Understanding Upper Endoscopy

Upper Endoscopy Defined

An endoscope is a bendable, narrow tube with a lighted camera that’s used to perform internal exams. The instrument transmits video images to a monitor, giving the doctor a clear view of an interior area. In an upper endoscopy, this involves the upper GI (gastrointestinal) tract, which is defined as the esophagus, stomach and top section of the small intestine, also known as the duodenum. Other names for this procedure include esophagogastroduodenoscopy (EGD), upper GI endoscopy and panendoscopy.

Purpose of an Upper Endoscopy

By looking directly into your GI tract, your doctor can determine the cause of various symptoms you may be experiencing. If you’ve had ongoing nausea, vomiting, abdominal pain in the upper GI region, gastric reflux, trouble swallowing, anemia or unexpected weight loss, an upper endoscopy can be useful in finding the cause.

An upper endoscopy helps to discover inflammation, bleeding in the upper GI area, ulcers, obstructions and abnormal growths. It also detects a narrowed esophagus, enlarged veins and Hiatal hernias.

In addition to diagnostics, an upper endoscopy can be used to take a small tissue sample known as a biopsy. This sample undergoes tests and further study to determine issues that weren’t clearly visible. Alternatively, your doctor might choose a cytology test, which is a sweep of internal cells. Note: Biopsies are not always related to cancer detection.

Certain treatments are also possible during an upper endoscopy. These might include removing obstructions, such as stuck food or swallowed items; treating bleeding ulcers; and dilating, or stretching narrowed areas.

Preparing for an Upper Endoscopy

Before your procedure, tell your doctor about your medical circumstances, especially heart or lung conditions, diabetes, pregnancy, and previous surgery or other treatments to the upper GI area. Mention all types of medications you take, including over-the-counter ones, and also note any medication allergies; this includes anesthetics.

It’s important not to eat or drink anything before the procedure; this includes water. Typically, such fasting is necessary for 6 to 8 hours prior to your exam. It provides a clear visual field and also helps prevent possible vomiting. Also, don’t chew gum or smoke during this period.

Because you’ll likely be sedated during the endoscopy, you’ll need to arrange for someone to drive you home and to do any other necessary driving for 12 to 24 hours following your release.

Medication Restrictions

You may be asked to stop taking aspirin and other non-steroidal anti-inflammatories (NSAIDs) up to two weeks before the procedure to avoid the risk of bleeding. You may also be asked to stop blood thinners, antiplatelet agents, antidepressants, clopidogrel, sucralfate, antacids, dietary supplements, iron supplements, and medications for arthritis, blood pressure and diabetes. You may only need to stop these medications a few days before the exam or possibly only on the exam day.

The Upper Endoscopy Procedure

An upper endoscopy usually takes place in a hospital or outpatient facility. The exam typically lasts between 30 and 45 minutes, but it could take longer. You’ll receive a topical anesthetic, either sprayed or gargled, to help numb your throat. Many patients also receive an intravenous (IV) sedative, which could cause sleepiness. You might want to arrange a signal in advance to let the doctor know if you experience trouble during the exam since you won’t be able to talk.

An endoscopy generally requires you to lie on your side. A mouth guard may be inserted to protect your teeth. Then the endoscope will be gently passed through your mouth, down your esophagus, and into your stomach and duodenum. It’s helpful to remember that the scope is no larger than food you swallow, and, in the esophagus, it won’t interfere with breathing. Sometimes, because of the anesthetic, patients feel as if they can’t breathe. Remember to breathe slowly and deeply; there’s plenty of air space.

A nurse or assistant may use suction to collect saliva during the exam so that you don’t have to worry about swallowing. Also, air might be pumped into your stomach to provide a better visual field.

The doctor will use a video monitor to view the images transmitted by the endoscope, and the camera also allows still pictures for further examination. The doctor may send small instruments through the endoscope to perform biopsies or other treatments. Upon completion, he or she will carefully withdraw the endoscope. Most patients experience only mild discomfort during the exam. Some even fall asleep due to the sedative.

Upper Endoscopy Aftercare

When the endoscopy is over, you’ll enter a recovery area where you’ll be monitored for roughly an hour while the sedative wears off. You might feel nauseated or bloated from the air pumped into your stomach. You may have a sore throat, which could last a day or two.

The doctor will talk to you before you leave, offering immediate observations and results of the upper endoscopy. If you had a biopsy, it will probably take a few days to learn those results.

After someone drives you home, plan to rest for the remainder of the day. You can eat normally unless your doctor says not to, but you should avoid alcohol for up to 24 hours. You should be able to take your normal medications once you’re home. Your doctor will give you any specific instructions necessary.

Possible Complications From Upper Endoscopy

Complications from upper endoscopy are uncommon but they do occur. There might be some bleeding from a polyp removal or biopsy; this is often minimal and doesn’t usually require treatment. On occasion, the endoscope accidentally perforates the lining of the upper GI tract. In this very rare event, surgery may be necessary to repair the tear. Also, some patients may react poorly to the sedative.

Call your doctor immediately if you have difficulty swallowing or breathing; worsening pain in your throat, chest or abdomen; dizziness; fever; vomiting, especially blood; or if you notice blood in your stools, either fresh or black. Note: bleeding could occur up to several days following the exam. If any symptoms concern you, contact your doctor.