What Is an Upper Endoscopy and Why Is It Performed?
The Gastroenterologists at Manhattan Gastroenterology offer endoscopy screening (including bowel cancer screening), diagnosis, and treatment for diseases that affect any part of the digestive system, from the upper esophagus, stomach, and small intestine right through to the colon, rectum, and anus. Upper endoscopy (also known as EGD or endoscopy) is a non-surgical procedure performed by our doctors to examine a person’s upper digestive tract. An endoscope is a flexible tube with a light and camera attached at the end, which allows your doctor to view pictures of your upper digestive tract on a screen.
The endoscope is a bendable, narrow tube, less than the size of a finger, and is easily passed through the mouth and throat and into the esophagus and allows visualization of the esophagus, stomach, and upper part of the small intestine. Other names for this procedure include esophagogastroduodenoscopy (EGD) and upper GI endoscopy. At Manhattan Gastroenterology, we utilize this exam to diagnose a wide range of digestive disorders accurately. We use state-of-the-art high-definition endoscopy equipment for optimal visualization of the GI tract to allow for a complete and accurate exam in our gold star awarded JCAHO certified procedure room.
Why Is It Important to Have an Upper Endoscopy and What Will the Doctor Be Looking for During My Exam?
Upper endoscopy is the gold standard for visual evaluation of the upper digestive tract. It is instrumental to diagnosing a wide range of digestive disorders, including stomach pain, ulcers, reflux, anemia, upper gastrointestinal bleeding, weight loss, nausea/vomiting, and difficulty swallowing. The camera on the endoscope allows for direct visualization of the lining of the esophagus, stomach, and duodenum.
In addition to visualization, our doctors can take biopsies of any abnormalities of the lining of the intestines, mass lesions, or any other abnormalities that they may see. They may take biopsies even if the lining may appear normal to the naked eye to diagnose infections such as h. pylori or to make a diagnosis such as celiac disease or eosinophilic esophagitis, which requires a tissue diagnosis.
They can also utilize the endoscope to treat gastrointestinal bleeding conditions if needed or remove foreign bodies. Your gastroenterologist can use upper endoscopy in conjunction with other tests such as blood work, imaging, etc., to formulate an effective diagnosis and treatment plan customized for you.
Why Chose Manhattan Gastroenterology for Your Endoscopy?
At Manhattan Gastroenterology, we utilize the latest medical technology and high definition equipment, and imaging modalities to optimally visualize your bowel during your upper endoscopy to make a diagnosis and establish an effective treatment plan. Our gold-star-rated JCAHO procedure room is equipped to ensure your procedure is safe while having your endoscopy performed. Our board-certified anesthesiologists are also there with you the entire time, making sure the procedure is both comfortable and safe. Importantly, our award-winning doctors will perform your procedure and help you get the answers you need.
Cleaning The Endoscope and High-Level Disinfection to Ensure Your Safety
At Manhattan Gastroenterology, we utilize the Advantage Plus endoscopic reprocessing machine. The ADVANTAGE PLUS™ is a fully automated, computer-based asynchronous endoscope reprocessor that monitors each endoscope channel separately for blockage and proper flow, ensuring complete high-level disinfection. A computerized detection system eliminates human error in the selection and connection of hook-ups. It is a state-of-the-art system to ensure your safety and the highest level of infection control. The device is placed on a unique hanger until the next procedure to ensure that it does not contact any other instruments or surfaces. We take every measure to ensure the safety of your procedure.
What Is the Preparation for the Procedure?
It’s important not to eat or drink anything before the procedure; this includes water. Typically, such fasting is necessary for 8 hours before your exam. It provides a clear visual field and helps prevent possible vomiting and aspiration, which is very important for the procedure at our facility for your endoscopy. Certain medications, such as blood pressure medication as one example, can be taken with a small sip of water on the morning of the exam. Still, all your medications regimen should be discussed with your doctor.
★ ★ ★ ★ ★I was experiencing a lot of discomfort, and my doctor recommended Manhattan Gastroenterology for me. I went there, and they recommended I have an endoscopy. It was not nearly as uncomfortable an experience as I thought, and the facility was very modern. They discovered that I had gastritis and recommended some changes in my diet, and told me to avoid stress. If I ignored it, it could have become worse. I feel much better today, thanks to this gastroenterologist.
What About Medications That I Take?
You should discuss all the medications that you are taking with your gastroenterologist before your procedure. Your doctor will advise you accurately if there is any reason to discontinue any of their use. Certain medications, such as blood pressure medication as one example, can be taken with a small sip of water on the morning of the exam. Still, all your medications regimen should be discussed with your doctor. Ensure to tell your gastroenterologist if you are allergic to any medications before having an upper endoscopy performed. At Manhattan Gastroenterology, we will be glad to discuss this with you before your procedure.
What Can I Expect When I Arrive and Immediately Before the Procedure?
When you arrive at the office, you will be checked in and complete office paperwork and consent forms for the procedure. You will then be taken to your dressing bay and allowed to change into your gown. The staff will ask you some questions about your condition and indications for the procedure and to make sure you are fasting before your procedure adequately. Your vital signs will also be taken at that time, and answer any questions you may have.
Will I Receive Sedation?
After you are changed and check-in, our board-certified anesthesiologists will place an IV line in anticipation of providing sedation for the procedure. The anesthesiologist will place a nasal canal for oxygen, and EKG electrodes will be attached to your chest for safe monitoring during the procedure. The sedation will help you better tolerate any discomfort, such as pressure, bloating, or cramping. Our board-certified anesthesiologists are always present to make sure you are comfortable and safe during your entire procedure. Since sedation is given, you will need a driver to take you home, which should be arranged ahead of time.
What Can I Expect During the Procedure?
Before beginning the procedure, you will be asked to lie on your left side. You may receive a topical anesthetic, either sprayed or gargled, to help numb your throat. A bite block will be placed in your mouth to protect your teeth from the endoscope. It’s helpful to remember that the scope is no larger than the food you swallow, and it won’t interfere with breathing. The anesthesiologist will then slowly administer the medication, making you sleepy.
Your doctor will then insert the endoscope into your mouth and into your esophagus to examine its lining. The anesthesiology or an assistant may use suction to collect saliva during the exam so that you don’t have to worry about swallowing. Air may also be pumped into your stomach to provide a better visual field. Since sedation is given, you most likely will not feel pain or discomfort during this time, and many patients fall asleep.
We utilize the latest high definition imaging modalities in order to optimally visualize your upper digestive tract during endoscopy
What Is the Doctor Looking for During My Endoscopy and What Kind of Results Are Obtained?
During the procedure, our doctors control the movements of the endoscope and visualize the upper digestive tract on a high-definition video screen. They examine the lining of your esophagus, stomach, and duodenum very carefully. If our endoscopy doctors find an area they want to study further, they can pass instruments through the endoscope to retrieve a biopsy — a small tissue sample — to analyze. They’ll send the sample to a laboratory to distinguish between benign (non-cancerous) and malignant (cancerous) tissues. Biopsies can help identify many conditions; the doctor may take one even if they don’t suspect cancer to help diagnose other conditions.
Keep in mind that the doctor may take a biopsy for many reasons, even if they don’t suspect cancer. For example, a biopsy can test for Helicobacter pylori, the bacterium that can cause ulcers. This does not cause any discomfort or pain and is generally very well tolerated. It also provides very important information to the doctor to formulate an accurate diagnosis and treatment plan.
Upper endoscopy is the perfect tool for treating medical conditions in your upper gastrointestinal tract. The gastroenterologist can pass a variety of instruments through the endoscope with little or no discomfort to you. For example, they may use upper endoscopy to perform a cytology test, in which they pass a small brush through the endoscope to collect cells for later analysis. They can stretch or dilate a narrowed area, treat bleeding or remove polyps, which usually are benign growths, from the lining of your gastrointestinal tract.
How Long Does an Endoscopy Take?
The procedure usually takes 15-20 minutes or less and is performed at our JCAHO certified office-based surgery unit. However, due to the preparation and recovery time, plan on spending two to three hours at the office. If you’ve been sedated, you will need someone responsible for driving you home after the procedure.
Recovering from an Upper Endoscopy
Our board-certified anesthesiologists are always present to make sure you are comfortable and safe during your procedure. While the sedatives wear off after the endoscopy procedure, the office staff will monitor your recovery. You may experience some minor cramping or bloating, or nausea due to air introduced into your stomach during the examination, but it should pass quickly. Before you are released, your doctor will explain what, if anything, they found, although they won’t yet know the results of any biopsies. Again, since you have received sedation, you must have someone drive you home and stay with you before being released. Even if you feel alert, your judgment and reflexes may be impaired for the next 12-24 hours. You can eat after the procedure unless you are instructed otherwise.
In general, endoscopy is a very safe procedure when performed by trained and experienced gastroenterologists. Complications are rare, but the most severe is a perforation which may require surgery to repair. Other complications include bleeding from the site of a biopsy. Symptoms from complications include severe abdominal pain, fever, chills, or rectal bleeding, and others. While these complications are rare, you should contact your doctor immediately if you notice them or any other symptoms that concern you. We would be glad to discuss this with you.
How many days do I need to take off work?
You will need to take off work the day of the procedure.
Please call us if you have any other questions or would like to schedule an appointment with one of our doctors. As best-in-class NYC gastroenterologists, we provide highly personalized and comprehensive care. Their philosophies regarding the doctor/patient relationship are based on trust and have earned them some of the most respected reputations in NYC.
For more information about an upper endoscopy in NYC or to schedule an endoscopy appointment with one of our GI doctors, please contact our Midtown or Upper East Side NYC offices.