Upper Endoscopy (EGD)
How is the test done?
After you arrive and change into a gown, a nurse will ask you questions about your medical history and medicines you take. The nurse will put an IV into your arm and take you to the Endoscopy Room. You will be given oxygen to breathe. You will be hooked up to monitors that measure your blood pressure, heart rate and oxygen level during the test. Your doctor will explain the procedure and risks, and have you sign a consent form. The doctor will then give you a special medicine through the veins to sedate you. Most people will gradually lose awareness of their surroundings before the procedure begins.
When you are sedated, the doctor will place a long scope inside you through a plastic mouthpiece, and pass it into your esophagus. This has a video camera on it and will help the doctor to see your upper GI tract - esophagus, stomach, and upper duodenum. If tissue is found that does not look normal, the doctor may take biopsies or remove tissues to do more studies. The doctor may also perform other procedures through the endoscope as well - such as stretching the esophagus, injecting medications, or cauterizing bleeding spots if needed. Most of these procedures take about 10 to 20 minutes after sedation to complete.
After the procedure, a nurse will monitor you and check your vital signs until you wake. Most patients find the procedure to be quite comfortable and are surprised when they wake and learn that it is over.
What are the risks of the test?
These procedures and tests are important to help the doctor examine you. Many exams and tests have risks. At times, though unusual, a serious medical condition that is present may not be found in these exams. Other risks of Upper GI Endoscopy include:
- Perforation of tissues
- Internal bleeding
- Aspiration pneumonia
- Heart attack
- Adverse reaction to medications
- Damage to teeth or dental work and
- Clotting or infection in the veins where medicine is given
Such complications can sometimes lead to surgery, or very rarely, death.
Are there other options to the test?
An alternative to Upper GI Endoscopy is a barium x-ray of the upper GI tract, called an "Upper GI Series." Barium x-ray studies however are not as sensitive in finding disease. At least 10% of ulcers are not seen, and over 50% of erosive esophagitis is missed by this procedure. In addition, Upper GI endoscopy must often be done to further study and biopsy abnormalities found on barium x-rays.
Preparation for the test
You may have a regular diet up until the day of the procedure. On the day of your procedure, you may have only clear liquids and take your usual medicines (except for antacids and Carafate) up until 4 hours prior to your procedure. For the 4 hours prior to your procedure take nothing by mouth. This includes gum, lozenges, candy, and chewing tobacco.
Patients on aspirin or Plavix
If you take aspirin and/or Plavix due to a prior heart attack, stroke, heart rhythm problems, blood clots or have a heart stent in place, you should continue these medications. If you take aspirin daily but have no history of any of the above conditions, you should stop the aspirin five days prior to your exam.
Patients on Coumadin
If you take Coumadin or any other blood thinner such as Lovenox and have not been seen in our office, you will need to make an appointment with one of our Physician Assistants prior to scheduling your endoscopy.
Patients on iron, vitamins, herbal supplements
Stop any iron supplement or herbal remedies five days before your endoscopy. This includes multivitamins containing iron.
You must arrange for someone to drive you home, because you may be drowsy after the procedure and driving will be unsafe. Have your driver come with you when you arrive to confirm your pick-up time. The procedure will not be done unless proper transportation arrangements have been made.
Feel free to call our office about the procedure or the preparation process with any questions.