EGD - Upper GI Endoscopy

The Gastrointestinal (GI) tract comprises the food pipe (esophagus), the stomach, and the upper part of the small intestine.

An upper GI endoscopy is a procedure that helps doctors to diagnose problems in the GI and treat these problems effectively. GI endoscopy is also called an EGD or esophagogastroduodenoscopy.

For GI endoscopy, a long and flexible tube with a camera on one end, called the endoscope, is inserted through the patient’s mouth to get an inside view of the upper GI tract. It allows for accurate diagnosis and treatment. The procedure can only be done by a surgeon, a gastroenterologist, or a qualified medical professional. Small tools can also be attached to an endoscope for collecting GI tissue, removing obstructions from the esophagus, stopping bleeding in the GI tract, and treating any wounds in the upper GI tract.

A doctor or specialist may suggest an upper GI endoscopy to study your symptoms internally, diagnose the signs accurately, and even treat the problems during the procedure.

When Do You Need a GI Endoscopy?

An upper GI endoscopy is done when you have a few unexplained symptoms like:

• Bleeding in the esophagus, stomach, or intestine
• Chest pain not caused by the heart
• Heartburn
• Sudden, unexpected weight loss
• Continuous vomiting
• Problems with swallowing

Many GI diseases can be identified by performing a GI endoscopy like:

• Blockages anywhere in the GI tract
• Celiac disease
• Swelling or inflammation in the GI tract
• Ulcers
• Gastritis
• Narrowing of the esophagus leading to difficulty in swallowing
• Cancerous or non-cancerous tumors
• Abnormalities in the GI tract
• GERD (reflux)

How Should You Prepare for An Upper GI Endoscopy?

During an endoscopy, the doctor or gastroenterologist gets a good view of the upper gastrointestinal tract. You need to go for the procedure with an empty stomach to make the process easier. Before the procedure, you need to sit down with your doctor to understand what you can do to make the process more bearable.

It is necessary to discuss your medical history to ensure that your existing medications will not be detrimental to your endoscopy. For example, a small nick or cut during the endoscopy could lead to unexpected heavy bleeding if you are on blood thinners.

Since the GI endoscopy procedure pertains to problems in the upper digestive system, there may be restrictions on food and drinks for at least a day before the scheduled procedure.

Two specific things are recommended the day before a GI endoscopy:

No Solid Foods the Day before the Procedure.

It would be best if you only consumed liquids like water, clear broths, black tea, black coffee, popsicles, etc., the day before a GI endoscopy.

Stop Blood-Thinning Medications or Medicines That May Prevent Blood Clotting.

Even drugs like ibuprofen may need to be stopped. In severe illnesses like diabetes or hypertension, getting alternative medications from your doctor is advised.

It is essential that you understand the problem in your GI tract and why you need the endoscopy. You also need to understand the risks and complications involved in the procedure. Then, you can ask your doctors to explore alternate options or any other medical tests that can be done instead of an endoscopy.

It is critical to have a conversation with your doctors before agreeing to go through an endoscopy.

What Are the Risks Involved in a GI Endoscopy?

Unlike many other medical procedures, a GI endoscopy is relatively low risk. However, as with any system, there is some element of risk involved. Potential complications may include:

• The patient may be injected with an anesthetic prior to the endoscopy to reduce discomfort. There may be adverse reactions to the drug, which may become apparent only during or after the procedure.
• During the endoscopy, any part of your digestive tract could get nicked and result in internal bleeding.
• An infection could set in the internal walls of the GI tract from where tissue samples may have been taken.

With advancement in science, doctors can immediately treat adverse reactions to sedatives or anesthesia to prevent severe complications. Any case of bleeding during an upper GI endoscopy is minor and can be staunched by the doctors quickly. Even in rare cases of severe cuts or perforations, doctors should be able to treat the affected area quickly and avoid unnecessary complications.

Other than these specific risks, there may be some risks that may be particular to you because of some preexisting conditions or medications which will all be explained to you beforehand by the physician

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What Can You Expect from GI Endoscopy?

Depending on the findings from your upper GI endoscopy, you may be discharged from the hospital within one or two days. However, if some severe issues are identified, the stay may need to be extended.

Here Is What Is Expected with an Upper GI Endoscopy

The day before the endoscopy, food for the patient will be restricted to a liquid diet of clear drinks like water and nutritious broths. Even medications for diabetes and inflammation need to be stopped till the procedure is done.

Other than these, here is what you can expect before the endoscopy:

• Anything you are wearing, like jewelry or restrictive clothing that may interfere with the endoscopy, will need to be removed.
• If you have false teeth, i.e., dentures, they may also need to be released as it could hamper the procedure.
• Sedatives or anesthesia are first injected into your body through an intravenous line on your arm.
• Like all surgeries, doctors will monitor your vitals like the blood pressure, heart rate, and oxygen levels throughout the procedure.
• The patient's throat is numbed to ensure that the endoscope can be inserted without gagging as it could disrupt the process and harm the patient.
• The patient's mouth will be kept open with a mouthguard to prevent biting down on the endoscope tube. The saliva gathering in the mouth will also be suctioned out periodically.

What Happens During an Endoscopy?

Once you have been prepared for the endoscopy, the doctor or surgeon will start the procedure.

• Since your throat has been numbed, it is easier for the endoscopic tube to be inserted down the throat.
• The flexible tube is guided down the throat, through the esophagus, into the stomach, and finally into the small intestine. Whatever issue is plaguing you can be checked through the camera embedded at the end of the endoscope.
• If tissue samples are required for examination, they can be taken anytime during the endoscopy, from any part of the Upper GI tract.
• While the tube travels down the throat during the endoscopy, the patient may feel slight pressure. In case of treating any bleeding or infection, it can be done simultaneously as the endoscope has been inserted down the throat. The camera gives the doctors a clear view of the insides, which helps them diagnose and treat the patient effectively.

What Happens After the Endoscopy Is Over?

• Once the endoscopy has ended, the tube is gently removed without causing the patient any discomfort.
• After the tube has been removed, you will be moved to a recovery room for observation. Once the sedative or anesthesia wears off, you are monitored to ensure that the blood pressure, breathing, and heartbeat are normal.
• Since the procedure involves suppressing the gag reflex in the throat, you are not allowed to eat or drink anything till it returns. You may be provided nutrients through an IV line.
• If all the base parameters are stable, you may be discharged from the hospital within two or three hours of the procedure.
• The procedure might cause you to feel gassy or cause discomfort in the abdomen.
• You may need to rest for the remainder of the day after the procedure and not exert yourself, if possible.
• However, it is necessary to make sure that you get in touch with your doctors in case of fevers or chills.

Other than mild discomfort after the procedure, there are typically no symptoms following an upper GI endoscopy. However, it is critical that you immediately contact a doctor in case you see one or more of these symptoms:

• Vomit that is dark in color and has a grainy texture.
• Bloody or tar-like stools
• Unbearable pain in the abdomen
• Breathing issues
• Discomfort or pain in the chest
• Throat pain or increasing problems swallowing 
• Swelling, bleeding, or pain where the intravenous tube (IV) was injected.

In some cases, upper GI endoscopy results are immediately available. The doctor will be able to show you the results and discuss the treatments based on the findings.

If the endoscopy involves the collection of tissue, blood, or any fluid sample, these samples need to be studied in the laboratory to provide an accurate diagnosis. Ideally, it may take the pathologists a few days to test samples from biopsies, especially if they are checking for cancerous cells.

What Other Procedures Are Conducted with An Upper GI Endoscopy?

An upper GI endoscopy is usually done along with an ultrasound. Rather than just a camera, an endoscope may be attached with an ultrasound probe to get a more detailed view of the gastrointestinal tract. This procedure can even help detect severe conditions like Barrett's esophagus.

Conclusion

While relatively low risk, an upper GI endoscopy is a necessary procedure that can prevent more severe illnesses from setting in. An endoscopy can help detect ulcers, narrowing of the food pipe, gastric issues, and abnormal growth in the parts of the upper digestive tract. The procedure can help detect several other diseases, including detecting cancer early.

To know more about an Upper GI Endoscopy, please get in touch with us at Northlake Gastroenterology Associates.  

If you are experiencing any GI tract-related issues, please book an appointment for a consultation.