The Digestive System

Upper Endoscopy

Upper endoscopy enables the physician to look inside the esophagus, stomach, and duodenum (first part of the small intestine). The procedure might be used to discover the reason for swallowing difficulties, nausea, vomiting, reflux, bleeding, indigestion, abdominal pain, or chest pain. Upper endoscopy is also called EGD, which stands for
esophagogastro-duodenoscopy.

For the procedure, you will lie on your left side on the examining table. A needle for intravenous (IV) medicines will be placed in your arm vein before the procedure. Right before the procedure the physician may spray your throat with a numbing agent that may help prevent gagging. You will then be given a mild sedative through the IV to keep you comfortable and to help you relax during the exam.

Once you are sedated, the physician will insert a thin, flexible, lighted tube called an endoscope into your mouth. The endoscope is guided slowly down and transmits an image of the inside of the esophagus, stomach, and duodenum, so the physician can carefully examine the lining of these organs. The scope also puffs air into the stomach; this expands the folds of tissue and makes it easier for the physician to examine the stomach.

The physician can see abnormalities like inflammation, bleeding, ulcers or tumors through the endoscope that don't show up well on x-rays. The physician can also insert instruments into the scope to treat bleeding abnormalities or remove samples of tissue (biopsy) for further tests.

Endoscopy with biopsy is associated with a low risk of complications when performed by a physician who has been specially trained and is experienced in the procedure. However, there are risks associated with any endoscopic examination, such as: a medication reaction, lack of awareness lasting a few hours, or swelling of an arm vein following medication injection. More serious complications can also occur, such as: bleeding after a biopsy or removal of an intestinal growth, infection, or a perforation of the intestine which may require immediate surgery. Surgery or hospitalization may also be required for any unforeseen complication. Overall, such complications are rare. Most people will probably have nothing more than a mild sore throat after the procedure.

Upper endoscopy takes 20 to 30 minutes. Because you will be sedated, you will need to rest at the endoscopy facility for a short time until the medication wears off.

Preparation

Your stomach and duodenum must be completely empty for the procedure to be thorough and safe, so you will not be able to eat or drink after midnight the night before your procedure.  If you take medications in the morning, you may take them with a small sip of water. Also, you must arrange for someone to take you home—you will not be allowed to drive for the rest of the day because of the sedatives. Your physician may give you other special instructions. Inform your physician of any medical conditions or medications that you take before your endoscopy.