AIM:The fears and concerns are associated with gastroscopy (EGD)decrease patient compliance.Conscious sedation (CS)and non-pharmacological interventions have been proposed to reduce anxiety and allow better execution of EGD.The aim of this study was to assess whether CS, supplementary information with a videotape,or presence of a relative during the examination could improve the tolerance to EGD. METHODS:Two hundred and twenty-six outpatients(pts), scheduled for a first-time non-emergency EGD were randomly assigned to 4 groups:Co-group(62 pts):throat anaesthesia only;Mi-group(52 pts):CS with i.v.midazolam;Re-group (58 pts):presence of a relative throughout the procedure; Vi-group(54 pts):additional information with a videotape. Anxiety was measured using the“Spielberger State and Trait Anxiety Scales”.The patients assessed the overall discomfort during the procedure on an 100-mm visual analogue scale,and their tolerance to EGD answering a questionnaire. The endoscopist evaluated the technical difficulty of the examination and the tolerance of the patients on an 100-mm visual analogue scale and answering a questionnaire. RESULTS:Pre-endoscopy anxiety levels were higher in the Mi-group than in the other groups(P<0.001).On the basis of the patients’evaluation,EGD was well tolerated by 80.7% of patients in Mi-group,43.5% in Co-group,58.6% in Re- group,and 50% in Vi-group(P<0.01).The discomfort caused by EGD,evaluated by either the endoscopist or the patients, was lower in Mi-group than in the other groups.The discomfort was correlated with“age”(P<0.001)and“groups of patients” (P<0.05)in the patients’evaluation,and with“gender” (females tolerated better than males,P<0.001)and“groups of patients”(P<0.05)in the endoscopist’s evaluation. CONCLUSION:Conscious sedation can improve the tolerance to EGD.Male gender and young age are predictive factors of bad tolerance to the procedure. AIM: The fears and concerns are associated with gastroscopy (EGD) decreasing patient compliance. Consensus sedation (CS) and non-pharmacological interventions have been reduced to anxiety and allow better execution of EGD. The AIM of this study was to assess whether CS , supplementary information with a videotape, or presence of a relative during the examination could improve the tolerance to EGD. METHODS: Two hundred and twenty-six outpatients (pts), scheduled for a first-time non-emergency EGD were randomly assigned to 4 Groups: Co-group (62 pts): throat anaesthesia only; Mi-group (52 pts): CS with ivmidazolam; Re-group (58 pts): presence of a relative throughout the procedure; Vi-group : additional information with a videotape. Anxiety was measured using the “Spielberger State and Trait Anxiety Scales”. The patients assessed the overall discomfort during the procedure on an 100-mm visual analogue scale, and their tolerance to EGD answering a questionnaire. The endoscopist evaluated the technical difficulty of the examination and the tolerance of the patients on an 100-mm visual analogue scale and answering a questionnaire. RESULTS: Pre-endoscopy anxiety levels were higher in the Mi-group than in the other groups (P <0.001) .On the basis of the patients evaluation, EGD was well tolerated by 80.7% of patients in Mi-group, 43.5% in Co-group, 58.6% in Re-group and 50% in Vi-group (P <0.01). discomfort caused by EGD, evaluated by either the endoscopist or the patients, was lower in Mi-group than in the other groups. discomfort was correlated with “age ” (P <0.001) and “groups of patients ” P <0.05) in the patients’evaluation, and with “gender ” (females tolerated better than males, P <0.001) and “groups of patients ” (P <0.05) in the endoscopist’s evaluation. CONCLUSION: Conscious sedation can improve the tolerance to EGD.Male gender and young age are predictive factors of bad tolerance to the procedure.