Colonoscopy and Gastroscopy in One Visit: Sedation, Prep and Cost

If your doctor has suggested both a colonoscopy and a gastroscopy (an upper endoscopy), you may be wondering whether they can be done together. In many hospitals, including in China, they routinely are. As one patient in China put it:

This guide explains how a combined procedure works, what the sedation and prep involve, what it costs, and how some visitors build it into a single trip with a health checkup.

Can a colonoscopy and gastroscopy be done at the same time?

Yes. A gastroscopy and a colonoscopy are often done in the same session, one straight after the other, under a single sedation. The gastroscopy goes through the mouth to look at the oesophagus, stomach and the first part of the small intestine; the colonoscopy goes through the back passage to look at the large bowel. Different scopes are used for each.

Doing both together means one day off, one sedation, one recovery and one escort home. Whether both tests are actually needed is a decision for the doctor who assesses you, based on your symptoms and history. In the US, insurance rules can get in the way of combining them.

When is a gastroscopy needed instead of a colonoscopy?

The two tests look at different parts of the gut, so the choice follows your symptoms. Symptoms such as reflux, difficulty swallowing or upper abdominal pain point to the upper gut, while a change in bowel habit or bleeding from the back passage point to the large bowel. Some symptoms, such as anaemia or unexplained weight loss, can come from either end, which is one reason doctors sometimes suggest both. Many people also add a gastroscopy to a screening colonoscopy as part of a wider checkup, but only your doctor can say whether it is useful for you.

Is sedation needed for a gastroscopy, or is a throat spray enough?

A gastroscopy can be done with a numbing throat spray alone, and many people manage that, but sedation is widely available and makes it more comfortable. The main discomfort without sedation is gagging as the scope passes the throat. When the gastroscopy is combined with a colonoscopy, the usual approach is to sedate for both, so the throat-spray question mostly falls away.

Some people are comfortable with an unsedated gastroscopy but want sedation for the colonoscopy, which is the longer and often less comfortable of the two.

In China the sedated version is called a "painless" gastroscopy or colonoscopy, and the sedation is given by an anaesthetist. A pre-anaesthesia assessment comes first, and you will need someone with you afterwards. Your hospital will tell you what level of sedation it uses and what is safe for you.

Is the preparation harder when you have both?

Not much. The bowel prep for the colonoscopy is the main work, and the gastroscopy only adds the need for an empty stomach, which you will have anyway. You follow a low-fibre diet, then clear liquids, then the laxative drink, and you stop eating and drinking for a set time before the procedure. Follow your own hospital's instructions on timing, because they differ between hospitals and prep products.

The prep is worth taking seriously. If the bowel is not clear, the colonoscopy may have to be repeated, even if the gastroscopy goes ahead.

On a trip abroad, that is a good reason to keep a spare day in your plans.

How much do a gastroscopy and colonoscopy cost together?

In China, patients report paying a median of about CNY 1,500 (≈ USD 220) for a sedated gastroscopy and colonoscopy together, commonly CNY 1,300–1,700 (≈ USD 190–250), before insurance (Chinese patient reports, 2025–26). That usually covers both scopes, the sedation, the prep drugs and pre-procedure blood tests and ECG. If a polyp is removed in the same session, the total rises to a median of about CNY 2,850 (≈ USD 430), and sedation billed on its own has a median of about CNY 500 (≈ USD 75). At a standard department, foreign patients pay the same listed price as local patients who pay without insurance; international departments charge more.

We did not find published combined prices for the US, the UK or Australia. For context, PHIN puts a private colonoscopy alone at GBP 2,000–4,000 in the UK (2025), and New Choice Health puts the US average for a colonoscopy alone at about USD 2,750 (2024–26). Waits are similar for both tests on the NHS: in July 2026, 29.0% of people waiting for a gastroscopy and 30.8% waiting for a colonoscopy had waited six weeks or more, according to NHS England.

What should you expect during and after a combined gastroscopy and colonoscopy?

On the day, you are given sedation, the gastroscopy and colonoscopy are done one after the other, and you wake in recovery. Some bloating and wind afterwards is common and usually passes as you move around. You are normally told what the doctor saw before you leave; if a polyp or biopsy was taken, pathology follows later. Because of the sedation, plan to rest for the rest of the day and have someone take you back.

Some visitors build the procedure into a wider trip. A comprehensive health checkup at a Chinese public hospital can be done in the same stay: patients report a median of about CNY 1,500 (≈ USD 220) for a full-body checkup and about CNY 4,000 (≈ USD 600) for a high-end package. Reports take time; Beijing Chaoyang Hospital says its paper checkup report takes 7–8 working days, with a copy sent by WeChat.

Some people also book a traditional Chinese medicine (TCM) consultation while they are there, for example acupuncture or a tongue and pulse assessment. In China TCM is used alongside medical care, not instead of it, and how people respond varies. As a price guide, patients in China report paying a median of about CNY 100 (≈ USD 15) per acupuncture session without insurance.