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Upper GI Endoscopy (Procedure)

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Upper GI Endoscopy (Procedure) Upper GI Endoscopy National Digestive Diseases Information Clearinghouse What is an upper gastrointestinal (GI) endoscopy? An upper GI endoscopy is a procedure that Esophagus Mouth uses an endoscope—a small, flexible tube with a light—to see the lining of the upper GI tract. A gastroenterologist, surgeon, or other trained health care provider performs Stomach the procedure. A gastroenterologist is a doctor who specializes in digestive diseases. A health care provider may refer to the procedure as an EGD or Duodenum esophagogastroduodenoscopy. Small What is the upper intestine gastrointestinal tract? Anus The upper GI tract is the first part of the GI tract, which includes a series of hollow The upper GI tract organs joined in a long, twisting tube from the mouth to the anus—the 1-inch-long opening through which stool leaves the body. food or drink from leaking out of the stomach The upper GI tract includes the mouth, and back into the esophagus. This process is esophagus, stomach, duodenum, and small automatic and people are usually not aware intestine. The duodenum is the first part of of it, though people sometimes feel food in the small intestine. their esophagus when they swallow something too large, try to eat too quickly, or drink very The esophagus carries food and liquids from hot or cold liquids. the mouth to the stomach. The muscular layers of the esophagus are normally pinched The stomach slowly pumps the food and together at both the upper and lower ends liquids into the small intestine, which absorbs by muscles called sphincters. When a person needed nutrients. The body digests food swallows, the sphincters relax to let food or using the movement of the muscles in the drink pass from the mouth into the stomach. GI tract, along with the release of hormones The muscles then close rapidly to prevent the and enzymes. Why is an upper Health care providers also use upper GI gastrointestinal endoscopy endoscopy to performed? • obtain a biopsy—a procedure that involves taking a small piece of tissue for An upper GI endoscopy can help diagnose examination with a microscope the cause of • remove objects, including food, that may • abdominal pain be stuck in the upper GI tract • anemia—a condition in which the • treat conditions such as bleeding ulcers number of red blood cells is less than normal, resulting in less oxygen carried to the body’s cells How does a person prepare • bleeding in the upper GI tract for an upper gastrointestinal • nausea and vomiting endoscopy? A person prepares for an upper GI • problems swallowing endoscopy by • unexplained weight loss • talking with a health care provider Upper GI endoscopy can also show • arranging for a ride home after the • abnormal growths. procedure • bowel obstruction—partial or complete • clearing the upper GI tract blockage of the small or large intestine. Talking with a health care provider. A • gastroesophageal reflux—occurs when person should talk with his or her health care stomach contents flow back up into the provider about medical conditions he or she esophagus. has and all prescribed and over-the-counter medications, vitamins, and supplements he or • a hiatal hernia—when the upper she takes, including part of the stomach slips through the diaphragm and moves up into the chest. • aspirin, or medications that contain The diaphragm is the muscle wall that aspirin separates the stomach from the chest. • arthritis medications • inflammation, or swelling, of the GI tract • nonsteroidal anti-inflammatory drugs lining. such as ibuprofen and naproxen • precancerous cells. • blood thinners • ulcers—sores on the stomach or • blood pressure medications duodenal lining. • diabetes medications 2 Upper GI Endoscopy Arranging for a ride home. For safety The person lies on his or her side on an reasons, people can’t drive for 24 hours examination table. The health care provider after the procedure to allow time for the carefully feeds the endoscope down the medications used during the procedure to person’s esophagus and into the stomach and wear off. Health care providers will ask duodenum. A small camera mounted on the people to make advance arrangements for endoscope sends a video image to a monitor, getting home after the procedure. allowing close examination of the intestinal lining. The health care provider will pump air Clearing the upper GI tract. The health care through the endoscope to inflate the stomach provider needs to examine the lining of the and duodenum, making them easier to see. upper GI tract during the procedure. If food or drink is present inside the upper GI tract During the upper GI endoscopy, the health at the time of the procedure, the health care care provider may pass tiny tools through the provider will not be able to see this lining endoscope to clearly. To ensure that the upper GI tract • remove polyps. Polyps are common is clear, health care providers usually advise in adults and are usually harmless. people not to eat, drink, smoke, or chew gum However, some polyps can become during the 8 hours before the procedure. cancer, so removing polyps early is an effective way to prevent cancer. How is an upper • perform a biopsy of tissue in the upper gastrointestinal endoscopy GI tract. A biopsy is a procedure performed? that involves taking a small piece of A health care provider performs an upper intestinal lining for examination with a GI endoscopy at a hospital or an outpatient microscope. The person will not feel the center. A nurse or technician will give the biopsy. A pathologist—a doctor who person a liquid anesthetic to gargle or will specializes in diagnosing diseases—will spray the anesthetic on the back of the examine the tissue to help confirm a person’s throat. The anesthetic numbs the diagnosis. throat and calms the gag reflex. The nurse • stop any bleeding with an electrical or technician will then place an intravenous probe or special medications. (IV) needle in the person’s arm to provide a sedative. The medical staff will monitor the The procedure usually takes between person’s vital signs and try to make sure he or 15 and 60 minutes. The endoscope does not she is as comfortable as possible. interfere with the person’s breathing and many people fall asleep during the procedure. 3 Upper GI Endoscopy What can a person What are the risks of an expect after an upper upper gastrointestinal gastrointestinal endoscopy? endoscopy? After an upper GI endoscopy, a person can The risks of an upper GI endoscopy include expect the following: • reaction to the medications used for • bloating or nausea for a short time after sedation the procedure • bleeding from the biopsy site or where • a sore throat for 1 to 2 days the health care provider removed a polyp • to stay at the hospital or outpatient • perforation—a small tear in the lining of center for 1 to 2 hours after the the upper GI tract procedure so the sedation can wear off A health care provider can treat an abnormal • to resume a normal diet once his or her reaction to the sedatives with medications gag reflex has returned during or after the procedure. Bleeding and • to rest at home for the remainder of perforation are more common in endoscopies the day used for treatment rather than diagnosis. Bleeding often stops without treatment. A health care provider will advise on when Research has shown that complications occur the person can begin driving again. A in one out of every 1,000 procedures and may member of the health care team will review need to be treated with surgery.1 the discharge instructions with the person— or with an accompanying friend or family member if the person is still groggy—and provide a written copy. The person should Seek Immediate Care follow all instructions given. People who have any of the following symptoms after an upper GI endoscopy Some results from an upper GI endoscopy should seek immediate medical attention: are available immediately after the procedure. After the sedative has worn off, • chest pain the health care provider will share results • difficulty breathing with the person or a designee. Biopsy results take a few days to come back. • problems swallowing or throat pain that worsens • vomiting—particularly vomit that is bloody or looks like coffee grounds • abdominal pain that worsens • bloody or black, tar-colored stool • fever 1Yusuf TE, Bhutani MS. Esophagogastroduodenoscopy. Medscape website. http://emedicine.medscape.com/ article/1851864-overview#a17. Updated June 3, 2013. Accessed March 26, 2014. 4 Upper GI Endoscopy Points to Remember • After an upper GI endoscopy, a person can expect the following: • An upper gastrointestinal (GI) endoscopy is a procedure that uses an – bloating or nausea for a short time endoscope—a small, flexible tube with after the procedure a light—to see the lining of the upper – a sore throat for 1 to 2 days GI tract. – to stay at the hospital or outpatient • An upper GI endoscopy can help center for 1 to 2 hours after the diagnose the cause of procedure so the sedation can – abdominal pain wear off – anemia—a condition in which the – to resume a normal diet once his or number of red blood cells is less her gag reflex has returned than normal, resulting in less oxygen – to rest at home for the remainder of carried to the body’s cells the day – bleeding in the upper GI tract • People who have any of the following – nausea and vomiting symptoms after an upper GI endoscopy should seek immediate medical – problems swallowing attention: – unexplained weight loss – chest pain • To ensure that the upper GI tract is – difficulty breathing clear, health care providers usually advise people not to eat, drink, smoke, – problems swallowing or throat pain or chew gum during the 8 hours before that worsens the procedure.
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