Patient Information: Upper Endoscopy
Upper Endoscopy (also known as gastroscopy, EGD, or esophagogastroduodenoscopy) is a procedure that enables your surgeon to examine the lining of the esophagus (swallowing tube), stomach and duodenum (first portion of the small intestine. A bendable, lighted tube about the thickness of your little finger is placed through your mouth and into the stomach and duodenum.
Why Do An Upper Endoscopy?
Upper endoscopy is performed to evaluate symptoms of persistent upper abdominal pain, nausea, vomiting, difficulty swallowing or heartburn. It is an excellent method for finding the cause of bleeding from the upper gastrointestinal tract. It can be used to evaluate the esophagus or stomach after major surgery. It is more accurate than X-rays for detecting inflammation, ulcers or tumors of the esophagus, stomach and duodenum. Upper endoscopy can detect early cancer and can distinguish between cancerous and non-cancerous conditions by performing biopsies of suspicious areas. Biopsies are taken by using a specialized biting instrument to sample tissue. These are then sent to the laboratory to be analyzed. A biopsy is taken for many reasons and does not mean that cancer is suspected. A variety of instruments can be passed through the endoscope that allow the surgeon to treat many abnormalities with little or no discomfort. Your surgeon can stretch narrowed areas, remove polyps, remove swallowed objects, or treat upper gastrointestinal bleeding. Safe and effective control of bleeding has reduced the need for transfusions and surgery in many patients.
What Preparation Is Required?
The stomach should be completely empty. You should have nothing to eat or drink for at least 8 hours before the examination. Your surgeon will be more specific about the time to begin fasting depending on the time of day that your test is scheduled. Medication may need to be adjusted or avoided. It is therefore best to inform your surgeon of ALL your current medications as well as allergies to medications a few days prior to the examination. Also, if you have any major diseases, such as heart or lung disease that may require special attention during the procedure, discuss this with your surgeon. You will be sedated during the procedure and arrangements to have someone accompany you home afterward is imperative. Sedatives will affect your judgment and reflexes for the rest of the day. You should not drive or operate machinery until the next day.
What Can Be Expected During The Upper Endoscopy?
You may have your throat sprayed with a local anesthetic before the test begins and given medication through a vein to help you relax during the examination. You will be laid on your side in a comfortable position as the endoscope is gently passed through your mouth and into your esophagus, stomach and duodenum. The procedure usually lasts 10-15 minutes. The endoscope does not interfere with your breathing. Most patients fall asleep during the procedure. A few find it only slightly uncomfortable.
What Happens After Upper Endoscopy?
You will be monitored in the endoscopy area until the effects of the sedatives have worn off. Your throat may be a little sore for a day or two. You may feel bloated immediately after the procedure because of the air that is introduced into your stomach during the examination. You will be able to resume your diet and take your routine medication after you leave the endoscopy area, unless otherwise instructed. Your surgeon will usually inform you of your test results on the day of the procedure, unless biopsy samples were taken. These results take several days to return. The effects of sedation may make you forget what you were told so typically the individual that accompanies you will be given instructions regarding findings and follow-up. If you have any questions you should call your surgeon’s office.
What Complications Can Occur?
Gastroscopy and biopsy are generally safe when performed by surgeons who have had special training and are experienced in these endoscopic procedures. Complications are rare. However, they can occur and include bleeding from the site of a biopsy or polypectomy and a tear (perforation) through the lining of the intestinal wall. Blood transfusions are rarely required. A reaction to the sedatives can occur. Irritation to the vein that medications were given is uncommon, but may cause a tender lump lasting a few weeks. Warm, moist towels will help relieve this discomfort. It is important for you to recognize the early signs of possible complications and to contact your surgeon if you notice symptoms of difficulty swallowing, worsening throat pain, chest pains, severe abdominal pain, fevers, chills or rectal bleeding of more than one-half cup.
If you have any questions about your need for an upper endoscopy, alternative tests, the cost of the procedure, billing or insurance coverage, do not hesitate to ask your surgeon or his office staff about it. If you have questions about the exam or subsequent follow-up, please discuss them with your surgeon before or after the examination.