Brief Answer:
There is nothing wrong its just increased gag reflex.Its your genetics.

Detailed Answer:
Hello,
Thank you for choosing HealthcareMagic for your query.
Have seen you details and i appreciate your concern.

The gag reflex is a somatic natural response in which the body attempts to eliminate instruments or agents from the oral cavity by muscle contraction. Some patients suffered from such severe retching that behavioral techniques did not sufficiently reduce gagging.In these patients, pharmacological management was thought to be the last alternative to eliminate the reflex.

Hyperactive gag reflex is the body's response to the stimulation of soft palate or posterior pharynx. Every one has a gag, but it becomes a problem when an individual finds it difficult to eat certain foods or perform certain activity. Whenever something that is not part of the natural swallowing process enters the throat so far as to touch the soft palate, the back of the throat contracts and we get a feeling that we are about to vomit. The glossopharyngeal nerve fibers, which pass from behind the nasal cavity, pick up the sensation whenever an unnaturally large amount of food is swallowed or something other than food is attempted to be pushed down the throat like in your case. These nerve fibers transmit the gag sensations to the solitary tract and spinal trigeminal nuclei. Finally, these signals reach the brain which sends back instructions, in the form of electric pulses and chemical signals, back to the pharyngeal nerves to contract and cause such invasive objects to be expelled.There are no particular causes of hyperactive gag reflex as such. It's just an aversion to certain things that induces a severe urge to gag. Certain activities that need you to open your mouth for a long time or putting something in the mouth can also result in a gag. Basically, anything that brushes against the soft palate and stimulates it, results in a gag. Experiencing iit while getting a dental job done,or during endoscopy is absolutely normal. However increased amount of sedation is the only thing one can do as gag is controlled by your genetics.

Advice
Use higher sedation.
Regards.

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Brief Answer:
Follow up answer.

Detailed Answer:
Hello again,
I am sorry you are not satisfied with my answer.

However firstly i would say that endoscopy is NEVER done in general anaesthesia usually used anaesthetic agents are short term and fast acting like propofol(Day care anaesthesia usually agent of choice for endoscopy).
However If endoscopy can't be performed in normal inhalational anaesthesia(As in your case) then such patients are considered for Deep anaesthesia. In case if Deep anaesthesia also fails then we use general anaesthesia(Personally i have never seen a doctor doing a small procedure like endoscopy in general anaesthesia in my last 32 years). In fact general anaesthesia has its own mortality rate of about 0.5% in which patient either fails to come back or lands up in coma.IO don't think any qualified doctor will use general anaesthesia for doing a minor procedure like endoscopy.

Rather what we do is called Deep sedation endoscopy.

"Deep sedation" in endoscopy is the combination of a benzodiazipine and narcotic used to achieve deep sedation. Such combinations may require higher doses than those used for moderate sedation alone. Agents that have been added to the benzodiazipine/narcotic combination include diphenhydramine, promethazine and droperidol. These potentiate the action of the benzodiazipine/narcotic, and may lead to a deeper level of sedation. Anesthetic agents commonly used for endoscopic procedures, and include propofol and the inhalation agents such as nitrous oxide, enflurane, isoflurane etc The inhalation agents will not be further considered here in this case.

Total unconsciousness does not mean that you are in general anaesthesia.So please recheck the informations you have been provided by your consultant.

Infact frankly speaking it can't be general anaesthesia. Major and complex operations involving brain heart transplants and multiple organs etc are done under general anaesthesia. Having a Gag reflex is impossible if patient is in G.A.

Sedation can be given by a number of agents.Strenght and potency of various anaesthetics are different.There are a number of different drugs used for giving various sorts of anaesthesia. So if there was a gag reflex in your case it was indicative of rather improper response to the particular drug used on you or you have hyperactive reflex which need deep sedation.

Take home message-Endoscopy is very very rarely done in general anaesthesia. Patient can never have a gag reflex in general anaeshesia.
I am sorry for your disappointment but your doctor should use deep sedation and test could be done easily after that.

If you are still not satisfied with my reply, you are free to contact customer care for redirecting this query to other specialists.

Regards.

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Brief Answer:
Follow up answer.

Detailed Answer:
Hi again,
Firstly I want to give you a small briefing to make you understand things better.

The simple logic is that a gag is a normal protective response of our body to prevent it surface(mucosa) from any unwanted external stimulant.Whenever a irritant will irritate our mucosa the brain will guide the muscles in that area to contract with more power hence stopping the the irritant particle to come in contact with mucosa.

Role of anaesthesia in preventing gag-
Aneasthetic agents in lay mans language desensitize the small nerves in mucosal layer. Hence our brain will not know that an external irritant is stimulating the mucosa. As brain is not getting any signal there will be no gag reflex.
In your case the amount of drug administered to you is not sufficient enough to inhibit the neurons from transferring signals to brain hence causing reflex.

I don't feel that it means that there is any nerve damage in that area.In case of nerve damage there would be a permanent hyper reflexia. The pain in that area can be due to inflammation caused by the scopy tube(have caused erosion of soft mucosa because of severe gag).

So a good suggestion is firstly consult your anaesthesiologist and get the name and doses of the medication you were given.
After that while going for test next time tell your doctor about the previous failed attempts and doses that were administered.
Thirdly ask him/her to go for deep sedation.

In case they still suspect nerve injury easy way out is to go for a MRI. If there is a nerve injury it would be reflected in MRI.

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