What is an upper GI endoscopy?
An upper GI endoscopy, often referred to as EGD, esophago-gastro-duodenoscopy or gastroscopy, is a procedure that allows a Gastroenterology specialist to directly examine the upper part of the gastrointestinal (GI) tract, which includes the esophagus, the stomach, and the duodenum (the first section of the small intestine).
An endoscope is used to look for inflammation (redness, irritation), bleeding, ulcers, or tumors.
Why would I need an upper GI endoscopy?
The most common reasons for endoscopy are:
- Unexplained discomfort or pain in the upper abdomen.
- GERD or gastroesophageal reflux disease (often called heartburn).
- Persistent nausea and vomiting.
- Upper gastrointestinal (GI) bleeding (vomiting blood or blood found in the stool that originated from the upper part of the GI tract). Bleeding can be treated during endoscopy.
- Iron deficiency anemia (low blood count associated with a low iron level in the blood) in someone who has had no visible bleeding.
- Difficulty swallowing; food/liquids getting stuck in the esophagus during swallowing. This may be caused by a narrowing (stricture) or tumor or because the esophagus is not contracting properly. If there is a stricture, it can often be dilated with special balloons or dilation tubes during the endoscopy.
- Abnormal or unclear findings on an upper GI x-ray, CT scan, or MRI.
- Removal of a foreign body (a swallowed object).
- To check healing or progress on previously found polyps (growths), tumors, or ulcers.
How do I prepare for an upper GI endoscopy?
You may be asked not to eat or drink anything for up to eight hours before the test. It is important for your stomach to be empty to allow the endoscopist to visualize the entire area and to decrease the possibility of food or fluid being vomited into the lungs while under sedation (called aspiration).
You may be asked to adjust the dose of your medications (such as insulin) or to stop specific medications (such as blood thinning medications) temporarily before the examination. You should discuss your medications with us before your appointment for the endoscopy.
You should arrange for a friend or family member to escort you home after the examination. Although you will be awake by the time you are discharged, the medications used for sedation may cause temporary changes in the reflexes and judgment and interfere with your ability to drive or make decisions (similar to the effects of alcohol).
What is the upper GI endoscopy procedure?
The procedure typically takes between 10 and 20 minutes to complete. The endoscopy is performed while you lie on your left side. A plastic mouth guard is placed between the teeth to prevent damage to the teeth and endoscope.
The endoscope (also called a gastroscope) is a flexible tube that is about the size of a finger. The endoscope has a lens and a light source that allows us to see the inner lining of the upper gastrointestinal (GI) tract, usually on a TV monitor. Most people have no difficulty swallowing the flexible gastroscope as a result of the sedating medications. Many people sleep during the test; others are very relaxed and generally not aware of the examination.
We may take tissue samples called biopsies. Obtaining biopsies is not painful. We may also perform specific treatments (such as dilation, removal of polyps, treatment of bleeding), depending upon what is found during the examination. Air or carbon dioxide gas is gently introduced through the endoscope to open the esophagus, stomach, and intestine, allowing the endoscope to be passed through these areas and improving the endoscopist’s ability to see completely. You may experience mild discomfort as air is pushed into the stomach and intestinal tract. This is not harmful; belching may relieve the sensation. The endoscope does not interfere with breathing. Taking slow, deep breaths just before and during the procedure may help you to relax.
How do I recover from an upper GI endoscopy?
After the endoscopy, you will be observed for a period of time, generally less than one hour, while the sedative medication wears off. Some of the medicines commonly used cause some people to temporarily feel tired or have difficulty concentrating. You typically will be instructed not to drive and not to return to work for the balance of the day of the procedure.
The most common discomfort after the examination is a feeling of bloating as a result of the air introduced during the examination. This usually resolves quickly. Some patients also have a mild sore throat. Most patients are able to eat shortly after the examination.
You may also feel groggy from the sedation medications. You should not return to work, drive, or drink alcohol that day. Most people are able to eat normally after the test.