The things to know before getting an upper GI endoscopy
An esophagogastroduodenoscopy (EGD), or better known as upper GI endoscopy, involves the insertion of an endoscope into a person's body through the mouth. An endoscope is a thin flexible tube with a light and camera at its end. During the investigation, the endoscope records and gives doctors information about the tissues in the mouth down to the esophagus, stomach, and duodenum. The gastroenterologist, who is the expert performing the examination, visualizes the patient’s digestive tract to look for any abnormalities.
Why have an upper GI endoscopy?
When viewing internal organs, especially in the intestinal tract, an endoscopy is usually more precise than x-rays. There are many conditions which require this type of exploratory investigation. It is used to diagnose the cause of severe gastrointestinal reflux disease, stomach pain, bloating, nausea, vomiting, weight loss, or trouble swallowing.
This investigation is carried out to evaluate and sometimes even cure problems with the esophagus, stomach, or the duodenum. The upper GI endoscopy is an effective way to check on the healing of previous surgical procedures on the stomach or small intestine, measure the healing progress of issues such as ulcers Hiatal hernias, and measure inflammation of the stomach or esophagus. Specialists can find and treat issues such as finding swallowed foreign objects, unexplained bleeding, blockages in the small intestine and removing growths and polyps.
Is the upper GI endoscopy safe?
The upper GI endoscopy has been proven to be very safe when done by a qualified gastroenterologist. The minor risks associated are bleeding, allergy to the anesthesia, and possible perforation of the gut wall. Risks involved in the process are reduced if the whole investigation is done by an expert.
Perforation of the stomach or small intestines is a possible risk and bleeding from the biopsy site or the site where a polyp was removed is another possible complication of this procedure. These are two of the most common risks of undergoing an endoscopy. Negative reactions to anesthesia is a less common reaction but is much more severe when it does occur.
Preparation for an upper GI endoscopy
Just like any other medical procedure, an upper GI endoscopy requires some preparation. You should let your doctor know what medications you take, if you have any allergies, bleeding problems, take blood thinners, might be pregnant, have heart issues, are diabetic, or have had any surgeries or treatments like radiation in the area. Certain medications, like antacids and sucralfate, interfere with the doctor's ability to see your upper tract clearly.
To be able to get clear images of the inside of the gastrointestinal tract, food matter should not be present. Patients are advised not to eat or drink anything at least 6 hours before the procedure. This 'fasting’ requirement is vital to the whole process. Acts such as drinking water, chewing gum, or even smoking may interfere with the investigation result and cause increased risk of vomit entering the lungs, called aspiration, while under anesthesia.
The actual exam may occur in a hospital or an outpatient clinic, depending on the initial reason for the procedure and the risk factors present. You are not usually required to stay in the hospital overnight for an upper GI endoscopy. In preparation for the test, doctors often require bloodwork to check for clotting issues or a low blood count. These conditions dramatically increase the risk for the patient.
The upper GI endoscopy procedure
The patient is sedated during an upper GI endoscopy, and a numbing spray can be applied to the throat to minimize pain and discomfort when the long and flexible camera, or endoscope is inserted. The patient lies down on their left side, and the endoscope is slowly inserted into their mouth. Once the patient has swallowed the scope, they are repositioned on their back. Saliva may be suctioned away or allowed to drip down the side of the mouth. You should try not to swallow unless the doctor asks you to.
The live feed on the endoscope is seen on a monitor, and images are saved for further examination. The endoscope mainly visualizes the esophagus, but it also goes through the stomach, down to the first section of the small intestine called the duodenum. The doctor will look for any abnormal tissue or structures of the upper tract. This includes inflammation, signs of infection, polyps, bleeding, tumors, and ulcers.
Biopsies can be done during this procedure if the gastroenterologist finds any abnormal tissue. A biopsy involves taking a sample of tissue and examining it under a microscope. Endoscopic biopsies are important since they can provide help explaining the symptoms a patient is experiencing. Polyps can also be removed, and bleeding can be treated during an upper GI endoscopy intervention.
The whole process takes approximately 30 minutes to one hour, but it can last longer if the doctor encounters any complications, and exact results of the investigation are given to the patient within 96 hours.
The patient is usually asked to have someone drive them home after the endoscopy, since the sedation takes an hour or two to wear off, and it will not be safe for the patient to drive themselves. Patients are also advised not to operate heavy machinery or perform high-risk tasks since their reflexes and thought process are impaired by the anesthesia.
There are some findings that the doctor will be able to discuss with you immediately after the procedure, and others will take some time to be finalized. Your doctor will be able to talk to you about surgical recovery progress, ulcer recovery progress, polyps that were removed, and bleeding that was stopped. Results of biopsies take more time to obtain, and your doctor will want to wait until the medications have cleared your system before discussing any serious complications or results.
Some findings that are abnormal include swelling or irritation of the upper tract, bleeding, ulcers, a tumor, or dilated veins. If a hiatal hernia is discovered, the gastroenterologist will want to schedule a follow-up surgery to repair it. Tears in the esophagus, stomach or small intestines may be fixed during the exploratory procedure, but often surgery at a later date will be required. Likewise, if a foreign object is discovered that is too big to remove with the scope, you will need to have surgery to remove it.
Tests for infectious bacteria, fungus, and cancer cells may take a few weeks to complete. If you have not heard from your doctor about biopsy results in four weeks, you should call and check on the progress.
Upper GI endoscopy costs
The good news is that an endoscopy is usually covered by health insurance, but patients that do not have insurance can expect to pay between $1,500 to $8,000. The cost usually depends on the country, the anesthetic used, and whether the procedure was performed in a hospital or imaging center.
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