Upper GI Endoscopy (EGD)
This procedure allows the physician to see the upper GI tract including the esophagus, stomach and the duodenum using a thin, lighted, flexible tube (called an endoscope). This procedure is used to evaluate difficulty swallowing, upper abdominal pain, nausea, vomiting, or to detect inflammation, ulcers, or tumors in the esophagus, stomach, or duodenum. During the procedure, the physician may take tissue samples for biopsy or collect cells for analysis. The procedure also can be used to treat certain upper GI conditions by removing polyps and stopping some types of bleeding.
Why is an upper endoscopy done?
An upper endoscopy helps your doctor evaluate symptoms of persistent upper abdominal pain, nausea, vomiting or difficulty swallowing. It’s an excellent test for finding 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.
Your doctor might use an upper endoscopy to obtain a biopsy (small tissue samples). A biopsy helps your doctor distinguish between benign and malignant (cancerous) tissues. Remember, biopsies are taken for many reasons, and your doctor might order one even if he or she does not suspect cancer. For example, your doctor might use a biopsy to test for Helicobacter pylori, which is a bacterium that causes ulcers.
Your doctor might also use upper endoscopy to perform a cytology test, where he or she will introduce a small brush to collect cells for analysis.
An upper endoscopy is also used to treat conditions of the upper gastrointestinal tract. Your doctor can pass instruments through the endoscope to directly treat many abnormalities with little or no discomfort. For example, your doctor might stretch a narrowed area, remove polyps (usually benign growths) or treat bleeding.
How should I prepare for the procedure?
An empty stomach allows for the best and safest examination, so you should have nothing to eat or drink (including water) for approximately six hours before the examination. Our staff will tell you when to start fasting.
Tell your doctor in advance about any medications you take as you might need to adjust your usual dose for the examination. Discuss any allergies to medications as well as medical conditions, such as heart or lung disease.
What happens during an upper endoscopy exam?
You should plan to spend about two hours at one of our endoscopy centers the day of your procedure. The exam itself, however, only takes approximately 15 to 30 minutes.
Since you will be sedated, you will need to arrive with someone who can drive you home and plan to take the remainder of the day off from work.
Before the exam:
- Wear comfortable clothing to your appointment.
- You will be asked about your medical history.
- You will be given a consent form to sign.
During the exam:
- You will be given medicine through an IV line in your hand or arm to help you relax.
- You will lie on your left side.
- Your heart rate and oxygen levels will be monitored continuously. If your blood pressure is low you may be given fluids through your IV line.
- Your doctor will pass the endoscope through your mouth and into the esophagus, stomach and duodenum. The endoscope doesn’t interfere with your breathing.
After the exam:
- You will rest for about 30 minutes after the upper endoscopy until most of the effects of the medication have worn off.
- You might notice that your throat is a little sore as well as some slight bloating because of the air introduced into your stomach during the test.
- The doctor will talk with you about the initial results of your examination. He generally can tell you your test results on the day of the procedure; however, the results of some tests might take 7-10 days.
- Following the exam you may resume your normal diet. You should, however, avoid alcohol on the day of your exam.
- You may resume your regular activities the day after the procedure.
- If you take a blood thinning medication such as aspirin, Coumadin or Plavix be sure and clarify instruction before you leave.
- A nurse will provide you with complete discharge instructions before you leave the endoscopy center.
What are the possible complications of an upper endoscopy?
Although complications can occur, they are rare when doctors who are specially trained and experienced in this procedure perform the test. Bleeding can occur at a biopsy site or where a polyp was removed, but it’s usually minimal and rarely requires follow-up. Other potential risks include a reaction to the sedative used, complications from heart or lung diseases, and perforation (a tear in the gastrointestinal tract lining). It’s important to recognize early signs of possible complications. If you have a fever after the test, trouble swallowing or increasing throat, chest or abdominal pain, tell your doctor immediately.