• Upper GI Endoscopy

    (Upper Gastrointestinal Endoscopy; Esophagogastroduodenoscopy [EGD])

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    Definition

    This is a test that uses a fiberoptic scope to examine the esophagus (throat), stomach, and upper part of the small intestines.
    Upper GI Endoscopy
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    Reasons for Test

    Upper GI endoscopy may be recommended if you have:
    • Abdominal pain
    • Severe heartburn
    • Persistent nausea and vomiting
    • Difficulty swallowing
    • Blood in stool or vomit
    • Abnormal x-ray or other examinations of the gastrointestinal tract
    Conditions that can be diagnosed with upper GI endoscopy include:
    • Ulcers
    • Tumors
    • Polyps
    • Abnormal narrowing
    • Inflammation

    Possible Complications

    Complications are rare, but no procedure is completely free of risk. If you are planning to have upper GI endoscopy, your doctor will review a list of possible complications, which may include:
    • Bleeding
    • Damage to the esophagus, stomach, or intestine
    • Infection
    • Respiratory depression (reduced breathing rate and/or depth)
    • Reaction to sedatives or anesthesia
    Some factors that may increase the risk of complications include:
    • Age: 60 or older
    • Pregnancy
    • Obesity
    • Smoking, alcoholism, or drug use
    • Malnutrition
    • Recent illness
    • Diabetes
    • Heart or lung problems
    • Bleeding disorders
    • Use of certain medicines
    Be sure to discuss these risks with your doctor before the test.

    What to Expect

    Prior to test

    Leading up to the test:
    • Your doctor may instruct you to take antibiotics.
    • Arrange for a ride home after the test. Also, arrange for help at home.
    • The night before, eat a light meal. Do not eat or drink anything for 6-10 hours before the test.
    • Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, such as:
      • Anti-inflammatory drugs (such as aspirin)
      • Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)

    Description of the Test

    To numb your throat, you may be given an anesthetic solution to gargle. Or, your throat may be sprayed with a numbing medicine. You may be given a sedative through an IV. This is to help you relax during the test.
    You may be asked to lie on your left side. You will have monitors tracking your breathing, heart rate, and blood oxygen levels. If sedation is used, you will be given supplemental oxygen to breathe through your nose.
    A mouthpiece will be positioned to help keep your mouth open. During the test, a small suction tube will be used to clear saliva and fluids from your mouth. The endoscope will be lubricated and placed in your mouth. You will be asked to try to swallow it. Then, it will be carefully and slowly advanced down your throat. It will be passed through your esophagus and into your stomach and intestine.
    While the endoscope is being advanced, your doctor will view the images on the screen. Air may be passed through the endoscope into your digestive tract. This will be done to smooth the normal folds in the tissues, allowing your doctor to view the tissue more easily. Tiny tools may be passed through the endoscope in order to take biopsies or do other tests.

    After Test

    After the test, you will be observed for an hour. Then, you will be allowed to go home.
    When you return home after the test, do the following to help ensure a smooth recovery:
    • Rest when you get home.
    • Ask your doctor if you can resume your normal diet. In most cases, you will be able to.
    • Sedatives can slow your reaction time. Do not drive or use machinery for the rest of the day.
    • Avoid alcohol for the rest of the day.
    • Be sure to follow your doctor's instructions.

    How Long Will It Take?

    About 10-15 minutes

    Will It Hurt?

    Yes, you will have discomfort during the test. Your throat will be sore. Also, you may feel bloated after the test.

    Results

    This test gives your doctor information about the health of your digestive system. The results can help to explain your symptoms. You and your doctor will talk about the results and your treatment plan.

    Call Your Doctor

    After the test, call your doctor if any of the following occur:
    • Signs of infection, including fever and chills
    • Severe abdominal pain
    • Hard, swollen abdomen
    • Difficulty swallowing or breathing
    • Any change or increase in your original symptoms
    • Bloody or black tarry colored stools
    • Nausea and/or vomiting
    • Cough, shortness of breath, or chest pain
    • Bleeding
    In case of an emergency, call for medical help right away.

    RESOURCES

    The American Gastroenterological Association http://www.gastro.org

    American Society for Gastrointestinal Endoscopy http://www.asge.org

    CANADIAN RESOURCES

    Canadian Digestive Health Foundation http://www.cdhf.ca

    Health Canada http://www.hc-sc.gc.ca/index-eng.php

    References

    Davila M, Keeffe E. Complications of Upper Endoscopy. In: Feldman M, Friedman L, Sleisenger M. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 7th ed. Philadelphia, PA: Saunders; 2002:539-543.

    Endoscopy. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/endoscopy/MY00138. Updated July 2008. Accessed July 27, 2009.

    Pasricha PJ. Gastrointestinal Endoscopy. Cecil Textbook of Medicine. 21st ed. Philadelphia, PA: WB Saunders Company; 2000: 649-653.

    Understanding upper endoscopy. American Society for Gastrointestinal Endoscopy website. Available at: http://www.asge.org/patientinfoindex.aspx?id=378&terms=understanding+upper+endoscopy. Accessed July 27, 2009.

    What is upper GI endoscopy? The American Gastroenterological Association website. Available at: http://www.gastro.org/wmspage.cfm?parm1=5388. Accessed July 27, 2009.

    Your upper GI. Emory University School of Medicine website. Available at: http://medicine.emory.edu/gi/tests/pdfs/Your%20Upper%20GI%20Endoscopy%20At%20Emory.pdf. Updated May 2004. Accessed July 27, 2009.

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