Upper GI Endoscopy
Esophagogastroduodenoscopy (EGD), also referred to as an upper endoscopy, is a procedure where a thin flexible scope is introduced through the mouth, into the pharynx, down the esophagus and into the stomach and duodenum. There is a light and camera at the end of the scope which allows images to be projected on to a television screen to allow the doctor to evaluate the lining of your upper gastrointestinal (GI) tract, take biopsies and perform therapeutic measures where necessary.
Who needs an Upper Endoscopy?
Upper Endoscopy can be used to evaluate many conditions, including:
- Gastroesophageal Reflux Disease (GERD)
- Peptic Ulcer Disease
- Barrett’s Esophagus (pre-cancerous condition of the esophagus that can lead to esophageal cancer)
- Non-Cardiac chest pain
- Hiatal Hernia
- Upper abdominal pain
- Upper gastrointestinal bleeding (vomiting blood or passing black stool)
- Difficulty swallowing
What preparation is required for this procedure?
Minimal preparation is required.
Activity and diet: You may carry out your regular activities and have your regular diet the day before your procedure date. No solid food after midnight prior to the procedure. Nothing to eat or drink 6 hrs prior to the procedure time.
Medication: It is important for your doctor to know what medication you are taking. Please bring a list of your medication with you to your consultation appointment. Necessary medication (such as Aspirin, if taken for known heart conditions, such as heart attack) can be taken with clear fluids (water, apple juice, coconut water) up to 4-6 hrs prior to procedure. If you are diabetic, do not take oral diabetic medication on the morning of the procedure as your blood sugar may drop too low. If you are on blood thinners (such as Coumadin, Rivaroxaban, Apixaban, Dabigatran), this will need to be discussed with the physician to determine the appropriate timing to stop taking them, once safe to do so. Blood thinners will need to be stopped anywhere from 1-5 days depending on the indication for it and level of your kidney function. Stop iron tablets for 1 week prior to the procedure as these may alter visualization for your procedure. If you have any concerns about your medications, please contact your physician.
Strictly follow the instructions outlined to allow the physician to be able to properly see the lining of your GI tract and prevent the procedure from being aborted.
An EGD is typically done in an endoscopy suite. FOSA has a recently furnished suite with state of the art equipment to facilitate this procedure under optimal conditions. Your heart rate, blood pressure, respiratory rate, and oxygen level will be monitored throughout your procedure. You will have a pulse oximeter placed on your finger that measures oxygen saturation and pulse, and a blood pressure cuff will be placed on your arm.
You will be given a protective device to put into in your mouth to protect your teeth from the endoscope. You will then be positioned so that you lie on your left side. The procedure is done under conscious sedation, where intravenous medication is given to make you comfortable. The back of your throat will also be sprayed to numb the area. The procedure is relatively quick and is usually completed within 30 minutes. Once you are comfortable the scope is gently placed into the mouth and advanced down the upper gastrointestinal tract. The tube will not interfere with your ability to breathe and is only mildly uncomfortable following the initial insertion. The procedure is not painful. A detailed evaluation of the mucosal lining is done and an appropriate assessment made. Biopsies are usually taken of your stomach lining as well as any additional concerning areas. In the event of bleeding lesions, such as ulcers, therapeutic measures can be undertaken at the same time to treat the area.
What to expect after the procedure?
After the procedure you will remain in the office for approximately 30 minutes until you are alert. However, ensure you make arrangements for someone to take you home on that day as you will not be able to drive or take public transportation on your own after receiving sedation. It is advised to take that day off work to allow the medication to completely wear out of your system. It is safe to return to work the day following the procedure.
Air is used to open up the GI tract and so you may experience some bloating immediately after the procedure. This will be passed out as belching or flatulence. It is recommended therefore that you have comfortable clothing to put on after the procedure that won’t restrict your abdominal area.
You may experience sore throat for 1-2 days as the scope may irritate the back of the throat. This is typically alleviated with gargling with warm salt water.
Often times, a biopsy may be taken of the mucosal lining. This will be sent to a pathologist for further evaluation. The results of this will typically be available a few weeks after submission. Your doctor will advise you of the results thereafter.
When resuming eating, please do so slowly. It is a good idea to start with cool or room temperature liquids and then gradually advance your diet as tolerated.
An Upper Endoscopy is a relatively quick procedure and is generally well tolerated. Please feel free to contact our office at FOSA if you are experiencing upper GI symptoms and need evaluation.