Upper Gastrointestinal Endoscopy
An upper gastrointestinal (UGI) endoscopy is a procedure that allows your doctor to look at the interior lining of your esophagus, your stomach, and the first part of your small intestine (duodenum) through a thin, flexible viewing instrument called an endoscope. The tip of the endoscope is inserted through your mouth and then gently moved down your throat into the esophagus, stomach, and duodenum (upper gastrointestinal tract).
Since the entire upper gastrointestinal (GI) tract can be examined during this test, the procedure is sometimes called esophagogastroduodenoscopy (EGD).
Using the endoscope, your doctor can look for ulcers, inflammation, tumors, infection, or bleeding. Tissue samples can be collected (biopsy), polyps can be removed, and bleeding can be treated through the endoscope. Endoscopy can reveal problems that do not show up on X-ray tests, and it can sometimes eliminate the need for exploratory surgery.
Why It Is Done
An upper gastrointestinal endoscopy may be done to:
Endoscopy may also be done to:
How To Prepare
Before having an upper gastrointestinal endoscopy, tell your doctor if you:
Do not eat or drink anything for 6 to 8 hours before the test. An empty stomach helps your doctor see your stomach clearly during the test. It also reduces your chances of vomiting. If you vomit, there is a small risk that your stomach contents could enter your lungs (aspiration). If the test is done in an emergency, a tube may be inserted through your nose or mouth to empty your stomach.
You will usually be asked to sign a consent form before the test. Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form(What is a PDF document?).
You may be asked to stop taking aspirin products or iron supplements 7 to 14 days before the test. If you take blood-thinning medicines regularly, discuss with your doctor how to manage your medicine.
Do not take sucralfate (Carafate) or antacids the day of the test. These medicines can interfere with your doctor's ability to view the gastrointestinal tract.
If biopsy samples are taken or polyps are removed during the test, bleeding may also occur. This bleeding usually stops on its own without treatment. To reduce this risk, avoid aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) for several days before the endoscopy. If you take blood-thinning medicine, you may be instructed to stop the medicine temporarily before the test.
Before the test, you will put on a hospital gown. If you are wearing dentures, jewelry, contact lenses, or glasses, remove them. For your own comfort, empty your bladder before the test begins.
Arrange to have someone take you home after the test because you will be given a sedative before the test.
How It Is Done
A gastrointestinal endoscopy may be done in a doctor's office, clinic, or a hospital. An overnight stay in the hospital usually is not needed. The test is most often performed by a doctor who specializes in problems of the digestive system (gastroenterologist). The doctor may also have an assistant. Some family medicine doctors, internists, and surgeons are also trained to do endoscopy.
Before the procedure, blood tests may be done to check for a low blood count or clotting problems. Your throat may be numbed with an anesthetic spray, gargle, or lozenge to relax your gag reflex and make it easier to insert the endoscope into your throat.
During the test, you may receive a pain medicine and a sedative through an intravenous (IV) line in your arm or hand. These medicines reduce pain and will make you feel relaxed and drowsy during the test. You may not remember much about the actual test.
You will be asked to lie on your left side with your head bent slightly forward. A mouth guard may be placed in your mouth to protect your teeth from the endoscope. Then the lubricated tip of the endoscope will be guided into your mouth and your doctor may gently press your tongue out of the way. You may be asked to swallow to help move the tube along. It is helpful to remember that the instrument is no thicker than many foods you swallow and will not cause problems with breathing.
Once the endoscope is in your esophagus, your head will be tilted upright. This makes it easier for the scope to slide down your esophagus. During the procedure, try not to swallow unless requested to. An assistant may remove the saliva from your mouth with a suction device, or you can allow the saliva to drain from the side of your mouth.
Your doctor will slowly move the endoscope while looking through an eyepiece or watching on a video monitor to examine the walls of your esophagus, stomach, and duodenum. Air or water may be injected through the scope to help clear a path for the scope or to clear its lens, and suction may be applied to remove air or secretions.
A camera attached to the endoscope takes pictures for viewing on the monitor and stores some pictures for later study. The doctor may also insert tiny instruments (forceps, loops, swabs) through the endoscope to collect tissue samples (biopsy) or remove growths. The biopsy test is completely painless.
To make it easier for your doctor to see different parts of your upper gastrointestinal (GI) tract, you may be repositioned or have gentle pressure applied to your belly. When the examination is completed, the endoscope is slowly withdrawn.
See a picture of upper gastrointestinal endoscopy.
After the test
The test usually takes 30 to 45 minutes, but it may take longer, depending upon what is found and what is done during the test.
After the test, you will be observed for 1 to 2 hours until the medicines wear off. If your throat was numbed before the test, you should not eat or drink until your throat is no longer numb and your gag reflex has returned to normal.
When you are fully recovered, you can go home. You will not be able to drive or operate machinery for 12 hours after the test. Your doctor will tell you when you can resume your usual diet and activities. Do not drink alcohol for 12 to 24 hours after the test.
How It Feels
You may notice a brief, sharp pain when the intravenous (IV) needle is placed in a vein in your arm. The local anesthetic sprayed into your throat usually tastes slightly bitter and will make your tongue and throat feel numb and swollen. Some people report that they feel as if they cannot breathe at times because of the tube in their throat, but this is a false sensation caused by the anesthetic. There is always plenty of breathing space around the tube in your mouth and throat. Remember to relax and take slow, deep breaths.
During the test, you may feel very drowsy and relaxed from the sedative and pain medicines. You may have some gagging, nausea, bloating, or mild abdominal cramping as the tube is moved. If you are having pain, alert your doctor with an agreed-upon signal or a tap on the arm. Even though you won't be able to talk during the procedure, you can still communicate.
The suction machine used to remove secretions may be noisy but does not cause pain. The removal of biopsy samples is also painless.
You will feel groggy after the test until the medicine wears off, usually in a few hours. Many people report that they remember very little of the test because of the sedative given before and during the test.
After the test, you may belch and feel bloated for a while. You may also have a tickling, dry throat or mouth; slight hoarseness; or a mild sore throat. These symptoms may last several days. Throat lozenges and warm saltwater gargles can help relieve the throat symptoms. Do not drink alcohol after the test.
Complications from gastrointestinal endoscopy are rare. There is a slight risk of puncturing your throat (esophagus), stomach, or upper small intestine (duodenum). If this happens, you may need to have surgery to fix it. There is also a slight chance of infection after an endoscopy.
Bleeding may also occur from the test or if a tissue sample (biopsy) is taken, but this usually stops on its own without treatment. If you vomit during the examination and some of the material you vomit enters your lungs, aspiration pneumonia is a possible risk. If it develops, it can be treated with antibiotics.
An irregular heartbeat may occur during the test but nearly always subsides on its own without treatment.
The procedure has more risk for people with serious heart disease, older adults, and those who are frail or physically weakened. Although complications are rare, you should discuss your specific risks with your doctor.
After the test
After the test, call
After the test, call your doctor immediately if you:
An upper gastrointestinal (UGI) endoscopy is a procedure that allows your doctor to look at the interior lining of your esophagus, your stomach, and the first part of your small intestine (duodenum) through a thin, flexible viewing instrument called an endoscope.
Your doctor may be able to talk to you about some of the findings with you immediately after your upper gastrointestinal endoscopy. But the medicines given to help relax you may impair your memory, so your doctor may wait until they wear off completely. Other results are usually available in 2 to 4 days. Tests for certain infections may take several weeks.
A biopsy sample may be taken to:
Many conditions can change the results of an upper gastrointestinal endoscopy. Your doctor will talk with you about any abnormal results that may be related to your symptoms and past health.
What Affects the Test
Reasons you may not be able to have the test or why the results may not be helpful include the following:
What To Think About
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