What is Upper Endoscopy?
Upper endoscopy (also known as an upper GI endoscopy, esophagogastroduodenoscopy
[EGD], or panendoscopy) is a procedure that enables your physician 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.
Why is Upper Endoscopy done?
Upper endoscopy is usually performed to evaluate symptoms of persistent upper
abdominal pain, nausea, vomiting, 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 cytology 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.
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 antibiotics prior to undergoing dental procedures, since you may
need antibiotics prior to upper endoscopy as well.
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 a heart or lung
condition that might require special attention during the procedure.
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.
What Can Be Expected During the Upper Endoscopy?
Your doctor will review with you why upper endoscopy is being performed, whether
any alternative tests are available and possible complications from the
procedure. Practices may vary among doctors, but you may 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
What Happens After Upper Endoscopy?
After the test, you will be monitored in the endoscopy area until most of the
effects of the medication have worn off. Your throat may be a little sore 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, your doctor can inform you of your test results on the
day of the procedure; however, the results of any biopsies or cytology samples
taken will take several days.
What are the Possible Complications of Upper Endoscopy?
Endoscopy is generally safe. Complications can occur but are rare when the test
is performed by physicians with specialized training and experience in this
procedure. Bleeding may occur from a biopsy site or where a polyp was removed.
It is usually minimal and rarely requires blood transfusions or surgery.
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 help 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
might 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.
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 your physician before
the examination begins.