An esophagogastroduodenoscopy, also known as an upper GI endoscopy or EGD, is a procedure where a doctor uses an endoscope (a long flexible tube with a camera attached) to see the lining of your upper GI tract (the area of your body that encompasses your esophagus, stomach, and the first part of your small intestine, or duodenum). It is used to find the cause of abnormal lab tests and can identify many different diseases and shed light on unexplained symptoms of persistent heartburn, bleeding, nausea, pain, problems swallowing or unexplained weight loss.
If these problems are caused by any of the following diseases, an upper GI endoscopy can identify the cause of it:
- Barrett’s Esophagus: a condition that increases your risk of esophageal cancer
- Celiac Disease
- Gastroesophogeal Reflux Disease
- Inflammation of the Esophagus (Esophagitis) or Stomach (Gastritis)
- Nutritional Deficiencies
- Precancerous Abnormalities
Sometimes the doctor will pass an instrument through the endoscope to take a small piece of your tissue to test for cancer, celiac disease or gastritis. Upper GI endoscopies can also be used to treat conditions, dilate strictures, or remove objects in your upper GI tract.
Before The Procedure
Your doctor will review your medical history with you and ask you questions. Let your doctor know if you are allergic to any medicine, what medications you are taking, have bleeding problems or take blood thinners, have heart problems, are or might be pregnant, take insulin for your diabetes, or if you have had surgery or radiation treatments to your esophagus, stomach, or duodenum before.
Do not eat or drink anything for 6-8 hours before the test. Having your stomach empty can help your doctor see your stomach more clearly, and it reduces your chances of vomiting. Vomiting is especially undesirable during the procedure because there is a small risk of vomit entering your lungs (aspiration). If the test is performed during an emergency situation your stomach may be pumped of its contents beforehand. Make sure you remove your dentures, jewelry, or contacts/glasses before the test. For your own comfort, make sure you empty your bladder as well. You will be given a sedative before the test and will need to arrange a ride home for yourself.
An upper GI endoscopy can be done in a doctor’s office, a clinic, or a hospital. An overnight stay is usually not needed. Most often it is performed by a gastroenterologist, a doctor who specializes in the digestive system. Sometimes family medicine doctors, internists, and surgeons are also trained to do this test.
Before your procedure, your blood will be tested for low blood counts or clotting problems. Your throat will be numbed with an anesthetic that will relax your gag reflex and make it easier for the specialist to insert the endoscope into your throat. A sedative will be administered through an IV in your arm or hand. You will be asked to lie on your left side with your head bent slightly forward. A mouth guard will be placed in your mouth to protect your teeth from the endoscope, and its lubricated tip will be guided into your mouth. Your tongue will be pressed down by the doctor and you may be ask to swallow to help the tube along. It all sounds a bit intrusive and scary, but don’t worry! The scope is thinner than most of the food you swallow and it will not cause breathing problems. After the scope is in your esophagus your head is tilted upright. As the scope slides down your esophagus someone may remove the saliva from your mouth with a draining device or you will be allowed to let the saliva drain from the sides of your mouth. The doctor looks through an eyepiece or watches a screen while slowly moving the endoscope. The walls of your esophagus, stomach, and duodenum will be checked, with air or water occasionally injected through the scope to help clear a path for the lens. Suction may be applied to remove air or secretions as the scope’s camera takes pictures. The doctor may insert tiny tools to collect tissue samples, remove growths, or stop any bleeding. Someone may change your position or apply gentle pressure to your belly to make it easier for the doctor to see different parts of your upper GI tract more clearly. When the exam is over the scope will be slowly pulled out of you.
Upper GI Endoscopy Recovery
The test usually takes around 45 minutes, but may take longer depending on what the doctor finds and what is being done during the test. After it’s over, you will be under observation for about 2 hours until the medicines wear off. For your own safety, do not eat or drink anything until your throat is no longer numb and your gag reflex is back to normal. When you are fully recovered you can go home. Talk to your doctor about when you can go back to your usual diet and activities. Do not drink any alcohol for 24 hours after the test.
Complications during an upper GI endoscopy are rare, but the risks of problems is higher if you have serious heart disease, are over 50, or are frail or physically weakened. The slight risks of an upper GI endoscopy are:
- Holes – small holes in the esophagus, stomach, or upper small intestine. If this happens you may need surgery to fix it.
- Bleeding – the bleeding usually stops on its own without treatment.
- Aspiration Pneumonia – if you vomit during the procedure, and some of your vomit enters your lungs it can cause aspiration, which can be treated with antibiotics.
- Irregular Heartbeat – you may feel your heart beating irregularly during the test, but it almost always goes away on its own.
After the test, call emergency services right away if you feel short of breath or dizzy, have fever or chills (possible symptoms of infection), or are vomiting blood (it can either be fresh and red or is old and looks like coffee grounds).
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