Educational Articles

Upper Endoscopy

 
WHAT IS AN UPPER ENDOSCOPY?

Upper endoscopy (also known as gastroscopy, EGD, or esophagogastroduodenoscopy) is a procedure that enables an examination of the lining of the esophagusstomach, and duodenum (first portion of the small intestine). A bendable, lighted tube about the thickness of a pencil is placed through the mouth and into the stomach and duodenum.


Upper Endoscope

WHY IS AN UPPER ENDOSCOPY PERFORMED?

Upper endoscopy is usually performed to evaluate symptoms of thought to arise from the upper intestinal tract. Common reasons for performing upper endoscopy include persistent upper abdominal pain, nausea, vomiting, or heartburn. Frequently, upper endoscopy is performed if bleeding is suspected from the upper gastrointestinal tract. Upper endoscopy can be very useful in detecting ulcerGERD (gastro-esophageal reflux disease) and even an infection by Helicobacter pylori, by taking a sampling of stomach tissue. Upper endoscopy can detect most cancer and can distinguish between cancerous and non-cancerous conditions both visually and by performing biopsies of suspicious areas. Biopsies are taken by utilizing a specialized forceps to sample tissue. These samples are then sent to the laboratory to be analyzed under the microscope.

Using a variety of accessories passed through the endoscope, a GI specialist (gastroenterologist) can simultaneously treat many abnormalities. In fact, narrowed areas can be stretched, polyps removed, swallowed foreign objects removed, and even bleeding stopped.

WHAT PREPARATION IS REQUIRED?

To optimally visualize the stomach, it should be completely empty of any food. This means that food should be avoided for 8 hours before the examination.  This usually means that you are not to eat or drink anything after midnight.

In addition, medication may need to be adjusted or avoided. In general, it is best to inform your GI specialist ALL your current medications. Most medications can be continued as usual on the day prior and after the examination. Whether to continue medication that may affect tendency to bleed such as aspirin and blood thinners should be discussed with your doctor prior to the examination. 
 
Furthermore, if you have any major diseases, such as heart or lung condition that may require special attention during the procedure, this be discussed well in advance of examination.

In most cases, sedatives are administered intravenously so that you will be comfortable through out the procedure. This means that someone should be available to drive you home after the examination since if is not safe to drive right after the test.  

WHAT CAN BE EXPECTED DURING THE UPPER ENDOSCOPY?

Before starting the procedure, the throat is usually sprayed with a local anesthetics and sedatives are given through a vein to help you relax and be comfortable during the examination. You are then asked to be in side-position, so that the endoscope can be gently passed through your mouth and into the esophagus, stomach and duodenum. Air is introduced into the stomach during the procedure to allow a better visualization of the stomach lining. The procedure usually lasts about 15 minutes.  

WHAT HAPPENS AFTER UPPER ENDOSCOPY?

After the actual examination, you will be monitored in the recovery area for 1-2 hours while you recover and until the effects of the sedatives have mostly worn off. Your throat may be a little sore and uncomfortable for a day or two. You may feel bloated immediately after the procedure, because of the air that was introduced during the procedure. In most circumstances, you can expect to eat normally afterward and resume routine medication. Although the result of upper endoscopy examination should be available immediately, if a biopsy samples was taken, that result may require up to several weeks.  

WHAT COMPLICATIONS CAN OCCUR?

Upper endoscopy is generally very safe, especially when performed by those fully-trained in gastroenterology. Although complications are extremely rare, they can occur. The possible complications include bleeding from the site of a biopsy or polypectomy (removal of stomach polyp) and a tear (perforation) through the lining of the intestinal wall.  

It is important for you to recognize the early signs of possible complications and to contact your doctor if you notice any symptoms of difficulty swallowing, worsening throat pain, chest pains, severe abdominal pain, fevers, chills or rectal bleeding of more than trivial amount.
 

 

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