Your physician
has determined that EGD is necessary for further evaluation
or treatment of your condition. This sheet has been prepared
to help you better understand the procedure. It includes answers
to questions patients ask most frequently. Please read it carefully.
If you have additional questions, please feel free to discuss
them with the endoscopy nurse or physician before the examination
begins.
WHAT IS EGD AND WHY IS EGD DONE?
EGD (also
known as upper GI endoscopy 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 video camera and light
source. EGD is usually performed to evaluate symptoms of persistent
upper abdominal pain, nausea, vomiting or difficulty swallowing.
It is also the best for finding the cause of bleeding from the
upper gastrointestinal tract. EGD 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. EGD 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 trans fusions and surgery in many patients.
WHAT PREPARATION IS REQUIRED?
It is necessary
to have a completely empty stomach for the safest and best possible
examination. You should have nothing solid to eat for approximately
6 hours before the procedure. You may however, drink water or
clear liquids up to 2 hours before procedure. Several days before
the examination you should notify the physician of any medications
you take regularly, any heart or lung conditions (or any major
diseases), and whether you have any drug allergies. You should
alert your physician if you require antibiotics prior to undergoing
dental procedures, since you may need antibiotics prior to EGD
as well.
WHAT CAN BE EXPECTED DURING EGD?
Your physician
will review with you why EGD is being performed, potential complications
from EGD, and alternative diagnostics or therapeutic tests that
are available. A local nesthetic may be applied to your throat
and an intravenous sedative will be given to make you more comfortable
during the test; most patients remember or feel very little
of the examination and many patients fall asleep during the
test. Some patients may also receive antibiotics before the
procedure. The test begins with you lying comfortably on your
left side. The endoscope is passed through the mouth, esophagus
and stomach into the duodenum. The instrument does not interfere
with breathing. Air is introduced through the instrument and
may cause temporary bloating during and after the procedure.
The test usually lasts between 5 and 15 minutes.
WHAT HAPPENS AFTER EGD?
After the
test, you will be monitored in the recovery room 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 air introduced into your stomach
during the test. 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 will take several
days.
WHAT ARE POSSIBLE COMPLICATIONS OF EGD?
EGD is
generally safe. Complications can occur but are rare when
the test is performed by physicians with special training
and experienced in this procedure. BLEEDING may occur in approximately
0.1% from a biopsy site or where a polyp was removed. It is
usually minimal and rarely requires blood transfusions or
surgery. PHLEBITIS or localized irritation of the vein into
where medication was injected may rarely cause a tender lump
that may last several weeks, but this will go away eventually.
The application of heat packs or hot moist towels may help
relieve the 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 (less
than 1%).
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 right away.
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