Understanding Upper Endoscopy
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Information
on this Page:
The
doctor has determined that upper endoscopy is necessary for further evaluation
of treatment of your condition. This information has been prepared to help you
understand the procedure. It includes answers to questions patients ask most
frequently. Please read it carefully. If you have additional questions, please
feel free to discuss them with the endoscopy nurse or the doctor before the
examination begins.
What is upper endoscopy?
Upper endoscopy (also
known as an upper Gl endoscopy, esophagogastroduodenoscopy [EGD], or
panendoscopy) is a procedure that enables the doctor to examine the lining of
the upper part of your gastrointestinal tract, i.e., the esophagus (swallowing
tube), stomach, and duodenum (first portion of the small intestine) using a thin
flexible tube
with
its own lens and light source.
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Why is Upper Endoscopy done?
Upper
endoscopy is usually performed to evaluate symptoms of persistent upper abnormal
pain, nausea, vomiting, anemia, or difficulty swallowing. It is also the best
test for finding the cause of bleeding from the upper gastrointestinal tract.
Upper
endoscopy is more accurate than x-ray films for detecting inflammation, ulcers,
or tumors of the esophagus, stomach and duodenum. Upper endoscopy can detect
early cancer and can distinguish between benign and malignant (cancerous)
conditions when biopsies (small tissue samples) of suspicious areas are
obtained. Biopsies are taken for many reasons and do not necessarily mean that
cancer is suspected. A cylology test (introduction of a small brush to collect
cells) may also be performed.
Upper
endoscopy is also used to treat conditions present in the upper gastrointestinal
tract. A variety of instruments can be passed through the endoscope that allow
many abnormalities to be treated directly with little or no discomfort, for
example, stretching narrowed areas, removing polyps (usually benign growths) or
swallowed objects, or treating upper gastrointestinal bleeding. Safe and
effective endoscopic control of bleeding has reduced the need for transfusions
and surgery in many patients.
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What Preparation is Required?
For
the best (and safest) examination the stomach must be completely empty. You
should have nothing to eat or drink, including water, for approximately 6 hours
before the examination. Your doctor will be more specific about the time to
begin fasting, depending on the time of day that your test is scheduled.
It is
best to inform your doctor of your current medications as well as any allergies
several days prior to the examination. You should alert your doctor if you
require antibodies prior to undergoing dental procedures, since you may need
antibiotics prior to upper endoscopy as well.
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Possible
Medication Adjustments
Before the test, be sure to discuss with the doctor whether you should adjust
any of your usual medications before the procedure, any drug allergies you may
have, and whether you have any other major diseases such as heart or lung
condition that might require special attention during the procedure.
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Arrangements To Get Home After the Test
If
you are sedated, you will need to arrange to have someone accompany you home
from the examination because sedatives may affect your judgment and reflexes for
the rest of the day. If you received sedation, you will not be allowed to drive
after the procedure even though you may not feel tired.
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What Can Be Expected During the Upper
Endoscopy?
The
doctor will review with you why upper endoscopy is being performed, whether any
alternative tests are available and possible complications from the procedure.
You will have your throat sprayed with a local anesthetic before the test begins
and may be given medication through a vein to help you relax during the test.
While you are in a comfortable position on your side, the endoscope is passed
through the mouth and then in turn through the esophagus, stomach, and
duodenum. The endoscope does not interfere with your breathing during the
test. Most patients consider the test to be only slightly uncomfortable and
many patients fall asleep during the procedure.
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What Happens
After Endoscopy?
After
the test, you will monitor in the endoscopy area until most of the effects of
the medication have worn off. Your throat may be a little soar for a while, and
you may feel bloated right after the procedure because of the air introduced
into your stomach during the test. You will be able to resume your diet after
you leave the procedure area unless you are instructed otherwise.
In
most circumstances, the doctor can inform you of your test results on the day of
the procedure; however, the results of any biopsies or cylology samples taken
will take several days.
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What are the
Possible Complications of Upper Endoscopy?
Endoscopy is generally safe. Complications can occur but are rare when
physicians with specialized training and experience in this procedure perform
the test. Bleeding may occur from a biopsy site or where a polyp was removed.
This bleeding is usually minimal and may require a blood transfusion. In extreme
cases hospitalizations or surgery may be warranted. Localized irritation of the
vein where the medication was injected may rarely cause a tender lump lasting
for several weeks, but this will go away eventually. Applying heat packs or hot
moist towels may relieve discomfort. Other potential risks include a reaction
to the sedatives used and complications from heart or lung diseases. Major
complications, e.g., perforation (a tear that may require surgery for repair)
are very uncommon. It is important for you to recognize early signs of any
possible complication. If you begin to run a fever after the test, begin to
have trouble swallowing, or have increasing throat, chest, or abdominal pain,
let your doctor know about it promptly.
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To the Patient
Because education is an important part of comprehensive medical care, you have
been provided with this information to prepare you for this procedure. If you
have any questions about your need for upper endoscopy, alternative tests, the
cost of the procedure, methods of billing, or insurance coverage, do not
hesitate to speak to your doctor or doctor’s office staff about it. Most
endoscopists are highly trained specialists and welcome your questions regarding
their credentials and training. If you have questions that have not been
answered, please discuss them with the endoscopy nurse or the doctor before the
examination begins.
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