Procedures

Upper Endoscopy

Sometimes referred to as upper GI endoscopy, esophagogastroduodenoscopy (EGD), or panendoscopy, an upper endoscopy is performed when a physician needs to examine the lining of the upper part of the patient’s gastrointestinal tract, including the esophagus, stomach, and duodenum. During an upper endoscopy, a small flexible tube-shaped camera called an endoscope is used examine the upper part of the gastrointestinal tract, and images are viewed by the doctor on a video monitor.

Purpose

An upper endoscopy is used to evaluate upper abdominal pain, upset stomach, heartburn, nausea, vomiting, or difficulty swallowing. It can also be used to evaluate for gastrointestinal blood loss from the upper GI tract. At the time of an upper endoscopy, instruments can be passed through the endoscope to stretch or dilate a narrow area of the esophagus, to remove polyps, or to take biopsies, all without causing the patient any considerable discomfort. Upper Endoscopy is also known to be more accurate than X-rays when being used to diagnose ulcers, tumors, and pinpointing the cause of bleeding in the upper GI tract. This procedure may also be used to perform a cytology test, in which a small brush is used to collect cells for analysis similar to a biopsy.

During the procedure, the physician may choose to take a tissue sample, otherwise known as a biopsy, of any area that he or she feels may need further examination. However, biopsies are not always ordered to test for cancerous cells and should not automatically cause concern. For example, polyps, though typically benign, are commonly removed during an upper endoscopy. Physicians may also order a biopsy to diagnose Helicobacter pylori, which is a type of bacterium that may cause ulcers.

Preparation

Although most medications can be taken as usual, it is important to let your doctor know all medications that you take, because it is possible that they may need to be stopped temporarily prior to your procedure. In particular, let your doctor know if you take aspirin, arthritis medications, anticoagulants (blood thinners such as Warfarin, Lovenox, Plavix, Eliquis, Xarelto, Brilinta, Pradaxa, Effient), medications for diabetes, or iron products. Allergies to any medications should also be mentioned before the exam.
Preparation for the EGD is relatively simple: the procedure requires an empty stomach, so you will need to fast for approximately six hours before the exam. Timing can vary for certain patients, so make sure to review this with your doctor.

Before an upper endoscopy, an anesthesia provider may spray the throat with a local anesthetic. Intravenous anesthesia will be administered by our anesthesia staff. The patient will lie on their left side for the procedure. An endoscope is inserted into the mouth, through the esophagus, and into the stomach, and then into the duodenum. The endoscope will not impede on the patient’s breathing or cause any discomfort.

Post-Upper Endoscopy

After an upper endoscopy is completed, the patient will wake up within a few minutes. There will then be a period of time where the patient is monitored until most of the anesthesia has worn off, and then they can be discharged unless a physician instructs otherwise. The physician who performed the procedure will explain the results, and let the patient know if there were any biopsies performed. Biopsy results are usually available in one week. As anesthesia is administered as part of the examination, the patient will need to have someone drive them home and stay with them. Additionally, the throat may feel slightly irritated after an upper endoscopy and the stomach may feel bloated due to the introduction of additional air during the exam. Patients may eat immediately after the procedure unless their doctor gives other instructions.

Complications

Complications during an upper endoscopy are unusual, however, bleeding or perforation are rare complications of the procedure. Patients can have an adverse reaction to the anesthesia, or there can be complications due to existing heart or lung disease.
Upper Endoscopies are known for being very safe, but it is still important to know the warning signs of possible complications. In the event of a fever, difficulty swallowing, throat, chest or abdominal pain, bleeding, or black stool, contact the center or physician immediately. It is possible for bleeding to occur several days after the procedure. Any concerns should be addressed as soon as possible in order to treat any early signs of issues as a direct result of the procedure.