Upper endoscopy, also called esophagogastroduodenoscopy, or EGD, is a procedure in which a thin scope with a light and camera at its tip is used to look inside of the upper digestive tract -- the esophagus, stomach, and first part of the small intestine, called the duodenum.
Usually performed as an outpatient procedure, upper endoscopy sometimes must be performed in the hospital or emergency room to both identify and treat conditions such as upper digestive system bleeding.
By Janis Graham
Stuffing? Check. Stiff drinks? Check. Stress? Check. 'Tis the season -- for
stomachaches. "The holidays create a perfect storm for stomach problems because
of all the eating, traveling, and partying," says Roger D. Mitty, M.D., chief
of gastroenterology at Caritas St. Elizabeth's Medical Center in Boston. And
women are especially vulnerable, since some gastrointestinal ills occur up to
six times more often in women than in men. What's more, a recent survey found
Endoscopy can also help identify inflammation, ulcers, and tumors.
Upper endoscopy is more accurate than X-rays for detecting abnormal growths such as cancer and for examining the inside of the upper digestive system. In addition, abnormalities can be treated through the endoscope. For example:
Polyps (growths of tissue in the stomach) can be identified and removed, and tissue samples (biopsies) can be taken for analysis.
Narrowed areas or strictures of the esophagus, stomach, or duodenum from cancer or other diseases can be dilated or stretched using balloons or other devices. In some cases, a stent (a wire or plastic mesh tube) can be put in the stricture to prop it open.
Objects stuck in the esophagus can be removed.
Bleeding due to ulcers, cancer or varices can be treated.
How Do I Prepare for an Upper Endoscopy?
Before an upper endoscopy, tell your doctor if you are pregnant, have a lung or heart condition, or if you are allergic to any medications.
Also, tell your doctor if you have:
Ever been told you need to take antibiotics before a dental or surgical procedure
Ever had endocarditis (an infection of the heart valves)
An artificial heart valve
Rheumatic heart disease
If you have any of these conditions or devices, you may need to take antibiotics before the upper endoscopy.
Do not eat or drink anything for eight hours before the procedure.
Medications for high blood pressure, heart conditions, or thyroid conditions may be taken with a small sip of water before the procedure. If you have diabetes and use insulin, you must adjust the dosage of insulin the day of the test. Your diabetes care provider will help you with this adjustment. Bring your diabetes medication with you to your appointment so you can take it after the procedure.
Make arrangements to have someone drive you home following the endoscopy. The sedation given during the procedure causes drowsiness and dizziness and impairs your judgment, making it unsafe for you to drive or operate machinery for up to eight hours following the procedure.
What Happens During an Upper Endoscopy?
Before your doctor performs an upper endoscopy, he or she will explain the procedure in detail, including possible complications and side effects. The doctor will also answer any questions you may have.
You will be asked to wear a hospital gown and to remove your eyeglasses and dentures.
A local anesthetic (pain-relieving medication) may be applied at the back of your throat.
You will be given a pain reliever and a sedative intravenously (in your vein) to help you relax and make you feel drowsy.
A mouthpiece will be placed in your mouth.
You will lie on your left side during the procedure.
The doctor will insert the endoscope into your mouth, through your esophagus (the "food pipe" leading from your mouth into your stomach) and into your stomach.