An upper gastrointestinal endoscopy, also known as upper endoscopy or esophagogastroduodenoscopy (EGD), is a medical procedure performed to visually examine the upper digestive system. It involves using a flexible tube equipped with a small camera to capture images. This procedure is conducted by a gastroenterologist, a specialist in digestive system disorders. An upper endoscopy aims to diagnose and, in some cases, treat conditions affecting the upper portion of the digestive system. An esophagogastroduodenoscopy (EGD) can be conducted in a healthcare provider’s office, an outpatient surgery centre, or a hospital.
During the procedure, the doctor can visualise the inner lining of the following structures:
- Oesophagus: The muscular tube that transports food from the mouth to the stomach
- Stomach: The organ responsible for holding food and initiating the process of digestion
- Duodenum: The upper region of the small intestine, located immediately after the stomach
To get complete information about upper endoscopy and its uses, you can search the internet and type keywords such as, EGD, upper gastrointestinal endoscopy, esophagogastroduodenoscopy, upper endoscopy, or upper endoscopy surgery.
Why is Upper Endoscopy done?
Physicians utilise upper endoscopy to assist in the diagnosis and treatment of symptoms and ailments that impact the stomach, oesophagus, and upper part of the small intestine, known as the duodenum.
Upper endoscopy aids in identifying the underlying cause of persistent symptoms, including:
- Chronic heartburn
- Abdominal pain
- Gastrointestinal bleeding
- Difficulties with swallowing
- Unexplained weight loss
- Persistent nausea and vomiting
Upper endoscopy serves as a diagnostic tool to detect various diseases, including:
- Ulcers
- Gastroesophageal reflux disease (GERD)
- Cancer
- Precancerous conditions like Barrett’s oesophagus
- Swelling or inflammation
- Celiac disorder
- Blockages
- Narrowing of the oesophagus or strictures
Furthermore, upper GI endoscopy can be utilised to assess for damage caused by the ingestion of harmful substances post-consumption.
During an upper GI endoscopy, the doctor collects biopsies by inserting a specialised instrument through the endoscope to collect a small tissue sample for diagnostic testing. Biopsies are crucial in the identification of various conditions, including:
- Cancer
- Gastritis
- Celiac disease
Additionally, physicians utilise upper gastrointestinal endoscopy for therapeutic purposes, involving:
- Treating conditions such as bleeding from oesophageal varices, ulcers, or other related ailments
- Dilating or expanding narrow areas by employing a small balloon passed through the endoscope
- Extracting objects, including food, that may be lodged in the upper GI tract
- Extracting polyps or other abnormal growths
- Insert drainage tubes or feeding tubes
Furthermore, doctors are increasingly utilising upper GI endoscopy as a means to perform weight loss procedures for individuals with obesity.
In certain cases, endoscopy can be combined with other procedures, such as ultrasound. This involves attaching an ultrasound probe to the endoscope to generate detailed images of the oesophageal or gastric walls. Endoscopic ultrasound is also beneficial for visualising organs that are difficult to access, such as the pancreas. Modern endoscopes are equipped with high-definition video capabilities to provide enhanced clarity in the captured images. Additionally, many endoscopes utilise a technology called narrow-band imaging, which employs specialised light to improve the detection of precancerous conditions like Barrett’s oesophagus.
Preparations required for Upper Endoscopy
Your healthcare provider will provide you with detailed instructions on how to prepare for your endoscopy. These preparations may include:
Fasting prior to the procedure: Typically, you will be advised to refrain from consuming solid food for around eight hours and avoid drinking liquids for approximately four hours before your scheduled endoscopy. The purpose is to ensure that your stomach is empty during the procedure.
Discontinuation of specific medications: It may be necessary to discontinue taking certain blood-thinning medications before your endoscopy, ideally a few days in advance. This precaution is taken to minimise the risk of bleeding during any procedures conducted as part of the endoscopy. If you have pre-existing conditions such as diabetes, heart disease, or high blood pressure, your healthcare provider will provide you with personalised instructions concerning the management of your medications. Inform your healthcare specialist about all the medicines and supplements you are currently taking before your scheduled endoscopy. It is essential to provide a comprehensive list of your medications, including any over-the-counter drugs or dietary supplements.
Make preparations for your post-endoscopy recovery in advance: As part of an upper endoscopy procedure, individuals typically receive a sedative to induce relaxation and enhance comfort. It is important to plan in advance for the recovery period while the effects of the sedative gradually subside. You may feel mentally alert, but it is possible that your reaction times, memory, and judgement could be compromised. Thus, arranging for transportation is crucial to ensuring a safe journey back home.
What to expect During an Upper Endoscopy Surgery?
An upper GI endoscopy is performed by a doctor either in a hospital or an outpatient centre. Prior to the procedure, a sedative or medication will likely be administered to promote relaxation and ensure your comfort throughout the procedure. The sedative is typically delivered via an intravenous (IV) needle placed in your arm. However, in some cases, the procedure can be carried out without the need for a sedative. Additionally, you may receive a liquid medicine to gargle with or a throat-numbing spray to prevent gagging during the procedure. The healthcare team will closely monitor your vital signs and make efforts to keep you as comfortable as possible.
You will be instructed to lie on your side on an examination table. With precision, the doctor will gently insert the endoscope through your oesophagus and into your stomach and duodenum. Equipped with a small camera, the endoscope will transmit a video image to a monitor, enabling a detailed examination of the upper gastrointestinal (GI) tract lining. To improve visibility, the endoscope may introduce air into your stomach and duodenum.
During the course of an upper GI endoscopy, the doctor may engage in the following activities:
- Cease any ongoing bleeding
- Extract small tissue, cell, or fluid samples from the upper GI tract for further examination
- Conduct additional procedures, such as dilation of strictures
Typically, an upper GI endoscopy lasts around 15 to 30 minutes. Importantly, the presence of the endoscope does not obstruct your breathing, and it is not uncommon for individuals to drift into sleep during the procedure.
What to Expect After an Upper Endoscopy Surgery?
Following the procedure, you will be closely monitored to ensure that you don’t have any complications. If a sedative was administered, it is possible that you may not remember the procedure. Due to the introduction of air into your stomach during the examination, you may experience mild discomfort or bloating afterward. The numbness in your throat and mouth can last for a few hours; drinking and eating are restricted until the numbness wears off. Once the numbness subsides, you may have a cough, sore throat, or temporary hoarseness for the next day or so.
If the procedure was performed as an outpatient, you will likely be able to return home after a few hours, but you will require transportation due to the effects of anaesthesia. Your healthcare provider will provide specific instructions regarding post-procedure activities and restrictions. Biopsy results, if obtained, are typically available within a few days, although some tests may take longer to complete. It is important to schedule a follow-up appointment with your doctor to receive the test results.
Risks of an Upper Endoscopy
Upper GI endoscopy is generally regarded as a safe procedure with a low risk of complications; however, potential risks may include:
- Perforation in the wall of the upper GI tract
- Bleeding from the region where tissue samples were taken or polyps were removed
- Abnormal reactions to the sedative administered, which could involve heart issues or breathing
During the post-endoscopy period, if you experience any of the following symptoms, it is important to seek medical attention:
- Difficulty breathing
- Chest pain
- Vomiting, especially if the vomit contains blood or appears similar to coffee grounds
- Worsening throat pain or difficulty swallowing
- Presence of bloody or black, tarry stools
- Increasing abdominal pain
- Development of a fever
