Upper GI Endoscopy (Esophagogastroduodenoscopy, EGD)
What is upper endoscopy?
Upper GI endoscopy is a procedure that enables the examiner to examine the esophagus (swallowing tube), stomach, and duodenum (first portion of small bowel) using thin, flexible tubes through which the lining of the esophagus, stomach, and duodenum can be viewed using a TV monitor.
Important guidelines for performing endoscopy?
To accomplish a safe and complete examination, the stomach should be empty. The patient will most likely be asked to have nothing to eat or drink for six hours or more prior to the procedure. Prior to scheduling the procedure, the patient should inform his or her physician of any medications they are currently taking, any allergies, and all of their health problems. This information will remind the doctor whether the patient may need antibiotics prior to the procedure, what potential medications should not be used during the exam because of the patient's allergies, and will provide the individual scheduling the procedure an opportunity to instruct the patient whether any of the medications they are taking should be held or adjusted prior to the endoscopy.
Knowledge whether the patient has any major health problems, such as heart or lung diseases, will alert the examiner of possible need for special attention during the procedure.
Why have you been scheduled for an endoscopy?
Upper endoscopy usually is performed to evaluate possible problems with the esophagus, stomach or duodenum, and evaluate symptoms such as upper abdominal pain, nausea or vomiting, difficulty in swallowing, intestinal bleeding anemia, etc. Upper endoscopy is more accurate than X-ray for detecting inflammation or smaller abnormalities such as ulcers or tumors within the reach of the instrument. Its other major advantage over X-ray is the ability to perform biopsies (obtain small pieces of tissue) or cytology (obtain some cells with a fine brush) for microscopic examination to determine the nature of the abnormality and whether the abnormality is benign or malignant (cancerous).
Biopsies are taken for many reasons and may not mean that
cancer is suspected:
Upper endoscopy also can be used to treat many conditions within its reach. The endoscope's channels permit passage of accessory instruments enabling the examiner to treat many of the conditions such as stretching areas of narrowing (strictures), removal of benign growths such as polyps, accidentally swallowed objects, or treating upper gastrointestinal bleeding as seen in ulcers tears of the lining. These capabilities have markedly reduced the need for transfusions or surgery.
What can a patient expect during endoscopy?
It is most likely that before the procedure the doctor will discuss with the patient why the procedure is to be done, whether there are alternative procedures or tests, and what possible complications may result from the endoscopy. Practices vary amongst physicians but the patient may have the throat sprayed with a numbing solution and will probably be given a sedating and pain alleviating medication through the vein. While laying on your left side the flexible endoscope, the thickness of a small finger, is passed through the mouth into the esophagus, stomach, and duodenum. This procedure will not interfere with your breathing. Most patients experience only minimal discomfort during the test and many sleeps throughout the entire procedure.
What happens after the endoscopy?
After the test the patient will be observed and monitored by a qualified individual in the endoscopy or a recovery area until a significant portion of the medication has worn off. Occasionally a patient is left with a mild sore throat, which promptly responds to saline gargles, or a feeling of distention from the insufflated air that was used during the procedure. Both problems are mild and transient. When the patient fully recovered will be instructed when to resume their usual diet (probably within a few hours) and the patient's driver will be allowed to take him home.
When does patient get the results of the endoscopy?
Under most circumstances the examining physician will inform the patient of the test results or the probable findings prior to discharge from the recovery area. The results of biopsies or cytology usually take 72-96 hours and the doctor may only give the patient a presumptive diagnosis pending the definitive one, after the microscopic examination.
What are the risks of endoscopy?
Endoscopy is a safe procedure and when performed by a physician with specialized training in these procedures, the complications are extremely rare. They may include localized irritation of the vein where the medication was administered, reaction to the medication or sedatives used, complications from pre-existing heart, lung, or liver disease, bleeding may occur at the site of a biopsy or removal of a polyp (which if it occurs is almost always minor and rarely requires transfusions or surgery). Major complications such as perforation (punching a hole through the esophagus, stomach, or duodenum) are rare but usually require surgical repair.