EGD (Upper Endoscopy)

Indications for upper GI endoscopy

• Difficulty or pain in swallowing
• GI bleeding (vomiting blood, black stools, or iron-deficiency anemia)
• Troublesome heartburn
• Persistent ulcer-like pain
• Dyspepsia (indigestion), particularly with loss of appetite or weight loss
• Use of aspirin or NSAIDs with a history of gastric ulcer
• Persistent nausea, vomiting, or symptoms suggesting obstruction
• A gastric ulcer demonstrated by a prior barium meal
• Duodenal biopsy for suspected malabsorption

Reasons for a repeat endoscopy

You may be asked to repeat endoscopy for one or more of the following reasons:

• To determine the healing of a gastric ulcer
• Surveillance of dysplasia in Barrett's esophagus
• Follow-up of a duodenal ulcer complicated by previous bleeding or perforation
• A duodenal ulcer not responding to adequate ulcer therapy

Repeat endoscopy is not indicated in uncomplicated duodenal ulcers.

Benefits of upper GI endoscopy

An upper GI endoscopy is both diagnostic and therapeutic. A diagnosis can be made upon which specific treatment is given. If a bleeding site is identified, treatment can stop the bleeding; if a polyp is found, it can be removed without a major operation. Therapeutic uses include:

• Sclerotherapy for varices
• Dilation of strictures
• Pneumatic dilation of achalasia
• Removal and surveillance of gastric polyps
• Removal of foreign bodies

How to prepare

Your medical team will want to know if you have heart, lung, or other medical conditions that may need special attention before, during, or after the procedure. It is important not to eat or drink anything for at least eight hours before the endoscopy. Your doctor will instruct you about the use of regular medications, including blood thinners, before the exam.

What to expect during the procedure

• Prior to the procedure, you will be given intravenous medications to relax and sedate you.
• You will be asked to wear a hospital gown and to remove your eyeglasses and dentures.
• A local anesthetic may be applied to the back of your throat.
• A mouthpiece is placed in your mouth; it does not interfere with your breathing.
• You will lie on your left side during the procedure.
• The physician inserts the endoscope through your mouth, down the esophagus, and into your stomach. The endoscope does not interfere with your breathing.
• The procedure typically lasts 15 to 20 minutes.
• Afterward, you will stay in the recovery room for about 30 minutes for observation.

After the procedure

• Your doctor will explain the results to you and your family. If the effects of the sedatives are prolonged, results may be reviewed at a later visit.
• If a biopsy is performed or a polyp removed, results are typically available in three to seven days.
• Your endoscopy report and biopsy results will be sent to your referring physician.
• Have someone available to take you home, since you will not be able to drive for at least 24 hours.
• Do not eat or drink in the car on the way home; the combination of anesthesia, food, and car motion can cause nausea or vomiting.

Risks and complications

Apart from a minor sore throat, significant complications are extremely rare for diagnostic endoscopy in patients with adequate heart and lung status.

Therapeutic endoscopy carries an increased risk. Possible complications include bleeding and puncture of the stomach lining; however, such complications are rare.