What is an upper endoscopy?

In an upper endoscopy surgery, an instrument known as an endoscope, a thin, long, flexible tube with a lighted camera at one end is used by the doctor (gastroenterologist) to examine upper part of the digestive system that includes the esophagus, stomach, and duodenum. The tube is placed through the mouth and throat. Afterward, it is slowly pushed through the esophagus and stomach, and into the duodenum, the upper part of the small intestine.  The doctors can see the images captured by the endoscope on a computer screen.

 

Why is an EGD test performed?

A doctor can perform an EGD test to aid in identifying conditions affecting the esophagus, stomach, or duodenum. People who experience the following symptoms might need the test:

• Severe or chronic heartburn
• Vomiting blood
• Black or tarry stools
• Vomiting food
• Pain in the upper abdomen
• Unexplained anaemia
• Nausea or vomiting that is persistent
• Weight loss that cannot be explained
• Feeling full after having less food than usual
• Feeling that food is present behind the breastbone
• Difficulty or pain swallowing

 

The doctor can also use this test to aid in examining how a treatment is working or in tracking complications like:

• Crohn’s disease
• Peptic ulcers
• Cirrhosis
• Swollen veins in the lower esophagus

 

What are the advanced techniques in endoscopy technology?

Some examples of latest endoscopy technologies include:

• Capsule endoscopy: It is a revolutionary procedure that can be used when other tests are not conclusive. In capsule endoscopy, a small pill with a tiny camera is swallowed. This capsule passes through the digestive tract, without causing any discomfort, thus creating thousands of images of the intestines as it moves.
• Endoscopic retrograde cholangiopancreatography (ERCP): In ERCP, X-rays are combined with upper GI endoscopy to diagnose or treat issues with the pancreatic ducts and bile.
• Chromoendoscopy: In Chromoendoscopy technique, a specialized stain or dye is used on the lining of the intestine during an endoscopy procedure. The dye helps the physician to visualize better if there is any abnormality in the intestinal lining.
• Endoscopic ultrasound (EUS): EUS makes use of an ultrasound together with an endoscopy, which allows the treating doctors to visualize organs and other structures that are otherwise not visible during regular endoscopy. Then, a thin needle is inserted into the structure or organ to retrieve some tissue for viewing under a microscope. This procedure is called fine needle aspiration.

 

How is an upper endoscopy conducted?

Before an endoscopy

The procedure is explained to the patient by the doctor and they can ask relevant questions if any. A consent form can be given for signing. The patient should read it thoroughly, ask any questions that may arise, and subsequently sign the document.

The patient will, in all probability, be asked to avoid eating and drinking for four to eight hours prior to the endoscopy so that the stomach is empty for the procedure. If the patient is taking any medications including over-the-counter drugs and nutritional supplements, they should inform the doctor. They should also tell a physician about any allergies that they might suffer from. Patients can also be required to stop taking some medications that can increase the risk of bleeding including blood thinners like aspirin. If the patient suffers from chronic conditions like diabetes, heart disease, or high blood pressure; particular instructions about the medications and necessary precautions will be shared by the doctor.

Patients are likely to be sedated during the procedure and they should have someone else drive them home after the procedure.

During the procedure

Typically, endoscopy is performed as an outpatient procedure in a hospital or an outpatient surgical center. It means that a person can go home the same day after the procedure is performed. The procedure is typically not painful, however, it can cause slight discomfort. Patients will be administered an intravenous sedative or another form of anaesthesia.

On an exam table, the patient lies on their left side during the procedure. A numbing spray is then sprayed in the throat and a mouthguard is inserted to protect the teeth and the camera from damage.

The endoscope is inserted through mouth and down into the esophagus, stomach, and duodenum. Pressure can be felt as the endoscope passes the throat. Air is pumped through endoscope into the stomach and duodenum so that the doctor finds it easy to view the organs. The images from the endoscope are then displayed on a video monitor allowing the doctor to examine the digestive tract. If required a doctor can remove small pieces of tissue using the endoscope for biopsy. A doctor can also perform other treatments, if necessary.

After the endoscopy

Before going home, the patient spends time in the recovery area so that the health care team can monitor them as the effect of the sedative diminishes.

At home, patients can experience mild discomfort including symptoms like bloating and gas, cramping, and sore throat after completion of the procedure. The symptoms usually go away after some time. Patients should resume eating with a light snack post the procedure and based on the approval of the doctor, they should be able to start normal activities such as working and driving the following day.

What are the likely risks or complications of upper endoscopy?

The procedure is more or less a low-risk procedure. Likely complications can include:

• Allergic reactions to the sedative that is given
• Bleeding or infection in the digestive tract
• Tear in the lining of upper digestive tract

However, a doctor must be consulted if a patient experiences the following:

• Persistent cough
• Coughing or vomiting blood
• Difficulty swallowing
• Fever and chills
• Black or tarry stool
• Severe pain in the throat, chest, or abdominal

 

Conclusion

Upper endoscopy also called EGD (esophagogastroduodenoscopy) aids a doctor in finding the cause of certain digestive tract problems. The procedure is relatively low-risk. The procedure can also be used for the treatment of some other problems. After the procedure, patients can suffer throat irritation and bloating for one or two days. If a doctor has taken biopsy samples, then the results could take a few weeks to arrive.