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Upper Endoscopy

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UPPER ENDOSCOPY

Also known as an OGD, the upper endoscopy is used when symptoms present which suggest abnormalities in the esophagus, stomach and first potion of the duodenum, which is where the small intestine begins. Together, these portions of your digestive system are known as the upper digestive tract.

The OGD is usually performed as an outpatient service. A thin scope equipped with a small camera is inserted into the mouth to view the upper digestive tract. Sometimes, this procedure will be done at a hospital or in a hospital emergency ward, to pinpoint conditions like bleeding in the area and to treat them.

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Why it's done ?

INVESTIGATE SYMPTOMS

An endoscopy can help determine what’s causing digestive signs and symptoms, such as heartburn, nausea, vomiting, abdominal pain, difficulty swallowing and gastrointestinal bleeding.

DIAGNOSE

An endoscopy offers an opportunity to collect tissue samples (biopsy) to test for diseases and conditions that may be causing anemia, bleeding, inflammation or diarrhea. It can also detect some cancers of the upper digestive system.

TREAT

Special tools can be passed through the endoscope to treat problems in your digestive system. For example, an endoscopy can be used to burn a bleeding vessel to stop bleeding, widen a narrow esophagus, clip off a polyp or remove a foreign object.

DETECTING CANCER CONDITIONS

This procedure is much more reliable for detecting conditions like cancer in the upper digestive tract and much more accurate than X-rays for that purpose.

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Full overview of the procedure

1 - PRE-PROCEDURAL PREPARATION

1 – Discuss medical conditions or problems : Make sure to tell your doctor if you’re pregnant or have any health conditions, such as heart disease or cancer. This information helps your doctor know whether to take any necessary precautions to perform the procedure as safely as possible.

2 – Mention medications and allergies :You should also tell your doctor about any allergies you have and about any prescription and over-the-counter medications you’re taking. Your doctor may tell you to change your dosage or to stop taking certain medications before the endoscopy. Some medications can increase your risk for bleeding during the procedure. These medications include:

  • anti-inflammatory medications
  • warfarin (Coumadin)
  • heparin
  • aspirin
  • any blood thinners

Any medications that cause drowsiness can interfere with the sedatives that the procedure will require. Antianxiety medications and many antidepressants could affect your response to the sedative.

If you take insulin or other medications to control diabetes, it’s important to make a plan with your doctor so your blood sugar doesn’t get too low. Don’t make any changes to your daily dosage unless your doctor tells you to do so.

3 – Arrange for a ride home : You’ll likely be given a narcotic and a sedative to help you relax during the endoscopy. You shouldn’t drive after the procedure because these drugs will make you drowsy. Arrange to have someone pick you up and drive you home. Some medical centers won’t allow you to have the procedure unless you arrange for a ride home ahead of time.

4 – Don’t eat or drink :You shouldn’t eat or drink anything after midnight the night before the procedure. This includes gum or mints. However, you can usually have clear liquids after midnight up to six hours before the endoscopy if your procedure is in the afternoon. Clear liquids include:

  • water
  • coffee without cream
  • apple juice
  • clear soda
  • broth

You should avoid drinking anything red or orange.

5 – Dress comfortably : Although you’ll be given a medication to help you relax, an endoscopy can still cause some discomfort. Make sure to wear comfortable clothes and avoid wearing jewelry. You’ll be asked to remove glasses or dentures before the procedure.

6 – Bring any necessary forms: Make sure to fill out the consent form and any other paperwork that your doctor has requested. Prepare all forms the night before the procedure, and put them in your bag so you don’t forget to bring them with you.

7 – Plan for time to recover : You may have mild discomfort in your throat after the procedure, and the medication may take a while to wear off. It’s wise to take time off work and to avoid making important life decisions until you’re completely recovered.

2 - DURING THE PROCEDURE

During an Upper Endoscopy

During an upper endoscopy procedure, you’ll be asked to lie down on a table on your back or on your side. As the procedure gets underway:

  • Monitors often are attached to your body. This allows your health care team to monitor your breathing, blood pressure and heart rate.
  • You may receive a sedative medication. This medication, given through a vein in your forearm, helps you relax during the endoscopy.
  • An anesthetic may be used in your mouth. An anesthetic spray numbs your throat in preparation for insertion of the long, flexible tube (endoscope). You may be asked to wear a plastic mouth guard to hold your mouth open.
  • Then the endoscope is inserted in your mouth. Your provider may ask you to swallow as the scope passes down your throat. You may feel some pressure in your throat, but you shouldn’t feel pain.

You can’t talk after the endoscope passes down your throat, though you can make noises. The endoscope doesn’t interfere with your breathing.

As the endoscope travels down your esophagus:

  • A tiny camera at the tip transmits images to a video monitor in the exam room. Your provider watches this monitor to look for anything out of the ordinary in your upper digestive tract. If something unusual is found in your digestive tract, images can be taken for later examination.
  • Gentle air pressure may be fed into your esophagus to inflate your digestive tract. This allows the endoscope to move freely. And it allows the folds of your digestive tract to be examined more easily. You may feel pressure or fullness from the added air.
  • Your provider will pass special surgical tools through the endoscope to collect a tissue sample or remove a polyp. This is done with the help from a video monitor to guide the tools.

When the exam is finished, the endoscope is slowly retracted through your mouth. An endoscopy typically takes 10 to 20 minutes.

3 - POST-OPERATIVE CARE

Your throat might feel sore from the insertion of the endoscope, and you might temporarily feel bloated because of the carbon dioxide or air that’s used to give the physician a better view of the stomach. Nausea is possible, but the propofol often used for anesthesia helps prevent it.

You’ll feel groggy for about 30 minutes after the procedure, but that feeling should start to fade within the hour. Even so, you should not make any big decisions the rest of the day, and you will need to have someone take you home.

4 - YOUR RESULTS

When you receive the results of your endoscopy will depend on your situation. If, for instance, the endoscopy was performed to look for an ulcer, you may learn the findings right after your procedure. If a tissue sample (biopsy) was collected, you may need to wait a few days to get results from the testing laboratory. Ask your provider when you can expect the results of your endoscopy.

ADVANTAGES

Advantages of Upper Endoscopy include:

• The procedure is fast and you’ll be comfortable throughout.

• OGD is used by the doctors to find the cause of various symptoms like nausea, vomiting, abdominal pain or difficulty in swallowing.

• In some cases, your doctor can correct issues during the procedure

• It can be recorded for later examination or comparison to a follow-up test

• An EGD provides a more detailed view of the esophagus, stomach, and duodenum than an X-ray can provide

• With the help of small instruments passed through the endoscope, tumors are removed or bleeding is treated by injecting drugs or burning off the blood vessels by heat.

• Biopsy can also be done through OGD to determine cancerous growths.

RISKS & COMPLICATIONS

OGD is usually a safe procedure but the following risks are present:


• Irritation of the vein where the IV was administered.

• Reaction to medicines or sedation administered.

• Very rarely, bleeding may occur at the place where biopsy was conducted or the polyps were removed. Blood transfusion will be immediately required.

• Another major but rare risk is the perforation of the esophagus, stomach or duodenum. A surgery will be required to correct this problem.

• At time, lung infection could occur due to the vomit going into the lungs.

• Sometimes abnormalities or diseases could be missed.

• Incomplete procedure: This could be either due to problems inside the body or due to technical problems.

• Very rare, death can occur due to complications in the procedure.

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Disclaimer:

Information provided is only for educational purpose. Contact your Health consultant or Emergency services depending on your symptoms. Do not self-diagnose, treat or take health care decisions based on the information given. It cannot replace a medical consultation required for a patients individual needs.

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