Upper GI Endoscopy
What is an Upper GI Endoscopy?
Upper GI endoscopy, sometimes called EGD (esophagogastroduodenoscopy), is a procedure performed under sedation, during which the upper intestinal tract (esophagus, stomach, beginning of small intestine – duodenum) is visually examined using a lighted, flexible video endoscope (a flexible tube) that is placed into the mouth. The flexible endoscope is a remarkable piece of equipment that can be directed and moved around the many bends in the gastrointestinal tract. The newer video endoscopes can transmit up the scope to a computer, which then displays the image on a large video high definition screen. An open channel in these scopes allows other instruments to be passed through in order to take tissue samples (biopsies), remove polyps, and perform other exams. The exam takes approximately 10-15 minutes, after which the patient is taken to the recovery area. There is no pain with the procedure and patients seldom remember much about it.
What are Some Reasons Upper GI Endoscopies are Performed?
Endoscopies can be used to investigate the cause of symptoms, diagnose of a suspected (or sometimes even surprising) condition via biopsy, and sometimes, as a treatment method for known conditions. Endoscopies can investigate symptoms such as difficulty swallowing (dysphagia) and upper abdominal pain. Endoscopies can often diagnose Barrett’s disease, peptic ulcer disease, gastritis, esophageal stricture. Treatment via endoscopy is often accomplished by removal of polyps.
Endoscopies are indicated for those with GI symptoms that might be better understood via endoscopic scoping and for those who have a known history of peptic ulcer disease or Barrett’s esophagus.
How do I prepare for an Endoscopy?
It is important not to eat or drink anything for at least eight hours before the exam. The physician instructs the patient about the use of regular medications, including blood thinners, before the exam. In general, the important medications that might need adjustments are aspirin, Clopidogrel (Plavix), Warfarin (Coumadin), and Insulin. Blood pressure pills should be taken the morning of the procedure with a just a few small sips of water.
When will the Results of my Endoscopy be Available?
After the exam, the physician will explain the results to the patient and family. If the effects of the sedatives are prolonged, the physician may suggest a visit at a later date when the results can be fully understood. If a biopsy has been performed or a polyp removed, the results are not available for three to seven days.
What are Some Alternative Testing Methods to Endoscopy?
Alternative tests to upper GI endoscopy include a barium x-ray and ultrasound (sonogram) to study the organs in the upper abdomen. Study of the stools, blood and stomach juice can provide indirect information about a gastrointestinal condition. These exams, however, do not allow for a direct viewing of the esophagus, stomach and duodenum, removing of polyps or taking of biopsies.
What are Some Side Effects and Risks during an Endoscopy?
A temporary, mild throat irritation sometimes occurs after the exam. Serious risks with upper GI endoscopy, however, are very uncommon. One such risk is excessive bleeding, especially with removal of a large polyp. In extremely rare instances, a perforation, or tear, in the esophagus or stomach wall can occur. These complications may require hospitalization and, rarely, surgery. Quite uncommonly, a diagnostic error or oversight may occur. Other rare complications that could theoretically occur are oral-dental injuries, sedation complications like blood pressure changes, arrhythmia, vomiting. Due to the sedation, the patient should not drive or operate machinery following the exam. For this reason, someone else should be available to drive the patient home.