Virtual Reality and Gastroscopy: How to Eliminate Anxiety Before an Endoscopy

Gastroscopy is one of the most common diagnostic procedures in internal medicine. It is also one of the most feared. Not because of the pain — which is minimal with sedation — but because of the idea.

The problem: endoscopy anxiety is a real clinical obstacle

A significant number of patients postpone or refuse a gastroscopy due to fear of the procedure, even when clinically indicated. This leads to diagnostic delays, missed diagnoses, and disease progression that timely gastroscopy would have intercepted.

In patients who present for the procedure, anxiety produces concrete effects:

• Increased gag reflex due to the sympathetic response — making the procedure technically more difficult

• Higher consumption of procedural sedatives to compensate for anxiety-induced hyperactivation

• Involuntary movement during insertion of the instrument — increasing procedural risk

• Negative evaluation of the experience even in the absence of complications — resulting in low compliance with follow-up

How VR intervenes in the endoscopic journey

Immersive VR therapy can be integrated at two moments in the clinical pathway:

Before the procedure — waiting room

The patient waits wearing the VR headset in a relaxing environment. Waiting is the peak moment of anticipatory anxiety. Interrupting this cycle before the patient enters the endoscopy room results in a physiologically different patient at the time of the procedure.

During the procedure — for endoscopies under light sedation or without sedation

In certain contexts — short diagnostic gastroscopies, colonoscopies under conscious sedation — the VR headset can be worn during the procedure. The patient is immersed in an environment that captures their attention and reduces the perception of the procedure.

Scientific evidence

The specific literature on VR in endoscopy is growing rapidly:

• PubMed 2024 RCT (138 patients, diagnostic gastroscopy): the VR group showed significantly lower pre-procedural anxiety (STAI score -18 points), lower procedural midazolam consumption, and higher rating of the experience

• RCT on colonoscopy (Use of VR in patient education, 2024): educational VR pre-colonoscopy reduces anxiety by 22% and increases compliance with follow-up by 31%

• Study on endoscopy and virtual reality (PMC 2023): VR before endoscopy reduces anticipatory anxiety and gag reflex in patients without sedation

Operational impact for the endoscopy service

Reducing pre-procedural anxiety in endoscopy has cascade effects across the entire service:

• Smoother and faster procedures due to less patient resistance

• Lower consumption of sedatives — highly relevant in a context where sedation safety is monitored

• Lower incidence of aborted procedures due to patient intolerance

• Higher NPS ratings — in a setting where gastroscopy is often experienced as a negative event, the competitive differentiator is significant

The case of colonoscopy

We have already covered colonoscopy in detail in a dedicated article. In summary: pre-colonoscopy VR reduces anticipatory anxiety by 22-30% and significantly increases compliance with colorectal screening programs. The patient who has had a tolerable experience returns for follow-up.

Conclusion

Digestive endoscopy is one of the areas where immersive therapy produces the most immediate and measurable impact. The procedure is standardized, the context is controlled, and anxiety is almost always the only variable that makes the procedure difficult. Eliminating that variable is simpler than it seems.