, as it can worsen reflux symptoms.  The patient should be advised to avoid caffeine, which can stimulate the production of stomach acid and exacerbate the inflammation."
"678","Hospital Number: W2054819 , Hospital: Random NHS Foundation Trust , DOB:  1900-12-26 , General Practitioner: Dr. Kramer, Meghan  , Date of procedure:  2015-05-13Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  100mcg  , Midazolam  4mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia oesophageal stricture post chemorad for scc oesophagus FINDINGS: Normal gastroscopy to the duodenum. character(0)"
"679","Hospital Number: O8834134 , Hospital: Random NHS Foundation Trust , DOB:  1990-07-26 , General Practitioner: Dr. el-Koroma, Reema  , Date of procedure:  2008-02-15Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  150mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Chemorad for scc middle third of oeosphagus - post treatment assessement FINDINGS: There is a polyp in the antrum which is sessile.It has a normal pit pattern. A gastric polyp with a polypoid shape is seen in the cardia, with a smooth and rounded surface.The polyp was marked with a tattoo to aid in future surveillance endoscopy.. There is a stricture in the third part of the duodenum which is thickenedThere is very slight and non-restrcitve stricturing.. The diameter of the duodenal lumen at the stricture site is significantly smaller than the diameter of the duodenum proximal and distal to the stricture.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. character(0)  The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more polyps.  The patient should be advised to avoid carbonated drinks, which can increase the risk of developing more polyps by increasing the production of gas."
"680","Hospital Number: H6820128 , Hospital: Random NHS Foundation Trust , DOB:  1945-08-15 , General Practitioner: Dr. Abraham, Loutricia  , Date of procedure:  2012-03-05Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Nausea and/or Vomiting Other- Early satiety FINDINGS: Normal gastroscopy to the duodenum. "
"681","Hospital Number: P4350826 , Hospital: Random NHS Foundation Trust , DOB:  1949-01-23 , General Practitioner: Dr. Stebbins, Nicole  , Date of procedure:  2006-04-01Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  50mcg  , Midazolam  5mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Reflux-like Symptoms/Atypical Chest Pain Abdominal Pain FINDINGS: There is an ulcer in the stomach which is superficial.Forrest Ulcer classification:II B.. The patient's medical history, along with the ulcer's rugose surface and flat appearance, suggest a chronic, long-standing condition.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization..   Follow-up endoscopy should be performed in 4-6 weeks to assess for healing and to repeat biopsies if necessary.  The patient should avoid carbonated drinks, which can increase the production of gas and delay the healing of the ulcer."
"682","Hospital Number: D5429386 , Hospital: Random NHS Foundation Trust , DOB:  1971-05-25 , General Practitioner: Dr. Stevenson, Sharday  , Date of procedure:  2013-03-21Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Chemorad for scc middle third of oeosphagus - post treatment assessement FINDINGS: There is a polyp in the fundus which is stalked.It has a normal pit pattern. The hyperplastic gastric polyp presents with a smooth surface and regular shape, suggestive of a non-cancerous process.The polyp was grasped with a snare and cut with a hot biopsy forceps for removal..  character(0)    The patient should follow a healthy diet and lifestyle to reduce the risk of developing more polyps."
"683","Hospital Number: K5870127 , Hospital: Random NHS Foundation Trust , DOB:  1919-11-23 , General Practitioner: Dr. Meier, Susan  , Date of procedure:  2015-11-04Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  100mcg  , Midazolam  1mg  , Instrument:  FG1  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CD FINDINGS: The patient has Barrett's oesophagus. No loss of aceto-whitening  was also seen. No abnormal pit pattern is seen. It is a long segment. There is a stricture in the second part of the duodenum which is obliterativeIt will not allow the scope to pass.. The narrowing of the duodenal lumen at the stricture site is severe, allowing only a small-caliber endoscope to pass through.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. NA"
"684","Hospital Number: U3081246 , Hospital: Random NHS Foundation Trust , DOB:  1919-02-12 , General Practitioner: Dr. Westerberg, Abigail  , Date of procedure:  2014-10-28Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  12.5mcg  , Midazolam  7mg  , Instrument:  FG2  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Abdominal Pain FINDINGS: Hiatus Hernia- Small.. "
"685","Hospital Number: Y1506215 , Hospital: Random NHS Foundation Trust , DOB:  1942-05-16 , General Practitioner: Dr. Harris, Kristin  , Date of procedure:  2004-08-04Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- EMR/ESD Oesophagus- Dysplasia FINDINGS: No inlet patch.. "
"686","Hospital Number: S7145991 , Hospital: Random NHS Foundation Trust , DOB:  1977-03-15 , General Practitioner: Dr. Vigil, Taylor  , Date of procedure:  2011-11-27Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG3  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - Post caustic soda ingestion - assessment of healing FINDINGS: LA Grade  A oesophagitis. Candida present. The oesophageal mucosa is thickened and has a leathery appearance. There are scattered erosions present in the oesophageal mucosa. The patient has a stricture in the stomach which is unyieldingScope not held by stricture. A gastric stricture with a smooth and nodular surface is observed in the cardia, suggestive of a malignant lesion.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. NA"
"687","Hospital Number: R9404908 , Hospital: Random NHS Foundation Trust , DOB:  1974-12-04 , General Practitioner: Dr. Parker, Cicely  , Date of procedure:  2003-02-24Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  125mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Other- Early satiety FINDINGS: There is a polyp in the second part of the duodenum which is sessile.It has a normal pit pattern. The nodules are located in the second and third portions of the duodenum, with sparing of the duodenal papilla.ESD was performed to remove the polyp after lifting it with saline injection.. The patient has Barrett's oesophagus. No abnormal pit pattern is seen. No nodularity is present. Some areas of vascular abnormalities are seen. NA RECOMMENDATION: The patient should avoid eating or drinking for at least six hours before any scheduled appointments.  The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools. FOLLOW UP: The patient may be referred to a surgeon for a minimally invasive procedure to remove the nodule.  A blood test may be ordered to assess the patient's iron levels, as polyps can cause bleeding in the stomach and intestines."
"688","Hospital Number: Z6151451 , Hospital: Random NHS Foundation Trust , DOB:  1954-04-20 , General Practitioner: Dr. Dixon, Kenya  , Date of procedure:  2010-08-26Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  100mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal bloating chest discomfort reflux.Known fibromyalgia RA FINDINGS: There is an ulcer in the oesophagus at 39 cm which is exudativeIt is not bleeding. Characterized by a distinct loss of mucosal tissue and surrounded by erythema, the severe ulceration presents with a nodular surface.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. The oesophageal ulcer exhibits irregular borders and surrounding inflammation, indicating a potentially malignant process.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization.. OESOPHAGUS: Normal, no appreciable hiatus hernia.. NA RECOMMENDATION: Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) may be necessary for larger or more complex ulcers. RECOMMENDATION: If the patient experiences chest pain or difficulty breathing, they should seek emergency medical attention immediately.  The patient should be advised to eat slowly and chew their food thoroughly to aid digestion and reduce the risk of inflammation. FOLLOW UP: The patient should be informed of the diagnosis and provided with information on how to manage the ulcer. FOLLOW UP:   "
"689","Hospital Number: G1498153 , Hospital: Random NHS Foundation Trust , DOB:  1966-07-24 , General Practitioner: Dr. al-Ebrahim, Hishma  , Date of procedure:  2014-11-07Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  125mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Eosinophilic oesophatitis assessment FINDINGS: The patient has a 8mm nodule in the antrum which is benign-looking. A polypoid, solid nodule is observed in the antrum of the stomach, suggestive of a gastric adenoma.Follow-up with a primary care physician or gastroenterologist for ongoing management and symptom control is recommended..  NA RECOMMENDATION: The patient should avoid smoking and drinking alcohol, as these habits can increase the risk of cancer.  The patient should follow a healthy diet and lifestyle to reduce the risk of developing more polyps. FOLLOW UP: The patient should avoid eating fried or fatty foods, as these can increase the risk of reflux and further damage to the gastrointestinal tract.  The patient should be advised to avoid consuming alcohol, which can increase the risk of developing more polyps."
"690","Hospital Number: B8969666 , Hospital: Random NHS Foundation Trust , DOB:  1959-07-27 , General Practitioner: Dr. Littlewhiteman, Caitlyn  , Date of procedure:  2012-04-02Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  75mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Eosinophilic oesophatitis assessment FINDINGS: The patient has an ulcer in the second part of the duodenum which is fungatingForrest Ulcer classification: IIc.. Characterized by a distinct loss of mucosal tissue and surrounded by erythema, the severe ulceration presents with a nodular surface.The lesion was biopsied using a standard forceps.. The ulcer base appears to be necrotic and sloughing, with visible debris and exudate.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape..  character(0)  Repeat endoscopy with surveillance biopsies is recommended every 3-5 years for patients with a history of gastric ulcer to monitor for recurrence or malignancy.  A repeat gastroscopy may be recommended in six to twelve months' time to assess the response to treatment."
"691","Hospital Number: J1819477 , Hospital: Random NHS Foundation Trust , DOB:  1961-08-18 , General Practitioner: Dr. el-Basha, Maleeka  , Date of procedure:  2007-10-16Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abnormal Imaging FINDINGS: Normal gastroscopy to the duodenum. "
"692","Hospital Number: M8863036 , Hospital: Random NHS Foundation Trust , DOB:  1949-09-06 , General Practitioner: Dr. Duran, Ranada  , Date of procedure:  2001-02-26Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - Post caustic soda ingestion - assessment of healing FINDINGS: The patient has a 5mm nodule in the body which is stalked. The gastric mucosa appears thickened with a nodular surface, suggestive of a diffuse lymphoid hyperplasia.The patient may be referred to a specialist for further evaluation and treatment, such as surgery to widen the esophagus..   The patient may be prescribed medication to manage any symptoms associated with the nodule, such as pain or discomfort.  The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent further damage to the gastrointestinal tract."
"693","Hospital Number: C4021112 , Hospital: Random NHS Foundation Trust , DOB:  1983-06-21 , General Practitioner: Dr. al-Kanan, Habeeba  , Date of procedure:  2011-09-17Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG1  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Altered taste FINDINGS: Normal gastroscopy to the duodenum. "
"694","Hospital Number: Q8222665 , Hospital: Random NHS Foundation Trust , DOB:  1923-11-13 , General Practitioner: Dr. Walters, Madeline  , Date of procedure:  2015-06-20Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  50mcg  , Midazolam  5mg  , Instrument:  FG2  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR FINDINGS: Normal gastroscopy to the duodenum. "
"695","Hospital Number: X5836068 , Hospital: Random NHS Foundation Trust , DOB:  1960-07-14 , General Practitioner: Dr. al-Adel, Haajara  , Date of procedure:  2013-04-21Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Nausea and/or Vomiting Other- Early satiety FINDINGS: Normal gastroscopy to the duodenum. "
"696","Hospital Number: E8902521 , Hospital: Random NHS Foundation Trust , DOB:  1907-08-31 , General Practitioner: Dr. Velez, Marina  , Date of procedure:  2015-03-28Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  125mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Other- change in taste bile taste in mouth FINDINGS: There is a nodule in the second part of the duodenum which is sessile. LA Grade  D oesophagitis. The oesophageal mucosa is thickened and has a cobblestone appearance. The distal oesophagus appears normal, but there is diffuse erythema and friability in the mid and proximal oesophagus. character(0)  The patient should be advised to seek emotional support from friends, family, or a counselor, as the diagnosis of cancer can be difficult to cope with.  The patient should avoid eating or drinking for at least six hours before any scheduled appointments."
"697","Hospital Number: N7405188 , Hospital: Random NHS Foundation Trust , DOB:  1934-01-19 , General Practitioner: Dr. Kittrell, Demari  , Date of procedure:  2004-03-08Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  150mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Dyspepsia FINDINGS: The patient has a 9mm nodule in the D1/D2 angle which is sessile.   The patient should be advised to avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as these can increase the risk of bleeding in the gastrointestinal tract.  The patient may require additional endoscopies in the future to monitor the nodule and ensure that it is not progressing."
"698","Hospital Number: V9378773 , Hospital: Random NHS Foundation Trust , DOB:  1976-06-29 , General Practitioner: Dr. Francisquez-Gaspar, Alondra  , Date of procedure:  2003-08-21Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  75mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Longstanding history of IDA and high eosinophilis in blood. upper abdo pain /alternatin diarhoea/constipaton FINDINGS: The patient has an ulcer in the D1/D2 angle which is exudativeIt is not bleeding. The ulceration exhibits a cobblestone appearance and a yellowish base, suggestive of Helicobacter pylori infection.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample..   The patient should be advised to follow a soft diet and avoid spicy or acidic foods to reduce discomfort and promote healing.  The patient may be referred to a specialist in gastrointestinal disorders for further management of the ulcer."
"699","Hospital Number: L6117442 , Hospital: Random NHS Foundation Trust , DOB:  1941-04-24 , General Practitioner: Dr. Thomas, Haylee  , Date of procedure:  2006-02-25Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  50mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"700","Hospital Number: A3669324 , Hospital: Random NHS Foundation Trust , DOB:  1990-04-18 , General Practitioner: Dr. el-Hariri, Amal  , Date of procedure:  2003-01-21Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  125mcg  , Midazolam  2mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: High Dysphagia further assessment of previoius diagnosed peptic stricture also recent eus and aspirat of bengn perigastric cyst FINDINGS: Normal gastroscopy to the duodenum. "
"701","Hospital Number: O8583042 , Hospital: Random NHS Foundation Trust , DOB:  1945-07-17 , General Practitioner: Dr. Sago, Taylor  , Date of procedure:  2001-12-14Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  12.5mcg  , Midazolam  7mg  , Instrument:  FG1  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Small Bowel Biopsy Positive coeliac serology FINDINGS: The patient has inflammation in the stomach which is erosive. Erythematous patches with focal ulceration are noted in the gastric antrum, suggestive of acute erosive gastritis.The ulcer was biopsied x8 for further analysis.. The oesophagus demonstrates concentric rings, as well as a corrugated, or feline appearance.. NA RECOMMENDATION: Biopsy samples were taken from the ulcer base to rule out malignancy. The patient should follow up with their referring physician for results. RECOMMENDATION: The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent reflux.  A stool test may be ordered to assess the patient's fecal occult blood levels, as inflammation can cause bleeding in the stomach and intestines. FOLLOW UP:  FOLLOW UP: The patient should avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as these can worsen GERD symptoms.  The patient should avoid wearing tight clothing, as this can exacerbate the inflammation by increasing the pressure on the stomach."
"702","Hospital Number: H2587908 , Hospital: Random NHS Foundation Trust , DOB:  1979-04-29 , General Practitioner: Dr. Robb, Taneya  , Date of procedure:  2014-12-26Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  75mcg  , Midazolam  7mg  , Instrument:  FG3  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia FINDINGS: There is a polyp in the stomach which is sessile.It has an abnormal pit pattern. The gastric polyp looks malignant, presenting with an irregular surface, size, and signs of invasion.ESD was performed to remove the polyp after lifting it with saline injection..   The patient should be informed of the diagnosis and provided with information on how to manage the polyp.  A blood test may be ordered to assess the patient's iron levels, as polyps can cause bleeding in the stomach and intestines."
"703","Hospital Number: P9907275 , Hospital: Random NHS Foundation Trust , DOB:  1945-12-21 , General Practitioner: Dr. el-Ansari, Aamina  , Date of procedure:  2015-09-30Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting FINDINGS: There is an ulcer in the GOJ which is fibroticForrest Ulcer classification:II B.. The ulceration's irregular shape and size, along with a yellowish base, suggest a possible malignant process.The lesion was biopsied using a standard forceps.. Examination of the oesophageal ulcer reveals a raised, cobblestone appearance with a central area of necrosis and surrounding inflammation.The biopsy was performed using a needle biopsy forceps, with the tissue samples sent for pathological analysis.. No inlet patch was seen on narrow band imaging.. character(0) RECOMMENDATION: The patient should be instructed to avoid tight-fitting clothing to reduce pressure on the ulcer site. RECOMMENDATION: The patient should be advised to avoid lying down immediately after eating, as this can worsen reflux symptoms.  The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and exacerbate the inflammation. FOLLOW UP: The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and delay the healing of the ulcer. FOLLOW UP: The patient should be informed of the diagnosis and the importance of adhering to the recommended treatment plan.  The patient should be advised to avoid acidic foods and drinks, which can irritate the lining of the stomach and exacerbate the inflammation."
"704","Hospital Number: D9990587 , Hospital: Random NHS Foundation Trust , DOB:  1913-09-05 , General Practitioner: Dr. Davis, Kaitlin  , Date of procedure:  2011-12-25Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Ongoing dyspepsia FINDINGS: The patient has an ulcer in the third part of the duodenum which is necroticIt has rolled edges. The gastric ulcer presents with an irregular border and a fibrous base, suggestive of NSAID-induced injury.The lesion was biopsied using a standard forceps.. The edges of the ulcer appear to be irregular and ragged, suggesting ongoing tissue destruction and repair.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. At 18cm two inlet patches were seen.. character(0)  The patient should be advised to avoid straining during bowel movements to reduce pressure on the ulcer site.  The patient should be advised to avoid consuming caffeine, which can stimulate the production of stomach acid and delay the healing of the ulcer."
"705","Hospital Number: K9010769 , Hospital: Random NHS Foundation Trust , DOB:  1998-08-05 , General Practitioner: Dr. Mcgrier, Felicity  , Date of procedure:  2003-02-19Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  100mcg  , Midazolam  7mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Maleana FINDINGS: LA Grade  A oesophagitis. There are scattered erosions present in the oesophageal mucosa. The oesophageal mucosa has a furrowed or corrugated appearance. The oesophageal mucosa is thickened and has a leathery appearance.  NA"
"706","Hospital Number: U5728377 , Hospital: Random NHS Foundation Trust , DOB:  1979-06-03 , General Practitioner: Dr. Wright, Ijhanea  , Date of procedure:  2014-04-02Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  12.5mcg  , Midazolam  2mg  , Instrument:  FG5  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Dysphagia/Odynophagia FINDINGS: The patient has a 9mm nodule in the GOJ which is stalked. No evidence of bleeding or exudate is observed at the stricture site.The patient should be advised to avoid wearing tight clothing around their waist, as this can put pressure on the stomach and worsen GERD symptoms..  character(0)  If the nodule is found to be cancerous, the patient may require further imaging studies and biopsies to determine the stage of the cancer and the appropriate treatment.  The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the nodule."
"707","Hospital Number: Y3424765 , Hospital: Random NHS Foundation Trust , DOB:  1976-11-25 , General Practitioner: Dr. Gadlin, Alexis  , Date of procedure:  2011-06-09Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- EMR/ESD Oesophagus- Dysplasia FINDINGS: There is a nodule in the body which is sessile. The gastric mucosa appears thickened with multiple small nodules, suggestive of a lymphoproliferative disorder such as MALT lymphoma.Given the finding of a stricture, a referral to a gastroenterologist is recommended for further evaluation and management..   The patient may be referred to a specialist for further evaluation and treatment, such as surgery to remove the nodule.  The patient should avoid drinking alcohol, as this can increase the risk of bleeding in the gastrointestinal tract."
"708","Hospital Number: S9335497 , Hospital: Random NHS Foundation Trust , DOB:  1971-10-06 , General Practitioner: Dr. Mckinley, Asiah  , Date of procedure:  2009-11-20Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  12.5mcg  , Midazolam  5mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Haematemesis or Melaena/Blood PR FINDINGS: Normal gastroscopy to the duodenum. "
"709","Hospital Number: R3233951 , Hospital: Random NHS Foundation Trust , DOB:  1925-12-19 , General Practitioner: Dr. Villasano, Isatou  , Date of procedure:  2008-08-10Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Dysphagia/Odynophagia FINDINGS: The patient has a stricture in the body which is inflamedThere is very slight and non-restrcitve stricturing.. A gastric stricture with a web-like appearance is seen in the cardia, suggestive of an eosinophilic disorder.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. "
"710","Hospital Number: Z3118534 , Hospital: Random NHS Foundation Trust , DOB:  1988-06-08 , General Practitioner: Dr. Short, Ataya  , Date of procedure:  2002-08-24Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  25mcg  , Midazolam  3mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Dyspepsia FINDINGS: There is a nodule in the D1/D2 angle which is sessile.   The patient should be advised to maintain a healthy diet and lifestyle, as this may help prevent the growth of the nodule.  The patient should be advised to maintain a healthy diet and lifestyle, as this may help prevent the growth of the nodule."
"711","Hospital Number: G7303882 , Hospital: Random NHS Foundation Trust , DOB:  1926-08-20 , General Practitioner: Dr. al-Kaba, Waheeda  , Date of procedure:  2011-02-03Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG2  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Nausea and/or Vomiting Other- Early satiety FINDINGS: Normal gastroscopy to the duodenum. "
"712","Hospital Number: B2496144 , Hospital: Random NHS Foundation Trust , DOB:  1937-02-15 , General Practitioner: Dr. Toro Rivera, Orquidia  , Date of procedure:  2007-06-19Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Barretts FINDINGS: Normal gastroscopy to the duodenum. "
"713","Hospital Number: J9928505 , Hospital: Random NHS Foundation Trust , DOB:  1990-02-01 , General Practitioner: Dr. Brown, Catherine  , Date of procedure:  2008-05-10Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  25mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Positive coeliac FINDINGS: The patient has an ulcer in the body which is necroticIt has a visible vessel. Accompanied by white exudate and a cobblestone appearance, the gastric ulcer is likely caused by Helicobacter pylori infection.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling..   Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) may be necessary for larger or more complex ulcers.  A repeat gastroscopy may be recommended in six to twelve months' time to assess the response to treatment."
"714","Hospital Number: M7832839 , Hospital: Random NHS Foundation Trust , DOB:  1929-03-28 , General Practitioner: Dr. Luna, Taylor  , Date of procedure:  2001-06-07Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like SymptomsAbdominal Pain FINDINGS: The patient has a polyp in the stomach which is stalked with an abnormal pit pattern. A gastric polyp with a broad-based attachment is noted in the corpus, with a smooth and dome-shaped surface.Endoscopic mucosal resection was performed to remove the polyp in its entirety..   The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more polyps.  The patient should be informed of the diagnosis and provided with information on how to manage the polyp."
"715","Hospital Number: C1538169 , Hospital: Random NHS Foundation Trust , DOB:  1910-01-14 , General Practitioner: Dr. Fuentez, Mayra  , Date of procedure:  2016-02-23Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  150mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain . FINDINGS: At 18cm two inlet patches were seen.. "
"716","Hospital Number: Q6090326 , Hospital: Random NHS Foundation Trust , DOB:  1984-06-20 , General Practitioner: Dr. al-Nasr, Kawkab  , Date of procedure:  2001-03-10Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  125mcg  , Midazolam  5mg  , Instrument:  FG5  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: duodenal stent FINDINGS: There is a stricture in the fundus which is irregularIt will not allow the scope to pass.. A gastric stricture with a web-like appearance is seen in the cardia, suggestive of an eosinophilic disorder.The biopsy was performed using a needle biopsy forceps, with the tissue samples sent for pathological analysis.. The patient has an ulcer in the third part of the duodenum which is induratedForrest Ulcer classification: IIc.. The gastric lesion appears malignant, accompanied by active bleeding and a punched-out appearance.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization.. The ulcer base appears to be necrotic and sloughing, with visible debris and exudate.During biopsy, it was noted that the lesion had a friable surface and bled easily.. character(0)  The patient should be advised to eat smaller, more frequent meals to reduce pressure on the ulcer site and promote healing.  The patient should be advised to avoid consuming alcohol, which can delay the healing of the ulcer and increase the risk of developing more ulcers."
"717","Hospital Number: X8881813 , Hospital: Random NHS Foundation Trust , DOB:  1915-03-05 , General Practitioner: Dr. el-Asmar, Khawla  , Date of procedure:  2009-05-31Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal bloating chest discomfort reflux.Known fibromyalgia RA FINDINGS: There is a nodule in the body which is sessile. The nodular changes may represent early fundic gland polyps.The patient should be advised to avoid straining during bowel movements to reduce pressure on the ulcer site..  RECOMMENDATION: Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) may be necessary for larger or more complex ulcers. RECOMMENDATION: The patient should be advised to maintain a healthy diet and lifestyle, as this may help prevent the growth of the nodule.  The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more polyps. FOLLOW UP: The patient should be advised to avoid consuming dairy products, which can increase the production of stomach acid and delay the healing of the ulcer. FOLLOW UP: The patient should be advised to seek emotional support from friends, family, or a counselor, as the diagnosis of cancer can be difficult to cope with.  The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and increase the risk of polyp growth."
"718","Hospital Number: E5760181 , Hospital: Random NHS Foundation Trust , DOB:  1943-10-08 , General Practitioner: Dr. Marple, Michaella  , Date of procedure:  2013-09-30Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  25mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Haematemesis or Melaena/Blood PR FINDINGS: The patient has a 10mm nodule in the duodenal bulb which is stalked. The patient has a 10mm nodule in the D1/D2 angle which is sessile. NA  The patient should be advised to maintain a healthy diet and lifestyle, as this may help prevent the growth of the nodule.  The patient should be advised to avoid lifting heavy objects or engaging in strenuous physical activity, as this can increase the risk of bleeding in the gastrointestinal tract."
"719","Hospital Number: N3482935 , Hospital: Random NHS Foundation Trust , DOB:  1907-06-04 , General Practitioner: Dr. el-Hussein, Nafeesa  , Date of procedure:  2012-08-10Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Melaena/Blood PR FINDINGS: Normal gastroscopy to the duodenum. "
"720","Hospital Number: V6466799 , Hospital: Random NHS Foundation Trust , DOB:  1993-08-19 , General Practitioner: Dr. al-Hoda, Muzna  , Date of procedure:  2012-05-08Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  125mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- RFA Therapeutic- EMR/ESD FINDINGS: Columnar lined oesophagus is present. Gastric mucosal prolapse seen. No loss of aceto-whitening  was also seen. The segment looks flat. There is a polyp in the D1/D2 angle which is stalked with a normal pit pattern. character(0)  A repeat gastroscopy may be recommended in three to six months' time to assess the growth of the polyp.  The patient may be prescribed medication to reduce the risk of developing more polyps."
"721","Hospital Number: L2151400 , Hospital: Random NHS Foundation Trust , DOB:  1918-08-04 , General Practitioner: Dr. Cook, Ariel  , Date of procedure:  2005-01-01Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  125mcg  , Midazolam  2mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Nausea and/or Vomiting Weight Loss FINDINGS: Hiatus Hernia- Large.. "
"722","Hospital Number: A3080284 , Hospital: Random NHS Foundation Trust , DOB:  1969-08-17 , General Practitioner: Dr. Rodriguez, Anai  , Date of procedure:  2009-11-18Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia low iron normal HBAnaemia/Low Iron or Vitamins FINDINGS: There is a polyp in the antrum which is stalked with an abnormal pit pattern. Multiple polyps with variable size are seen throughout the gastric mucosa, suggestive of familial adenomatous polyposis.The polyp was visualized and biopsied during upper endoscopy..  NA  The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and increase the risk of polyp growth.  The patient should be advised to avoid consuming alcohol, which can increase the risk of developing more polyps."
"723","Hospital Number: I7491657 , Hospital: Random NHS Foundation Trust , DOB:  1929-10-11 , General Practitioner: Dr. Maker, Harley  , Date of procedure:  2002-05-27Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Other- candidiasis FINDINGS: The patient has a stricture in the D1/D2 angle which is scleroticTight stricture impassable with scope.. "
"724","Hospital Number: F8022001 , Hospital: Random NHS Foundation Trust , DOB:  1950-09-19 , General Practitioner: Dr. el-Shafi, Misbaah  , Date of procedure:  2010-02-15Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain . FINDINGS: Normal gastroscopy to the duodenum. "
"725","Hospital Number: T4904215 , Hospital: Random NHS Foundation Trust , DOB:  1985-01-27 , General Practitioner: Dr. el-Hashem, Rabdaa  , Date of procedure:  2006-08-22Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  100mcg  , Midazolam  3mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Abdominal Pain FINDINGS: Normal gastroscopy to the duodenum. "
"726","Hospital Number: W8932372 , Hospital: Random NHS Foundation Trust , DOB:  1981-04-06 , General Practitioner: Dr. Esquibel, Stephanie  , Date of procedure:  2004-05-23Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  150mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CD FINDINGS: LA Grade  B oesophagitis. Candida present. The oesophageal mucosa appears pale and atrophic. The patient has a 6mm nodule in the antrum which is benign-looking. The gastric mucosa appears elevated with a smooth surface and no ulcerations, suggestive of a submucosal gastric nodule.The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and delay the healing of the ulcer.. NA RECOMMENDATION: Proton pump inhibitors may be prescribed to reduce gastric acid production and promote ulcer healing.   FOLLOW UP: The patient may be prescribed medication to reduce the acidity of the stomach and promote healing of the ulcer.  "
"727","Hospital Number: O7967929 , Hospital: Random NHS Foundation Trust , DOB:  1924-01-10 , General Practitioner: Dr. Spagnuolo, Precious  , Date of procedure:  2005-06-13Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- liver abscesses FINDINGS: Small hiatus hernia.. "
"728","Hospital Number: H3844577 , Hospital: Random NHS Foundation Trust , DOB:  1981-12-05 , General Practitioner: Dr. Harrison, Calla  , Date of procedure:  2010-07-14Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  25mcg  , Midazolam  3mg  , Instrument:  FG1  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"729","Hospital Number: P4236233 , Hospital: Random NHS Foundation Trust , DOB:  1915-05-08 , General Practitioner: Dr. Turner, Adinidiin  , Date of procedure:  2010-08-12Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Oesophagus- Dysplasia FINDINGS: The patient has Barrett's oesophagus. It is a long segment. Some areas of vascular abnormalities are seen. There is an ulcer in the D1/D2 angle which is exudativeIt has a visible vessel. The gastric ulcer exhibits signs of NSAID-induced injury, with a fibrous base and punched-out appearance.The biopsy was performed using a needle biopsy forceps, with the tissue samples sent for pathological analysis.. NA  The patient should be advised to seek medical attention immediately if they experience symptoms of severe bleeding such as black tarry stools or vomiting blood.  A blood test may be ordered to assess the patient's iron levels, as ulcers can cause bleeding in the stomach and intestines."
"730","Hospital Number: D4826904 , Hospital: Random NHS Foundation Trust , DOB:  1906-12-29 , General Practitioner: Dr. Simon, Deja  , Date of procedure:  2008-10-17Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  75mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: MelaenaEpigastric Pain FINDINGS: The patient has a stricture in the antrum which is unyieldingIt is easily traversible.. A gastric stricture with an overlying ulceration is seen in the antrum, suggestive of a peptic stricture.The ulcer was biopsied x8 for further analysis.. Columnar lined oesophagus is present. No abnormal pit pattern is seen. The segment looks flat. Some areas of vascular abnormalities are seen. NA  The patient should be instructed to avoid hot beverages and foods to prevent further irritation to the ulcer.  The patient may be prescribed medication to reduce the acidity of the stomach and promote healing of the ulcer."
"731","Hospital Number: K8847627 , Hospital: Random NHS Foundation Trust , DOB:  1931-01-30 , General Practitioner: Dr. Gould, Amanda  , Date of procedure:  2009-12-25Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss . FINDINGS: Normal gastroscopy to the duodenum. "
"732","Hospital Number: U8525559 , Hospital: Random NHS Foundation Trust , DOB:  1939-09-13 , General Practitioner: Dr. Gomez, Zakiya  , Date of procedure:  2001-01-29Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  100mcg  , Midazolam  5mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Dilatation Nausea and/or Vomiting FINDINGS: Hiatus hernia.. "
"733","Hospital Number: Y5602439 , Hospital: Random NHS Foundation Trust , DOB:  1966-02-14 , General Practitioner: Dr. Ruiz, Alexus  , Date of procedure:  2005-07-08Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG1  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - VCE placement (previous gastric bypass)Anaemia/Low Iron or Vitamins FINDINGS: There is an ulcer in the fundus which is hemorrhagicForrest Ulcer classification: IIc.. The ulceration exhibits a cobblestone appearance and a yellowish base, suggestive of Helicobacter pylori infection.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. There is an ulcer in the third part of the duodenum which is crateredIt has a visible vessel. Accompanied by white exudate and a cobblestone appearance, the gastric ulcer is likely caused by Helicobacter pylori infection.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. Upon endoscopic examination, a duodenal ulcer is visible at the angle of the duodenum.The biopsy was performed using a needle biopsy forceps, with the tissue samples sent for pathological analysis.. character(0)  Biopsy samples were taken from the ulcer base to rule out malignancy. The patient should follow up with their referring physician for results.  The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and delay the healing of the ulcer."
"734","Hospital Number: S6682774 , Hospital: Random NHS Foundation Trust , DOB:  1910-02-07 , General Practitioner: Dr. Perez, Janell  , Date of procedure:  2016-06-28Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - chronic cough ?GORD FINDINGS: There is a polyp in the GOJ which is sessile.It has an abnormal pit pattern. An oesophageal polyp was detected during endoscopy, located approximately 10 cm from the incisors. The lesion had a nodular surface and measured 1.5 cm in diameter.The polyp was grasped with a snare and cut with a hot biopsy forceps for removal.. There is an ulcer in the body which is hemorrhagicForrest Ulcer classification:II B.. Accompanied by white exudate and a yellowish base, the gastric ulcer presents with a cobblestone appearance.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. NA RECOMMENDATION: Follow-up endoscopy should be performed in 4-6 weeks to assess for healing and to repeat biopsies if necessary.  A colonoscopy may be ordered to assess for the presence of polyps in the colon and rectum. FOLLOW UP: The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and ulcer recurrence.  The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and increase the risk of polyp growth."
"735","Hospital Number: R6103760 , Hospital: Random NHS Foundation Trust , DOB:  1935-03-18 , General Practitioner: Dr. Song, Julia  , Date of procedure:  2004-05-12Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG5  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Previous multiple surgeries for reflux . FINDINGS: The patient has a polyp in the stomach which is stalked.It has a normal pit pattern. The hyperplastic gastric polyp presents with a regular shape and a smooth surface, suggesting a non-neoplastic process.The polyp was removed with a combination of snare and forceps, and hemostasis was achieved with an endoscopic clip..   The patient may be referred to a specialist in gastrointestinal disorders for further management of the polyp.  Further investigations such as a biopsy may be recommended to determine the type of polyp and assess the risk of cancer."
"736","Hospital Number: Z1272661 , Hospital: Random NHS Foundation Trust , DOB:  1984-06-30 , General Practitioner: Dr. Melendez, Audrie  , Date of procedure:  2008-04-07Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG4  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Eosinophilic oesophatitis assessment FINDINGS: There is inflammation in the body which is mild. The gastric inflammation is characterized by the presence of lymphoid aggregates in the mucosal layer.Following the biopsy of the lesion, there was bleeding, which was promptly managed..  RECOMMENDATION: The patient should avoid eating before going to bed, as this can worsen reflux symptoms.  The patient should follow a strict diet and avoid irritants that can exacerbate the inflammation. FOLLOW UP: The patient should avoid eating large meals late at night, as this can worsen reflux symptoms.  The patient should be advised to avoid hot, spicy foods, which can irritate the lining of the stomach and exacerbate the inflammation."
"737","Hospital Number: G2227671 , Hospital: Random NHS Foundation Trust , DOB:  1976-05-27 , General Practitioner: Dr. Baker, Christi  , Date of procedure:  2004-05-22Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG1  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Other- candidiasis FINDINGS: Normal gastroscopy to the duodenum. "
"738","Hospital Number: B7082304 , Hospital: Random NHS Foundation Trust , DOB:  1976-11-04 , General Practitioner: Dr. Sakai, Jacky  , Date of procedure:  2013-04-12Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"739","Hospital Number: J8000143 , Hospital: Random NHS Foundation Trust , DOB:  1927-05-14 , General Practitioner: Dr. al-Jabara, Rif'a  , Date of procedure:  2014-01-09Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG4  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Ongoing dyspepsia FINDINGS: The patient has an ulcer in the oesophagus at 30 cm which is superficial.CLO test was taken.. The gastric lesion appears malignant, accompanied by active bleeding and a punched-out appearance.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample.. The oesophageal ulcer exhibits irregular borders and surrounding inflammation, indicating a potentially malignant process.The ulcer was biopsied x8 for further analysis.. Barrett's is present. The pit pattern is normal. It is a long segment. character(0) RECOMMENDATION: The patient should be advised to seek medical attention immediately if they experience symptoms of severe bleeding such as black tarry stools or vomiting blood. RECOMMENDATION: The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the stricture.  A consultation with a dietician may be beneficial to help the patient modify their diet to manage the inflammation. FOLLOW UP: The patient should be informed of the diagnosis and provided with information on how to manage the ulcer. FOLLOW UP: The patient should avoid eating or drinking for at least six hours before any scheduled appointments.  The patient should be advised to avoid carbonated drinks, which can exacerbate the inflammation by increasing the production of gas."
"740","Hospital Number: M2497777 , Hospital: Random NHS Foundation Trust , DOB:  1923-08-10 , General Practitioner: Dr. al-Safar, Zaitoona  , Date of procedure:  2002-02-25Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  75mcg  , Midazolam  7mg  , Instrument:  FG3  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia . FINDINGS: There is a stricture in the body which is contractedThe endoscope passed through the stricture with resistance. A gastric stricture with a smooth and tapered appearance is observed in the corpus, suggestive of a benign fibrotic process.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. "
"741","Hospital Number: C1910592 , Hospital: Random NHS Foundation Trust , DOB:  1900-06-14 , General Practitioner: Dr. Velasquez, Sheree  , Date of procedure:  2010-09-26Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Hb drop ?GI bleed previous gastric surgery FINDINGS: Normal gastroscopy to the duodenum. "
"742","Hospital Number: Q9535363 , Hospital: Random NHS Foundation Trust , DOB:  1910-11-01 , General Practitioner: Dr. Raday, Ashley  , Date of procedure:  2008-10-26Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  150mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Barretts FINDINGS: Columnar lined oesophagus is present. Some areas of vascular abnormalities are seen. No abnormal pit pattern is seen. Gastric mucosal prolapse seen. The patient has a polyp in the fundus which is sessile.It has a normal pit pattern. A gastric polyp with a broad-based attachment is noted in the corpus, with a smooth and dome-shaped surface.The polyp did not lift on saline injection and was therefore not amenable to endoscopic resection.. character(0)  A repeat gastroscopy may be required in six months' time to monitor the growth of the polyp.  The patient should be advised to avoid carbonated drinks, which can increase the risk of developing more polyps by increasing the production of gas."
"743","Hospital Number: X7857756 , Hospital: Random NHS Foundation Trust , DOB:  1960-04-03 , General Practitioner: Dr. Pham, Emily  , Date of procedure:  2007-08-18Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Weight Loss FINDINGS: Small hiatus hernia only.. "
"744","Hospital Number: E8303284 , Hospital: Random NHS Foundation Trust , DOB:  1963-12-14 , General Practitioner: Dr. Velasquez, Mayra  , Date of procedure:  2008-12-26Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Barrett's is present. Gastric mucosal prolapse seen. "
"745","Hospital Number: N5562828 , Hospital: Random NHS Foundation Trust , DOB:  1918-12-02 , General Practitioner: Dr. Christopher, Jasmine  , Date of procedure:  2016-10-10Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Nausea and/or Vomiting Weight Loss FINDINGS: There is inflammation in the duodenal bulb which is erosive. The duodenal mucosa appears edematous and congested, with evidence of exudate present in some areas.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. There is inflammation in the GOJ which is severe. The oesophageal mucosa appears thickened and friable, with diffuse erosions and ulcerations.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. NA RECOMMENDATION: The patient should be instructed to chew food thoroughly and eat slowly to reduce the risk of further irritation to the ulcer. RECOMMENDATION: The patient may be prescribed medication to reduce the production of stomach acid and prevent reflux.  The patient should be advised to avoid consuming too much sugar, as this can exacerbate the inflammation by increasing the risk of bacterial overgrowth in the stomach. FOLLOW UP: The patient should be advised to avoid consuming caffeine, which can stimulate the production of stomach acid and delay the healing of the ulcer. FOLLOW UP: Further investigations, such as imaging studies and blood tests, may be required to determine the underlying cause of the stricture.  The patient should avoid consuming large meals, as this can exacerbate the inflammation."
"746","Hospital Number: V8753920 , Hospital: Random NHS Foundation Trust , DOB:  1902-05-26 , General Practitioner: Dr. el-Hameed, Raafida  , Date of procedure:  2009-09-23Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- RFA FINDINGS: The patient has a stricture in the fundus which is thickenedIt will not allow the scope to pass.. The gastric stricture is likely the result of chronic inflammation and fibrosis, rather than extrinsic compression.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. No inlet patch.. NA RECOMMENDATION: The patient may require additional endoscopies in the future to monitor the stricture and ensure that it is not progressing.  A barium swallow study may be ordered to assess the extent of the inflammation. FOLLOW UP: The patient should be advised to avoid lying down for at least three hours after eating to help prevent reflux.  A proton pump inhibitor medication may be prescribed to manage the inflammation."
"747","Hospital Number: L1479863 , Hospital: Random NHS Foundation Trust , DOB:  1965-11-14 , General Practitioner: Dr. Edwards, Lakesha  , Date of procedure:  2001-09-15Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG2  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Abdominal Pain FINDINGS: LA Grade  C oesophagitis. Gastric mucosal prolapse also seen There is diffuse mucosal edema throughout the oesophagus. The patient has inflammation in the fundus which is erosive. Erythematous and edematous mucosa is observed in the gastric antrum, with no distinct ulcerations, suggestive of antral gastritis.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. character(0) RECOMMENDATION: Follow-up endoscopy with surveillance biopsies may be necessary for patients with a history of gastric ulcer or increased risk for malignancy. RECOMMENDATION: The patient may be referred to a nutritionist to develop a diet plan that is easier to swallow and that meets their nutritional needs.  The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and exacerbate the inflammation. FOLLOW UP: The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and ulcer recurrence. FOLLOW UP: The patient should be advised to chew their food thoroughly and to eat slowly to help prevent swallowing difficulties.  The patient should avoid smoking and alcohol, which can worsen the inflammation."
"748","Hospital Number: A5218459 , Hospital: Random NHS Foundation Trust , DOB:  1953-09-15 , General Practitioner: Dr. Flyinghawk, Alexandrina  , Date of procedure:  2016-09-04Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  150mcg  , Midazolam  4mg  , Instrument:  FG5  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Ongoing dyspepsia FINDINGS: Normal gastroscopy to the duodenum. "
"749","Hospital Number: I2777268 , Hospital: Random NHS Foundation Trust , DOB:  1976-02-14 , General Practitioner: Dr. Amerson, Tisa  , Date of procedure:  2005-05-15Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like SymptomsAbdominal Pain FINDINGS: Normal gastroscopy to the duodenum. "
"750","Hospital Number: F7726169 , Hospital: Random NHS Foundation Trust , DOB:  1969-06-17 , General Practitioner: Dr. Worrell, Laura  , Date of procedure:  2007-12-21Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG3  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia oesophageal stricture post chemorad for scc oesophagus FINDINGS: There is a nodule in the D1/D2 angle which is sessile. NA  The patient should be advised to seek emotional support from friends, family, or a counselor, as the diagnosis of cancer can be difficult to cope with.  The patient may be referred to a specialist for further evaluation and treatment, such as surgery to remove the nodule."
"751","Hospital Number: T1978921 , Hospital: Random NHS Foundation Trust , DOB:  1906-04-02 , General Practitioner: Dr. Jackson, Valencia  , Date of procedure:  2004-09-25Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG1  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Other-BloatingAbdominal Pain FINDINGS: OESOPHAGUS: Normal apart from small hiatus hernia.. "
"752","Hospital Number: W8248560 , Hospital: Random NHS Foundation Trust , DOB:  1918-06-24 , General Practitioner: Dr. Ramirez, Audrianna  , Date of procedure:  2011-03-27Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  100mcg  , Midazolam  4mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia   post oesophagectomy FINDINGS: Normal gastroscopy to the duodenum. character(0)"
"753","Hospital Number: O8592861 , Hospital: Random NHS Foundation Trust , DOB:  1956-12-23 , General Practitioner: Dr. Murtaugh, Jordan  , Date of procedure:  2014-04-20Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia large hiatus hernia FINDINGS: The distal oesophagus shows signs of an eosinophilic infiltrate, with a white exudate coating the mucosa.. There is an ulcer in the third part of the duodenum which is superficial s*It is not bleeding. The severe ulceration presents with a depth greater than 5 mm and an irregular border.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. The surrounding mucosa appears hyperemic and erythematous, consistent with active inflammation.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. character(0) RECOMMENDATION: The patient should be instructed to avoid tight-fitting clothing to reduce pressure on the ulcer site. RECOMMENDATION: The patient may be prescribed medication to reduce the production of stomach acid and prevent reflux.  The patient should avoid eating before bedtime, as this can exacerbate the inflammation by increasing the risk of reflux. FOLLOW UP: The patient should avoid stress and maintain good mental health, as stress can delay the healing of the ulcer. FOLLOW UP: The patient should avoid smoking and drinking alcohol, as these habits can worsen GERD symptoms.  The patient should be informed of the diagnosis and provided with information on how to manage the inflammation."
"754","Hospital Number: H1442477 , Hospital: Random NHS Foundation Trust , DOB:  1983-11-08 , General Practitioner: Dr. Ramirez, Danni  , Date of procedure:  2011-03-08Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known coeliac disease vomitting FINDINGS: The patient has inflammation in the GOJ which is mild. The oesophageal mucosa is diffusely granular and erythematous, consistent with reflux oesophagitis.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. The patient has a polyp in the stomach which is stalked.It has a normal pit pattern. The gastric polyp presents with an irregular shape, ulceration, and invasive margins, suggestive of a malignant process.The polyp was visualized and biopsied during upper endoscopy.. The patient's medical history and the ulcer's rugose surface suggest a chronic inflammatory process.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. NA RECOMMENDATION: Surgical intervention may be necessary in the event of complications such as perforation or obstruction. RECOMMENDATION: The patient may be referred to a psychologist to help manage any anxiety or stress that may be contributing to their symptoms. RECOMMENDATION: The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and inflammation.  The patient is advised to return for a follow-up appointment in four to six weeks' time to discuss the findings and plan for further management. FOLLOW UP: The patient should be advised to eat slowly and chew their food thoroughly to aid digestion and reduce the risk of ulcer recurrence. FOLLOW UP: If the stricture is causing symptoms such as difficulty swallowing, the patient may be referred to a speech therapist for swallowing therapy. FOLLOW UP: A stool test may be ordered to assess the patient's fecal occult blood levels, as inflammation can cause bleeding in the stomach and intestines.  The patient should be advised to avoid consuming alcohol, which can increase the risk of developing more polyps."
"755","Hospital Number: P1673382 , Hospital: Random NHS Foundation Trust , DOB:  1968-10-23 , General Practitioner: Dr. Decluette, Jocelyn  , Date of procedure:  2012-12-05Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: duodenal stent FINDINGS: There is a polyp in the stomach which is sessile with an abnormal pit pattern. Multiple polyps with variable size are seen throughout the gastric mucosa, suggestive of familial adenomatous polyposis.The polyp did not lift on saline injection and was therefore not amenable to endoscopic resection..   The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and increase the risk of polyp growth.  "
"756","Hospital Number: D3953088 , Hospital: Random NHS Foundation Trust , DOB:  1932-07-04 , General Practitioner: Dr. Peters, Ashley  , Date of procedure:  2014-03-03Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  125mcg  , Midazolam  4mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain FINDINGS: LA Grade  A oesophagitis. There are scattered erosions present in the oesophageal mucosa. The gastroesophageal junction appears normal, but there is diffuse erythema of the distal oesophagus. There is inflammation in the antrum which is mild. The gastric inflammation is characterized by the presence of neutrophils and lymphocytes in the mucosal layer.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. NA RECOMMENDATION: The patient should avoid eating large meals and should instead eat smaller, more frequent meals throughout the day.  The patient should avoid lying down immediately after meals, as this can exacerbate the inflammation by increasing the risk of reflux. FOLLOW UP: A follow-up appointment with the gastroenterologist should be scheduled for six months after the initial diagnosis to monitor the patient's progress.  The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools."
"757","Hospital Number: K5760664 , Hospital: Random NHS Foundation Trust , DOB:  1916-03-03 , General Practitioner: Dr. Koga, Sun  , Date of procedure:  2013-08-13Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  100mcg  , Midazolam  5mg  , Instrument:  FG3  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: High Dysphagia further assessment of previoius diagnosed peptic stricture also recent eus and aspirat of bengn perigastric cyst FINDINGS: OESOPHAGUS: Normal apart from small hiatus hernia.. "
"758","Hospital Number: U6704720 , Hospital: Random NHS Foundation Trust , DOB:  1911-04-23 , General Practitioner: Dr. al-Pirani, Sabeeha  , Date of procedure:  2003-11-03Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  150mcg  , Midazolam  7mg  , Instrument:  FG6  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Dysphagia/Odynophagia Nausea and/orVomiting FINDINGS: There is a stricture in the fundus which is stiffTight distal stricture which would not allow passage of scope.. A gastric stricture with a smooth and nodular surface is observed in the cardia, suggestive of a malignant lesion.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape..  character(0)"
"759","Hospital Number: Y1451790 , Hospital: Random NHS Foundation Trust , DOB:  1962-11-30 , General Practitioner: Dr. el-Alam, Aamina  , Date of procedure:  2010-03-28Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  150mcg  , Midazolam  5mg  , Instrument:  FG3  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: anastomotic stricture post thoracoabdominal oesophagogastrecotmy for dilatation FINDINGS: LA Grade  B oesophagitis. The oesopahgitis is consistent with acid reflux.  character(0)"
"760","Hospital Number: S9523253 , Hospital: Random NHS Foundation Trust , DOB:  1919-10-03 , General Practitioner: Dr. La, Annie  , Date of procedure:  2002-02-18Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: High Dysphagia further assessment of previoius diagnosed peptic stricture also recent eus and aspirat of bengn perigastric cyst FINDINGS: The patient has an ulcer in the third part of the duodenum which is exudativeCLO test  was also taken.. Characterized by a distinct loss of mucosal tissue, the severe ulceration presents with a nodular surface.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. The surrounding mucosa appears to be friable and prone to bleeding upon contact.The lesion was biopsied using a standard forceps..  NA  The patient should be advised to eat smaller, more frequent meals to reduce pressure on the ulcer site and promote healing.  The patient should be informed of the diagnosis and provided with information on how to manage the ulcer."
"761","Hospital Number: R7817343 , Hospital: Random NHS Foundation Trust , DOB:  1900-07-21 , General Practitioner: Dr. Maker, Cam  , Date of procedure:  2013-07-31Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Dysphagia/Odynophagia FINDINGS: The patient's oesophagus is noted to have linear furrowing.. There is a stricture in the duodenal bulb which is fibrous.Tight stricture impassable with scope.. The stricture is non-tapering and involves the entire circumference of the duodenal lumen.The biopsy was performed using a needle biopsy forceps, with the tissue samples sent for pathological analysis.. NA"
"762","Hospital Number: Z7781233 , Hospital: Random NHS Foundation Trust , DOB:  1949-06-07 , General Practitioner: Dr. el-Akbari, Zuhriyaa  , Date of procedure:  2011-08-04Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  7mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known coeliac disease vomitting FINDINGS: There is inflammation in the stomach which is erosive. The gastric inflammation is characterized by the presence of neutrophils and lymphocytes in the mucosal layer.During biopsy, it was noted that the lesion had a friable surface and bled easily..  RECOMMENDATION:   The patient should avoid NSAIDs and aspirin, which can irritate the lining of the stomach and exacerbate the inflammation. FOLLOW UP: The patient should be informed of the diagnosis and the importance of adhering to the recommended treatment plan.  The patient should avoid eating before bedtime, as this can exacerbate the inflammation by increasing the risk of reflux."
"763","Hospital Number: G7755694 , Hospital: Random NHS Foundation Trust , DOB:  1968-01-19 , General Practitioner: Dr. el-Harron, Noora  , Date of procedure:  2010-06-25Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Abdominal Pain FINDINGS: Barrett's is present. The pit pattern is normal. "
"764","Hospital Number: B7780911 , Hospital: Random NHS Foundation Trust , DOB:  1932-02-03 , General Practitioner: Dr. Rocha, Kaci  , Date of procedure:  2013-01-07Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- FINDINGS: Normal gastroscopy to the duodenum. "
"765","Hospital Number: J8821698 , Hospital: Random NHS Foundation Trust , DOB:  1926-03-12 , General Practitioner: Dr. Tang, Ria  , Date of procedure:  2012-10-24Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG2  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Haematemesis or Melaena/Blood PR FINDINGS: Inflammatory changes seen in the oesophagus.  NA"
"766","Hospital Number: M8882071 , Hospital: Random NHS Foundation Trust , DOB:  1900-08-06 , General Practitioner: Dr. Ross, Kathryn  , Date of procedure:  2014-06-28Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - VCE placement (previous gastric bypass)Anaemia/Low Iron or Vitamins FINDINGS: There is inflammation in the antrum which is mild. The gastric inflammation is characterized by the presence of eosinophils and mast cells in the mucosal layer.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from..  character(0) RECOMMENDATION: The patient should be advised to avoid lying down for at least three hours after eating to help prevent reflux.  The patient should be advised to eat slowly and chew their food thoroughly to aid digestion and reduce the risk of inflammation. FOLLOW UP:   The patient should avoid eating too much fat, as this can exacerbate the inflammation by delaying gastric emptying and increasing the risk of reflux."
"767","Hospital Number: C4433311 , Hospital: Random NHS Foundation Trust , DOB:  1927-06-21 , General Practitioner: Dr. Rose, Aleena  , Date of procedure:  2007-11-12Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG1  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- clips positioning to oesophageal lesion FINDINGS: There is a polyp in the duodenal bulb which is sessile with a normal pit pattern. The nodules are distributed throughout the duodenal bulb and descending duodenum.Due to its large size, the polyp was not able to be resected during the current endoscopic session.. The patient has an ulcer in the third part of the duodenum which is necroticIt has rolled edges. The gastric ulcer presents with an irregular border and a fibrous base, suggestive of NSAID-induced injury.The lesion was biopsied using a standard forceps.. The edges of the ulcer appear to be irregular and ragged, suggesting ongoing tissue destruction and repair.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. NA RECOMMENDATION: The patient should be instructed to chew food thoroughly and eat slowly to reduce the risk of further irritation to the ulcer. RECOMMENDATION:   A repeat gastroscopy may be recommended in twelve months' time to assess the response to treatment. FOLLOW UP:  FOLLOW UP: The patient should be advised to avoid eating spicy or acidic foods, as these can irritate the gastrointestinal tract and worsen symptoms.  The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools."
"768","Hospital Number: Q1015837 , Hospital: Random NHS Foundation Trust , DOB:  1904-06-12 , General Practitioner: Dr. Two  Crow, Amanda  , Date of procedure:  2008-04-26Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  75mcg  , Midazolam  7mg  , Instrument:  FG6  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Coeliac  and ? RCD FINDINGS: No evidence of inlet patch on careful inspection.. "
"769","Hospital Number: X2594520 , Hospital: Random NHS Foundation Trust , DOB:  1941-02-08 , General Practitioner: Dr. Le, Nhi  , Date of procedure:  2006-10-18Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG1  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain x1 hematemesis Crohns colitis FINDINGS: There is inflammation in the D1/D2 angle which is mild.  RECOMMENDATION: If the patient is experiencing symptoms such as vomiting or fever, they should contact their healthcare provider immediately.  The patient should be informed of the diagnosis and provided with information on how to manage the inflammation. FOLLOW UP: The patient may be prescribed medication to reduce the production of stomach acid and prevent reflux.  The patient may be referred to a gastroenterologist for further management of the inflammation."
"770","Hospital Number: E6158591 , Hospital: Random NHS Foundation Trust , DOB:  1948-01-14 , General Practitioner: Dr. Young, Kendall  , Date of procedure:  2006-05-09Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known EOE oesophgeal biopsies FINDINGS: The patient's oesophagus shows a ringed appearance, with a degree of narrowing noted.. There is a nodule in the GOJ which is sessile. The stricture appears to have a smooth, regular contour without any visible masses or ulcers.Encourage the patient to maintain a healthy diet and exercise regimen to improve overall health and reduce inflammation.. character(0) RECOMMENDATION: The patient should be instructed to avoid tight-fitting clothing to reduce pressure on the ulcer site. RECOMMENDATION: The patient should be advised to avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as these can increase the risk of bleeding in the gastrointestinal tract. RECOMMENDATION: If the patient is experiencing symptoms such as vomiting or fever, they should contact their healthcare provider immediately.  A barium swallow study may be ordered to assess the extent of the inflammation. FOLLOW UP: The patient should be advised to avoid consuming caffeine, which can stimulate the production of stomach acid and delay the healing of the ulcer. FOLLOW UP: The patient should be advised to avoid eating spicy or acidic foods, as these can irritate the gastrointestinal tract and worsen symptoms. FOLLOW UP: The patient may be prescribed an H2 blocker to reduce stomach acid production and prevent reflux.  A repeat gastroscopy may be required in three to six months' time to monitor the progress of the inflammation."
"771","Hospital Number: N9571333 , Hospital: Random NHS Foundation Trust , DOB:  1991-12-23 , General Practitioner: Dr. Gilman, Danielle  , Date of procedure:  2013-10-29Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  75mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Weight Loss FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"")."
"772","Hospital Number: V3328807 , Hospital: Random NHS Foundation Trust , DOB:  1951-08-24 , General Practitioner: Dr. el-Salim, Aasima  , Date of procedure:  2011-02-19Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Chronic cough?reflux FINDINGS: The patient has a polyp in the GOJ which is stalked with a normal pit pattern. An oesophageal polyp was detected during endoscopy, located approximately 14 cm from the incisors. The lesion had a nodular surface and measured 1 cm in diameter.The base of the polyp was cauterized with an argon plasma coagulator to prevent bleeding..  NA  The patient should avoid smoking and alcohol, which can increase the risk of developing more polyps.  A colonoscopy may be ordered to assess for the presence of polyps in the colon and rectum."
"773","Hospital Number: L2721400 , Hospital: Random NHS Foundation Trust , DOB:  1993-10-03 , General Practitioner: Dr. Upadhyay, Amy  , Date of procedure:  2012-02-26Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  50mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow up oesophageal stricture dysphagia for recurrent dilatation FINDINGS: Inflammatory changes seen in the oesophagus.  NA"
"774","Hospital Number: A9747574 , Hospital: Random NHS Foundation Trust , DOB:  1924-04-12 , General Practitioner: Dr. Kim, Kerani  , Date of procedure:  2002-08-28Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CT findings: . FINDINGS: There is a polyp in the fundus which is sessile.It has an abnormal pit pattern. The gastric polyp appears fundic, with a pale surface and no evidence of dysplastic changes.The polyp was removed with minimal thermal injury to surrounding tissue using a cold snare technique.. LA Grade  D oesophagitis. Gastric mucosal prolapse also seen The distal oesophagus appears normal, but there is diffuse erythema and friability in the mid and proximal oesophagus. The oesophageal mucosa is thickened and has a cobblestone appearance. NA  The patient should be advised to avoid acidic foods and drinks, which can irritate the lining of the stomach and increase the risk of developing more polyps.  The patient should avoid consuming too much fat, as this can delay gastric emptying and increase the risk of reflux and polyp growth."
"775","Hospital Number: I9081757 , Hospital: Random NHS Foundation Trust , DOB:  1917-05-21 , General Practitioner: Dr. Ashley, Chantel  , Date of procedure:  2005-10-10Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain FINDINGS: There is inflammation in the stomach which is mild. Erythematous patches with focal ulceration are noted in the gastric antrum, suggestive of acute erosive gastritis.The biopsy was performed using a needle biopsy forceps, with the tissue samples sent for pathological analysis.. There is an ulcer in the D1/D2 angle which is induratedCLO test  was also taken.. The gastric ulcer presents with an irregular border and a fibrous base, suggestive of NSAID-induced injury.The ulcer was biopsied x8 for further analysis.. character(0) RECOMMENDATION: Referral to a registered dietitian may be helpful in providing guidance on a healthy, ulcer-friendly diet. RECOMMENDATION: The patient should avoid drinking carbonated beverages, as these can worsen reflux symptoms.  The patient may be prescribed a course of antibiotics to treat any underlying infection that may be causing the inflammation. FOLLOW UP: The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and delay the healing of the ulcer. FOLLOW UP: The patient may be referred to a nutritionist to develop a diet plan that is easier to swallow and that meets their nutritional needs.  The patient should be advised to avoid consuming too much sugar, as this can exacerbate the inflammation by increasing the risk of bacterial overgrowth in the stomach."
"776","Hospital Number: F6090839 , Hospital: Random NHS Foundation Trust , DOB:  1900-10-19 , General Practitioner: Dr. Sargent, Nicole  , Date of procedure:  2010-05-22Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  100mcg  , Midazolam  3mg  , Instrument:  FG5  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Varices FINDINGS: There is a nodule in the GOJ which is benign-looking. In the oesophagus, a Paris IIa/c nodular lesion was detected during endoscopy, measuring 0.6 cm in diameter. The lesion appeared to be sessile and had a regular nodular appearance.The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and increase the risk of polyp growth.. The patient has a 7mm nodule in the antrum which is stalked. The nodules have an abnormal pit pattern and may represent an early gastric cancer.The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the stricture.. character(0) RECOMMENDATION: The patient should be advised to avoid eating large meals or eating quickly, as this can increase the risk of reflux and further damage to the gastrointestinal tract.  The patient should avoid eating before bedtime, as this can increase the risk of reflux and polyp growth. FOLLOW UP:   The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and increase the risk of polyp growth."
"777","Hospital Number: T7480285 , Hospital: Random NHS Foundation Trust , DOB:  1987-08-27 , General Practitioner: Dr. Ketchum, Violet  , Date of procedure:  2004-03-15Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  100mcg  , Midazolam  1mg  , Instrument:  FG5  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Achalasia FINDINGS: There is inflammation in the oesophagus at 37 cm which is erosive. The oesophageal mucosa is erythematous and friable, with areas of exudate and sloughing consistent with moderate oesophagitis.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. There is a polyp in the stomach which is sessile with an abnormal pit pattern. A gastric polyp with a polypoid shape is seen in the cardia, with a smooth and rounded surface.Under endoscopic visualization, the polyp was removed using EMR.. character(0) RECOMMENDATION: The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent reflux. RECOMMENDATION: The patient is advised to return for a follow-up appointment in six weeks' time to evaluate the progress of the inflammation.  The patient should be advised to avoid eating too much fiber, as this can irritate the lining of the stomach and increase the risk of polyp growth. FOLLOW UP: If the stricture is due to a medical condition such as gastroesophageal reflux disease (GERD), the patient may be prescribed medication to manage their symptoms. FOLLOW UP: The patient should avoid smoking and alcohol, which can worsen the inflammation.  The patient should be advised to avoid NSAIDs and aspirin, which can increase the risk of developing more polyps."
"778","Hospital Number: W2054819 , Hospital: Random NHS Foundation Trust , DOB:  1953-07-15 , General Practitioner: Dr. Baker, Sabrina  , Date of procedure:  2006-01-01Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  25mcg  , Midazolam  5mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia   post oesophagectomy FINDINGS: Inflammatory changes seen in the oesophagus. The patient has a 4mm nodule in the antrum which is benign-looking. A small, solid nodule is observed in the gastric body, suggestive of a gastric carcinoid tumor.-----------------------------------------------------------------FD_Nodule_Recommendations. character(0)  The patient should avoid smoking and drinking alcohol, as these habits can increase the risk of cancer.  If the patient is experiencing symptoms such as vomiting or fever, they should contact their healthcare provider immediately."
"779","Hospital Number: O8834134 , Hospital: Random NHS Foundation Trust , DOB:  1937-07-17 , General Practitioner: Dr. Moore III, Cassidy  , Date of procedure:  2009-08-05Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  150mcg  , Midazolam  2mg  , Instrument:  FG5  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: ULCER CHECK. FINDINGS: The patient has a stricture in the antrum which is stenoticThe endoscope passed through the stricture with resistance. A long-segment gastric stricture is noted in the body of the stomach, with a stenotic and irregular contour.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. The patient has a polyp in the GOJ which is sessile.It has a normal pit pattern. Upon endoscopic examination of the oesophagus, a Paris IIa polypoid lesion was observed, measuring 1.3 cm in diameter. The lesion had a smooth surface and appeared to be pedunculated.Endoscopic mucosal resection was performed to remove the polyp in its entirety.. character(0) RECOMMENDATION: The patient should be counseled on the risks and benefits of any potential treatments for their ulcer.  The patient is advised to return for a follow-up appointment in four to six weeks' time to discuss the findings and plan for further management. FOLLOW UP: The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more ulcers.  "
"780","Hospital Number: H6820128 , Hospital: Random NHS Foundation Trust , DOB:  1910-12-21 , General Practitioner: Dr. Phan, Mujda  , Date of procedure:  2002-09-21Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  125mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Gastric ucers with hy pylori. FINDINGS: Normal gastroscopy to the duodenum. "
"781","Hospital Number: P4350826 , Hospital: Random NHS Foundation Trust , DOB:  1979-07-30 , General Practitioner: Dr. Amarsaikhan, Hayley  , Date of procedure:  2005-04-15Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  25mcg  , Midazolam  7mg  , Instrument:  FG5  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Therapeutic- Dilatation FINDINGS: Normal gastroscopy to the duodenum. "
"782","Hospital Number: D5429386 , Hospital: Random NHS Foundation Trust , DOB:  1968-11-24 , General Practitioner: Dr. el-Shahid, Asmaa  , Date of procedure:  2011-01-23Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Globus cough FINDINGS: There is an ulcer in the D1/D2 angle which is hemorrhagicIt is bleeding. Signs of NSAID-induced injury are evident in the gastric ulcer, which appears to have a punched-out appearance.Following the biopsy of the lesion, there was bleeding, which was promptly managed..   The patient should be advised to maintain a healthy weight and exercise regularly to reduce the risk of recurrent ulcers.  The patient should avoid stress and maintain good mental health, as stress can delay the healing of the ulcer."
"783","Hospital Number: K5870127 , Hospital: Random NHS Foundation Trust , DOB:  1951-08-25 , General Practitioner: Dr. Comer, Nerissa  , Date of procedure:  2005-01-21Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"784","Hospital Number: U3081246 , Hospital: Random NHS Foundation Trust , DOB:  1941-07-27 , General Practitioner: Dr. Navarro-Tapia, Fancy  , Date of procedure:  2001-11-28Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG5  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Previous chemo rad. rpt dilation. FINDINGS: There is a polyp in the body which is stalked.It has an abnormal pit pattern. The gastric polyp appears fundic with a smooth surface and no vascularization.Due to its large size, the polyp was not able to be resected during the current endoscopic session..     "
"785","Hospital Number: Y1506215 , Hospital: Random NHS Foundation Trust , DOB:  1928-08-22 , General Practitioner: Dr. al-Popal, Haazima  , Date of procedure:  2015-10-20Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  150mcg  , Midazolam  4mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Advanced  pancreatic CA.  Now worsening jaundice FINDINGS: Normal gastroscopy to the duodenum. "
"786","Hospital Number: S7145991 , Hospital: Random NHS Foundation Trust , DOB:  1995-05-26 , General Practitioner: Dr. al-Kaba, Ahlaam  , Date of procedure:  2007-01-20Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Nausea and/or Vomiting FINDINGS: The patient has inflammation in the D1/D2 angle which is severe.  RECOMMENDATION: The patient may be referred to a nutritionist to develop a diet plan that is easier to swallow and that meets their nutritional needs.  A repeat gastroscopy may be required in three to six months' time to monitor the progress of the inflammation. FOLLOW UP: The patient should avoid eating or drinking for at least six hours before any scheduled appointments.  The patient should be advised to avoid carbonated drinks, which can exacerbate the inflammation by increasing the production of gas."
"787","Hospital Number: R9404908 , Hospital: Random NHS Foundation Trust , DOB:  1928-01-24 , General Practitioner: Dr. al-Ahmed, Saalima  , Date of procedure:  2010-06-09Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known EOE oesophgeal biopsies FINDINGS: Normal gastroscopy to the duodenum. "
"788","Hospital Number: Z6151451 , Hospital: Random NHS Foundation Trust , DOB:  1919-02-07 , General Practitioner: Dr. el-Mahmoud, Ghuzaila  , Date of procedure:  2008-10-01Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  100mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Abdominal Pain FINDINGS: There is a stricture in the stomach which is tight and will not allow the scope to pass.. The mucosa of the esophagus  was also noted to be thickened and white in color during endoscopy. The esophageal mucosa appeared to be friable on endoscopic examination. Rings were noted throughout the esophagusconsistent with eosinophilic oesophagitis. The gastric stricture appears to be caused by chronic inflammation and fibrosis in the mucosa, rather than extrinsic compression.During biopsy, it was noted that the lesion had a friable surface and bled easily.. The patient has a 7mm nodule in the D1/D2 angle which is benign-looking. NA RECOMMENDATION: The patient should avoid smoking and drinking alcohol, as these habits can increase the risk of cancer. RECOMMENDATION: The patient should be advised to avoid lying down for at least three hours after eating to help prevent reflux.  The patient should follow a strict diet and avoid irritants that can exacerbate the inflammation. FOLLOW UP: If the nodule is suspicious for cancer, the patient may be referred to an oncologist for further evaluation and treatment. FOLLOW UP: The patient should be advised to elevate the head of their bed by six inches to help prevent reflux at night.  The patient may be prescribed a course of antibiotics to treat any underlying infection that may be causing the inflammation."
"789","Hospital Number: G1498153 , Hospital: Random NHS Foundation Trust , DOB:  1941-09-23 , General Practitioner: Dr. al-Bilal, Shamaail  , Date of procedure:  2012-07-27Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  12.5mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Weight Loss Mother has gastric cancer FINDINGS: Normal gastroscopy to the duodenum. "
"790","Hospital Number: B8969666 , Hospital: Random NHS Foundation Trust , DOB:  1969-08-26 , General Practitioner: Dr. Le, Olivia  , Date of procedure:  2016-02-24Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  125mcg  , Midazolam  2mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- EMR/ESD FINDINGS: Normal gastroscopy to the duodenum. "
"791","Hospital Number: J1819477 , Hospital: Random NHS Foundation Trust , DOB:  1916-03-30 , General Practitioner: Dr. al-Kanan, Thaamira  , Date of procedure:  2014-02-23Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Other- candidiasis FINDINGS: There is an ulcer in the antrum which is scarredIt has rolled edges. Accompanied by white exudate and a cobblestone appearance, the gastric ulcer is likely caused by Helicobacter pylori infection.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. There is inflammation in the duodenal bulb which is erosive. There is diffuse erythema and friability noted in the duodenal mucosa, with areas of active bleeding.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. character(0) RECOMMENDATION: H. pylori testing and treatment may be necessary to prevent recurrence of the ulcer. RECOMMENDATION: The patient should avoid eating or drinking for at least six hours before any scheduled appointments.  The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools. FOLLOW UP: The patient should be advised to avoid consuming alcohol, which can delay the healing of the ulcer and increase the risk of developing more ulcers. FOLLOW UP: If the patient experiences chest pain or difficulty breathing, they should seek emergency medical attention immediately.  "
"792","Hospital Number: M8863036 , Hospital: Random NHS Foundation Trust , DOB:  1990-07-02 , General Practitioner: Dr. Papilion, Brooke  , Date of procedure:  2015-10-22Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  125mcg  , Midazolam  5mg  , Instrument:  FG2  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- clips positioning to oesophageal lesion FINDINGS: The patient has a polyp in the duodenal bulb which is stalked with a normal pit pattern. The nodules are distributed throughout the duodenal bulb and descending duodenum.The base of the polyp was fulgurated with an electrocautery device to prevent future bleeding or regrowth.. There is a nodule in the D1/D2 angle which is sessile. character(0) RECOMMENDATION: If the nodule is benign, the patient may not require any treatment, but may require monitoring with regular endoscopies.  The patient is advised to return for a follow-up appointment in four to six weeks' time to discuss the findings and plan for further management. FOLLOW UP: The patient should avoid eating or drinking for at least six hours before any scheduled appointments.  The patient should be advised to avoid consuming alcohol, which can increase the risk of developing more polyps."
"793","Hospital Number: C4021112 , Hospital: Random NHS Foundation Trust , DOB:  1991-12-13 , General Practitioner: Dr. Lansing, Samantha  , Date of procedure:  2013-06-03Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  125mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known coeliac disease vomitting FINDINGS: There is inflammation in the body which is erosive. Focal areas of erythema with no exudate are observed in the gastric antrum, suggestive of mild gastritis.The ulcer was biopsied x8 for further analysis.. The patient has an ulcer in the D1/D2 angle which is induratedIt has a visible vessel. Characterized by a distinct loss of mucosal tissue and surrounded by erythema, the severe ulceration presents with a nodular surface.The ulcer was biopsied x8 for further analysis.. NA RECOMMENDATION: Referral to a gastroenterologist for further evaluation and management of the ulcer is recommended. RECOMMENDATION: The patient should avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as these can worsen GERD symptoms.  The patient should be advised to avoid acidic foods and drinks, which can irritate the lining of the stomach and exacerbate the inflammation. FOLLOW UP:  FOLLOW UP: The patient should be advised to avoid caffeine, as it can worsen reflux symptoms.  The patient should avoid lying down immediately after meals, as this can exacerbate the inflammation by increasing the risk of reflux."
"794","Hospital Number: Q8222665 , Hospital: Random NHS Foundation Trust , DOB:  1944-02-09 , General Practitioner: Dr. Kanamu-Santos, Kendra  , Date of procedure:  2008-02-20Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  100mcg  , Midazolam  3mg  , Instrument:  FG3  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain FINDINGS: There is a nodule in the stomach which is stalked. A well-circumscribed, pedunculated nodule is observed in the gastric antrum, suggestive of a gastric fibroma.The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and increase the risk of polyp growth.. There is inflammation in the fundus which is mild. The gastric inflammation is characterized by erythema and edema of the mucosa.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. NA RECOMMENDATION: The patient should be advised to maintain a healthy diet and lifestyle, as this may help prevent the growth of the nodule. RECOMMENDATION: The patient should avoid drinking carbonated beverages, as these can worsen reflux symptoms. RECOMMENDATION: A consultation with a dietician may be beneficial to help the patient modify their diet to manage the inflammation.  The patient should avoid smoking and alcohol, which can increase the risk of developing more polyps. FOLLOW UP:  FOLLOW UP: If the patient experiences chest pain or difficulty breathing, they should seek emergency medical attention immediately. FOLLOW UP: A proton pump inhibitor medication may be prescribed to manage the inflammation.  The patient should be advised to avoid consuming caffeine, which can stimulate the production of stomach acid and increase the risk of polyp growth."
"795","Hospital Number: X5836068 , Hospital: Random NHS Foundation Trust , DOB:  1966-10-09 , General Practitioner: Dr. Hall, Destiny  , Date of procedure:  2014-06-27Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain . FINDINGS: The patient has a polyp in the duodenal bulb which is stalked with a normal pit pattern. The nodules are uniform in appearance, without any areas of necrosis or ulceration.The polyp was grasped with a snare and cut with a hot biopsy forceps for removal.. There is a polyp in the body which is stalked with an abnormal pit pattern. A large, irregular gastric polyp is noted in the body of the stomach, with a nodular and friable surface.ESD was performed to remove the polyp after lifting it with saline injection.. character(0) RECOMMENDATION: Endoscopic resection of the ulcer may be necessary for larger or more complex ulcers. RECOMMENDATION: The patient should avoid eating fried or fatty foods, as these can increase the risk of reflux and further damage to the gastrointestinal tract.  The patient should be advised to eat slowly and chew their food thoroughly to aid digestion and reduce the risk of polyp growth. FOLLOW UP: The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and delay the healing of the ulcer. FOLLOW UP: The patient may be referred to a surgeon for a minimally invasive procedure to remove the nodule.  A repeat gastroscopy may be required in six months' time to monitor the growth of the polyp."
"796","Hospital Number: E8902521 , Hospital: Random NHS Foundation Trust , DOB:  1994-11-15 , General Practitioner: Dr. Olivares, Janay  , Date of procedure:  2007-10-21Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia . FINDINGS: Normal gastroscopy to the duodenum. "
"797","Hospital Number: N7405188 , Hospital: Random NHS Foundation Trust , DOB:  1934-06-28 , General Practitioner: Dr. Cornejo, Alondra  , Date of procedure:  2001-03-15Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  12.5mcg  , Midazolam  5mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia RegurgitationReflux-like Symptoms/Atypical Chest Pain FINDINGS: The patient has a 5mm nodule in the antrum which is sessile. A large, ulcerated nodule is noted in the gastric antrum, with surrounding erythema and exudates, suggestive of a malignant gastric neoplasm.. LA Grade  C oesophagitis. The oesopahgitis is consistent with acid reflux. NA RECOMMENDATION: The patient should be advised to eat smaller, more frequent meals to reduce pressure on the ulcer site and promote healing.  The patient should avoid drinking alcohol, as this can increase the risk of bleeding in the gastrointestinal tract. FOLLOW UP: The patient should avoid carbonated drinks, which can increase the production of gas and delay the healing of the ulcer.  If the nodule is found to be cancerous, the patient may require further imaging studies and biopsies to determine the stage of the cancer and the appropriate treatment."
"798","Hospital Number: V9378773 , Hospital: Random NHS Foundation Trust , DOB:  1968-03-27 , General Practitioner: Dr. Ding, Nina  , Date of procedure:  2009-04-15Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  50mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow up oesophageal stricture dysphagia for recurrent dilatation FINDINGS: There is a stricture in the fundus which is narrowedTight distal stricture which would not allow passage of scope.. The gastric stricture is likely due to fibrotic changes in the mucosa, rather than extrinsic compression.The ulcer was biopsied x8 for further analysis.. There is a cervical inlet patch of dubious significance.. NA  The patient should be advised to avoid aspirin or other blood thinners unless prescribed by a physician.  The patient may be referred to a specialist in gastrointestinal disorders for further management of the ulcer."
"799","Hospital Number: L6117442 , Hospital: Random NHS Foundation Trust , DOB:  1938-05-14 , General Practitioner: Dr. Olivera, Kenia  , Date of procedure:  2011-08-16Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG2  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Varices/Vascular FINDINGS: LA Grade  A oesophagitis. The oesophageal mucosa is thickened and has a leathery appearance. The patient has a polyp in the duodenal bulb which is sessile.It has a normal pit pattern. The nodules are monitored over time for any signs of growth or malignant transformation.Endoscopic mucosal resection was performed to remove the polyp in its entirety.. character(0) RECOMMENDATION: The patient should be advised to avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as these can increase the risk of bleeding in the gastrointestinal tract.  A blood test may be ordered to assess the patient's iron levels, as polyps can cause bleeding in the stomach and intestines. FOLLOW UP: The patient should be advised to avoid eating large meals or eating quickly, as this can increase the risk of reflux and further damage to the gastrointestinal tract.  "
"800","Hospital Number: A3669324 , Hospital: Random NHS Foundation Trust , DOB:  1924-07-27 , General Practitioner: Dr. Yohannes, Dominique  , Date of procedure:  2006-11-22Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG3  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain . FINDINGS: No inlet patch.. "
"801","Hospital Number: O8583042 , Hospital: Random NHS Foundation Trust , DOB:  1949-05-06 , General Practitioner: Dr. Swiney, Haley  , Date of procedure:  2014-04-10Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  75mcg  , Midazolam  7mg  , Instrument:  FG5  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Polypectomy FINDINGS: Normal gastroscopy to the duodenum.     The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more polyps."
"802","Hospital Number: H2587908 , Hospital: Random NHS Foundation Trust , DOB:  1938-11-02 , General Practitioner: Dr. Watts, Tessa  , Date of procedure:  2005-04-27Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  100mcg  , Midazolam  1mg  , Instrument:  FG6  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: duodenal stent FINDINGS: There is a polyp in the second part of the duodenum which is sessile with a normal pit pattern. The base of the polyp was cauterized with an argon plasma coagulator to prevent bleeding.. There is a stricture in the duodenal bulb which is narrowedScope not held by stricture. The stricture has a fibrotic appearance, suggesting chronicity.The ulcer was biopsied x8 for further analysis.. NA RECOMMENDATION: Referral to a gastroenterologist for further evaluation and management of the ulcer is recommended.  A repeat gastroscopy may be required in six months' time to monitor the growth of the polyp. FOLLOW UP: The patient should be advised to avoid consuming caffeine, which can stimulate the production of stomach acid and delay the healing of the ulcer.  The patient should be advised to avoid consuming alcohol, which can increase the risk of developing more polyps."
"803","Hospital Number: P9907275 , Hospital: Random NHS Foundation Trust , DOB:  1948-12-14 , General Practitioner: Dr. Geist, Antatenique  , Date of procedure:  2002-03-20Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Nausea and/or Vomiting FINDINGS: The oesophagus appears to have a mildly friable mucosa..  NA"
"804","Hospital Number: D9990587 , Hospital: Random NHS Foundation Trust , DOB:  1918-03-07 , General Practitioner: Dr. al-Azad, Shaheera  , Date of procedure:  2014-04-17Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other-  Check for angiodysplasia FINDINGS: There is inflammation in the GOJ which is severe. The oesophageal mucosa appears thickened and friable, with diffuse erosions and ulcerations.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury..  NA RECOMMENDATION: The patient should be instructed to chew food thoroughly and eat slowly to reduce the risk of further irritation to the ulcer. RECOMMENDATION: The patient may be prescribed medication to reduce the production of stomach acid and prevent reflux.  Further investigations such as a biopsy may be recommended to determine the underlying cause of the inflammation. FOLLOW UP: The patient should be advised to avoid consuming caffeine, which can stimulate the production of stomach acid and delay the healing of the ulcer. FOLLOW UP: The patient may be referred to a specialist for further evaluation and treatment, such as surgery to widen the esophagus.  The patient should be advised to avoid hot, spicy foods, which can irritate the lining of the stomach and exacerbate the inflammation."
"805","Hospital Number: K9010769 , Hospital: Random NHS Foundation Trust , DOB:  1979-03-24 , General Practitioner: Dr. Yohe-Ironwing, Morgan  , Date of procedure:  2002-10-06Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG7  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Hb drop ?GI bleed previous gastric surgery FINDINGS: Hiatus Hernia- Small.. "
"806","Hospital Number: U5728377 , Hospital: Random NHS Foundation Trust , DOB:  1924-07-16 , General Practitioner: Dr. el-Saba, Shaimaaa  , Date of procedure:  2002-07-04Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  125mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Chronic cough?reflux FINDINGS: There is a nodule in the D1/D2 angle which is stalked.   The patient should avoid eating fried or fatty foods, as these can increase the risk of reflux and further damage to the gastrointestinal tract.  "
"807","Hospital Number: Y3424765 , Hospital: Random NHS Foundation Trust , DOB:  1974-11-24 , General Practitioner: Dr. Gorski, Kasia  , Date of procedure:  2004-09-11Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  100mcg  , Midazolam  1mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Post CRT stricture FINDINGS: Normal gastroscopy to the duodenum. "
"808","Hospital Number: S9335497 , Hospital: Random NHS Foundation Trust , DOB:  1971-09-25 , General Practitioner: Dr. Martinez, Angelica  , Date of procedure:  2013-11-16Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  150mcg  , Midazolam  5mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain FINDINGS: Normal gastroscopy to the duodenum. "
"809","Hospital Number: R3233951 , Hospital: Random NHS Foundation Trust , DOB:  1993-09-13 , General Practitioner: Dr. Tran, Lauren  , Date of procedure:  2013-12-28Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  12.5mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Biopsies for H pylori FINDINGS: The patient has an ulcer in the third part of the duodenum which is hemorrhagicIt is bleeding. Surrounded by erythema and exhibiting a nodular surface, the severe ulceration presents with a distinct loss of mucosal tissue.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization.. The ulcer appears to be a chronic lesion, with signs of previous healing and scarring.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. There is a stricture in the body which is fibroticTight distal stricture which would not allow passage of scope.. A circumferential gastric stricture with an overlying mucosal lesion is seen in the fundus, suggestive of a malignant tumor.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample.. NA  The patient should be instructed to chew food thoroughly and eat slowly to reduce the risk of further irritation to the ulcer.  The patient should avoid stress and maintain good mental health, as stress can delay the healing of the ulcer."
"810","Hospital Number: Z3118534 , Hospital: Random NHS Foundation Trust , DOB:  1978-06-15 , General Practitioner: Dr. el-Kalil, Razeena  , Date of procedure:  2006-02-04Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  100mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia post LTA FINDINGS: The endoscopic findings are consistent with eosinophilic oesophagitis.. The patient has an ulcer in the third part of the duodenum which is hemorrhagicIt is bleeding. The gastric lesion appears malignant, accompanied by active bleeding and a punched-out appearance.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. Upon endoscopic examination, a duodenal ulcer is visible at the angle of the duodenum.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. character(0)  Follow-up endoscopy with surveillance biopsies may be necessary for patients with a history of gastric ulcer or increased risk for malignancy.  A blood test may be ordered to assess the patient's iron levels, as ulcers can cause bleeding in the stomach and intestines."
"811","Hospital Number: G7303882 , Hospital: Random NHS Foundation Trust , DOB:  1915-04-01 , General Practitioner: Dr. Dhillon, Crysta  , Date of procedure:  2012-04-15Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  12.5mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Weight Loss Anaemia/Low Iron or Vitamins FINDINGS: There is an ulcer in the GOJ which is excavated.Forrest Ulcer classification:II B.. The ulceration's irregular shape and size, along with a yellowish base, suggest a possible malignant process.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. Examination of the oesophageal ulcer reveals a serpiginous, irregular margin with a central area of necrosis.The biopsy was performed using a needle biopsy forceps, with the tissue samples sent for pathological analysis..  NA  The patient should be instructed to avoid caffeine and carbonated beverages to reduce discomfort and promote healing.  The patient should be informed of the diagnosis and provided with information on how to manage the ulcer."
"812","Hospital Number: B2496144 , Hospital: Random NHS Foundation Trust , DOB:  1990-02-13 , General Practitioner: Dr. Seo, Caitlin  , Date of procedure:  2003-06-25Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Globus cough FINDINGS: LA Grade  C oesophagitis. The oesophageal mucosa is friable and edematous. There is a nodule in the third part of the duodenum which is stalked. character(0)  The patient should be advised to seek emotional support from friends, family, or a counselor, as the diagnosis of cancer can be difficult to cope with.  Further investigations, such as imaging studies and biopsy, may be required to determine the nature of the nodule."
"813","Hospital Number: J9928505 , Hospital: Random NHS Foundation Trust , DOB:  1922-02-21 , General Practitioner: Dr. Sky, Hysendra  , Date of procedure:  2014-08-26Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  150mcg  , Midazolam  4mg  , Instrument:  FG7  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: ULCER CHECK. FINDINGS: There is inflammation in the body which is severe. The gastric inflammation is characterized by the presence of lymphoid aggregates in the mucosal layer.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample..  RECOMMENDATION: The patient should be instructed to chew food thoroughly and eat slowly to reduce the risk of further irritation to the ulcer. RECOMMENDATION: If the stricture is due to a medical condition such as gastroesophageal reflux disease (GERD), the patient may be prescribed medication to manage their symptoms.   FOLLOW UP: The patient should avoid lying down immediately after meals, as this can increase the risk of reflux and ulcer recurrence. FOLLOW UP: The patient should be informed of the diagnosis and the importance of adhering to the recommended treatment plan.  "
"814","Hospital Number: M7832839 , Hospital: Random NHS Foundation Trust , DOB:  1935-01-02 , General Practitioner: Dr. Touch, Vina  , Date of procedure:  2007-02-16Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  25mcg  , Midazolam  5mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Worsening epigastric pain. constipatiom. suggest checking HP FINDINGS: The patient has an ulcer in the second part of the duodenum which is superficial.CLO test  was also taken.. The patient's medical history, along with the ulcer's rugose surface and irregular border, suggest a chronic inflammatory process.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. There is a visible blood vessel at the edge of the ulcer, suggesting a high risk of bleeding.During biopsy, it was noted that the lesion had a friable surface and bled easily..  NA  Follow-up imaging such as CT or MRI may be necessary to assess for potential complications or to guide management decisions.  The patient should avoid stress and maintain good mental health, as stress can delay the healing of the ulcer."
"815","Hospital Number: C1538169 , Hospital: Random NHS Foundation Trust , DOB:  1998-10-04 , General Practitioner: Dr. Gonzales, Mariah  , Date of procedure:  2013-03-07Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  125mcg  , Midazolam  3mg  , Instrument:  FG1  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CT findings: . FINDINGS: There is a polyp in the duodenal bulb which is sessile with an abnormal pit pattern. The nodules appear to be confined to the mucosa and submucosa, without any evidence of deeper invasion.The base of the polyp was cauterized with an argon plasma coagulator to prevent bleeding.. The patient has a stricture in the D1/D2 angle which is unyieldingTight stricture impassable with scope.. character(0) RECOMMENDATION:   The patient should be advised to avoid consuming alcohol, which can increase the risk of developing more polyps. FOLLOW UP: The patient should avoid smoking and drinking alcohol, as these habits can increase the risk of cancer.  A blood test may be ordered to assess the patient's iron levels, as polyps can cause bleeding in the stomach and intestines."
"816","Hospital Number: Q6090326 , Hospital: Random NHS Foundation Trust , DOB:  1925-02-22 , General Practitioner: Dr. Holmes, Magnea  , Date of procedure:  2004-07-06Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Dysphagia/Odynophagia FINDINGS: There is inflammation in the third part of the duodenum which is mild. The mucosa is ulcerated and friable, with evidence of pus and exudate present in some areas.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. The patient has a polyp in the second part of the duodenum which is stalked with an abnormal pit pattern. The nodules vary in size, with the largest measuring approximately 1 cm in diameter.The polyp was visualized and biopsied during upper endoscopy.. character(0) RECOMMENDATION: Surgical intervention may be necessary in the event of complications such as perforation or obstruction. RECOMMENDATION: The patient should be advised to maintain a healthy diet and lifestyle, as this may help prevent the growth of the nodule. RECOMMENDATION: The patient should avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as these can worsen GERD symptoms. RECOMMENDATION: The patient should be informed of the diagnosis and provided with information on how to manage the inflammation.  A repeat gastroscopy may be recommended in twelve months' time to assess the response to treatment. FOLLOW UP: The patient should avoid consuming acidic foods and drinks, which can irritate the lining of the stomach and delay the healing of the ulcer. FOLLOW UP: If the nodule is benign, the patient may not require any treatment, but may require monitoring with regular endoscopies. FOLLOW UP: If the patient is experiencing symptoms such as vomiting or fever, they should contact their healthcare provider immediately. FOLLOW UP: The patient should be advised to avoid caffeine, which can stimulate the production of stomach acid and exacerbate the inflammation.  The patient should be advised to avoid acidic foods and drinks, which can irritate the lining of the stomach and increase the risk of developing more polyps."
"817","Hospital Number: X8881813 , Hospital: Random NHS Foundation Trust , DOB:  1976-07-17 , General Practitioner: Dr. Wake, Zella  , Date of procedure:  2008-01-27Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  100mcg  , Midazolam  4mg  , Instrument:  FG2  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Abdominal Pain FINDINGS: The patient has a 4mm nodule in the fundus which is benign-looking. A nodular lesion with surrounding erythema and nodularity of the overlying mucosa is observed in the gastric cardia, suggestive of a malignant gastric neoplasm.If nonsteroidal anti-inflammatory drugs (NSAIDs) are contributing to inflammation, the patient should be advised to avoid or limit their use.. The patient has an ulcer in the antrum which is scarredForrest Ulcer classification: IIc.. Characterized by a distinct loss of mucosal tissue, the severe ulceration presents with a nodular surface.The ulcer was biopsied x8 for further analysis.. character(0) RECOMMENDATION: The patient should be advised to maintain a healthy weight and exercise regularly to reduce the risk of recurrent ulcers. RECOMMENDATION: The patient should be advised to avoid eating large meals or eating quickly, as this can increase the risk of reflux and further damage to the gastrointestinal tract. RECOMMENDATION: The patient should be advised to avoid caffeine, as it can worsen reflux symptoms.  The patient should be advised to avoid acidic foods and drinks, which can irritate the lining of the stomach and exacerbate the inflammation. FOLLOW UP:  FOLLOW UP: The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent further damage to the gastrointestinal tract. FOLLOW UP: The patient may require additional endoscopies in the future to monitor the stricture and ensure that it is not progressing.  The patient may be referred to a gastroenterologist for further management of the inflammation."
"818","Hospital Number: E5760181 , Hospital: Random NHS Foundation Trust , DOB:  1908-10-07 , General Practitioner: Dr. Intermill, Kathleen  , Date of procedure:  2010-11-26Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Other-BloatingAbdominal Pain FINDINGS: LA Grade  B oesophagitis. The oesophageal mucosa has a furrowed or corrugated appearance. There is an ulcer in the body which is deep with rolled edges. Signs of NSAID-induced injury are evident in the gastric ulcer, which appears to have a punched-out appearance.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample.. character(0)  The patient should be counseled on the importance of maintaining good oral hygiene to prevent oral bacteria from entering the ulcer site.  The patient should be advised to avoid consuming dairy products, which can increase the production of stomach acid and delay the healing of the ulcer."
"819","Hospital Number: N3482935 , Hospital: Random NHS Foundation Trust , DOB:  1917-11-10 , General Practitioner: Dr. Lerma, Shaylene  , Date of procedure:  2015-11-16Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG2  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Therapeutic- Dilatation FINDINGS: Small hiatus hernia.. "
"820","Hospital Number: V6466799 , Hospital: Random NHS Foundation Trust , DOB:  1958-11-09 , General Practitioner: Dr. Carmon, Elise  , Date of procedure:  2008-06-07Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG3  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Weight Loss FINDINGS: There is an ulcer in the fundus which is necroticForrest Ulcer classification: IIc.. Signs of NSAID-induced injury are evident in the gastric ulcer, which appears to have a punched-out appearance.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. The patient has a stricture in the antrum which is unyieldingIt is easily traversible.. A gastric stricture with an overlying ulceration is seen in the antrum, suggestive of a peptic stricture.The ulcer was biopsied x8 for further analysis.. character(0)  The patient should be counseled on the importance of maintaining good oral hygiene to prevent oral bacteria from entering the ulcer site.  The patient should avoid NSAIDs and aspirin, which can delay the healing of the ulcer and increase the risk of developing more ulcers."
"821","Hospital Number: L2151400 , Hospital: Random NHS Foundation Trust , DOB:  1987-06-20 , General Practitioner: Dr. Cary, Teah  , Date of procedure:  2003-08-06Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abnormal Imaging FINDINGS: The patient's oesophagus is noted to have linear furrowing.. No inlet patch  was also seen on narrow band imaging.. character(0)"
"822","Hospital Number: A3080284 , Hospital: Random NHS Foundation Trust , DOB:  1943-08-14 , General Practitioner: Dr. Arsenault, Karleigh  , Date of procedure:  2012-07-03Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  100mcg  , Midazolam  5mg  , Instrument:  FG5  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Worsening epigastric pain. constipatiom. suggest checking HP FINDINGS: There is a stricture in the antrum which is thickenedIt is easily traversible.. A short-segment gastric stricture with overlying inflammation and ulceration is seen in the pylorus, suggestive of an inflammatory disorder.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. The patient has a 3mm nodule in the stomach which is stalked. A nodular lesion is seen in the gastric fundus, with a central umbilication and surrounding erythema, suggestive of a gastric leiomyoma.If inflammation is severe or has led to complications such as bleeding, hospitalization may be necessary for further evaluation and management.. NA RECOMMENDATION: The patient should be counseled on the importance of taking any prescribed medications for ulcer healing and symptom control as directed. RECOMMENDATION:  RECOMMENDATION:   A blood test may be ordered to assess the patient's iron levels, as chronic inflammation can cause anemia. FOLLOW UP: The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and delay the healing of the ulcer. FOLLOW UP: The patient should avoid drinking alcohol, as this can increase the risk of bleeding in the gastrointestinal tract. FOLLOW UP: The patient should be advised to maintain a healthy weight, as obesity can worsen the symptoms of GERD.  The patient may be referred to a gastroenterologist for further management of the inflammation."
"823","Hospital Number: I7491657 , Hospital: Random NHS Foundation Trust , DOB:  1956-03-22 , General Practitioner: Dr. Leal, Amaris  , Date of procedure:  2012-06-09Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  25mcg  , Midazolam  3mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Abdominal Pain FINDINGS: The patient has a stricture in the second part of the duodenum which is roughScope not held by stricture. The stricture has a sharp and well-defined margin, suggesting a compressive etiology.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. Small hiatus hernia.. character(0)"
"824","Hospital Number: F8022001 , Hospital: Random NHS Foundation Trust , DOB:  1927-10-27 , General Practitioner: Dr. Secor, Olivia  , Date of procedure:  2014-07-26Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG6  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Reflux-like Symptoms/Atypical Chest Pain FINDINGS: Normal gastroscopy to the duodenum. "
"825","Hospital Number: T4904215 , Hospital: Random NHS Foundation Trust , DOB:  1994-04-21 , General Practitioner: Dr. Xiong, Linda  , Date of procedure:  2015-03-10Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  50mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow-up oesophagitis healing FINDINGS: The patient has a polyp in the D1/D2 angle which is sessile with a normal pit pattern. NA  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and polyp growth.  The patient should follow a healthy diet and lifestyle to reduce the risk of developing more polyps."
"826","Hospital Number: W8932372 , Hospital: Random NHS Foundation Trust , DOB:  1924-11-23 , General Practitioner: Dr. Shine, Kendra  , Date of procedure:  2006-08-15Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CT findings: . FINDINGS: There is a nodule in the second part of the duodenum which is sessile. mild trachealization.. NA  The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent further damage to the gastrointestinal tract.  "
"827","Hospital Number: O7967929 , Hospital: Random NHS Foundation Trust , DOB:  1916-12-13 , General Practitioner: Dr. Combest, Edna  , Date of procedure:  2016-08-25Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Longstanding history of IDA and high eosinophilis in blood. upper abdo pain /alternatin diarhoea/constipaton FINDINGS: The patient has inflammation in the second part of the duodenum which is severe. There is diffuse erythema and friability noted in the duodenal mucosa, with areas of active bleeding.The ulcer was biopsied x8 for further analysis.. The patient has Barrett's oesophagus. It is a long segment. Some areas of vascular abnormalities are seen. character(0) RECOMMENDATION: Proton pump inhibitors may be prescribed to reduce gastric acid production and promote ulcer healing. RECOMMENDATION: If the patient experiences chest pain or difficulty breathing, they should seek emergency medical attention immediately.  The patient should avoid eating before bedtime, as this can exacerbate the inflammation by increasing the risk of reflux. FOLLOW UP: The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more ulcers. FOLLOW UP: Further investigations, such as imaging studies and blood tests, may be required to determine the underlying cause of the stricture.  A consultation with a dietician may be beneficial to help the patient modify their diet to manage the inflammation."
"828","Hospital Number: H3844577 , Hospital: Random NHS Foundation Trust , DOB:  1956-03-02 , General Practitioner: Dr. Martinez, Bianca  , Date of procedure:  2016-01-13Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  25mcg  , Midazolam  7mg  , Instrument:  FG1  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Epigastric pain. Previously on asprin for Cerebral infarction FINDINGS: Normal gastroscopy to the duodenum. "
"829","Hospital Number: P4236233 , Hospital: Random NHS Foundation Trust , DOB:  1932-10-12 , General Practitioner: Dr. Soto, Jaquelyn  , Date of procedure:  2009-01-21Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like SymptomsAbdominal Pain FINDINGS: Normal gastroscopy to the duodenum. "
"830","Hospital Number: D4826904 , Hospital: Random NHS Foundation Trust , DOB:  1901-07-28 , General Practitioner: Dr. el-Hamid, Hikma  , Date of procedure:  2014-10-02Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  100mcg  , Midazolam  7mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain x1 hematemesis Crohns colitis FINDINGS: The patient has a stricture in the fundus which is ulceratedTight distal stricture which would not allow passage of scope.. The gastric lesion exhibits an irregular shape and size, with a raised edge and depth greater than 5 mm.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. The gastric stricture is located in the body of the stomach, causing narrowing of the lumen.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. LA Grade  C oesophagitis. There are scattered erosions present in the oesophageal mucosa. Food present in the oesophagus The oesophageal mucosa is hyperemic and has a granular appearance with areas of erosion and exudate. character(0)  The patient should be counseled on the importance of maintaining good oral hygiene to prevent oral bacteria from entering the ulcer site.  The patient should avoid stress and maintain good mental health, as stress can delay the healing of the ulcer."
"831","Hospital Number: K8847627 , Hospital: Random NHS Foundation Trust , DOB:  1904-04-01 , General Practitioner: Dr. Diaz, Patiense  , Date of procedure:  2008-09-19Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG3  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: anastomotic stricture post thoracoabdominal oesophagogastrecotmy for dilatation FINDINGS: Normal gastroscopy to the duodenum. NA"
"832","Hospital Number: U8525559 , Hospital: Random NHS Foundation Trust , DOB:  1992-03-05 , General Practitioner: Dr. Long, Gloria  , Date of procedure:  2016-04-24Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG4  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Ongoing dyspepsia FINDINGS: LA Grade  A oesophagitis. The oesophageal mucosa is thickened and has a cobblestone appearance. There is diffuse mucosal edema throughout the oesophagus. There are scattered erosions present in the oesophageal mucosa.  NA"
"833","Hospital Number: Y5602439 , Hospital: Random NHS Foundation Trust , DOB:  1923-01-09 , General Practitioner: Dr. Clark, Jada  , Date of procedure:  2016-02-05Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Haematemesis or Melaena/Blood PR FINDINGS: Normal gastroscopy to the duodenum. "
"834","Hospital Number: S6682774 , Hospital: Random NHS Foundation Trust , DOB:  1940-09-07 , General Practitioner: Dr. Demaree, Raelynn  , Date of procedure:  2008-03-06Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG3  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia . FINDINGS: On retroflexion the wrap is in correct position, with no evidence of recurrent hiatus hernia.. "
"835","Hospital Number: R6103760 , Hospital: Random NHS Foundation Trust , DOB:  1941-10-31 , General Practitioner: Dr. Klimek, Vanna  , Date of procedure:  2005-10-26Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia RegurgitationReflux-like Symptoms/Atypical Chest Pain FINDINGS: The patient has inflammation in the fundus which is mild. The gastric mucosa appears diffusely atrophic with a smooth surface and no erosions, suggestive of chronic gastritis with intestinal metaplasia.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. No inlet patch  was also seen.. NA RECOMMENDATION: The patient may require additional endoscopies in the future to monitor the stricture and ensure that it is not progressing.  A repeat gastroscopy may be recommended in six months' time to assess the response to treatment. FOLLOW UP: The patient should be advised to avoid eating foods that are difficult to swallow, such as hard or crunchy foods.  A barium swallow study may be ordered to assess the extent of the inflammation."
"836","Hospital Number: Z1272661 , Hospital: Random NHS Foundation Trust , DOB:  1964-11-07 , General Practitioner: Dr. Copley, Madeline  , Date of procedure:  2011-07-29Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Reflux-like Symptoms/Atypical Chest Pain FINDINGS: The patient has a polyp in the body which is stalked.It has a normal pit pattern. Multiple polyps with variable size are seen throughout the gastric mucosa, suggestive of familial adenomatous polyposis.Using a snare, the polyp was excised and retrieved for pathologic analysis..   A blood test may be ordered to assess the patient's iron levels, as polyps can cause bleeding in the stomach and intestines.  "
"837","Hospital Number: G2227671 , Hospital: Random NHS Foundation Trust , DOB:  1906-08-16 , General Practitioner: Dr. Solarin, Aspen  , Date of procedure:  2008-01-17Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  12.5mcg  , Midazolam  7mg  , Instrument:  FG2  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins . FINDINGS: Normal gastroscopy to the duodenum. "
"838","Hospital Number: B7082304 , Hospital: Random NHS Foundation Trust , DOB:  1926-11-13 , General Practitioner: Dr. el-Jabara, Shaahira  , Date of procedure:  2002-11-06Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  50mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Abdominal Pain FINDINGS: LA Grade  C oesophagitis. There are scattered erosions present in the oesophageal mucosa. Food present in the oesophagus The oesophageal mucosa is hyperemic and has a granular appearance with areas of erosion and exudate. Lax cardia with small hiatus hernia. NA"
"839","Hospital Number: J8000143 , Hospital: Random NHS Foundation Trust , DOB:  1938-08-27 , General Practitioner: Dr. Greene, Reghan  , Date of procedure:  2011-03-07Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: High Dysphagia further assessment of previoius diagnosed peptic stricture also recent eus and aspirat of bengn perigastric cyst FINDINGS: No evidence of inlet patch on careful inspection.. "
"840","Hospital Number: M2497777 , Hospital: Random NHS Foundation Trust , DOB:  1935-05-22 , General Practitioner: Dr. Rodriguez, Angelica  , Date of procedure:  2005-12-24Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  12.5mcg  , Midazolam  2mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia post LTA FINDINGS: The endoscopic appearance of the oesophagus is suggestive of eosinophilic oesophagitis, with multiple linear furrows and white plaques.. The patient has a stricture in the third part of the duodenum which is scleroticIt will not allow the scope to pass.. The duodenal mucosa proximal to the stricture appears slightly erythematous, while the distal mucosa appears normal.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. NA"
"841","Hospital Number: C1910592 , Hospital: Random NHS Foundation Trust , DOB:  1951-07-11 , General Practitioner: Dr. Lopez, Angela  , Date of procedure:  2006-06-30Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  125mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Small Bowel Biopsy Positive coeliac serology FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"")."
"842","Hospital Number: Q9535363 , Hospital: Random NHS Foundation Trust , DOB:  1920-01-18 , General Practitioner: Dr. Dozier, Marrisa  , Date of procedure:  2006-04-02Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  125mcg  , Midazolam  1mg  , Instrument:  FG1  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Varices FINDINGS: The patient has a stricture in the third part of the duodenum which is HhpertrophiedThere is very slight and non-restrcitve stricturing.. The narrowing of the duodenal lumen at the stricture site is severe, allowing only a small-caliber endoscope to pass through.The ulcer was biopsied x8 for further analysis.. No evidence of inlet patch on careful inspection.. NA  Proton pump inhibitors may be prescribed to reduce gastric acid production and promote ulcer healing.  The patient should avoid lying down immediately after meals, as this can increase the risk of reflux and ulcer recurrence."
"843","Hospital Number: X7857756 , Hospital: Random NHS Foundation Trust , DOB:  1980-07-17 , General Practitioner: Dr. Robinson, Anna  , Date of procedure:  2002-01-12Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG2  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Abdominal Pain FINDINGS: Normal gastroscopy to the duodenum. "
"844","Hospital Number: E8303284 , Hospital: Random NHS Foundation Trust , DOB:  1979-04-14 , General Practitioner: Dr. al-Rasheed, Awda  , Date of procedure:  2003-07-30Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  25mcg  , Midazolam  7mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Nausea and/or Vomiting Dysphagia/Odynophagia FINDINGS: Normal gastroscopy to the duodenum. "
"845","Hospital Number: N5562828 , Hospital: Random NHS Foundation Trust , DOB:  1985-11-11 , General Practitioner: Dr. Sleeper, Tyana  , Date of procedure:  2015-03-20Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG5  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CD FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"")."
"846","Hospital Number: V8753920 , Hospital: Random NHS Foundation Trust , DOB:  1917-08-30 , General Practitioner: Dr. Gozeh, Tylee  , Date of procedure:  2003-03-11Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  25mcg  , Midazolam  5mg  , Instrument:  FG1  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Ongoing reflux symptoms. FINDINGS: The oesophagus is mildly dilated and shows signs of crepe paper appearance.. The mucosa of the esophagus  was also noted to be thickened and white in color during endoscopy. The esophageal mucosa appeared to be friable on endoscopic examination.  NA"
"847","Hospital Number: L1479863 , Hospital: Random NHS Foundation Trust , DOB:  1920-04-16 , General Practitioner: Dr. el-Emami, Musheera  , Date of procedure:  2016-01-26Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  125mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss FINDINGS: There is a nodule in the D1/D2 angle which is stalked.   The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the nodule.  The patient should be advised to maintain a healthy weight, as obesity can increase the risk of cancer and other gastrointestinal diseases."
"848","Hospital Number: A5218459 , Hospital: Random NHS Foundation Trust , DOB:  1962-06-25 , General Practitioner: Dr. Nolasco, Gabriela  , Date of procedure:  2013-09-16Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Anaemia/Low Iron or Vitamins FINDINGS: Columnar lined oesophagus is present. No nodularity is present. It is a long segment. The segment looks flat. mild trachealization.. NA"
"849","Hospital Number: I2777268 , Hospital: Random NHS Foundation Trust , DOB:  1979-06-20 , General Practitioner: Dr. Bernal, Christian  , Date of procedure:  2011-06-27Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Dysphagia/Odynophagia FINDINGS: Normal gastroscopy to the duodenum. "
"850","Hospital Number: F7726169 , Hospital: Random NHS Foundation Trust , DOB:  1953-01-08 , General Practitioner: Dr. Mclennan, Anissa  , Date of procedure:  2014-02-02Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow-up ULCER HEALING FINDINGS: LA Grade  B oesophagitis. Candida present. The lower oesopahgeal sphincter looks widely patent  NA  The patient should be advised to avoid straining during bowel movements to reduce pressure on the ulcer site.  The patient is advised to return for a follow-up appointment in two to four weeks' time to discuss the findings and plan for further management."
"851","Hospital Number: T1978921 , Hospital: Random NHS Foundation Trust , DOB:  1974-06-20 , General Practitioner: Dr. Brogan, Passion  , Date of procedure:  2009-12-28Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  150mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Dysphagia/Odynophagia Nausea and/orVomiting FINDINGS: There is an ulcer in the second part of the duodenum which is induratedForrest Ulcer classification: IIc.. Accompanied by white exudate and a yellowish base, the gastric ulcer presents with a cobblestone appearance.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization.. Upon endoscopic examination, a duodenal ulcer is visible at the angle of the duodenum.Biopsy samples of the lesion were obtained using a cold snare to minimize the risk of thermal injury.. The patient has inflammation in the third part of the duodenum which is severe. The duodenal mucosa appears edematous and congested, with evidence of exudate present in some areas.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. character(0) RECOMMENDATION: The patient should be advised to avoid hot spices, sauces, and acidic foods to reduce discomfort and promote healing. RECOMMENDATION: The patient may be prescribed an H2 blocker to reduce stomach acid production and prevent reflux.  The patient should avoid eating too much fat, as this can exacerbate the inflammation by delaying gastric emptying and increasing the risk of reflux. FOLLOW UP: The patient should avoid lying down immediately after meals, as this can increase the risk of reflux and ulcer recurrence. FOLLOW UP: The patient should avoid eating large meals late at night, as this can worsen reflux symptoms.  The patient may be prescribed a course of antibiotics to treat any underlying infection that may be causing the inflammation."
"852","Hospital Number: W8248560 , Hospital: Random NHS Foundation Trust , DOB:  1984-12-13 , General Practitioner: Dr. Santiago, Phoenix  , Date of procedure:  2009-07-01Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  75mcg  , Midazolam  7mg  , Instrument:  FG7  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: IDA FINDINGS: Normal gastroscopy to the duodenum. "
"853","Hospital Number: O8592861 , Hospital: Random NHS Foundation Trust , DOB:  1932-04-05 , General Practitioner: Dr. Yang, Sahza  , Date of procedure:  2009-06-18Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Abdominal Pain FINDINGS: The patient has Barrett's oesophagus. The pit pattern is normal. There is a polyp in the duodenal bulb which is stalked with an abnormal pit pattern. The nodules are seen in the context of underlying inflammatory bowel disease, including Crohn's disease and ulcerative colitis.The base of the polyp was fulgurated with an electrocautery device to prevent future bleeding or regrowth.. character(0) RECOMMENDATION: Referral to a registered dietitian may be helpful in providing guidance on a healthy, ulcer-friendly diet. RECOMMENDATION: The patient should avoid eating fried or fatty foods, as these can increase the risk of reflux and further damage to the gastrointestinal tract.  A blood test may be ordered to assess the patient's iron levels, as polyps can cause bleeding in the stomach and intestines. FOLLOW UP: The patient should avoid consuming acidic foods and drinks, which can irritate the lining of the stomach and delay the healing of the ulcer. FOLLOW UP:   A colonoscopy may be ordered to assess for the presence of polyps in the colon and rectum."
"854","Hospital Number: H1442477 , Hospital: Random NHS Foundation Trust , DOB:  1936-10-16 , General Practitioner: Dr. Sandoval, Bianca  , Date of procedure:  2015-03-22Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  25mcg  , Midazolam  3mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Abdominal Pain FINDINGS: Normal gastroscopy to the duodenum. "
"855","Hospital Number: P1673382 , Hospital: Random NHS Foundation Trust , DOB:  1929-09-07 , General Practitioner: Dr. Sawyer, Taylor  , Date of procedure:  2001-11-19Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Anaemia/Low Iron or Vitamins FINDINGS: The patient has inflammation in the body which is severe. The gastric mucosa appears diffusely erythematous with erosions and exudates, suggestive of acute hemorrhagic gastritis.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization..  RECOMMENDATION: The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the stricture.  The patient should follow a strict diet and avoid irritants that can exacerbate the inflammation. FOLLOW UP: The patient should be advised to chew their food thoroughly and to eat slowly to help prevent swallowing difficulties.  The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools."
"856","Hospital Number: D3953088 , Hospital: Random NHS Foundation Trust , DOB:  1963-06-15 , General Practitioner: Dr. Gutierrez, Jacqueline  , Date of procedure:  2012-07-10Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia large hiatus hernia FINDINGS: The patient has inflammation in the body which is mild. Erythematous streaks with punctate hemorrhages are seen in the gastric mucosa, suggestive of superficial gastritis.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding..  RECOMMENDATION: The patient should avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, as these can worsen GERD symptoms.  The patient should be advised to avoid acidic foods and drinks, which can irritate the lining of the stomach and exacerbate the inflammation. FOLLOW UP:   The patient should avoid eating too much fat, as this can exacerbate the inflammation by delaying gastric emptying and increasing the risk of reflux."
"857","Hospital Number: K5760664 , Hospital: Random NHS Foundation Trust , DOB:  1955-12-09 , General Practitioner: Dr. Aguilar, Josefyna  , Date of procedure:  2001-06-15Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  75mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known coeliac disease vomitting FINDINGS: Likely paraoesophageal hernia present. There is a nodule in the GOJ which is benign-looking. The mucosa appears thickened and covered with white patches, consistent with a fungal infection.The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent further damage to the gastrointestinal tract.. NA  The patient may be referred to a specialist for further evaluation and treatment, such as surgery to remove the nodule.  Further investigations, such as imaging studies and biopsy, may be required to determine the nature of the nodule."
"858","Hospital Number: U6704720 , Hospital: Random NHS Foundation Trust , DOB:  1918-01-23 , General Practitioner: Dr. Salinas, Samantha  , Date of procedure:  2016-11-26Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  100mcg  , Midazolam  7mg  , Instrument:  FG3  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Food bolus/foreign body removal FINDINGS: Normal gastroscopy to the duodenum. "
"859","Hospital Number: Y1451790 , Hospital: Random NHS Foundation Trust , DOB:  1960-11-10 , General Practitioner: Dr. Harvey, Arlisa  , Date of procedure:  2005-04-25Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  100mcg  , Midazolam  5mg  , Instrument:  FG1  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Previous chemo rad. rpt dilation. FINDINGS: The patient has inflammation in the stomach which is mild. The gastric inflammation is characterized by the presence of lymphoid aggregates in the mucosal layer.The ulcer was biopsied x8 for further analysis..  RECOMMENDATION: The patient should be advised to maintain a healthy weight and exercise regularly to reduce the risk of recurrent ulcers. RECOMMENDATION: The patient should be advised to avoid lying down for at least three hours after eating to help prevent reflux.  A consultation with a dietician may be beneficial to help the patient modify their diet to manage the inflammation. FOLLOW UP: Further investigations such as a biopsy may be recommended to determine the cause of the ulcer and assess the risk of cancer. FOLLOW UP: The patient should be advised to avoid eating acidic or spicy foods, as these can worsen GERD symptoms.  The patient should be advised to avoid carbonated drinks, which can exacerbate the inflammation by increasing the production of gas."
"860","Hospital Number: S9523253 , Hospital: Random NHS Foundation Trust , DOB:  1908-08-02 , General Practitioner: Dr. Thompson, Ashley  , Date of procedure:  2010-02-05Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG6  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal bloating chest discomfort reflux.Known fibromyalgia RA FINDINGS: There is a nodule in the D1/D2 angle which is sessile.     The patient may be prescribed medication to reduce the size of the nodule and prevent it from growing."
"861","Hospital Number: R7817343 , Hospital: Random NHS Foundation Trust , DOB:  1981-05-18 , General Practitioner: Dr. Pham, Alexa  , Date of procedure:  2009-08-14Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  150mcg  , Midazolam  7mg  , Instrument:  FG7  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Therapeutic- Dilatation FINDINGS: Barrett's is present. The pit pattern is normal. No loss of aceto-whitening  was also seen. Some areas of vascular abnormalities are seen. "
"862","Hospital Number: Z7781233 , Hospital: Random NHS Foundation Trust , DOB:  1929-05-20 , General Practitioner: Dr. Walborn, Kaylie  , Date of procedure:  2008-07-09Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Post oesophagectomy for Pagets FINDINGS: The patient has an ulcer in the GOJ which is necroticIt is bleeding. Helicobacter pylori infection is the likely cause of the ulcer, which exhibits a fibrous base and active bleeding.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample.. The oesophageal ulcer appears to be a shallow, non-healing lesion with a diameter of approximately 1 cm.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample..  NA  Referral to a gastroenterologist for further evaluation and management of the ulcer is recommended.  Further investigations such as a biopsy may be recommended to determine the cause of the ulcer and assess the risk of cancer."
"863","Hospital Number: G7755694 , Hospital: Random NHS Foundation Trust , DOB:  1927-08-09 , General Practitioner: Dr. Lafebre, Shannon  , Date of procedure:  2016-03-28Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  25mcg  , Midazolam  3mg  , Instrument:  FG3  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain FINDINGS: There is inflammation in the antrum which is severe. The gastric inflammation is characterized by the presence of neutrophils and lymphocytes in the mucosal layer.The lesion was biopsied using a standard forceps.. The patient has Barrett's oesophagus. Gastric mucosal prolapse seen. The pit pattern is normal. NA RECOMMENDATION: The patient should avoid eating before going to bed, as this can worsen reflux symptoms.  The patient should be advised to avoid acidic foods and drinks, which can irritate the lining of the stomach and exacerbate the inflammation. FOLLOW UP: The patient should avoid smoking and drinking alcohol, as these habits can worsen GERD symptoms.  A blood test may be ordered to assess the patient's iron levels, as chronic inflammation can cause anemia."
"864","Hospital Number: B7780911 , Hospital: Random NHS Foundation Trust , DOB:  1966-03-20 , General Practitioner: Dr. Morris, Vanessa  , Date of procedure:  2010-12-23Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  75mcg  , Midazolam  4mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Biopsies from duodenal stricture FINDINGS: Normal gastroscopy to the duodenum. "
"865","Hospital Number: J8821698 , Hospital: Random NHS Foundation Trust , DOB:  1966-10-31 , General Practitioner: Dr. Littlethunder, Isabella  , Date of procedure:  2013-01-11Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  75mcg  , Midazolam  4mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- EMR/ESD Oesophagus- Dysplasia FINDINGS: The patient has inflammation in the second part of the duodenum which is severe. There are areas of nodularity seen throughout the duodenal mucosa, suggestive of chronic inflammation.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. The patient has a polyp in the body which is stalked.It has an abnormal pit pattern. The hyperplastic gastric polyp presents with a smooth surface and no evidence of glandular dysplasia.The polyp was grasped with a snare and cut with a hot biopsy forceps for removal.. character(0) RECOMMENDATION: If the stricture is due to a medical condition such as gastroesophageal reflux disease (GERD), the patient may be prescribed medication to manage their symptoms. RECOMMENDATION: A blood test may be ordered to assess the patient's iron levels, as chronic inflammation can cause anemia.  The patient should be advised to avoid NSAIDs and aspirin, which can increase the risk of developing more polyps. FOLLOW UP: The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the stricture. FOLLOW UP: The patient should be advised to avoid carbonated drinks, which can exacerbate the inflammation by increasing the production of gas.  The patient should be advised to maintain good oral hygiene, as poor oral hygiene can increase the risk of bacterial infection in the stomach and increase the risk of polyp growth."
"866","Hospital Number: M8882071 , Hospital: Random NHS Foundation Trust , DOB:  1965-11-04 , General Practitioner: Dr. Casados, Vivian  , Date of procedure:  2005-07-21Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Chronic cough?reflux FINDINGS: There is a nodule in the duodenal bulb which is sessile.  NA  The patient should be advised to maintain a healthy diet and lifestyle, as this may help prevent the growth of the nodule.  The patient should avoid eating fried or fatty foods, as these can increase the risk of reflux and further damage to the gastrointestinal tract."
"867","Hospital Number: C4433311 , Hospital: Random NHS Foundation Trust , DOB:  1931-09-01 , General Practitioner: Dr. Fry, Jieying  , Date of procedure:  2016-01-08Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  75mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Reflux-like Symptoms/Atypical Chest Pain FINDINGS: The patient has inflammation in the antrum which is severe. The gastric inflammation appears to be associated with the use of proton pump inhibitors (PPIs), with the presence of rebound hypergastrinemia.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. The patient has a polyp in the D1/D2 angle which is sessile.It has a normal pit pattern. NA RECOMMENDATION: The patient may be referred to a specialist for further evaluation and treatment, such as surgery to widen the esophagus. RECOMMENDATION: The patient may be referred to a gastroenterologist for further management of the inflammation.  A repeat gastroscopy may be recommended in twelve months' time to assess the response to treatment. FOLLOW UP: The patient should be advised to chew their food thoroughly and to eat slowly to help prevent swallowing difficulties. FOLLOW UP: The patient should avoid eating before bedtime, as this can exacerbate the inflammation by increasing the risk of reflux.  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and polyp growth."
"868","Hospital Number: Q1015837 , Hospital: Random NHS Foundation Trust , DOB:  1974-10-01 , General Practitioner: Dr. Yazawa, Carrena  , Date of procedure:  2009-04-08Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  25mcg  , Midazolam  4mg  , Instrument:  FG1  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia FINDINGS: There is a stricture in the third part of the duodenum which is tight.There is very slight and non-restrcitve stricturing.. OGD showed the presence of several white exudates in the mid and distal esophagus. Rings  were also noted throughout the esophagusconsistent with eosinophilic oesophagitis. The stricture has a fibrotic appearance, suggesting chronicity.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization..  NA"
"869","Hospital Number: X2594520 , Hospital: Random NHS Foundation Trust , DOB:  1910-04-06 , General Practitioner: Dr. Keen, Tamara  , Date of procedure:  2007-09-09Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  125mcg  , Midazolam  3mg  , Instrument:  FG5  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Varices FINDINGS: OESOPHAGUS: small hiatus hernia.. "
"870","Hospital Number: E6158591 , Hospital: Random NHS Foundation Trust , DOB:  1976-05-18 , General Practitioner: Dr. Paul, Valentina  , Date of procedure:  2007-02-26Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  150mcg  , Midazolam  1mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Endoscopic ultrasound findings: Reflux-like Symptoms/Atypical Chest Pain FINDINGS: There is a nodule in the oesophagus at 26 cm which is sessile. Inspection of the oesophageal ulcer reveals an elevated, nodular appearance, consistent with a malignancy.The patient should be advised to seek medical attention immediately if they experience symptoms of severe bleeding such as black tarry stools or vomiting blood..  NA RECOMMENDATION: The patient should be advised to seek medical attention immediately if they experience symptoms of severe bleeding such as black tarry stools or vomiting blood.  If the nodule is suspicious for cancer, the patient may be referred to an oncologist for further evaluation and treatment. FOLLOW UP: The patient should avoid consuming too much fat, as this can delay gastric emptying and delay the healing of the ulcer.  The patient should be advised to avoid eating large meals or eating quickly, as this can increase the risk of reflux and further damage to the gastrointestinal tract."
"871","Hospital Number: N9571333 , Hospital: Random NHS Foundation Trust , DOB:  1953-09-14 , General Practitioner: Dr. Kell, Cassandra  , Date of procedure:  2004-05-10Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG4  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: High Dysphagia further assessment of previoius diagnosed peptic stricture also recent eus and aspirat of bengn perigastric cyst FINDINGS: Columnar lined oesophagus is present. The pit pattern is normal. The segment looks flat. There is a nodule in the second part of the duodenum which is sessile. character(0)  The patient may require additional endoscopies in the future to monitor the nodule and ensure that it is not progressing.  The patient may be referred to a surgeon for a minimally invasive procedure to remove the nodule."
"872","Hospital Number: V3328807 , Hospital: Random NHS Foundation Trust , DOB:  1946-01-23 , General Practitioner: Dr. Ojeda, Meranda  , Date of procedure:  2016-07-18Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  12.5mcg  , Midazolam  2mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Abdominal Pain FINDINGS: The patient has a stricture in the body which is contractedIt is easily traversible.. A gastric stricture with an overlying ulceration is seen in the antrum, suggestive of a peptic stricture.The lesion was biopsied using a standard forceps..  character(0)  Endoscopic resection of the ulcer may be necessary for larger or more complex ulcers.  "
"873","Hospital Number: L2721400 , Hospital: Random NHS Foundation Trust , DOB:  1924-04-15 , General Practitioner: Dr. Lucero, Arianel  , Date of procedure:  2012-04-25Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  50mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain . FINDINGS: Hiatus Hernia- Large.. "
"874","Hospital Number: A9747574 , Hospital: Random NHS Foundation Trust , DOB:  1944-02-01 , General Practitioner: Dr. Darner, Raven  , Date of procedure:  2016-11-16Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  125mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Food bolus/foreign body removal FINDINGS: There is a polyp in the stomach which is stalked.It has a normal pit pattern. The gastric polyp appears fundic with a smooth surface and regular shape, suggestive of a benign process.The base of the polyp was fulgurated with an electrocautery device to prevent future bleeding or regrowth..     Further investigations such as a biopsy may be recommended to determine the type of polyp and assess the risk of cancer."
"875","Hospital Number: I9081757 , Hospital: Random NHS Foundation Trust , DOB:  1998-04-26 , General Practitioner: Dr. Rucker, Catherine  , Date of procedure:  2015-09-21Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG5  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain x1 hematemesis Crohns colitis FINDINGS: The patient has inflammation in the D1/D2 angle which is mild.  RECOMMENDATION: The patient may be referred to a specialist for further evaluation and treatment, such as surgery to widen the esophagus.  The patient should be advised to avoid carbonated drinks, which can exacerbate the inflammation by increasing the production of gas. FOLLOW UP: The patient should be advised to chew their food thoroughly and to eat slowly to help prevent swallowing difficulties.  The patient should avoid smoking and alcohol, which can worsen the inflammation."
"876","Hospital Number: F6090839 , Hospital: Random NHS Foundation Trust , DOB:  1955-12-22 , General Practitioner: Dr. Nunez, Chris  , Date of procedure:  2007-11-08Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"")."
"877","Hospital Number: T7480285 , Hospital: Random NHS Foundation Trust , DOB:  1985-05-28 , General Practitioner: Dr. al-Bashir, Shafaaa  , Date of procedure:  2004-10-28Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting FINDINGS: LA Grade  B oesophagitis. The oesophageal mucosa appears pale and atrophic. The patient has a stricture in the fundus which is thickenedIt will not allow the scope to pass.. The gastric stricture is likely the result of chronic inflammation and fibrosis, rather than extrinsic compression.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. character(0) RECOMMENDATION: The patient should avoid smoking and drinking alcohol, as these habits can worsen GERD symptoms.  The patient may be prescribed a course of antibiotics to treat any underlying infection that may be causing the inflammation. FOLLOW UP:   The patient should avoid consuming large meals, as this can exacerbate the inflammation."
"878","Hospital Number: W2054819 , Hospital: Random NHS Foundation Trust , DOB:  1906-04-04 , General Practitioner: Dr. el-Bacchus, Fawzaana  , Date of procedure:  2007-04-25Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- EMR/ESD FINDINGS: The mucosa of the oesophagus appears thickened and edematous.. OESOPHAGUS: small hiatus hernia.. NA"
"879","Hospital Number: O8834134 , Hospital: Random NHS Foundation Trust , DOB:  1920-12-12 , General Practitioner: Dr. Cook, Risa  , Date of procedure:  2005-01-20Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain x1 hematemesis Crohns colitis FINDINGS: Normal gastroscopy to the duodenum. "
"880","Hospital Number: H6820128 , Hospital: Random NHS Foundation Trust , DOB:  1904-04-10 , General Practitioner: Dr. Zhang, Elizabeth  , Date of procedure:  2015-07-03Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  4mg  , Instrument:  FG7  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Chemorad for scc middle third of oeosphagus - post treatment assessement FINDINGS: The patient has a 9mm nodule in the stomach which is benign-looking. A nodular lesion with surrounding erythema and nodularity of the overlying mucosa is observed in the gastric cardia, suggestive of a malignant gastric neoplasm.The patient may require additional endoscopies in the future to monitor the nodule and ensure that it is not progressing..   If the nodule is suspicious for cancer, the patient may be referred to an oncologist for further evaluation and treatment.  The patient should be advised to maintain a healthy weight, as obesity can increase the risk of cancer and other gastrointestinal diseases."
"881","Hospital Number: P4350826 , Hospital: Random NHS Foundation Trust , DOB:  1998-08-02 , General Practitioner: Dr. Martinez, Kelly  , Date of procedure:  2015-11-21Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG5  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Altered taste FINDINGS: Normal gastroscopy to the duodenum. "
"882","Hospital Number: D5429386 , Hospital: Random NHS Foundation Trust , DOB:  1948-08-28 , General Practitioner: Dr. Fitzsimmons, Heraa  , Date of procedure:  2013-05-05Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG3  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Eosinophilic oesophatitis assessment FINDINGS: Normal gastroscopy to the duodenum. "
"883","Hospital Number: K5870127 , Hospital: Random NHS Foundation Trust , DOB:  1960-02-17 , General Practitioner: Dr. Jeranko, Selina  , Date of procedure:  2014-03-20Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia low iron normal HBAnaemia/Low Iron or Vitamins FINDINGS: LA Grade  B oesophagitis. There is significant narrowing of the oesophageal lumen due to stricture formation with areas of mucosal ulceration. The patient's medical history and the ulcer's rugose surface suggest a chronic inflammatory process.The biopsy was performed using a needle biopsy forceps, with the tissue samples sent for pathological analysis..  NA  The patient should be counseled on the importance of maintaining good oral hygiene to prevent oral bacteria from entering the ulcer site.  The patient should avoid NSAIDs and aspirin, which can delay the healing of the ulcer and increase the risk of developing more ulcers."
"884","Hospital Number: U3081246 , Hospital: Random NHS Foundation Trust , DOB:  1908-04-07 , General Practitioner: Dr. Higganbotham, Madison  , Date of procedure:  2008-07-16Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- PEG FINDINGS: Normal gastroscopy to the duodenum. "
"885","Hospital Number: Y1506215 , Hospital: Random NHS Foundation Trust , DOB:  1992-04-06 , General Practitioner: Dr. al-Tawil, Randa  , Date of procedure:  2012-11-14Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  125mcg  , Midazolam  2mg  , Instrument:  FG2  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: ULCER CHECK. FINDINGS: Small hiatus hernia only..   The patient should be counseled on the importance of taking any prescribed medications for ulcer healing and symptom control as directed.  "
"886","Hospital Number: S7145991 , Hospital: Random NHS Foundation Trust , DOB:  1989-11-13 , General Practitioner: Dr. Badsky, Fiona  , Date of procedure:  2003-03-06Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  75mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Weight Loss FINDINGS: Several white exudates were seen. Multiple white exudates were observed in the esophagus, which may indicate candida or food debris. OGD revealed a tight esophageal lumen in the mid and distal segments. "
"887","Hospital Number: R9404908 , Hospital: Random NHS Foundation Trust , DOB:  1900-06-27 , General Practitioner: Dr. el-Yacoub, Sanaaa  , Date of procedure:  2016-03-02Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  50mcg  , Midazolam  3mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow-up oesophagitis healing FINDINGS: There is a nodule in the duodenal bulb which is sessile. No inlet patch.. character(0)  The patient should avoid smoking and drinking alcohol, as these habits can increase the risk of cancer.  "
"888","Hospital Number: Z6151451 , Hospital: Random NHS Foundation Trust , DOB:  1916-04-07 , General Practitioner: Dr. Abeyta, Zayra  , Date of procedure:  2006-05-01Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting FINDINGS: No evidence of inlet patch on careful inspection.. "
"889","Hospital Number: G1498153 , Hospital: Random NHS Foundation Trust , DOB:  1988-03-05 , General Practitioner: Dr. Sedillo, Loagyn  , Date of procedure:  2010-01-23Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  12.5mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Ongoing reflux symptoms. FINDINGS: Normal gastroscopy to the duodenum. "
"890","Hospital Number: B8969666 , Hospital: Random NHS Foundation Trust , DOB:  1937-05-13 , General Practitioner: Dr. Weckwerth Pineda, Raquelle  , Date of procedure:  2015-02-18Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Family history of gastric cancer FINDINGS: The patient has a stricture in the GOJ which is inflexibleTight distal stricture which would not allow passage of scope.. Biopsy specimens obtained from the stricture reveal squamous mucosa with mild chronic inflammation.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. The patient has a stricture in the second part of the duodenum which is roughScope not held by stricture. The stricture has a sharp and well-defined margin, suggesting a compressive etiology.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. character(0) RECOMMENDATION: The patient should be advised to avoid wearing tight clothing around their waist, as this can put pressure on the stomach and worsen GERD symptoms.  The patient should be advised to avoid caffeine, which can stimulate the production of stomach acid and exacerbate the inflammation. FOLLOW UP: A follow-up appointment with the gastroenterologist should be scheduled for six months after the initial diagnosis to monitor the patient's progress.  The patient should be advised to avoid carbonated drinks, which can exacerbate the inflammation by increasing the production of gas."
"891","Hospital Number: J1819477 , Hospital: Random NHS Foundation Trust , DOB:  1911-08-15 , General Practitioner: Dr. Begay, Brianna  , Date of procedure:  2001-04-16Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  100mcg  , Midazolam  5mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow up oesophageal stricture dysphagia for recurrent dilatation FINDINGS: There is a nodule in the D1/D2 angle which is sessile. NA  The patient should avoid eating fried or fatty foods, as these can increase the risk of reflux and further damage to the gastrointestinal tract.  The patient may be referred to a nutritionist to develop a diet plan that is easier to digest and that meets their nutritional needs."
"892","Hospital Number: M8863036 , Hospital: Random NHS Foundation Trust , DOB:  1916-08-31 , General Practitioner: Dr. Pavisook, Leona  , Date of procedure:  2013-07-07Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Varices FINDINGS: There is an ulcer in the D1/D2 angle which is induratedIt is bleeding. Signs of NSAID-induced injury are evident in the gastric ulcer, which appears to have a punched-out appearance.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample..   Follow-up endoscopy should be performed in 4-6 weeks to assess for healing and to repeat biopsies if necessary.  Further investigations such as a biopsy may be recommended to determine the cause of the ulcer and assess the risk of cancer."
"893","Hospital Number: C4021112 , Hospital: Random NHS Foundation Trust , DOB:  1920-02-23 , General Practitioner: Dr. Alvarez, Staci  , Date of procedure:  2011-03-18Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  25mcg  , Midazolam  4mg  , Instrument:  FG7  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - VCE placement (previous gastric bypass)Anaemia/Low Iron or Vitamins FINDINGS: Normal gastroscopy to the duodenum. "
"894","Hospital Number: Q8222665 , Hospital: Random NHS Foundation Trust , DOB:  1935-02-04 , General Practitioner: Dr. Martinez, Josephine  , Date of procedure:  2016-01-05Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  150mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- FINDINGS: Normal gastroscopy to the duodenum. "
"895","Hospital Number: X5836068 , Hospital: Random NHS Foundation Trust , DOB:  1904-02-12 , General Practitioner: Dr. Cervantes, Sarena  , Date of procedure:  2011-05-03Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG1  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Therapeutic- Dilatation FINDINGS: The patient has a polyp in the second part of the duodenum which is stalked with an abnormal pit pattern. Biopsies of the nodules reveal lymphoid hyperplasia with reactive germinal centers.The polyp was removed with a combination of snare and forceps, and hemostasis was achieved with an endoscopic clip.. There is an ulcer in the fundus which is necroticForrest Ulcer classification:II B.. The patient's medical history, along with the ulcer's rugose surface and irregular border, suggest a chronic inflammatory process.The lesion was biopsied using a standard forceps.. character(0) RECOMMENDATION: Follow-up endoscopy should be performed in 4-6 weeks to assess for healing and to repeat biopsies if necessary. RECOMMENDATION: The patient should be advised to avoid eating large meals or eating quickly, as this can increase the risk of reflux and further damage to the gastrointestinal tract.  The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and increase the risk of polyp growth. FOLLOW UP: The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and delay the healing of the ulcer. FOLLOW UP: The patient may be referred to a nutritionist to develop a diet plan that is easier to digest and that meets their nutritional needs.  The patient should avoid eating before bedtime, as this can increase the risk of reflux and polyp growth."
"896","Hospital Number: E8902521 , Hospital: Random NHS Foundation Trust , DOB:  1936-07-17 , General Practitioner: Dr. Lobato, Erika  , Date of procedure:  2005-04-12Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  100mcg  , Midazolam  5mg  , Instrument:  FG7  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Biopsies for H pylori FINDINGS: The patient has an ulcer in the third part of the duodenum which is scarredIt has rolled edges. The gastric lesion appears malignant, accompanied by active bleeding and a punched-out appearance.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. The edges of the ulcer appear to be irregular and ragged, suggesting ongoing tissue destruction and repair.During biopsy, it was noted that the lesion had a friable surface and bled easily..  character(0)  Proton pump inhibitors may be prescribed to reduce gastric acid production and promote ulcer healing.  The patient should avoid lying down immediately after meals, as this can increase the risk of reflux and ulcer recurrence."
"897","Hospital Number: N7405188 , Hospital: Random NHS Foundation Trust , DOB:  1998-02-05 , General Practitioner: Dr. Whiteman, Jennifer  , Date of procedure:  2013-06-26Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  150mcg  , Midazolam  7mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Weight Loss Anaemia/Low Iron or Vitamins FINDINGS: Normal gastroscopy to the duodenum. "
"898","Hospital Number: V9378773 , Hospital: Random NHS Foundation Trust , DOB:  1976-12-04 , General Practitioner: Dr. el-Malik, Mujaahida  , Date of procedure:  2003-02-15Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  25mcg  , Midazolam  3mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - chronic cough ?GORD FINDINGS: The patient has a 3mm nodule in the second part of the duodenum which is sessile. There is a stricture in the third part of the duodenum which is irregularScope not held by stricture. The duodenal stricture has a non-distensible appearance, suggestive of fibrosis.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. NA  The patient should avoid drinking alcohol, as this can increase the risk of bleeding in the gastrointestinal tract.  The patient should be advised to maintain a healthy diet and lifestyle, as this may help prevent the growth of the nodule."
"899","Hospital Number: L6117442 , Hospital: Random NHS Foundation Trust , DOB:  1951-02-05 , General Practitioner: Dr. Mills, Elberta  , Date of procedure:  2006-07-01Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  25mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Abdominal Pain FINDINGS: Normal gastroscopy to the duodenum. "
"900","Hospital Number: A3669324 , Hospital: Random NHS Foundation Trust , DOB:  1908-12-26 , General Practitioner: Dr. Gallegos, Savannah  , Date of procedure:  2013-02-15Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  12.5mcg  , Midazolam  6mg  , Instrument:  FG1  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Weight Loss FINDINGS: The patient has a polyp in the fundus which is stalked.It has a normal pit pattern. A solitary gastric polyp is noted in the body, with a sessile attachment and nodular surface.Using a snare, the polyp was excised and retrieved for pathologic analysis.. The patient has a stricture in the body which is inflamedThere is very slight and non-restrcitve stricturing.. A gastric stricture with a web-like appearance is seen in the cardia, suggestive of an eosinophilic disorder.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. NA  A blood test may be ordered to assess the patient's iron levels, as polyps can cause bleeding in the stomach and intestines.  The patient should follow a healthy diet and lifestyle to reduce the risk of developing more polyps."
"901","Hospital Number: O8583042 , Hospital: Random NHS Foundation Trust , DOB:  1902-07-01 , General Practitioner: Dr. Brown, Shekonah  , Date of procedure:  2013-01-23Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  150mcg  , Midazolam  3mg  , Instrument:  FG3  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Dilatation Nausea and/or Vomiting FINDINGS: No evidence of inlet patch on careful inspection.. "
"902","Hospital Number: H2587908 , Hospital: Random NHS Foundation Trust , DOB:  1980-08-26 , General Practitioner: Dr. Moore, Klaudia  , Date of procedure:  2001-03-21Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  100mcg  , Midazolam  3mg  , Instrument:  FG7  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Nausea and/or Vomiting FINDINGS: No inlet patch.. "
"903","Hospital Number: P9907275 , Hospital: Random NHS Foundation Trust , DOB:  1936-11-18 , General Practitioner: Dr. Wainright, Adaobi  , Date of procedure:  2003-08-17Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Oesophagus- Dysplasia FINDINGS: Normal gastroscopy to the duodenum. "
"904","Hospital Number: D9990587 , Hospital: Random NHS Foundation Trust , DOB:  1961-06-26 , General Practitioner: Dr. Contreras, Jacqueline  , Date of procedure:  2009-06-04Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  100mcg  , Midazolam  5mg  , Instrument:  FG1  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Reduced appetite early satiety FINDINGS: Multiple concentric rings are noted throughout the oesophagus.. There is a nodule in the fundus which is sessile. The nodular changes may represent early fundic gland polyps.The patient should be advised to avoid straining during bowel movements to reduce pressure on the ulcer site.. NA RECOMMENDATION: The patient should be advised to follow a soft diet and avoid spicy or acidic foods to reduce discomfort and promote healing. RECOMMENDATION: The patient should avoid drinking alcohol, as this can increase the risk of bleeding in the gastrointestinal tract.  The patient should avoid eating before bedtime, as this can increase the risk of reflux and polyp growth. FOLLOW UP: A blood test may be ordered to assess the patient's iron levels, as ulcers can cause bleeding in the stomach and intestines. FOLLOW UP: A follow-up appointment with the gastroenterologist should be scheduled for six months after the initial diagnosis to monitor the patient's progress.  The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and increase the risk of polyp growth."
"905","Hospital Number: K9010769 , Hospital: Random NHS Foundation Trust , DOB:  1902-03-09 , General Practitioner: Dr. Briscoe, Camille  , Date of procedure:  2007-11-27Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Dysphagia/Odynophagia FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"")."
"906","Hospital Number: U5728377 , Hospital: Random NHS Foundation Trust , DOB:  1901-08-15 , General Practitioner: Dr. Duncanson, Saoli  , Date of procedure:  2009-10-25Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  100mcg  , Midazolam  7mg  , Instrument:  FG2  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Nausea and/or Vomiting Other- diarrhoea FINDINGS: Normal gastroscopy to the duodenum. "
"907","Hospital Number: Y3424765 , Hospital: Random NHS Foundation Trust , DOB:  1927-03-29 , General Practitioner: Dr. Gutierrez, Paige  , Date of procedure:  2013-05-28Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Small Bowel Biopsy Positive coeliac serology FINDINGS: Normal gastroscopy to the duodenum. "
"908","Hospital Number: S9335497 , Hospital: Random NHS Foundation Trust , DOB:  1997-07-23 , General Practitioner: Dr. Craig, Fiona  , Date of procedure:  2003-12-14Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG7  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia FINDINGS: Normal gastroscopy to the duodenum. "
"909","Hospital Number: R3233951 , Hospital: Random NHS Foundation Trust , DOB:  1900-08-07 , General Practitioner: Dr. Vallie, Kelly  , Date of procedure:  2008-10-14Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Positive coeliac FINDINGS: There is an ulcer in the stomach which is excavated.Forrest Ulcer classification:II B.. Accompanied by white exudate and a yellowish base, the gastric ulcer presents with a cobblestone appearance.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling..   Follow-up endoscopy with surveillance biopsies may be necessary for patients with a history of gastric ulcer or increased risk for malignancy.  The patient should avoid consuming too much fat, as this can delay gastric emptying and delay the healing of the ulcer."
"910","Hospital Number: Z3118534 , Hospital: Random NHS Foundation Trust , DOB:  1992-12-15 , General Practitioner: Dr. Pico, Vanessa  , Date of procedure:  2002-04-01Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  150mcg  , Midazolam  7mg  , Instrument:  FG7  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Anaemia/Low Iron or Vitamins FINDINGS: The patient has a stricture in the antrum which is OedematousIt is easily traversible.. A gastric stricture with a smooth and tapered appearance is observed in the corpus, suggestive of a benign fibrotic process.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample..  NA"
"911","Hospital Number: G7303882 , Hospital: Random NHS Foundation Trust , DOB:  1935-12-26 , General Practitioner: Dr. Navarro, Kendall  , Date of procedure:  2013-12-18Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  12.5mcg  , Midazolam  2mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Nausea and/or Vomiting FINDINGS: There is an ulcer in the duodenal bulb which is exudativeForrest Ulcer classification:II B.. The patient's medical history and the ulcer's rugose surface suggest a chronic inflammatory process.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. The base of the ulcer is covered in a yellowish fibrinous exudate.The lesion was biopsied using a standard forceps.. A large hiatus hernia is present. character(0)  Referral to a registered dietitian may be helpful in providing guidance on a healthy, ulcer-friendly diet.  "
"912","Hospital Number: B2496144 , Hospital: Random NHS Foundation Trust , DOB:  1940-10-10 , General Practitioner: Dr. al-Samaan, Maazina  , Date of procedure:  2013-01-19Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  12.5mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- RFA Therapeutic- EMR/ESD FINDINGS: The patient has a polyp in the second part of the duodenum which is stalked.It has an abnormal pit pattern. The nodular lesions appear to be inflammatory in nature, without any features suggestive of neoplasia.Due to its large size, the polyp was not able to be resected during the current endoscopic session.. The patient has an ulcer in the body which is necroticIt has a visible vessel. Accompanied by white exudate and a cobblestone appearance, the gastric ulcer is likely caused by Helicobacter pylori infection.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. character(0) RECOMMENDATION: Follow-up imaging such as CT or MRI may be necessary to assess for potential complications or to guide management decisions.  The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools. FOLLOW UP: The patient should be informed of the diagnosis and provided with information on how to manage the ulcer.  The patient should avoid consuming too much fat, as this can delay gastric emptying and increase the risk of reflux and polyp growth."
"913","Hospital Number: J9928505 , Hospital: Random NHS Foundation Trust , DOB:  1986-11-17 , General Practitioner: Dr. Kochenower, Jordan  , Date of procedure:  2009-11-24Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  150mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Ongoing reflux symptoms. FINDINGS: Normal gastroscopy to the duodenum. "
"914","Hospital Number: M7832839 , Hospital: Random NHS Foundation Trust , DOB:  1979-11-29 , General Practitioner: Dr. Shooner, Jenni  , Date of procedure:  2009-03-19Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Eosinophilic oesophagitis assesment FINDINGS: Normal gastroscopy to the duodenum. character(0)"
"915","Hospital Number: C1538169 , Hospital: Random NHS Foundation Trust , DOB:  1926-06-04 , General Practitioner: Dr. Hollins, Dakota  , Date of procedure:  2003-06-15Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: duodenal stent FINDINGS: There is inflammation in the body which is erosive. The gastric mucosa appears diffusely atrophic with a smooth surface and no erosions, suggestive of chronic gastritis with intestinal metaplasia.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape..  RECOMMENDATION: The patient should avoid smoking and drinking alcohol, as these habits can worsen GERD symptoms.  The patient should avoid NSAIDs and aspirin, which can irritate the lining of the stomach and exacerbate the inflammation. FOLLOW UP: The patient should avoid eating before going to bed, as this can worsen reflux symptoms.  A repeat gastroscopy may be recommended in six months' time to assess the response to treatment."
"916","Hospital Number: Q6090326 , Hospital: Random NHS Foundation Trust , DOB:  1925-04-13 , General Practitioner: Dr. Kraft, Kayla  , Date of procedure:  2003-11-11Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Weight Loss Anaemia/Low Iron or Vitamins FINDINGS: OESOPHAGUS: Normal, no appreciable hiatus hernia.. "
"917","Hospital Number: X8881813 , Hospital: Random NHS Foundation Trust , DOB:  1996-06-18 , General Practitioner: Dr. Stack, Emma  , Date of procedure:  2005-07-24Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Abdominal Pain FINDINGS: The patient has a stricture in the fundus which is irregularScope not held by stricture. A gastric stricture with a smooth and nodular surface is observed in the cardia, suggestive of a malignant lesion.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling..  NA"
"918","Hospital Number: E5760181 , Hospital: Random NHS Foundation Trust , DOB:  1998-06-09 , General Practitioner: Dr. Mendez, Cristal  , Date of procedure:  2016-07-29Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  150mcg  , Midazolam  1mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - chronic cough ?GORD FINDINGS: Barrett's is present. The segment looks flat. "
"919","Hospital Number: N3482935 , Hospital: Random NHS Foundation Trust , DOB:  1977-05-23 , General Practitioner: Dr. el-Asmar, Muneera  , Date of procedure:  2015-04-01Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  100mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting FINDINGS: Normal gastroscopy to the duodenum. "
"920","Hospital Number: V6466799 , Hospital: Random NHS Foundation Trust , DOB:  1972-07-25 , General Practitioner: Dr. Tovar, Yesenia  , Date of procedure:  2005-01-12Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  25mcg  , Midazolam  7mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Nausea and/or Vomiting Reflux-like Symptoms/Atypical Chest Pain Weight Loss FINDINGS: The patient has an ulcer in the body which is excavated.Forrest Ulcer classification:II B.. Characterized by a distinct loss of mucosal tissue, the severe ulceration presents with a nodular surface.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from..   The patient should be advised to avoid smoking, alcohol, and NSAIDs to reduce the risk of recurrent ulcers.  "
"921","Hospital Number: L2151400 , Hospital: Random NHS Foundation Trust , DOB:  1948-02-28 , General Practitioner: Dr. Saunders, Zoe  , Date of procedure:  2001-03-17Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG1  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Therapeutic- Dilatation Therapeutic- NJ Tube/PEG/DPEJ FINDINGS: There is a nodule in the stomach which is sessile. A large, lobulated nodule is observed in the gastric body, suggestive of a gastrointestinal autonomic nerve tumor (GANT).They should also be instructed to report any new or worsening symptoms to their healthcare provider promptly..   The patient should be informed of the diagnosis and the importance of adhering to the recommended treatment plan.  If the nodule is found to be cancerous, the patient may require further imaging studies and biopsies to determine the stage of the cancer and the appropriate treatment."
"922","Hospital Number: A3080284 , Hospital: Random NHS Foundation Trust , DOB:  1992-02-05 , General Practitioner: Dr. Fellhauer, Carys  , Date of procedure:  2008-02-25Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Hb drop ?GI bleed previous gastric surgery FINDINGS: Normal gastroscopy to the duodenum. "
"923","Hospital Number: I7491657 , Hospital: Random NHS Foundation Trust , DOB:  1976-11-22 , General Practitioner: Dr. Whitbeck, Taylor  , Date of procedure:  2004-10-13Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG1  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Coeliac  and ? RCD FINDINGS: Normal gastroscopy to the duodenum. "
"924","Hospital Number: F8022001 , Hospital: Random NHS Foundation Trust , DOB:  1991-07-19 , General Practitioner: Dr. al-Abdella, Sahheeda  , Date of procedure:  2011-06-17Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  12.5mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia Vomiting known hiatus hernia FINDINGS: Rings were seen throughout the oesophagus. The patient had crepe paper-like appearance of the oesophageal mucosa on endoscopy, suggestive of eosinophilic oesophagitis. OGD showed the presence of several white exudates in the mid and distal esophagus. No inlet patch.. NA"
"925","Hospital Number: T4904215 , Hospital: Random NHS Foundation Trust , DOB:  1957-01-05 , General Practitioner: Dr. el-Zamani, Aliyya  , Date of procedure:  2012-10-02Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow up oesophageal stricture dysphagia for recurrent dilatation FINDINGS: Normal gastroscopy to the duodenum. character(0)"
"926","Hospital Number: W8932372 , Hospital: Random NHS Foundation Trust , DOB:  1942-03-22 , General Practitioner: Dr. Abbott, Sandra  , Date of procedure:  2009-06-05Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Dysphagia/Odynophagia FINDINGS: Normal gastroscopy to the duodenum. "
"927","Hospital Number: O7967929 , Hospital: Random NHS Foundation Trust , DOB:  1977-07-28 , General Practitioner: Dr. Melonas, Samantha  , Date of procedure:  2012-09-21Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  25mcg  , Midazolam  7mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- persumed per DU managed conservativelyPrevious persumed DU ulcer managed conservatively. FINDINGS: There is a polyp in the D1/D2 angle which is sessile.It has a normal pit pattern.  RECOMMENDATION: Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) may be necessary for larger or more complex ulcers.  The patient should follow a healthy diet and lifestyle to reduce the risk of developing more polyps. FOLLOW UP: The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more ulcers.  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and polyp growth."
"928","Hospital Number: H3844577 , Hospital: Random NHS Foundation Trust , DOB:  1957-03-07 , General Practitioner: Dr. Spottedwarbonnet, Ashley  , Date of procedure:  2009-02-21Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  50mcg  , Midazolam  5mg  , Instrument:  FG1  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins weight loss. On warfarin and clopidogrel, FINDINGS: Columnar lined oesophagus is present. Some areas of vascular abnormalities are seen. No nodularity is present. There is a polyp in the stomach which is sessile with a normal pit pattern. Multiple gastric polyps are seen in the antrum, with a clustered distribution and variable surface contour.The polyp was removed with minimal thermal injury to surrounding tissue using a cold snare technique.. NA  The patient should follow a healthy diet and lifestyle to reduce the risk of developing more polyps.  The patient should be advised to eat slowly and chew their food thoroughly to aid digestion and reduce the risk of polyp growth."
"929","Hospital Number: P4236233 , Hospital: Random NHS Foundation Trust , DOB:  1954-03-31 , General Practitioner: Dr. el-Mousa, Aseela  , Date of procedure:  2003-09-28Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  50mcg  , Midazolam  4mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CD FINDINGS: LA Grade  A oesophagitis. There is significant ulceration and bleeding present in the oesophageal mucosa. The oesophageal mucosa appears pale and atrophic. Surrounded by erythema and exhibiting a nodular surface, the severe ulceration presents with a distinct loss of mucosal tissue.The lesion was biopsied using a standard forceps.. The patient has a stricture in the body which is HhpertrophiedThere is very slight and non-restrcitve stricturing.. A gastric stricture with an overlying ulceration is seen in the antrum, suggestive of a peptic stricture.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. character(0)  The patient should be advised to seek medical attention immediately if they experience symptoms of severe bleeding such as black tarry stools or vomiting blood.  The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools."
"930","Hospital Number: D4826904 , Hospital: Random NHS Foundation Trust , DOB:  1911-07-14 , General Practitioner: Dr. Fulmer, Ashlee  , Date of procedure:  2005-02-19Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Weight Loss Mother has gastric cancer FINDINGS: Inflammatory changes seen in the oesophagus. The patient has a polyp in the D1/D2 angle which is sessile with a normal pit pattern. character(0)  The patient should be advised to avoid hot, spicy foods, which can irritate the lining of the stomach and increase the risk of polyp growth.  The patient should follow a healthy diet and lifestyle to reduce the risk of developing more polyps."
"931","Hospital Number: K8847627 , Hospital: Random NHS Foundation Trust , DOB:  1954-01-12 , General Practitioner: Dr. Gast, Katherine  , Date of procedure:  2004-11-07Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Altered taste FINDINGS: Normal gastroscopy to the duodenum. "
"932","Hospital Number: U8525559 , Hospital: Random NHS Foundation Trust , DOB:  1993-10-20 , General Practitioner: Dr. Hauner, Jessica  , Date of procedure:  2010-02-16Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  25mcg  , Midazolam  7mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia RegurgitationReflux-like Symptoms/Atypical Chest Pain FINDINGS: There is an ulcer in the body which is fungatingIt is not bleeding. The ulceration exhibits a cobblestone appearance and a yellowish base, suggestive of Helicobacter pylori infection.The ulcer was biopsied x8 for further analysis..   Referral to a gastroenterologist for further evaluation and management of the ulcer is recommended.  The patient should be advised to avoid consuming caffeine, which can stimulate the production of stomach acid and delay the healing of the ulcer."
"933","Hospital Number: Y5602439 , Hospital: Random NHS Foundation Trust , DOB:  1947-09-27 , General Practitioner: Dr. Johnson, Michaela  , Date of procedure:  2003-07-10Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  75mcg  , Midazolam  1mg  , Instrument:  FG3  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal bloating chest discomfort reflux.Known fibromyalgia RA FINDINGS: There is a stricture in the third part of the duodenum which is scarredIt will not allow the scope to pass.. The narrowing of the lumen is more pronounced during end-inspiration.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization.. The patient has a 3mm nodule in the GOJ which is sessile. An oesophageal polyp was detected during endoscopy, located approximately 18 cm from the incisors. The lesion had a nodular surface and measured 1.2 cm in diameter.Referral to a nutritionist may be appropriate to provide guidance on a healthy diet for the patient.. NA RECOMMENDATION: The patient should be advised to avoid eating large meals or eating quickly, as this can increase the risk of reflux and further damage to the gastrointestinal tract.  The patient should be advised to eat slowly and chew their food thoroughly to aid digestion and reduce the risk of polyp growth. FOLLOW UP: The patient may be prescribed a proton pump inhibitor (PPI) to reduce stomach acid production and prevent further damage to the gastrointestinal tract.  The patient should be advised to avoid hot, spicy foods, which can irritate the lining of the stomach and increase the risk of polyp growth."
"934","Hospital Number: S6682774 , Hospital: Random NHS Foundation Trust , DOB:  1959-05-28 , General Practitioner: Dr. Harris, Ruth  , Date of procedure:  2011-10-13Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  100mcg  , Midazolam  1mg  , Instrument:  FG7  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Coeliac  and ? RCD FINDINGS: Multiple concentric rings are noted throughout the oesophagus.. There is a nodule in the second part of the duodenum which is sessile. character(0)  If the nodule is suspicious for cancer, the patient may be referred to an oncologist for further evaluation and treatment.  The patient may require additional endoscopies in the future to monitor the nodule and ensure that it is not progressing."
"935","Hospital Number: R6103760 , Hospital: Random NHS Foundation Trust , DOB:  1998-01-16 , General Practitioner: Dr. Kirven, Kaylie  , Date of procedure:  2002-03-21Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  100mcg  , Midazolam  7mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR Nausea and/or Vomiting Dysphagia/Odynophagia FINDINGS: The patient has an ulcer in the GOJ which is exudativeIt is bleeding. The patient's medical history, along with the ulcer's rugose surface and flat appearance, suggest a chronic, long-standing condition.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. The oesophageal ulcer is characterized by a fibrinous exudate overlying a deep, ulcerated base.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization.. The patient has a 10mm nodule in the duodenal bulb which is stalked. NA RECOMMENDATION: The patient should be advised to avoid hot spices, sauces, and acidic foods to reduce discomfort and promote healing.   FOLLOW UP: The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and delay the healing of the ulcer.  The patient may be prescribed medication to manage any symptoms associated with the nodule, such as pain or discomfort."
"936","Hospital Number: Z1272661 , Hospital: Random NHS Foundation Trust , DOB:  1931-11-13 , General Practitioner: Dr. Bustamante, Aryan  , Date of procedure:  2011-08-09Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  150mcg  , Midazolam  2mg  , Instrument:  FG5  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Achalasia FINDINGS: Normal gastroscopy to the duodenum. "
"937","Hospital Number: G2227671 , Hospital: Random NHS Foundation Trust , DOB:  1934-04-11 , General Practitioner: Dr. Maltos, Maria  , Date of procedure:  2012-01-13Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia post LTA FINDINGS: Normal gastroscopy to the duodenum. "
"938","Hospital Number: B7082304 , Hospital: Random NHS Foundation Trust , DOB:  1974-11-12 , General Practitioner: Dr. Beerman, Hayley  , Date of procedure:  2010-06-27Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG2  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Anaemia/Low Iron or Vitamins FINDINGS: Normal gastroscopy to the duodenum. "
"939","Hospital Number: J8000143 , Hospital: Random NHS Foundation Trust , DOB:  1970-03-04 , General Practitioner: Dr. Wilcox, Sarah  , Date of procedure:  2013-08-28Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Known coeliac ch diarrhoea.Myelofibrosis on ruxolitinib and panobinostat FINDINGS: The patient has a polyp in the D1/D2 angle which is stalked with an abnormal pit pattern.   A repeat gastroscopy may be recommended in twelve months' time to assess the response to treatment.  The patient may be referred to a specialist in gastrointestinal disorders for further management of the polyp."
"940","Hospital Number: M2497777 , Hospital: Random NHS Foundation Trust , DOB:  1943-12-19 , General Practitioner: Dr. Ray, Savanna  , Date of procedure:  2001-03-20Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  100mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Weight Loss FINDINGS: LA Grade  D oesophagitis. There is significant narrowing of the oesophageal lumen due to stricture formation with areas of mucosal ulceration. The oesophageal mucosa appears pale and atrophic. There is significant ulceration and bleeding present in the oesophageal mucosa. The ulceration exhibits a cobblestone appearance and a yellowish base, suggestive of Helicobacter pylori infection.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. The patient has an ulcer in the antrum which is superficial s*It is bleeding. Signs of NSAID-induced injury are evident in the gastric ulcer, which appears to have a punched-out appearance.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. NA  The patient should be advised to avoid straining during bowel movements to reduce pressure on the ulcer site.  The patient should follow a healthy diet and lifestyle to reduce the risk of developing more ulcers."
"941","Hospital Number: C1910592 , Hospital: Random NHS Foundation Trust , DOB:  1932-07-28 , General Practitioner: Dr. Lee, Victoria  , Date of procedure:  2011-05-07Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG3  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: IDA FINDINGS: There is a stricture in the third part of the duodenum which is OedematousTight distal stricture which would not allow passage of scope.. The stricture is located at the level of the ampulla of Vater and appears to be extrinsic in nature.The ulcer was biopsied x8 for further analysis..  NA  The patient should be instructed to avoid caffeine and carbonated beverages to reduce discomfort and promote healing.  The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and delay the healing of the ulcer."
"942","Hospital Number: Q9535363 , Hospital: Random NHS Foundation Trust , DOB:  1944-06-28 , General Practitioner: Dr. Bivings, Danni  , Date of procedure:  2004-12-14Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG2  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CT findings: . FINDINGS: The patient has a polyp in the fundus which is sessile.It has a normal pit pattern. A gastric polyp with a broad-based attachment is noted in the corpus, with a smooth and dome-shaped surface.The polyp did not lift on saline injection and was therefore not amenable to endoscopic resection.. There is an ulcer in the stomach which is excavated.Forrest Ulcer classification:II B.. Accompanied by white exudate and a yellowish base, the gastric ulcer presents with a cobblestone appearance.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. character(0) RECOMMENDATION: The patient should be advised to avoid straining during bowel movements to reduce pressure on the ulcer site.  The patient should be advised to seek medical attention immediately if they experience severe abdominal pain, vomiting, or bloody stools. FOLLOW UP: The patient should avoid stress and maintain good mental health, as stress can delay the healing of the ulcer.  A colonoscopy may be ordered to assess for the presence of polyps in the colon and rectum."
"943","Hospital Number: X7857756 , Hospital: Random NHS Foundation Trust , DOB:  1947-10-13 , General Practitioner: Dr. Carter, Taneil  , Date of procedure:  2010-06-20Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  100mcg  , Midazolam  4mg  , Instrument:  FG1  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Bloating FINDINGS: Barrett's is present. Gastric mucosal prolapse seen. No loss of aceto-whitening was seen. Short segment only. "
"944","Hospital Number: E8303284 , Hospital: Random NHS Foundation Trust , DOB:  1903-07-27 , General Practitioner: Dr. Benjamin, Khadijah  , Date of procedure:  2004-06-20Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG1  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Post oesophagectomy for Pagets FINDINGS: The patient has a polyp in the stomach which is stalked with an abnormal pit pattern. The hyperplastic gastric polyp presents with a smooth surface and regular shape, suggestive of a non-cancerous process.ESD was performed to remove the polyp after lifting it with saline injection.. character(0)  The patient should be advised to avoid consuming caffeine, which can stimulate the production of stomach acid and increase the risk of polyp growth.  The patient should avoid lying down immediately after meals, as this can increase the risk of reflux and polyp growth."
"945","Hospital Number: N5562828 , Hospital: Random NHS Foundation Trust , DOB:  1926-09-11 , General Practitioner: Dr. Ransom, Aerika  , Date of procedure:  2006-05-02Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  50mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - exclude Lynch and coeliac FINDINGS: The patient has a 3mm nodule in the GOJ which is sessile. An oesophageal polyp was detected during endoscopy, located approximately 18 cm from the incisors. The lesion had a nodular surface and measured 1.2 cm in diameter.Referral to a nutritionist may be appropriate to provide guidance on a healthy diet for the patient.. The patient has an ulcer in the stomach which is crateredIt has a visible vessel. The severe ulceration presents with a depth greater than 5 mm and an irregular border.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. NA RECOMMENDATION: Endoscopic resection of the ulcer may be necessary for larger or more complex ulcers. RECOMMENDATION: If the nodule is found to be cancerous, the patient may require further imaging studies and biopsies to determine the stage of the cancer and the appropriate treatment.  The patient should be advised to avoid hot, spicy foods, which can irritate the lining of the stomach and increase the risk of polyp growth. FOLLOW UP: The patient should avoid NSAIDs and aspirin, which can delay the healing of the ulcer and increase the risk of developing more ulcers. FOLLOW UP: The patient may be referred to a specialist for further evaluation and treatment, such as surgery to remove the nodule.  The patient should avoid smoking and alcohol, which can increase the risk of developing more polyps."
"946","Hospital Number: V8753920 , Hospital: Random NHS Foundation Trust , DOB:  1970-03-17 , General Practitioner: Dr. Dawson, Ariana  , Date of procedure:  2012-03-22Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG1  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Therapeutic- Dilatation Therapeutic- NJ Tube/PEG/DPEJ FINDINGS: Small hiatus hernia.. "
"947","Hospital Number: L1479863 , Hospital: Random NHS Foundation Trust , DOB:  1907-02-17 , General Practitioner: Dr. Khatter, Maya  , Date of procedure:  2009-07-28Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG3  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Chemorad for scc middle third of oeosphagus - post treatment assessement FINDINGS: The patient has a stricture in the D1/D2 angle which is unyieldingTight stricture impassable with scope.. "
"948","Hospital Number: A5218459 , Hospital: Random NHS Foundation Trust , DOB:  1928-04-08 , General Practitioner: Dr. Wiggins, Asiah  , Date of procedure:  2015-08-18Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  50mcg  , Midazolam  3mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- RFA Therapeutic- EMR/ESD FINDINGS: There is a nodule in the third part of the duodenum which is benign-looking. On retroflexion the wrap is in correct position, with no evidence of recurrent hiatus hernia.. NA  The patient should avoid eating or drinking for at least six hours before any scheduled appointments.  The patient should be advised to maintain a healthy weight, as obesity can increase the risk of cancer and other gastrointestinal diseases."
"949","Hospital Number: I2777268 , Hospital: Random NHS Foundation Trust , DOB:  1943-04-21 , General Practitioner: Dr. Muncher, Jehan  , Date of procedure:  2011-05-02Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  100mcg  , Midazolam  3mg  , Instrument:  FG7  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Gastric ucers with hy pylori. FINDINGS: There is a stricture in the duodenal bulb which is fibrous.Tight stricture impassable with scope.. The stricture is non-tapering and involves the entire circumference of the duodenal lumen.The biopsy was performed using a needle biopsy forceps, with the tissue samples sent for pathological analysis.. There is a stricture in the body which is contractedIt is easily traversible.. A gastric stricture with a smooth and nodular surface is observed in the cardia, suggestive of a malignant lesion.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. NA"
"950","Hospital Number: F7726169 , Hospital: Random NHS Foundation Trust , DOB:  1955-09-21 , General Practitioner: Dr. Estrella, Katia  , Date of procedure:  2012-06-30Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  125mcg  , Midazolam  5mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Family history of gastric cancer FINDINGS: The patient has a stricture in the D1/D2 angle which is thickenedThe endoscope passed through the stricture with resistance. "
"951","Hospital Number: T1978921 , Hospital: Random NHS Foundation Trust , DOB:  1905-01-14 , General Practitioner: Dr. Mcmaster, Summer  , Date of procedure:  2004-02-12Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  75mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Worsening epigastric pain. constipatiom. suggest checking HP FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"")."
"952","Hospital Number: W8248560 , Hospital: Random NHS Foundation Trust , DOB:  1969-02-26 , General Practitioner: Dr. Juan, Mai Jing  , Date of procedure:  2007-11-23Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  100mcg  , Midazolam  3mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Positive coeliac serology FINDINGS: Normal gastroscopy to the duodenum. "
"953","Hospital Number: O8592861 , Hospital: Random NHS Foundation Trust , DOB:  1975-08-11 , General Practitioner: Dr. Truong, Christina  , Date of procedure:  2005-02-14Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia low iron normal HBAnaemia/Low Iron or Vitamins FINDINGS: There is an ulcer in the body which is hemorrhagicForrest Ulcer classification:II B.. Accompanied by white exudate and a yellowish base, the gastric ulcer presents with a cobblestone appearance.Following the biopsy of the lesion, there was bleeding, which was promptly managed..   The patient should be advised to avoid aspirin or other blood thinners unless prescribed by a physician.  The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and delay the healing of the ulcer."
"954","Hospital Number: H1442477 , Hospital: Random NHS Foundation Trust , DOB:  1911-10-25 , General Practitioner: Dr. Figueroa Mendoza, Iesha  , Date of procedure:  2012-06-14Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  150mcg  , Midazolam  5mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Other- Early satiety FINDINGS: There is an ulcer in the fundus which is necroticForrest Ulcer classification:II B.. The patient's medical history, along with the ulcer's rugose surface and irregular border, suggest a chronic inflammatory process.The lesion was biopsied using a standard forceps.. On retroflexion the wrap is in correct position, with no evidence of recurrent hiatus hernia.. character(0)  The patient should be counseled on the importance of taking any prescribed medications for ulcer healing and symptom control as directed.  The patient may be referred to a specialist in gastrointestinal disorders for further management of the ulcer."
"955","Hospital Number: P1673382 , Hospital: Random NHS Foundation Trust , DOB:  1933-11-04 , General Practitioner: Dr. Pyakuryal, Ribkha  , Date of procedure:  2013-01-26Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Nausea and/or Vomiting Other- diarrhoea FINDINGS: As an incidental finding she also has a cervical inlet patch.. "
"956","Hospital Number: D3953088 , Hospital: Random NHS Foundation Trust , DOB:  1922-09-14 , General Practitioner: Dr. Esquibel, Shailyn  , Date of procedure:  2010-01-27Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  12.5mcg  , Midazolam  7mg  , Instrument:  FG2  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Follow-up oesophagitis healing FINDINGS: There is a polyp in the body which is stalked.It has a normal pit pattern. A hyperplastic gastric polyp is seen in the cardia, with a serrated and folded surface.Due to its large size, the polyp was not able to be resected during the current endoscopic session.. NA  The patient should follow a healthy diet and lifestyle to reduce the risk of developing more polyps.  The patient should be encouraged to maintain a healthy weight to reduce the risk of developing more polyps."
"957","Hospital Number: K5760664 , Hospital: Random NHS Foundation Trust , DOB:  1977-08-30 , General Practitioner: Dr. Dent, Ja'Taya  , Date of procedure:  2009-05-08Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain Dysphagia/Odynophagia Vaters syndrome astric pull-up surgery FINDINGS: There is a nodule in the duodenal bulb which is stalked. The patient has a stricture in the GOJ which is thickenedIt is easily traversible.. The mucosal surface proximal to the stricture appears mildly ulcerated, while the distal mucosa is normal.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. character(0) RECOMMENDATION: Follow-up endoscopy should be performed in 4-6 weeks to assess for healing and to repeat biopsies if necessary.  The patient should avoid eating fried or fatty foods, as these can increase the risk of reflux and further damage to the gastrointestinal tract. FOLLOW UP: The patient should avoid smoking and alcohol, which can delay the healing of the ulcer and increase the risk of developing more ulcers.  The patient may be referred to a surgeon for a minimally invasive procedure to remove the nodule."
"958","Hospital Number: U6704720 , Hospital: Random NHS Foundation Trust , DOB:  1972-10-31 , General Practitioner: Dr. Foutz, Alana  , Date of procedure:  2012-03-23Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG6  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Dysphagia/Odynophagia Nausea and/orVomiting FINDINGS: There is a stricture in the third part of the duodenum which is thickenedThere is very slight and non-restrcitve stricturing.. The narrowing of the duodenal lumen is accompanied by a slight mucosal fold thickening.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. The patient has an ulcer in the stomach which is excavated which is not bleeding. Signs of NSAID-induced injury are evident in the gastric ulcer, which appears to have a punched-out appearance.Biopsies of the lesion were taken from both the edges and the center to obtain a representative sample.. character(0)  Referral to a gastroenterologist for further evaluation and management of the ulcer is recommended.  A repeat gastroscopy may be recommended in six to twelve months' time to assess the response to treatment."
"959","Hospital Number: Y1451790 , Hospital: Random NHS Foundation Trust , DOB:  1977-01-06 , General Practitioner: Dr. Lumba, Sarah  , Date of procedure:  2010-09-19Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  25mcg  , Midazolam  4mg  , Instrument:  FG7  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Dysphagia/Odynophagia FINDINGS: At 18cm two inlet patches  were also seen.. "
"960","Hospital Number: S9523253 , Hospital: Random NHS Foundation Trust , DOB:  1905-01-06 , General Practitioner: Dr. el-Haque, Wadee'a  , Date of procedure:  2012-06-19Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  25mcg  , Midazolam  1mg  , Instrument:  FG6  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Chemorad for scc middle third of oeosphagus - post treatment assessement FINDINGS: The patient has an ulcer in the duodenal bulb which is exudativeCLO test  was also taken.. Accompanied by white exudate and a cobblestone appearance, the gastric ulcer is likely caused by Helicobacter pylori infection.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. The base of the ulcer is covered in a yellowish fibrinous exudate.The lesion was biopsied using a standard forceps.. There is a cervical inlet patch of dubious significance.. character(0)  Endoscopic resection of the ulcer may be necessary for larger or more complex ulcers.  The patient should avoid lying down immediately after meals, as this can increase the risk of reflux and ulcer recurrence."
"961","Hospital Number: R7817343 , Hospital: Random NHS Foundation Trust , DOB:  1952-12-14 , General Practitioner: Dr. Caraballo, Savannah  , Date of procedure:  2003-11-17Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  150mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain x1 hematemesis Crohns colitis FINDINGS: No inlet patch.. "
"962","Hospital Number: Z7781233 , Hospital: Random NHS Foundation Trust , DOB:  1908-04-30 , General Practitioner: Dr. Acosta, Maggie  , Date of procedure:  2003-10-21Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  12.5mcg  , Midazolam  5mg  , Instrument:  FG6  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Abdominal Pain FINDINGS: There is inflammation in the fundus which is severe. Focal areas of erythema with no exudate are observed in the gastric fundus, suggestive of mild chronic gastritis.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding.. The patient had crepe paper oesophagitis. Endoscopy revealed the presence of concentric rings throughout the esophagus, suggestive of eosinophilic oesophagitis. Rings were noted throughout the esophagusconsistent with eosinophilic oesophagitis. OGD showed the presence of several white exudates in the mid and distal esophagus. NA RECOMMENDATION: If the stricture is causing symptoms such as difficulty swallowing, the patient may be referred to a speech therapist for swallowing therapy.  The patient should be advised to avoid carbonated drinks, which can exacerbate the inflammation by increasing the production of gas. FOLLOW UP: The patient should be informed of the diagnosis and the importance of adhering to the recommended treatment plan.  The patient should follow a strict diet and avoid irritants that can exacerbate the inflammation."
"963","Hospital Number: G7755694 , Hospital: Random NHS Foundation Trust , DOB:  1927-10-12 , General Practitioner: Dr. Parker, Latensia  , Date of procedure:  2007-11-07Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  25mcg  , Midazolam  2mg  , Instrument:  FG4  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: On going epigastric pain FINDINGS: LA Grade  C oesophagitis. Food present in the oesophagus The oesophageal mucosa is thickened and has a cobblestone appearance severe oesophagitis with ulceration. The gastric lesion exhibits an irregular shape and size, with a raised edge and depth greater than 5 mm.After taking a biopsy of the lesion, hemostasis was achieved with hemoclips to control any bleeding..  character(0)  The patient should be advised to avoid straining during bowel movements to reduce pressure on the ulcer site.  A blood test may be ordered to assess the patient's iron levels, as ulcers can cause bleeding in the stomach and intestines."
"964","Hospital Number: B7780911 , Hospital: Random NHS Foundation Trust , DOB:  1991-12-31 , General Practitioner: Dr. el-Irani, Urwa  , Date of procedure:  2009-02-07Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG5  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: CT findings: . FINDINGS: The patient has a stricture in the third part of the duodenum which is stenoticScope not held by stricture. The duodenal stricture is non-peristaltic and exhibits limited mobility upon insufflation.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. There is a polyp in the second part of the duodenum which is sessile.It has a normal pit pattern. The nodules are located in the second and third portions of the duodenum, with sparing of the duodenal papilla.ESD was performed to remove the polyp after lifting it with saline injection.. character(0) RECOMMENDATION: The patient may be referred to a nutritionist to develop a diet plan that is easier to digest and that meets their nutritional needs.   FOLLOW UP: The patient may be referred to a nutritionist to develop a diet plan that is easier to digest and that meets their nutritional needs.  A repeat gastroscopy may be recommended in twelve months' time to assess the response to treatment."
"965","Hospital Number: J8821698 , Hospital: Random NHS Foundation Trust , DOB:  1971-12-02 , General Practitioner: Dr. el-Youssef, Thamra  , Date of procedure:  2012-10-10Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  75mcg  , Midazolam  7mg  , Instrument:  FG6  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss . FINDINGS: The patient has an ulcer in the fundus which is fibroticIt has a visible vessel. Accompanied by white exudate and a cobblestone appearance, the gastric ulcer is likely caused by Helicobacter pylori infection.During biopsy, it was noted that the lesion had a friable surface and bled easily.. At 18cm two inlet patches were seen.. NA  The patient should be advised to avoid hot spices, sauces, and acidic foods to reduce discomfort and promote healing.  The patient should be advised to elevate the head of their bed while sleeping to reduce the risk of reflux and ulcer recurrence."
"966","Hospital Number: M8882071 , Hospital: Random NHS Foundation Trust , DOB:  1975-02-10 , General Practitioner: Dr. Manuel, San-Toi  , Date of procedure:  2004-01-22Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  50mcg  , Midazolam  2mg  , Instrument:  FG3  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Weight Loss FINDINGS: No inlet patch  was also seen on narrow band imaging.. "
"967","Hospital Number: C4433311 , Hospital: Random NHS Foundation Trust , DOB:  1905-07-01 , General Practitioner: Dr. Chapleski, Mckenna  , Date of procedure:  2004-05-16Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG3  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Dyspepsia FINDINGS: The patient has inflammation in the GOJ which is erosive. The oesophageal mucosa appears congested and edematous, with scattered superficial ulcerations.Following the biopsy of the lesion, there was bleeding, which was promptly managed.. There is a cervical inlet patch of dubious significance.. NA RECOMMENDATION: Follow-up endoscopy should be performed in 4-6 weeks to assess for healing and to repeat biopsies if necessary. RECOMMENDATION: If the stricture is causing symptoms such as difficulty swallowing, the patient may be referred to a speech therapist for swallowing therapy.  The patient should avoid smoking and alcohol, which can worsen the inflammation. FOLLOW UP: The patient should be advised to eat slowly and chew their food thoroughly to aid digestion and reduce the risk of ulcer recurrence. FOLLOW UP: The patient may be prescribed an H2 blocker to reduce stomach acid production and prevent reflux.  The patient should avoid eating too much fat, as this can exacerbate the inflammation by delaying gastric emptying and increasing the risk of reflux."
"968","Hospital Number: Q1015837 , Hospital: Random NHS Foundation Trust , DOB:  1918-05-19 , General Practitioner: Dr. Chavez, Stephani  , Date of procedure:  2011-06-30Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  50mcg  , Midazolam  3mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Dilatation FINDINGS: There is a nodule in the fundus which is sessile. The nodular changes may represent early fundic gland polyps.The patient should be advised to avoid straining during bowel movements to reduce pressure on the ulcer site.. The patient has a polyp in the third part of the duodenum which is sessile with a normal pit pattern. The nodules vary in size, with the largest measuring approximately 1 cm in diameter.The base of the polyp was fulgurated with an electrocautery device to prevent future bleeding or regrowth.. NA RECOMMENDATION: Referral to a gastroenterologist for further evaluation and management of the ulcer is recommended. RECOMMENDATION: The patient should be advised to maintain a healthy diet and lifestyle, as this may help prevent the growth of the nodule.  A blood test may be ordered to assess the patient's iron levels, as polyps can cause bleeding in the stomach and intestines. FOLLOW UP: The patient should avoid stress and maintain good mental health, as stress can delay the healing of the ulcer. FOLLOW UP: The patient should avoid smoking and drinking alcohol, as these habits can increase the risk of cancer.  A blood test may be ordered to assess the patient's iron levels, as polyps can cause bleeding in the stomach and intestines."
"969","Hospital Number: X2594520 , Hospital: Random NHS Foundation Trust , DOB:  1930-12-12 , General Practitioner: Dr. Minjares, Marie  , Date of procedure:  2011-10-06Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  75mcg  , Midazolam  6mg  , Instrument:  FG4  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- clips positioning to oesophageal lesion FINDINGS: Hiatus hernia.. NA"
"970","Hospital Number: E6158591 , Hospital: Random NHS Foundation Trust , DOB:  1939-10-07 , General Practitioner: Dr. Tan, Monaz  , Date of procedure:  2011-03-10Endoscopist: Dr. al-Mannan, Kawkab  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  25mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain . FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"")."
"971","Hospital Number: N9571333 , Hospital: Random NHS Foundation Trust , DOB:  1988-04-28 , General Practitioner: Dr. Barnes, Ashleigh  , Date of procedure:  2013-03-06Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  125mcg  , Midazolam  5mg  , Instrument:  FG4  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- liver abscesses FINDINGS: Normal gastroscopy to the duodenum. "
"972","Hospital Number: V3328807 , Hospital: Random NHS Foundation Trust , DOB:  1927-05-05 , General Practitioner: Dr. el-Habib, Shadhaa  , Date of procedure:  2012-08-19Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  25mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia oesophageal stricture post chemorad for scc oesophagus FINDINGS: Barrett's is present. Some areas of vascular abnormalities are seen. No loss of aceto-whitening was seen. NA"
"973","Hospital Number: L2721400 , Hospital: Random NHS Foundation Trust , DOB:  1987-05-09 , General Practitioner: Dr. Lutton, Abby  , Date of procedure:  2002-06-17Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  50mcg  , Midazolam  7mg  , Instrument:  FG3  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Dilatation FINDINGS: LA Grade  D oesophagitis. The oesophageal mucosa is friable and edematous. There are scattered erosions present in the oesophageal mucosa. There is significant ulceration and bleeding present in the oesophageal mucosa. Accompanied by white exudate and a yellowish base, the gastric ulcer presents with a cobblestone appearance.During biopsy, it was noted that the lesion had a friable surface and bled easily.. On retroflexion the wrap is in correct position, with no evidence of recurrent hiatus hernia.. NA  The patient should be instructed to avoid caffeine and carbonated beverages to reduce discomfort and promote healing.  The patient should avoid smoking and alcohol, which can delay the healing of the ulcer and increase the risk of developing more ulcers."
"974","Hospital Number: A9747574 , Hospital: Random NHS Foundation Trust , DOB:  1956-02-13 , General Practitioner: Dr. Pico, Kiana  , Date of procedure:  2015-04-07Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Ellis, Jamia  , Medications: Fentanyl  75mcg  , Midazolam  2mg  , Instrument:  FG5  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other - chronic cough ?GORD FINDINGS: The oesophagus demonstrates concentric rings, as well as a corrugated, or feline appearance.. No inlet patch.. character(0)"
"975","Hospital Number: I9081757 , Hospital: Random NHS Foundation Trust , DOB:  1982-10-15 , General Practitioner: Dr. Mangus, Kendall  , Date of procedure:  2005-12-16Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  100mcg  , Midazolam  1mg  , Instrument:  FG2  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Weight Loss Reflux-like Symptoms/Atypical Chest Pain FINDINGS: The patient has inflammation in the GOJ which is mild. At the gastro-oesophageal junction, there is visible erythema and loss of vascular pattern.The lesion was suspicious, and multiple biopsies were taken to ensure adequate tissue sampling.. There is inflammation in the antrum which is severe. The gastric inflammation appears to be associated with the use of proton pump inhibitors (PPIs), with the presence of rebound hypergastrinemia.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. character(0) RECOMMENDATION: The patient should be advised to chew their food thoroughly and to eat slowly to help prevent swallowing difficulties.  The patient should be advised to avoid caffeine, which can stimulate the production of stomach acid and exacerbate the inflammation. FOLLOW UP: The patient may be referred to a specialist for further evaluation and treatment, such as surgery to widen the esophagus.  The patient should avoid eating too much fat, as this can exacerbate the inflammation by delaying gastric emptying and increasing the risk of reflux."
"976","Hospital Number: F6090839 , Hospital: Random NHS Foundation Trust , DOB:  1954-09-22 , General Practitioner: Dr. Ylitalo, Alexandra  , Date of procedure:  2014-11-09Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  12.5mcg  , Midazolam  3mg  , Instrument:  FG1  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Other- Altered taste FINDINGS: Normal gastroscopy to the duodenum. "
"977","Hospital Number: T7480285 , Hospital: Random NHS Foundation Trust , DOB:  1948-05-19 , General Practitioner: Dr. el-Hashemi, Najaat  , Date of procedure:  2015-11-01Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  100mcg  , Midazolam  6mg  , Instrument:  FG2  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Reflux-like Symptoms/Atypical Chest Pain FINDINGS: There is a nodule in the oesophagus at 33 cm which is stalked. -----------------------------------------------------------------FD_OesophagealUlcerDescriptorsFurther testing may be necessary to determine the underlying cause of the inflammation and to guide appropriate treatment.. Hiatus Hernia- Large.. character(0) RECOMMENDATION: The patient should be instructed to avoid hot beverages and foods to prevent further irritation to the ulcer. RECOMMENDATION: A follow-up appointment with the gastroenterologist should be scheduled for six months after the initial diagnosis to monitor the patient's progress. RECOMMENDATION: If the patient is experiencing symptoms such as vomiting or fever, they should contact their healthcare provider immediately.  A repeat gastroscopy may be required in three to six months' time to monitor the progress of the inflammation. FOLLOW UP: The patient may be referred to a specialist in gastrointestinal disorders for further management of the ulcer. FOLLOW UP: If the nodule is suspicious for cancer, the patient may be referred to an oncologist for further evaluation and treatment. FOLLOW UP: The patient should avoid eating large meals late at night, as this can worsen reflux symptoms.  A proton pump inhibitor medication may be prescribed to manage the inflammation."
"978","Hospital Number: W2054819 , Hospital: Random NHS Foundation Trust , DOB:  1993-01-17 , General Practitioner: Dr. Corby, Charlene  , Date of procedure:  2004-06-14Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  12.5mcg  , Midazolam  1mg  , Instrument:  FG2  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Haematemesis or Melaena/Blood PR FINDINGS: The endoscopic appearance of the oesophagus shows a friable mucosa with a fine white stippling, which is highly suggestive of eosinophilic oesophagitis.. There is inflammation in the stomach which is erosive. Erythematous patches with focal ulceration are noted in the gastric antrum, suggestive of acute erosive gastritis.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample.. NA RECOMMENDATION: H. pylori testing and treatment may be necessary to prevent recurrence of the ulcer. RECOMMENDATION: The patient should be informed of the diagnosis and the importance of adhering to the recommended treatment plan.  The patient should be advised to avoid consuming too much sugar, as this can exacerbate the inflammation by increasing the risk of bacterial overgrowth in the stomach. FOLLOW UP: The patient should be advised to avoid consuming too much sugar, as this can increase the risk of bacterial overgrowth in the stomach and delay the healing of the ulcer. FOLLOW UP: The patient should be advised to chew their food thoroughly and to eat slowly to help prevent swallowing difficulties.  The patient should avoid wearing tight clothing, as this can exacerbate the inflammation by increasing the pressure on the stomach."
"979","Hospital Number: O8834134 , Hospital: Random NHS Foundation Trust , DOB:  1903-04-14 , General Practitioner: Dr. al-Mirza, Haibaa  , Date of procedure:  2001-08-06Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  12.5mcg  , Midazolam  2mg  , Instrument:  FG2  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Small Bowel Biopsy Positive coeliac serology FINDINGS: Normal gastroscopy to the duodenum. "
"980","Hospital Number: H6820128 , Hospital: Random NHS Foundation Trust , DOB:  1951-09-07 , General Practitioner: Dr. Miles, Janea  , Date of procedure:  2011-09-06Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  150mcg  , Midazolam  5mg  , Instrument:  FG2  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Anaemia/Low Iron or Vitamins FINDINGS: There is a stricture in the duodenal bulb which is narrowedScope not held by stricture. The stricture has a fibrotic appearance, suggesting chronicity.The ulcer was biopsied x8 for further analysis.. The patient has a 5mm nodule in the antrum which is sessile. A large, ulcerated nodule is noted in the gastric antrum, with surrounding erythema and exudates, suggestive of a malignant gastric neoplasm.. NA RECOMMENDATION: The patient should be advised to follow a soft diet and avoid spicy or acidic foods to reduce discomfort and promote healing.  If the nodule is found to be cancerous, the patient may require further imaging studies and biopsies to determine the stage of the cancer and the appropriate treatment. FOLLOW UP: The patient should avoid carbonated drinks, which can increase the production of gas and delay the healing of the ulcer.  "
"981","Hospital Number: P4350826 , Hospital: Random NHS Foundation Trust , DOB:  1991-05-28 , General Practitioner: Dr. Holmes, Pamala  , Date of procedure:  2003-07-22Endoscopist: Dr. Currier, Xavia  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  100mcg  , Midazolam  5mg  , Instrument:  FG2  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting FINDINGS: There is a stricture in the body which is circumferential.The endoscope passed through the stricture with resistance. A gastric stricture with a smooth and nodular surface is observed in the cardia, suggestive of a malignant lesion.During biopsy, the lesion was noted to be firm and required multiple passes to obtain a diagnostic sample.. "
"982","Hospital Number: D5429386 , Hospital: Random NHS Foundation Trust , DOB:  1901-02-23 , General Practitioner: Dr. Lawson, Jasmine  , Date of procedure:  2009-08-15Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  25mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain Nausea and/or Vomiting FINDINGS: Columnar lined oesophagus is present. No abnormal pit pattern is seen. It is a long segment. There is a polyp in the fundus which is stalked.It has a normal pit pattern. The hyperplastic gastric polyp presents with a smooth surface and regular shape, suggestive of a non-cancerous process.The polyp was grasped with a snare and cut with a hot biopsy forceps for removal.. character(0)    The patient should be advised to avoid NSAIDs and aspirin, which can increase the risk of developing more polyps."
"983","Hospital Number: K5870127 , Hospital: Random NHS Foundation Trust , DOB:  1982-03-17 , General Practitioner: Dr. Mancha, Lynsz  , Date of procedure:  2006-12-02Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  75mcg  , Midazolam  3mg  , Instrument:  FG4  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Weight Loss Anaemia/Low Iron or Vitamins FINDINGS: On retroflexion the wrap is in correct position, with no evidence of recurrent hiatus hernia.. "
"984","Hospital Number: U3081246 , Hospital: Random NHS Foundation Trust , DOB:  1959-03-11 , General Practitioner: Dr. Cuvelier, Sarah  , Date of procedure:  2015-08-16Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  100mcg  , Midazolam  1mg  , Instrument:  FG6  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Dilatation FINDINGS: Inflammatory changes seen in the oesophagus. There is a nodule in the third part of the duodenum which is benign-looking. NA  The patient may be prescribed medication to reduce the size of the nodule and prevent it from growing.  The patient should be advised to seek emotional support from friends, family, or a counselor, as the diagnosis of cancer can be difficult to cope with."
"985","Hospital Number: Y1506215 , Hospital: Random NHS Foundation Trust , DOB:  1992-06-05 , General Practitioner: Dr. Anderson, Madison  , Date of procedure:  2006-04-19Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Dearden, Laura  , Medications: Fentanyl  125mcg  , Midazolam  5mg  , Instrument:  FG5  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss Other- Early satiety FINDINGS: The patient has an ulcer in the GOJ which is fungatingIt has a visible vessel. The patient's medical history, along with the ulcer's rugose surface and flat appearance, suggest a chronic, long-standing condition.During biopsy, it was noted that the lesion had a friable surface and bled easily.. Examination of the oesophageal ulcer reveals a deep, necrotic base with surrounding granulation tissue.A biopsy of the lesion was taken using a forceps under direct endoscopic visualization.. The patient has a stricture in the second part of the duodenum which is inflexibleTight stricture impassable with scope.. The stricture is non-tapering and involves the entire circumference of the duodenal lumen.During biopsy, it was noted that the lesion had a friable surface and bled easily.. character(0)  The patient should be advised to maintain a healthy weight and exercise regularly to reduce the risk of recurrent ulcers.  The patient is advised to return for a follow-up appointment in two to four weeks' time to discuss the findings and plan for further management."
"986","Hospital Number: S7145991 , Hospital: Random NHS Foundation Trust , DOB:  1945-11-16 , General Practitioner: Dr. Tozcano Segovia, Lorena  , Date of procedure:  2003-08-13Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Carter, Tatyanna  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG3  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia Weight Loss Anaemia/Low Iron or Vitamins FINDINGS: Normal gastroscopy to the duodenum. "
"987","Hospital Number: R9404908 , Hospital: Random NHS Foundation Trust , DOB:  1937-07-20 , General Practitioner: Dr. Dance, Jaime  , Date of procedure:  2002-04-27Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  12.5mcg  , Midazolam  4mg  , Instrument:  FG3  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Surveillance- Previous chemo rad. rpt dilation. FINDINGS: Normal gastroscopy to the duodenum. "
"988","Hospital Number: Z6151451 , Hospital: Random NHS Foundation Trust , DOB:  1976-11-01 , General Practitioner: Dr. Cousins III, Dezjanay  , Date of procedure:  2007-12-01Endoscopist: Dr. al-Rashid, Muzna  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG7  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- RFA Therapeutic- EMR/ESD FINDINGS: The patient has a 6mm nodule in the antrum which is benign-looking. The gastric mucosa appears elevated with a smooth surface and no ulcerations, suggestive of a submucosal gastric nodule.The patient should avoid wearing tight clothing, as this can increase the pressure on the stomach and delay the healing of the ulcer.. There is a polyp in the stomach which is sessile with an abnormal pit pattern. Multiple polyps with variable size are seen throughout the gastric mucosa, suggestive of familial adenomatous polyposis.The polyp did not lift on saline injection and was therefore not amenable to endoscopic resection.. character(0) RECOMMENDATION: The patient should be counseled on the importance of maintaining good oral hygiene to prevent oral bacteria from entering the ulcer site. RECOMMENDATION: The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the nodule.   FOLLOW UP: The patient should be advised to avoid consuming dairy products, which can increase the production of stomach acid and delay the healing of the ulcer. FOLLOW UP: The patient should be advised to maintain a healthy diet and lifestyle, as this may help prevent the growth of the nodule.  A blood test may be ordered to assess the patient's iron levels, as polyps can cause bleeding in the stomach and intestines."
"989","Hospital Number: G1498153 , Hospital: Random NHS Foundation Trust , DOB:  1954-03-13 , General Practitioner: Dr. Briseno, Marissa  , Date of procedure:  2007-06-02Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  125mcg  , Midazolam  6mg  , Instrument:  FG5  , Extent of Exam:  Oesophagus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Abdominal Pain x1 hematemesis Crohns colitis FINDINGS: Normal gastroscopy to the duodenum. "
"990","Hospital Number: B8969666 , Hospital: Random NHS Foundation Trust , DOB:  1933-03-09 , General Practitioner: Dr. Nyamekye, Shakaila  , Date of procedure:  2016-07-06Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  125mcg  , Midazolam  7mg  , Instrument:  FG1  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: anastomotic stricture post thoracoabdominal oesophagogastrecotmy for dilatation FINDINGS: Normal gastroscopy to the duodenum. NA"
"991","Hospital Number: J1819477 , Hospital: Random NHS Foundation Trust , DOB:  1982-05-21 , General Practitioner: Dr. Johnson, Mariah  , Date of procedure:  2015-06-19Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  75mcg  , Midazolam  4mg  , Instrument:  FG6  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia Vomiting known hiatus hernia FINDINGS: The patient has an ulcer in the fundus which is excavated.It has rolled edges. Surrounded by erythema and exhibiting a nodular surface, the severe ulceration presents with a distinct loss of mucosal tissue.Difficulty was encountered during biopsy as the tissue of the lesion appeared hard and challenging to obtain samples from.. No inlet patch  was also seen on narrow band imaging.. character(0)  Endoscopic resection of the ulcer may be necessary for larger or more complex ulcers.  The patient should avoid consuming too much fat, as this can delay gastric emptying and delay the healing of the ulcer."
"992","Hospital Number: M8863036 , Hospital: Random NHS Foundation Trust , DOB:  1980-12-29 , General Practitioner: Dr. De Blieck, Theresa  , Date of procedure:  2016-03-04Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  12.5mcg  , Midazolam  5mg  , Instrument:  FG7  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Anaemia/Low Iron or Vitamins Weight Loss FINDINGS: OESOPHAGUS: Normal, no appreciable hiatus hernia.. "
"993","Hospital Number: C4021112 , Hospital: Random NHS Foundation Trust , DOB:  1917-11-13 , General Practitioner: Dr. Parra, Shanelle  , Date of procedure:  2013-03-15Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Geist, Meg  , Medications: Fentanyl  100mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  D1  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Nausea and/or Vomiting Therapeutic- Dilatation Therapeutic- NJ Tube/PEG/DPEJ FINDINGS: No inlet patch  was also seen.. "
"994","Hospital Number: Q8222665 , Hospital: Random NHS Foundation Trust , DOB:  1947-08-22 , General Practitioner: Dr. Lim, Jessie  , Date of procedure:  2001-01-17Endoscopist: Dr. Ali, Marshae  , 2nd Endoscopist: Dr. Felder, Keiasha  , Medications: Fentanyl  150mcg  , Midazolam  6mg  , Instrument:  FG6  , Extent of Exam:  Failed intubation  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- Dilatation FINDINGS: There is a stricture in the stomach which is inflamedIt is easily traversible.. The gastric stricture appears to be located in the body of the stomach, with a circumferential narrowing of the lumen.Multiple biopsies were taken of the lesion to ensure adequate sampling, given its irregular shape.. "
"995","Hospital Number: X5836068 , Hospital: Random NHS Foundation Trust , DOB:  1908-02-10 , General Practitioner: Dr. al-Hannan, Sadeeqa  , Date of procedure:  2007-01-17Endoscopist: Dr. Garnier, Teryl  , 2nd Endoscopist: Dr. Gama, Samantha  , Medications: Fentanyl  12.5mcg  , Midazolam  7mg  , Instrument:  FG4  , Extent of Exam:  Stomach body  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Therapeutic- PEG FINDINGS: There is a polyp in the third part of the duodenum which is stalked with an abnormal pit pattern. The mucosa surrounding the nodules is inflamed and edematous, with a granular appearance.The polyp was marked with a tattoo to aid in future surveillance endoscopy..  character(0) RECOMMENDATION: The patient should avoid drinking alcohol, as this can increase the risk of bleeding in the gastrointestinal tract.  Further investigations such as a biopsy may be recommended to determine the type of polyp and assess the risk of cancer. FOLLOW UP: The patient should avoid drinking alcohol, as this can increase the risk of bleeding in the gastrointestinal tract.  The patient should be advised to avoid consuming alcohol, which can increase the risk of developing more polyps."
"996","Hospital Number: E8902521 , Hospital: Random NHS Foundation Trust , DOB:  1921-07-10 , General Practitioner: Dr. Van, Taylor  , Date of procedure:  2003-05-08Endoscopist: Dr. Fears, Bobbi  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  12.5mcg  , Midazolam  2mg  , Instrument:  FG1  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dyspepsia Other-BloatingAbdominal Pain FINDINGS: The patient has a polyp in the second part of the duodenum which is stalked with an abnormal pit pattern. The nodules vary in size, with the largest measuring approximately 1 cm in diameter.The polyp was visualized and biopsied during upper endoscopy..  character(0) RECOMMENDATION: The patient may be referred to a surgeon for a minimally invasive procedure to remove the nodule.  A colonoscopy may be ordered to assess for the presence of polyps in the colon and rectum. FOLLOW UP: The patient should be advised to attend all scheduled appointments and follow the treatment plan recommended by their healthcare provider.  The patient should be advised to avoid carbonated drinks, which can increase the risk of developing more polyps by increasing the production of gas."
"997","Hospital Number: N7405188 , Hospital: Random NHS Foundation Trust , DOB:  1970-01-19 , General Practitioner: Dr. Cardoza, Emily  , Date of procedure:  2001-02-20Endoscopist: Dr. Song, Makamaehokuliiokalani  , 2nd Endoscopist: Dr. Labeaux, Destiny  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG4  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Weight Loss CHRONIC DIARRHOEA-biopsies needed Nausea and/or Vomiting FINDINGS: There is a nodule in the second part of the duodenum which is sessile.  character(0)  The patient should be advised to avoid lifting heavy objects or engaging in strenuous physical activity, as this can increase the risk of bleeding in the gastrointestinal tract.  The patient may be referred to a specialist for further evaluation and treatment, such as surgery to remove the nodule."
"998","Hospital Number: V9378773 , Hospital: Random NHS Foundation Trust , DOB:  1982-12-17 , General Practitioner: Dr. Diaz, Elizabeth  , Date of procedure:  2002-10-26Endoscopist: Dr. el-Haque, Hiwaaya  , 2nd Endoscopist: Dr. Padilla, Jessica  , Medications: Fentanyl  75mcg  , Midazolam  5mg  , Instrument:  FG2  , Extent of Exam:  D2  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia/Odynophagia . FINDINGS: The patient has a 8mm nodule in the GOJ which is benign-looking. There is diffuse erythema of the oesophageal mucosa with prominent exudate and friability, suggestive of viral oesophagitis.The patient is advised to follow up with their gastroenterologist in two weeks to discuss the findings of the gastroscopy and the treatment plan for the stricture.. mild trachealization.. character(0)  The patient should be advised to maintain a healthy weight, as obesity can increase the risk of cancer and other gastrointestinal diseases.  If the nodule is suspicious for cancer, the patient may be referred to an oncologist for further evaluation and treatment."
"999","Hospital Number: L6117442 , Hospital: Random NHS Foundation Trust , DOB:  1939-01-04 , General Practitioner: Dr. el-Mahfouz, Rayyana  , Date of procedure:  2004-01-31Endoscopist: Dr. Stearns, Alyssa  , 2nd Endoscopist: Dr. Chavez, Diana  , Medications: Fentanyl  50mcg  , Midazolam  1mg  , Instrument:  FG2  , Extent of Exam:  Pylorus  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: Dysphagia oesophageal stricture post chemorad for scc oesophagus FINDINGS: Normal gastroscopy to the duodenum. NA"
"1000","Hospital Number: A3669324 , Hospital: Random NHS Foundation Trust , DOB:  1927-12-28 , General Practitioner: Dr. Briseno, Sammi  , Date of procedure:  2006-02-14Endoscopist: Dr. Presta, Hannah  , 2nd Endoscopist: Dr. Herrera, Alejandra  , Medications: Fentanyl  50mcg  , Midazolam  5mg  , Instrument:  FG5  , Extent of Exam:  GOJ  , Procedure Performed: Gastroscopy (OGD)  , INDICATIONS FOR PROCEDURE: MelaenaEpigastric Pain FINDINGS: list(""The stricture will need to be dilatated in radiology"", ""A superficial mucosal tear was seen after dilatation"", ""A deep mucosal tear was seen after dilatation"", ""dilated to 7 mm with a CRE balloon"", ""dilated to 4 mm with a CRE balloon"", ""dilated to 19 mm with a CRE balloon"", ""dilated to 16 mm with a CRE balloon"", ""dilated to 9 mm with a CRE balloon"", ""dilated to 14 mm with a CRE balloon"", ""dilated to 10 mm with a CRE balloon"", ""dilated to 18 mm with a CRE balloon"", ""dilated to 5 mm with a CRE balloon"", 
    ""dilated to 11 mm with a CRE balloon"", ""dilated to 20 mm with a CRE balloon"", ""dilated to 13 mm with a CRE balloon"", ""dilated to 17 mm with a CRE balloon"", ""dilated to 15 mm with a CRE balloon"", ""dilated to 3 mm with a CRE balloon"", ""dilated to 6 mm with a CRE balloon"", ""dilated to 12 mm with a CRE balloon"", ""dilated to 8 mm with a CRE balloon"")."