physician and patients

Diagnostics

EGD

An EGD (esophagogastroduodenoscopy) is an examination of the upper gastrointestinal (GI) tract with a special piece of equipment called an endoscope. The upper GI tract includes the throat, esophagus, stomach and first part of the small intestines (duodenum).

An endoscope is a thin and flexible (bendable) metal tube with a light and tiny video camera on the end. The physician can either look directly in the scope or can see the pictures projected on a TV monitor. The procedure gives physicians a clear view of the esophagus, stomach and duodenum and shows more detail than pictures taken with x-ray. The endoscope also has an open channel that allows for instruments to be passed in order to take tissue samples, cauterize bleeding or remove polyps.

Your physician will tell you the reason why an EGD has been recommended for you.

Anatomy

The digestive system helps the body digest and absorb the food we eat. Swallowed food goes through the esophagus. The food then passes through the stomach where it is partially digested. Food goes from the stomach, to the small intestine, where nutrients are further digested and partially absorbed. The beginning of the small intestine is called the duodenum.

Risks

An EGD is a common and safe procedure. Without this procedure, diseases may not be diagnosed and proper treatment may not be given. Complications are rare, but they can occur. You need to know about them just in case they happen. These risks include:

  • Abdominal pain or swelling in your upper GI tract, which results from having air pumped into your body during the procedure, that usually lasts a short period of time until your body passes the extra air.
  • Bleeding is rare but more likely if a biopsy is performed or if you take blood-thinning medication; if it occurs, it usually resolves on its own. In rare cases, patients require a blood transfusion; and in extremely rare cases, surgery may be needed.
  • Damage (perforation) to the esophagus, stomach or duodenum from the endoscope, which may require additional surgery to repair.
  • Infection, although rare, may occur. However, IVCH has stringent infection control procedures in place to help protect our patients and staff from cross-infection.
  • Minor discomfort during the procedure, if the local anesthetic doesn't numb the area sufficiently.
  • Allergic reaction to the medication given for the procedure.
  • Complications from pre-existing diseases, such as heart or lung conditions.

Be sure to talk with your physician if you are worried or have questions.

Before the Procedure

The physician or nurse will need to know your medical and surgical history, including whether you are or could be pregnant. He or she will also ask you about any medications you take (prescribed, over-the counter or other nutritional supplements) and any allergies you may have to medications or other substances. You should always carry a list of these items with you.

Depending on your condition and history, your physician may order additional tests for you. These may include blood, urine, or stool tests.

If you need a minor pain reliever in the week before the procedure, choose acetaminophen rather than aspirin, ibuprofen, or naproxen. This helps avoid extra bleeding during the procedure. If you are taking daily aspirin for a medical condition, ask your physician if you need to stop taking it before the procedure. If you have been taking Coumadin (a blood thinner), you will have to stop it several days before the exam.

Follow your physician’s instructions about not smoking before and after the procedure. If you are a smoker, you should quit at least two weeks before the procedure.

You should arrange to have someone be with you on the day of your procedure. If you are discharged after your EGD, you will not be able to drive home due to the medications you are given during the procedure.

You may eat meals or drink liquids as usual until midnight before the procedure. Try to avoid eating foods with residue or fiber, which are not easy to digest. These include fruits, vegetables, cereal, nuts, peas, beans, fried foods and bread.

Follow any other instructions your health care provider gives you.

On the Day of Your Procedure

Do not eat or drink anything on the morning of your procedure, unless you have been instructed to do so by your physician or the nurse. This includes food, liquid and medications. Food in the upper GI tract will block the view and hinder the examination. It can also cause vomiting. If you are instructed to take medicines, you may have them the morning of your procedure with few small sips of water.

Bring with you any papers your physician has given you to sign as well as your list of medications and allergies.

Wear loose fitting, comfortable clothing.

An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.

During the Procedure

You will be taken to the endoscopy room and lay on a special bed or table. The nurse will place pads on your chest to monitor your heart rate and attach a clip to your finger to monitor your oxygen levels. You will be given medication through your IV to relax and sedate you. A local anesthetic is given to help avoid gagging. This may be a spray or a medication to gargle with. It is important for you to try to relax and take slow, deep breaths through your nose. Every effort will be made to maintain your comfort and safety. Most patients sleep through the procedure. Your blood pressure, pulse and the oxygen level in your blood will be monitored. The procedure usually takes about 15 minutes to complete.

At the end of the examination, the physician will withdraw the endoscope and you will be taken to a recovery room to wait for the effect of the medications to wear off. This may take up to one hour. You will then be discharged to go home. Your physician may give you preliminary results before discharge. If any biopsy was done, these results will not be available for several days.

After Your Procedure

You will be observed for about an hour. This is to make sure that the numbing medicine given to you has worn off and that you are able to swallow without difficulty. You may continue to feel the same discomfort or symptoms that you had before the procedure.

You may have a sore throat, bloating or cramping. These are normal side effects and should go away within 24 hours.

You physician will tell you how soon you can eat, drink, and resume your regular activities.

You should not eat or drink until you can cough and swallow normally.

Since you will not have eaten since before midnight, you should start eating slowly after the test. Eat a light snack first. You may go back to your normal activities and begin drinking and eating as soon as you feel ready.

Call Your Physician If:

  • You cannot make it to your appointment on time.
  • You get sick (a cold or flu) or have a temperature over 101 degrees.
  • You have questions or concerns about your procedure.

Seek Care Immediately If:

  • You are not able to eat or drink, or are urinating less or not at all.
  • You have blood in your stool.
  • Your abdomen becomes tender and hard.
  • Your signs and symptoms are getting worse.
  • Your vomit has blood or bile in it.
  • You have problems swallowing.
  • You have nausea, vomiting or sharp pain in your stomach or abdomen.
  • You feel dizzy, short of breath or faint.

Following your caregiver's advice during and after the procedure may decrease your chances of having any problems.

Paperwork

Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments or procedures may be done to treat your condition. Your physician should also tell you about the risks and benefits of each treatment. You will be asked to sign a consent form that gives your physician and the hospital staff permission to do certain tests, treatments or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

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