Upper Endoscopy

What is an upper endoscopy?

Upper endoscopy (also known as an upper GI endoscopy, esophagogastroduodenoscopy [EGD], is a procedure that enables your physician to examine the lining of the esophagus (swallowing tube), stomach, and duodenum (first portion of the small intestine) using a thin flexible tube with its own lens and light source.

Upper endoscopy is also used to screed for the dilated veins (varices) in the esophagus and the lining of the stomach which can form in the presence of scarring of the liver (cirrhosis).

This procedure is also performed to evaluate symptoms of persistent upper abdominal pain,nausea, vomiting, and difficulty swallowing or weight loss.  It is the best test for finding the causeof upper intestinal bleeding.

Upper endoscopy is more accurate than x-ray films for detecting inflammation, ulcers, or early cancer. Biopsies and brush cytology can be easily and swiftly obtained if tumor or infection are suspected.

Upper endoscopy is also used to treat certain conditions and, thereby, to prevent the need for surgery. Strictures (narrowings) can be stretched, polyps can be removed, and bleeding lesions can be treated to stop or to prevent bleeding.

Preparation 

For the safest examination, the stomach must be empty. You should have nothing to eat or drink, including water, for 6 hours before endoscopy.

Your physician will need to know of any medications, major illnesses or allergies so that you can be given instructions about these prior to endoscopy. For some patients and some procedures, antibiotics are given intravenously prior to upper endoscopy.

The medical staff will also want to know if you have heart disease, lung disease, or any medical conditionthat may need special attention.  You must also arrange for someone to take you home afterward, because you will not be allowed to drive after being sedated.

Procedure

At the Endoscopy Center, you will be registered as a patient, will be given a consent form to read and to sign, and will have the opportunity to ask the nurse and doctor questions. A plastic catheter (IV) will be placed in an arm or hand vein. Your throat will be sprayed with a local anesthetic and your physician will give you medications through the vein to help you relax during the test.

Generally, patients are awake but so relaxed that there is no discomfort or memory of the endoscopy. While lying comfortably on your left side, a small tube (the endoscope) is passed through the mouth and gently guided into the esophagus by the physician. The esophagus, stomach, and duodenum are inspected for 5 to 15 minutes. Most patients have no discomfort and many patients fall asleep during the procedure

What happens after upper endoscopy?

After the test, you will be monitored in the Endoscopy Center for 15-60 minutes until most of the effects of the medication have worn off. Your throat may be a little sore for awhile, and you may feel bloated right after the procedure because of air introduced into your stomach during the test. Most patients are allowed to eat after leaving the Endoscopy Center.

Your physician will speak to you after the test but you likely will not remember this. Therefore, the physician will speak with the person driving you home and our nurse will give you written instructions and results of the procedure.

A report will be sent to your primary physician in a few days. (top) Please plan to be at the Endoscopy Center for three hours.

Possible complications of upper endoscopy

Endoscopy is generally safe and complications are rare when the test is performed by a Board-certified gastroenterologist.

Bleeding may occur from a biopsy site or where a polyp was removed. Bleeding is usually minimal and rarely requires blood transfusions or surgery.

Irritation may occur at the vein where medications were given, sometimes leaving a tender lump lasting several weeks. Applying hot moist towels may help relieve discomfort.

Other rare risks include a reaction to the sedatives used, aggravation of heart or lung diseases, or perforation (a tear that might require surgery for repair).

Please call the Hepatology Department immediately if after the procedure you develop fever, significant pain, or bleeding.