What is an upper gastrointestinal (GI) endoscopy?
An upper GI endoscopy is also called an EGD. EGD stands for esophagogastroduodenoscopy, also known as upper endoscopy or gastroscopy. An upper GI endoscopy is an exam that uses a thin flexible fiberoptic scope called an endoscope to evaluate the esophagus, stomach, and approximately five inches of the upper small intestine (duodenum). The endoscope has its own lens and light source so that Dr. Makhani can view the images on a video monitor.
Esophagus Stomach
Why is an upper GI endoscopy done?
This procedure is performed to evaluate symptoms of persistent upper abdominal pain, nausea, vomiting, acid reflux, anemia, difficulty swallowing or unexplained weight loss. It can be used to make a diagnosis in patients with heartburn, abdominal pain, or abnormal bleeding. It’s the best test for finding and treating the cause of bleeding from the upper gastrointestinal tract. It’s also more accurate than X-ray films for detecting inflammation, ulcers and tumors of the esophagus, stomach and duodenum. The endoscope can be used to take biopsies (tiny tissue samples). A biopsy helps Dr. Makhani distinguish between benign and malignant (cancerous) tissues. Remember, biopsies are taken for many reasons, and Dr. Makhani might perform a biopsy even if he does not suspect cancer. For example, he might use a biopsy to test for Helicobacter pylori, the bacterium that causes ulcers.
What preparations are required for an upper GI endoscopy?
An empty stomach allows for the best and safest examination, so patients should have nothing to eat or drink, including water, for approximately 8 hours before the examination. Usually patients should stop eating and drinking at midnight the evening before the procedure. Smoking and chewing gum are also prohibited during this time.
Can I take my current medications?
Most medications can be continued as usual, but some medications can interfere with the preparation or the examination. Certain medications including blood thinning medicines, particularly aspirin products, arthritis medications (NSAIDs such as Ibuprofen), anticoagulants (Warfarin, Lovenox, or Heparin), Plavix (clopidogrel), Ticlid (ticlopidine) and Aggrenox may need to be held. If you are a diabetic, you should take half of your normal morning insulin dose. Also, be sure to mention any allergies you have to medications on the day of the procedure.
What happens during the upper GI endoscopy?
You will check into the surgery center on the day of your procedure. To perform the endoscopy, you will be sedated with medicine given through an IV. A small sterile catheter will be placed in a vein of your arm. Medicine will then be injected through this catheter by a board certified anesthesiologist to make you sleepy and relaxed. During the procedure, your blood pressure, heart rate, and blood oxygen level will be monitored.
As you lay on your left side, Dr. Makhani will insert a thin, flexible tube into your mouth and gently advance it into your esophagus. The endoscope does not interfere with your breathing. By advancing the tube slowly and introducing air, the inner lining of the upper digestive tract can be viewed. Often a biopsy specimen (tiny bit of tissue) is taken for microscopic examination by a pathologist. You will not feel any discomfort when the biopsy is performed. The results of the test may take several days if a biopsy or other test is taken.
Sometimes a dilatation (stretching or widening) is performed during the endoscopy test, due to a narrowing (stricture) in the esophagus. Dr. Makhani will explain this to you in more detail prior to performing the dilation if it might be necessary.
An endoscopy exam takes 15 to 30 minutes to complete and there is no real pain. After the examination, you will be taken to a recovery area. Most people have no recollection of the procedure because of the amnesic effects of the medicine.
What happens after upper GI endoscopy?
After the procedure, you will feel drowsy and may sleep for a short time. You will be monitored until most of the effects of the medication have worn off. The effects of the medicine will wear off quickly, but you will not be allowed to drive yourself home, as it would be unsafe.
Before you leave the endoscopy center, Dr. Makhani will discuss the procedure findings and treatment plans with you, although you’ll probably have to wait for the results of any biopsies performed. You should have a family member or trusted friend present during this discussion, as the medication you received may make you forgetful.
Since you will receive sedatives during the procedure, someone must drive you home and stay with you. Even if you feel alert after the procedure, your judgment and reflexes could be impaired for the rest of the day. Do not drive a car or operate any dangerous equipment for at least 24 hours after being sedated.
Your throat might be a little sore, and you might feel bloated because of the air introduced into your stomach during the test. It is better to stick to liquids and soft foods until your pain is better. You will be able to eat after you leave unless Dr. Makhani instructs you otherwise.
Our nursing staff will provide you with a written copy of the findings and treatment instructions, as well as handouts on appropriate topics. Your primary physician will receive a report as well.
What are the possible complications of upper GI endoscopy?
Although complications can occur, serious complications are rare. Bleeding can occur at a biopsy site or where a polyp was removed, but it’s usually minimal and rarely requires follow-up. Perforation (a hole or tear in the gastrointestinal tract lining) may require surgery but this is a very uncommon complication. Some patients might have a reaction to the sedatives or complications from heart or lung disease.
Contact Dr. Makhani immediately if you have any of the following:
- Fever after the procedure
- Trouble swallowing
- Increasing throat, chest or abdominal pain
- Bleeding, including black stools. Note that bleeding can occur several days after the procedure.
We look forward to seeing you on the day of your procedure.
To better inform you about your scheduled procedure, we have referenced a video link that demonstrates what to expect before, during and after an upper GI endoscopy: