Upper
GI Endoscopy Upper
GI endoscopy, sometimes called EGD, is a visual examination of the
upper intestinal tract using a flexible fiberoptic or video endoscope.
The upper intestinal tract starts with the mouth, and continues
with the esophagus (which carries food to the stomach). The stomach
secretes a potent acid and churns the food into small particles.
The food then enters the duodenum, or small bowel, where bile from
the liver and digestive juices from the pancreas mix with it to
help the digestive process.
Reasons
for the Exam Due
to factors related to diet, environment, and heredity, the upper
GI tract is the site of numerous disorders. Upper GI endoscopy helps
in the diagnosis and treatment of these condition.
- Ulcers
- Tumors
- stomach or esophagus
- Difficulty
in swallowing
- Upper
abdominal pain or indigestion
- Intestinal
bleeding
- Esophagitis
and heartburn
- Gastritis
Preparation
It
is important not to eat or drink anything for at least 6 hours prior
to the exam. The physician instructs the patient about the use of
regular medications before the exam.
Procedure
Upper
GI endoscopy is usually performed on an outpatient basis. The throat
is anesthetized by a spray or liquid.
Intravenous sedation is usually given
to relax a patient, supress the gag reflex, and provide the patient
with "twilight sleep" so the patient will not recall any
pain. For some individuals who can relax on their own, the exam is
done without intravenous medications. The endoscope is inserted into
the upper esophagus. The patient can breathe easily throughout the
exam. Other tests including biopsies can be made by obtaining small
tissue specimens for microscopic analysis. The procedure takes 10
to 15 minutes and is seldom remembered by the sedated patient. A recovery
area is utilized to monitor vital signs until the patient is fully
awake. There is no pain with the procedure and patients seldom remember
much about it.
Results
After
the exam, the physician will detail any significant findings, which
will be briefly discussed between the nurse and the patient and/or
family. If the effects of the sedatives are prolonged, the physician
may suggest an appointment at a later date. The sedation will impair
the patients' ability to recall details immediately after the procedure.
This is one of the reasons procedure results are discussed later at
the physician's office. Also, biopsy and polyp removal results are
not available for 14 days. This is another reason results are discussed
with the doctor and/or nurse approximately two weeks after a procedure.
Benefits
of the Procedure An
upper GI endoscopy is performed to identify or correct problems in
the upper gastrointestinal tract. The test enables a diagnosis to
be made and a specific treatment to be given. If a polyp is found
during the exam, it can be removed at that time, eliminating the need
for a major operation later. If a bleeding site is identified, treatment
can be administered to stop the bleeding.
Alternative
Testing Barium
x-ray and ultrasound (sonogram) are alternative tests that study the
organs in the upper abdomen. Study of the stools, blood, and stomach
juice can provide indirect information about a gastrointestinal condition.
These exams, however, do not allow direct viewing of the esophagus,
stomach, and duodenum, removal of polyps, or the completion of biopsies.
Side
Effects and Risks A
temporary, mild throat condition sometimes occurs after the exam.
Serious risks are uncommon. One such risk is excessive bleeding, especially
with the removal of a large polyp. Due to mild sedation, the patient
should not drive or operate machinery following the exam. For this
reason, someone should be available to drive the patient home.
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