Upper GI Endoscopy, sometimes called EGD (Esophagogastroduodenoscopy), is a visual examination of the upper intestinal tract using a lighted, flexible fiber optic video endoscope.
The upper gastrointestinal tract begins with the mouth and continues with the esophagus (food tube), which carries the food to the stomach. The J-shaped stomach secretes a potent acid and churns 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.
The flexible endoscope is a remarkable piece of equipment that can be directed and moved around the many bends in the gastrointestinal tract. Electronic signals are then transmitted up to the scope to the computer, which then displays the image on a large video screen. An open channel in these scopes allows other instruments to be passed through in order to take tissue samples, remove polyps and perform other exams.
Reasons for the Exam
Due to factors related to diet, environment and heredity, the upper GI tract is the site of numerous disorders. These can develop into a variety of diseases and /or symptoms. Upper GI endoscopy helps in diagnosing and treating these conditions:
Ulcers, which can develop in the esophagus, stomach or duodenum; occasionally ulcers can be malignant tumors of the stomach or esophagus. Ulcers may cause difficulty in swallowing, upper abdominal pain or indigestion. Intestinal bleeding- hidden or massive bleeding can occur for various reasons Esophagitis or heartburn- chronic inflammation of the esophagus due to reflux of stomach acid and digestive juices. Gastritis- inflammation of the lining of the stomach.
It is important not to eat or drink anything for at least 8 hours before the exam. The physician will instruct you about the use of regular medications, including blood thinners, before the exam.
Upper GI endoscopy is usually performed with the patient lying on their left side. The throat is anesthetized by a spray. Intravenous sedation is given to relax the patient, deaden the gag reflex and cause short-term amnesia.
The endoscope is then gently inserted into the upper esophagus and is swallowed by the patient. The patient can breath easily throughout the exam. Other instruments can be passed through the endoscope to perform additional procedures if necessary.
For example, a biopsy can be done in which a small tissue specimen is obtained for microscopic analysis. A polyp can be removed using a thin wire snare and electrocautery (electrical heat).
The exam takes approximately 15 minutes, after which the patient is taken to the recovery area. There is no pain with the procedure and patients seldom remember much about it.
After the exam, the physician will explain the results to the patient and family. If the effects of the sedatives are prolonged, the physician may suggest an interview at a later date when the results can be fully understood. If a biopsy has been performed or a polyp removed, the results are not available for three to seven days.
An upper GI endoscopy is performed primarily to identify and /or correct a problem in the upper gastrointestinal tract. This means the test enables a diagnosis to be made upon which specific treatment can be given. If a bleeding site is identified, treatment can stop the bleeding or if a polyp is found, it can be removed without a major operation.
Alternative tests to the upper GI Endoscopy include a barium x-ray and ultrasound (sonogram) to study the organs in the upper abdomen. Study of the stools, blood and stomach acid can provide indirect information about a gastrointestinal condition. These exams, however, do not allow for a direct viewing of the esophagus, stomach and duodenum, removing of polyps or taking biopsies.
Side Effects and Risks
A temporary, mild throat irritation sometimes occurs after the exam. Serious risks with the upper GI endoscopy however are very uncommon. One such risk is excessive bleeding especially with removal of a large polyp.
In extremely rare instances, a perforation, or tear, in the esophagus or stomach wall can occur. These complications may require hospitalization and rarely, surgery. Quite uncommonly, a diagnostic error or oversight may occur.
Due to the mild sedation, the patient should not drive or operate machinery following the exam. For this reason this facility will not perform a sedated procedure on a person with no ride home!