Upper GI endoscopy (EGD)
Sometimes called EGD (esophagogastroduodenoscopy), is a visual examination
of the upper intestinal tract using a lighted, flexible fiberoptic
or video endoscope.
The endoscope can be directed and moved around the many bends
in the gastrointestinal tract. Electronic signals are then transmitted
up the scope to the computer which then displays the image on a
large video screen. An open channel in these scopes allows other
instruments to be passed through in order to take tissue samples,
remove polyps and perform other exams.
Upper GI endoscopy is usually performed on an outpatient basis.
The throat is often anesthetised by a spray or liquid. Intravenous
sedation is usually given to relax the patient, deaden the gag reflex
and cause short-term amnesia. For some individuals who can relax
on their own and whose gagging can be controlled, the exam is done
without intravenous medications. The endoscope is then gently inserted
into the upper esophagus. The patient can breath easily throughout
the exam. Other instruments can be passed through the endoscope
to perform additional procedures if necessary. For example, a biopsy
can be done in which a small tissue specimen is obtained for microscopic
analysis. A polyp or tumor can be removed using a thin wire snare
and electrocautery (electrical heat). The exam takes from 15 to
30 minutes, after which the patient is taken to the recovery area.
If a biopsy has been performed or a polyp removed, the results are
not available for three to seven days.
An upper GI endoscopy is performed primarily to identify and/or
correct a problem in the upper gastrointestinal tract. This means
the test enables a diagnosis to be made upon which specific treatment
can be given. If a bleeding site is identified, treatment can stop
the bleeding, or if a polyp is found, it can be removed without
a major operation. Other treatments can be given through the endoscope
when necessary.
Alternative tests to upper GI endoscopy include a barium x-ray and
ultrasound (sonogram) to study the organs in the upper abdomen.
Study of the stools, blood and stomach juice can provide indirect
information about a gastrointestinal condition. These exams, however,
do not allow for a direct viewing of the esophagus, stomach and
duodenum, removing of polyps or taking of biopsies.
A temporary, mild throat irritation sometimes occurs after the exam.
Serious risks with upper GI endoscopy, however, are very uncommon.
One such risk is excessive bleeding, especially with removal of
a large polyp. In extremely rare instances, a perforation, or tear,
in the esophagus or stomach wall can occur. These complications
may require hospitalization and, rarely, surgery. Quite uncommonly,
a diagnostic error or oversight may occur. Due to the mild sedation,
the patient should not drive or operate machinery following the
exam. For this reason, someone else should be available to drive
the patient home.
Upper GI endoscopy is a simple outpatient exam that is often performed
with the patient lightly sedated. The procedure provides significant
information upon which specific treatment can be given. In certain
cases, therapy can be administered directly through the endoscope.
Serious complications rarely occur from upper GI endoscopy.
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