How do you do an upper endoscopy?
Upper endoscopy, also called esophagogastroduodenoscopy (EGD), is a test that looks at the lining of the esophagus (the tube that helps you breathe), the stomach, and the first part of the small intestine (the duodenum).
The doctor may do this treatment to find out what’s wrong with the upper GI tract and fix it if possible. It is often used to look into stomach pain, trouble swallowing, puking and feeling sick for a long time, heartburn, weight loss that you can’t explain, anemia, or blood in your stools.
For many other reasons, your doctor may want to do this test. You should ask them what those reasons are. Upper endoscopy should only be done by doctors who have had extra training in it, with help from nurses and techs who have also had extra training.
Preparation
When you get to the test site, your doctor will go over the process again and answer any questions you have. You will be asked if you have any allergies or other health issues. After that, you will be asked to sign a form saying that you agree to go ahead with the test.
You should not eat or drink anything for at least 6 hours before the process, except for small sips of water to take any oral drugs with. This is because you need to be completely empty for the test. Ibuprofen (Advil, Motrin, Alleve) and antacids should not be taken.
Most of the time, “conscious sedation” is used during EGD. You will be given a mix of drugs through an IV that will make you very sleepy and relaxed during the process. The process itself might not be something you remember.
Because of these medicines, you shouldn’t drive yourself and shouldn’t sign anything official until the next day. Someone close to you will have to drive you home.
Examination
After you sign the permission form, you will put on a hospital gown and take off your glasses, contacts, and false teeth. Someone will put an IV needle into a vein in your hand or arm. Through this IV, fluids and medicines will be given. For the process, you will be taken to a separate room and told to sleep on your right side.
A local anesthetic that tastes bitter will be shot into your mouth to numb it and stop you from gagging. There will be monitors on your skin that will check your blood oxygen, blood pressure, and heart rate while the process is going on.
The doctor will put the endoscope, a thin, bendable tube, through the mouthguard once you are sleepy. He will slowly move the scope down your throat while you swallow. The doctor can see because the tip of the scope has a small video camera on it.
Aside from being able to move the tip of the tool in certain ways, the doctor can also blow air into the gut or suck out secretions and waste to clear his vision. You can also put special tools through a small hole in the endoscope. The doctor may need these to diagnose or treat you.
At first, you might feel like gagging, but that feeling will go away quickly, and you won’t feel any of the tests or treatments that need to be done. The camera won’t get in the way of your breathing at all.
The camera will be moved into your stomach after a careful look at your esophagus. This will make your stomach bigger so you can see better. A little air will be added. Your whole stomach will be looked at.
The camera is then moved through the pylorus, which is the opening between the stomach and the intestine. Though you might feel a little pressure here, it shouldn’t hurt. The duodenum, the first part of your small intestine, is then carefully checked for any problems.
After this, any diagnostic or therapeutic procedures will be carried out, and the scope will be carefully taken out of your mouth. Most of the time, the whole process takes 10 to 30 minutes.
After the Procedure
Over the years, progress has made it possible to treat diseases with endoscopes that used to need surgery. There are a lot of helpful treatments that can be used during EGD. When there are problems in the gut, they can cause major bleeding.
Large “varicose veins” called varices can be found in the stomach and esophagus, especially in people who have liver disease. They can break and make you bleed a lot. When you have an endoscopy, you can fix them by either filling them with medicine (sclerotherapy) or putting rubber bands on them.
In the same way, bleeding can be caused by sores in the stomach and intestines as well as abnormal blood vessels (AVMs). Medicine can be injected into these or electricity and heat can be applied to them through a special catheter (a plastic tube) at the end of the endoscope to seal them off. Once more, none of these treatments will hurt you.
Upper endoscopy can also get rid of foreign bodies (like batteries, coins, chicken or fish bones, etc.) that have been eaten on purpose or by accident. This is done without surgery. If there are any narrowings or strictures in the esophagus, stomach, or duodenum, they can generally be widened with balloons or other devices that do this. In the worst situations, usually when tumors can’t be removed, splinting devices known as “stents” can be left behind.
Stents are mesh tubes made of plastic and metal that get bigger after they are put in place to keep foods from getting stuck in the gut.
Lastly, a percutaneous endoscopic gastrostomy (PEG) tube can be put in during EGD in some people who can’t eat normally anymore. With the help of an endoscope, this small food tube is put through the skin and into the stomach. You should talk to your doctor about any other treatments that might be done at the same time as EGD before the process.
Diagnosis at EGD
When problems are seen in the upper GI system, it’s often possible to make a diagnosis. It is often necessary to take a small biopsy (a sample of tissue), though, to help with the diagnosis or make sure it is correct. A special pair of biopsy tools is used to get these samples, and you can’t feel them being taken.
For cytology testing, special brushes can be used to get other cell samples from the walls of the upper GI system. If there is swelling or damage in the esophagus (esophagitis), stomach (gastritis), or duodenum (duodenitis), biopsies can help find out what is causing it. If there is swelling or an ulcer in the intestine or stomach, a biopsy can be done to see if Helicobacter pylori is present.
This bacteria has been shown to cause some ulcers and can be treated with drugs if it is found. If any lumps, nodules, or tumors are discovered, tests can help figure out whether they are normal (not dangerous) or malignant (cancerous). Even if the lining of the upper GI tract looks fine, other biopsies are sometimes taken to look for tiny signs of gut diseases that could be causing certain symptoms or to check for certain diseases.
How Endoscopy Works
Over the years, progress has made it possible to treat diseases with endoscopes that used to need surgery. There are a lot of helpful treatments that can be used during EGD. When there are problems in the gut, they can cause major bleeding. Large “varicose veins” called varices can be found in the stomach and esophagus, especially in people who have liver disease.
They can break and make you bleed a lot. When you have an endoscopy, you can fix them by either filling them with medicine (sclerotherapy) or putting rubber bands on them. In the same way, bleeding can be caused by sores in the stomach and intestines as well as abnormal blood vessels (AVMs).
Medicine can be injected into these or electricity and heat can be applied to them through a special catheter (a plastic tube) at the end of the endoscope to seal them off. Once more, none of these treatments will hurt you. Upper endoscopy can also get rid of foreign bodies (like batteries, coins, chicken or fish bones, etc.) that have been eaten on purpose or by accident.
This is done without surgery. If there are any narrowings or strictures in the esophagus, stomach, or duodenum, they can generally be widened with balloons or other devices that do this. In the worst situations, usually when tumors can’t be removed, splinting devices known as “stents” can be left behind. Stents are mesh tubes made of plastic and metal that get bigger after they are put in place to keep foods from getting stuck in the gut.
Lastly, a percutaneous endoscopic gastrostomy (PEG) tube can be put in during EGD in some people who can’t eat normally anymore. With the help of an endoscope, this small food tube is put through the skin and into the stomach. You should talk to your doctor about any other treatments that might be done at the same time as EGD before the process.