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Upper GI Endoscopy
all information

Upper GI Endoscopy

(Upper Gastrointestinal Endoscopy; Esophagogastroduodenoscopy [EGD])

En Español (Spanish Version)

Click here to view an animated version of this procedure.

Definition

Upper GI endoscopy is a procedure that uses a fiberoptic scope to examine the upper part of the gastrointestinal system. A slim, flexible tube containing a tiny light and video camera is slipped into the mouth, down the throat, through the esophagus, stomach, and duodenum (the first part of the small intestine). Images from the video camera can be viewed on a monitor in the procedure room, and photographs of particular areas may be taken. Some procedures can be performed through the endoscope, such as biopsies , testing for the presence of bacteria in the gastrointestinal tract, removing small growths (polyps), or treating a bleeding ulcer.

Upper GI Endoscopy

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Parts of the Body Involved

  • Mouth
  • Throat
  • Esophagus
  • Stomach
  • Small intestine

Reasons for Procedure

Upper GI endoscopy may be recommended if you have:

  • Abdominal pain
  • Severe heartburn
  • Persistent nausea and vomiting
  • Difficulty swallowing
  • Bleeding
  • Abnormal x-ray or other examinations of the gastrointestinal tract

Conditions that can be diagnosed with upper GI endoscopy include:

  • Ulcers
  • Tumors
  • Polyps
  • Abnormal narrowing (strictures)
  • Inflammation

Risk Factors for Complications during the Procedure

  • Age: 60 or older
  • Pregnancy
  • Obesity
  • Smoking
  • Malnutrition
  • Recent or chronic illness
  • Diabetes
  • Heart or lung problems
  • Bleeding disorders
  • Alcoholism
  • Use of certain medications, including blood pressure pills, muscle relaxants, tranquilizers, sleeping pills, insulin, steroids, sedatives, and hypnotic agents
  • Use of street drugs, including LSD, hallucinogens, marijuana, and cocaine

What to Expect

Prior to Procedure

You may wish to ask your doctor:

  • Whether your condition truly necessitates further diagnostic study
  • Whether there are any alternatives to endoscopy, such as barium swallow x-rays or ultrasound examination
  • Whether you should discontinue any medications prior to endoscopy, change your diet, take antibiotics, or change any of your usual activities prior to the procedure
  • What time you should stop eating and drinking prior to your procedure
  • How many endoscopic procedures he or she has performed

In the days leading up to your procedure:

  • Arrange for a ride to and from the procedure
  • Arrange for help at home after returning from the hospital
  • The night before, eat a light meal and do not eat or drink anything for 6 to 10 hours before your procedure is scheduled (ask your doctor when you should begin fasting prior to the procedure)
  • You may be given antibiotics to take before or after the procedure

Anesthesia

  • To numb your throat, you may be given an anesthetic solution to gargle or your throat may be sprayed with a numbing anesthetic
  • You may be given a sedative medication through an intravenous needle to help you relax during the procedure

Description of the Procedure

You may be asked to lie on your left side. You’ll have monitors tracking your breathing, heart rate, and blood oxygen levels. If sedation is used, you will be given supplemental oxygen to breathe through your nose.

A supportive mouthpiece will be positioned to help keep your mouth open. During the procedure, a small suction tube will be used to clear saliva and fluids from your mouth. The endoscope will be lubricated and placed into your mouth. You’ll be asked to try to swallow it, then it will be carefully and slowly advanced down your throat, through your esophagus, and into your stomach and intestine.

While the endoscope is being advanced, your doctor will be carefully viewing the images on the video monitor. Air may be passed through the endoscope into your digestive tract in order to smooth the normal folds in the tissues, allowing your doctor to view the tissue more easily. Tiny tools may be passed through the endoscope in order to take biopsies or perform other necessary procedures.

After Procedure

Tissues samples acquired during the procedure will be analyzed in a pathology laboratory.

How Long Will It Take?

An uncomplicated upper GI endoscopy takes about 10 to 15 minutes.

Will It Hurt?

You may feel some discomfort as the endoscope tube is passed down your throat; you may have a sore throat after the procedure. Because of the introduction of air into your gastrointestinal tract, you may feel a bit bloated after the procedure.

Possible Complications

  • Bleeding
  • Accidental perforation of the esophagus, stomach, or intestine
  • Abnormal heartbeat
  • Aspiration (breathing in fluids or solids from the stomach in to the lungs, which can cause pneumonia)
  • Infection
  • Fever
  • Respiratory depression (reduced breathing rate and/or depth)
  • Reaction to sedatives or numbing anesthetics

Average Hospital Stay

Upper GI endoscopy is usually performed on an outpatient basis, in a doctor’s office, outpatient surgery center, or hospital. After the procedure, you’ll be observed for about an hour, and then allowed to go home.

Postoperative Care

When you return home after the procedure, do the following to ensure a smooth recovery:

  • Follow your doctor’s guidance regarding diet; you’ll usually be allowed to return to a normal diet
  • Don’t drive or use any machinery for at least a day after your procedure, since the sedatives may slow your reaction time
  • Don’t drink alcohol for at least a day after your procedure
  • Get good rest throughout the remainder of the day

Outcome

The outcome of a successful upper GI endoscopy is information regarding the health of your gastrointestinal tract, which can help explain symptoms you’ve been experiencing. This information will allow your healthcare provider to make a treatment plan for any conditions that are diagnosed.

Call Your Doctor If Any of the Following Occurs

It is essential for you to monitor your recovery once you leave the hospital. That way, you can alert your doctor to any problems immediately. If any of the following occurs, call your doctor:

  • Increasing or persistent pain
  • Bleeding
  • Fever
  • Nausea and vomiting
  • Difficulty breathing
  • Difficulty swallowing
  • Increase or change in your original symptoms

RESOURCES:

The American Gastroenterological Association
http://www.gastro.org

American Society for Gastrointestinal Endoscopy
http://www.asge.org

CANADIAN RESOURCES:

Health Canada
http://www.hc-sc.gc.ca/index-e.html

Canadian Digestive Health Foundation
http://www.cdhf.ca/aboutcdhf.htm

References:

Davila M, EB Keeffe. Complications of Upper Endoscopy. Sleisenger & Fordtran's Gastrointestinal and Liver Disease . 7th ed. Elsevier; 2002. pp. 539-543.

Pasricha PJ. Gastrointestinal Endoscopy. Cecil Textbook of Medicine . 21st ed. Philadelphia, PA: WB Saunders Company; 2000. pp.649-653.

Santacroce L, S Gagliardi. Gastrointestinal endoscopy. Available at: http://www.emedicine.com/aaem/topic219.htm . Accessed September 16, 2003.

Understanding upper endoscopy. American Society for Gastrointestinal Endoscopy website. Available at: http://www.asge.org/gui/patient/upper.asp . Accessed September 16, 2003.

What is upper GI endoscopy? The American Gastroenterological Association website. Available at: http://www.gastro.org/clinicalRes/brochures/uppergi.html . Accessed September 16, 2003.

Your upper endoscopy at emory. Emory University School of Medicine website. Available at: http://www.emory.edu/WHSC/MED/GI/PROCEDURES/aboutegd.html . Accessed September 16, 2003.



Last reviewed November 2007 by Daus Mahnke, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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