Upper Endoscopy
(Esophagogastroduodenoscopy or "EGD")
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What is the
test?
This test inspects your esophagus and stomach
using an endoscope. An upper endoscopy allows
the doctor to explore the cause of such symptoms
as difficulty swallowing, abdominal pain, vomiting
up blood, or passing blood in the stool. It can
also diagnose irritation, ulcers, and cancers
of the lining of the esophagus and stomach. During
this type of endoscopy, the doctor can also take
biopsy samples of tissue.
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How
do I prepare for the test?
Don't eat or drink anything for eight hours
before this test. It's also best to stop taking
aspirin and other NSAIDs for several days beforehand,
to reduce the chances of bleeding should your
doctor need to take a biopsy. Ask your doctor
if you should avoid taking any other medicines
on the day of the test. Because you have to fast
for this test, if you have diabetes talk with
your doctor about ways to avoid hypoglycemia.
If you wear dentures, remove them before the
test. Arrange for a ride home because the medicine
given for this test will make you drowsy.
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What
happens when the test is performed?
You'll probably be given a sedative through
an IV. This medicine may prevent you from remembering
the test; it might even make you sleep through
it.Wearing a hospital gown, you lie on your side
against a backrest. A local anesthetic is sprayed
into your throat to prevent you from gagging
when the endoscope is inserted.
The endoscope used in this test is about half
an inch in diameter and long enough to reach
from your mouth through your stomach and into
the first part of your small intestine.When the
doctor places the endoscope in your throat, he
or she asks you to swallow. This helps guide
the endoscope into your esophagus. You are likely
to feel pressure against your throat while the
tube is in place and you might experience a
"full" feeling in your stomach. The doctor or
doctor's assistant gently advances the tube into
your stomach. As the camera at the end of the
scope takes pictures that appear on a video screen,
your doctor will watch for any suspicious lesions
on the lining of your stomach or esophagus. If
any appear, your doctor might use some small
clippers on the end of the scope to remove a
tiny piece of tissue for a biopsy.
Though the exam itself takes only 10-15 minutes,
you will probably be in the exam room for 40
minutes or more because of the time it takes
to set up. Your throat will feel numb, but this
will wear off about 30 minutes later. The sedative
will make you sleepy for an hour or more.
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What
risks are there from the test?
Complications are rare.About 1 in 1,000 people
has a serious complication, such as aspiration
(accidentally inhaling saliva into the lungs),
which can cause pneumonia. If a biopsy is taken,
or if the endoscope injures the wall of the esophagus
or stomach, it can cause bleeding. If severe,
internal bleeding can require a transfusion.
In rare cases, perforation of the lining of the
stomach, esophagus, or intestine can also occur,
requiring surgery. The sedative given can sometimes
cause an allergic reaction.
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Must
I do anything special after the test is over?
Medical personnel will probably watch you for
half an hour or more after the test. Although
you may eat an hour after the test, you shouldn't
drive or drink alcohol for the rest of the day
due to grogginess from the sedative. Call your
doctor if you experience dizziness, chest pain,
dif- ficulty or pain with swallowing, fever,
black stools, or vomiting material that looks
like coffee grounds. The last two symptoms can
indicate that you are bleeding from your stomach
lining.
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How
long is it before the result of the test is
known?
Your doctor can tell you right after the test
what was seen in your upper digestive tract.
If biopsies were taken, it can take several days
to a week before the results are back.
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