What is Upper GI Endoscopy?
Upper GI endoscopy, also known as Oesophagogastroduodenoscopy (EGD) is a procedure to visually examine and treat problems in the upper gastrointestinal (GI) tract. It is usually performed on an outpatient basis using an endoscope, which is a long, thin, flexible tube with a tiny video camera and light on the end. The high-quality picture from the endoscope is shown on a TV monitor and by adjusting the various controls on the endoscope, your doctor can safely guide the instrument to carefully examine the inner lining of your upper gastrointestinal system and treat certain abnormal conditions. In many cases, upper GI endoscopy is a more precise examination than X-ray studies.
Indications of Upper GI Endoscopy
- Difficulty or pain in swallowing
- GI bleeding- hematemesis, melena, or iron-deficiency anaemia
- Troublesome heartburn
- Persistent ulcer-like pain
- With anorexia or weight loss
- Taking aspirin or NSAIDs
- With a history of gastric ulcer
- With a normal barium meal
- Persistent nausea, vomiting, or symptoms suggestive of pyloric obstruction
- Gastric ulcer demonstrated by barium meal
- Duodenal biopsy for suspected malabsorption
You may be asked to repeat endoscopy for one or more of the following reasons
- To determine the healing of a gastric ulcer
- Surveillance of dysplasia in Barrett's oesophagus
- Progress of duodenal ulcer complicated by previous haemorrhage or perforation
- Duodenal ulcer not responding to adequate ulcer therapy
Please note that repeat endoscopy is not indicated in uncomplicated duodenal ulcers.
Benefits of Upper GI Endoscopy
An upper GI endoscopy is both diagnostic and therapeutic. This means the test enables a diagnosis to be made upon which specific treatment can be given. If a bleeding site is identified, treatment can stop the bleeding, or if a polyp is found, it can be removed without a major operation. Other treatments can be given through the endoscope when necessary.
Therapeutic upper GI Endoscopy:
- Sclerotherapy for varicose
- Dilatation of strictures
- Pneumatic dilatation of achalasia
- Removal and surveillance of gastric polyps
- Removal of foreign bodies
Preparation of Upper GI Endoscopy
Your medical team will also want to know if you have heart, lung, or other medical conditions that may need special attention before, during, or after upper GI endoscopy.
It is important not to eat or drink anything for at least eight hours before the endoscopy. Your doctor will instruct you about the use of regular medications, including blood thinners, before the exam.
Procedure of Upper GI Endoscopy
- Prior to the procedure, you will be given intravenous medications to relax and sedate you.
- The procedure is performed by an experienced endoscopy physician.
- You are asked to wear a hospital gown and to remove your eyeglasses and dentures.
- A local anaesthetic (pain-relieving medication) may be applied at the back of your throat
- You are given a pain reliever and a sedative intravenously (in your vein) You will feel relaxed and drowsy.
- A mouthpiece is placed in your mouth. It does not interfere with your breathing.
- You will lie on your left side during the procedure.
- The physician inserts an endoscope into your mouth, through your oesophagus (the “food pipe" leading from your mouth into your stomach), and into your stomach. The endoscope does not interfere with your breathing.
- The procedure lasts from 15 to 20 minutes.
- After the procedure, you will stay in the recovery room for about 30 minutes for observation.
- Your doctor will explain the results to you and your family. If the effects of the sedatives are prolonged, your doctor may suggest an interview at a later date when the results can be fully understood.
- If a biopsy has been performed or a polyp removed, the results are not available for three to seven days.
- Your endoscopy report and biopsy results will be sent to your referring physician.
- Have someone available to take you home, you will not be able to drive for at least 24 hours.
- Do not drink or eat anything in the car on the trip home. The combination of anaesthesia, food, and car motion can quite often cause nausea or vomiting.
- Inform your doctor if you have severe abdominal pain, a continuous cough, fever,
- chills, chest pain, nausea, or vomiting within 72 hours after the procedure.
Complications of Upper GI Endoscopy
Apart from a minor sore throat, significant complications are extremely rare for diagnostic endoscopy in patients with adequate cardio-respiratory status.
Therapeutic endoscopy carries an increased risk. Possible complications of therapeutic endoscopy include bleeding and puncture of the stomach lining. However, such complications are rare.