Upper endoscopy or EGD (esophago-gastro-duodenscopy) is a procedure where a physician uses a flexible, thin tube with a camera and a light source to examine the inner lining of a patient’s upper gastrointestinal tract, which includes the esophagus, stomach and duodenum (first portion of the small intestine).
Upper endoscopy is performed to evaluate causes of upper abdominal pain, nausea, vomiting, trouble swallowing, or symptoms of indigestion (belching, heartburn, bloating, or upset stomach associated with eating). The test is also often performed to evaluate for causes of unexplained weight loss or anemia. It is the preferred test to evaluate upper gastrointestinal bleeding. Upper endoscopy can find problems in the upper gastrointestinal tract such as ulcers, abnormal growths, polyps, inflammation, or hiatal hernia.
Upper endoscopy can also be used to obtain tissue specimens (biopsies). It can also be used to treat problems of the upper gastrointestinal tract, such as removing foreign bodies or food stuck in the esophagus, stretch narrowed segments (strictures) or stop bleeding spots (such as bleeding ulcer).
The upper GI tract must be empty before upper endoscopy. Generally, no eating or drinking is allowed for 6 to 8 hours before the procedure. Smoking and chewing gum are also prohibited during this time.
Patients should tell their doctor about all health conditions they have—especially heart and lung problems, diabetes, and allergies— and all medications they are taking. Patients may be asked to temporarily stop taking medications that affect blood clotting or interact with sedatives, which are often given during upper GI endoscopy.
Medications and vitamins that may be restricted before and after upper GI endoscopy include:
Driving is not permitted for 24 hours after upper GI endoscopy to allow sedatives time to completely wear off. Before the appointment, patients should make plans for a ride home.
Upper endoscopy is conducted at a hospital or outpatient center. Patients will first change into a gown and their belongings will be stored in a secure area. Patients may receive a local, liquid anesthetic that is gargled or sprayed on the back of the throat. The anesthetic numbs the throat and calms the gag reflex. An intravenous (IV) needle is placed in a vein in the arm so sedatives can be administered. Sedatives help patients stay relaxed and comfortable. Most patients fall asleep with sedatives during the procedure. While patients are sedated, the doctor and medical staff monitor vital signs. Patients continue to breathe on their own throughout the procedure.
During the procedure, patients lie on their back or side on an examination table. An endoscope is carefully fed down the esophagus and into the stomach and duodenum. A small camera mounted on the endoscope transmits a video image to a video monitor, allowing close examination of the intestinal lining. Air is pumped through the endoscope to inflate the stomach and duodenum, making them easier to see. Special tools that slide through the endoscope allow the doctor to perform biopsies, stop bleeding, and remove abnormal growths.
After the upper endoscopy, patients are moved to a recovery room where they wait about an hour for the sedative to wear off. During this time, patients may feel bloated or nauseated. They may also have a sore throat, which can stay for a day or two. Patients will likely feel tired and should plan to rest for the remainder of the day. Unless otherwise directed, patients may immediately resume their normal diet and medications.
Some results from upper GI endoscopy are available immediately after the procedure. The doctor will often share results with the patient after the sedative has worn off. Biopsy results are usually ready in one to two weeks.
Overall, the risks associated with upper endoscopy are very low. Bleeding can occur from a biopsy or removal of a polyp or growth from the upper endoscopy, but such bleeding often stops on its own or can be controlled through the endoscopy. Perforation (a hole or a deep tear in the lining of the gastrointestinal tract) may require surgery, but this is a very uncommon complication. Other risks involve complications related to the anesthetics and sedatives (breathing difficulties, aspiration) or complications related to heart and lung disease.
Much of this content is derived from the website: http://digestive.niddk.nih.gov/ddiseases/pubs/upperendoscopy/
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