An upper GI Endoscopy can help to diagnose conditions of the upper GI tract

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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.

Upper GI Endoscopy 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.