Upper Endoscopy

WHAT IS AN UPPER ENDOSCOPY?

An upper endoscopy is a test popularly known as the “esophagogastroduodenoscopy (EGD)”. It involves the insertion of a tube that has a light and a little camera fitted at the edge of the tube into the upper part of the small intestine comprising of the upper digestive tract. This includes the esophagus, duodenum, and stomach.

This is a diagnostic test and this procedure is conducted as an ambulatory procedure i.e it does not require to be admitted overnight in the hospital. Though, it is most times performed in an emergency room to observe and resolves issues regarding the digestive tract such as bleeding. 

The diagnostic test has proven to be more efficient than X-rays for irregular growth in the body i.e cancer, tumors, or inflammation. 

WHY IS A UPPER ENDOSCOPY DONE?

An upper endoscopy is performed to determine conditions affecting the digestive system and most times treating them.

The endoscopy test is conducted based on the following factors:

• Signs and Symptoms

The endoscopy test can help the specialist detect causes of problems associated with digestion. 

This symptom is listed below:

1. Heartburns.
2. Excessive bleed.
3. Vomiting.
4. Nausea.
5. Weight loss.
6. Swallow issue.
7. Anemia.
8. Black or tarry stools.

Diagnosis

Diagnosis can be conducted by acquiring samples from the tissue to check for diseases like inflammation, anemia, cancer, or diarrhea. 

The diseases and disorders that can be detected utilizing the endoscopy technique are:

1. Gastroesophageal reflux disease (GERD).
2. Large veins in the esophagus. 
3. Tumors.
4. Celiac disease.
5. Narrowing (strictures) or blockages.
6. Upward movement of the stomach close to the esophagus.
7. Redness and swelling (inflammation) and sores (ulcers).
8. Damages resulting from the intake of harmful substances. 
9. Infection on the upper digestive system.
10. Crohn’s disease of the digestive system.

Treatment

Certain equipment can be used with the aid of an endoscopy to seize bleeding by burning or even removing an external object stuck in the throat. 

The gastrointestinal tract endoscopy can be used as a form of treatment by:

1. Besteering bleeding.
2. Removing tumors.
3. Expanding narrow areas.
4. Removing obstacles stuck in the upper part of the system.
5. Inserting the tube used for feeding into the stomach.
6. Contracting irregular veins in the esophagus.

ELIGIBILITY

Anyone with problems with relation to the upper digestive system can take this test, therefore, it is limited to no one in particular.

HOW DO YOU PREPARE FOR THE TEST?

To prepare for the test, it is recommended that there should be no food or water intake for 8 hours just before undergoing the test. Also, drugs such as painkillers are to be avoided 7 days before taking the test.

PROCESS

The process involved in conducting this diagnostic test is classified into the process before performing the test, what is to be done during the process, and after the test.

Before the Procedure

Before the process is initiated, certain measures are must be undergone and this involves:

1. Restricting the intake of food and water about 8 hours before undergoing the procedure. It is mandatory to conduct the test on an empty stomach.
2. No intake of any sort of pain killer 7 days before the test is to be done because they can spike the chances of bleeding while undergoing the process. 

During the Procedure

1. Firstly, it is necessary to be dressed in a hospital gown.
2. An intravenous needle is then injected through your arm containing a sedative which relaxes the nerves and then is placed under anesthesia which makes the patient feel no pain. They both aid to make the patient comfortable during the process.  
3. Local anesthesia is also sprayed inside the throat to make the insertion insensible or a liquid is given to gargle with to prevent gagging.
4. Then, a mouthpiece will be inserted by the doctor to hold the mouth wide open.
5. The patient will be laid on the back or side on an examination table before gently inserting the endoscope. The endoscope releases air into the system to give a better view of the lining.
6. The process lasts for about 20 to 30 minutes. Then the doctor gradually removes the endoscope before the patient is taken to the recovery room.

After the Procedure

In the recovery room, it is expected of the patient to relax and allow the anesthesia and sedative to wear off a little before taken home by a guardian due to the sedative and anesthesia incomplete wear-off. 

Then, the doctor will instruct the patient when to drink and eat anything before returning to full activity after 24 hours.

RESULTS

The determination of the result depends on the diagnosis. In some cases, the results are gotten fast, while, others too have different duration of result. This information is normally related to the patient by the doctor.

RISKS

The upper gastrointestinal endoscopy is known to be a safe process with few serious risks. Though, all processes tend to have complications one way or the other. 

These complications can include bleeding which can due to the removal of tissue samples from the system or even the removal of a polyp perforation in the upper gastrointestinal tract. Though bleeding as a result of the upper endoscopy is minimal and tends to stop even without treating it. 

The removal of the perforation is uncommon but some surgeries might need to be performed on the patient as a result of the complications encountered while medicines or intravenous fluids can be used for reactions that occur due to the anesthesia and sedatives.

SIDE EFFECTS

A sore throat might occur but it is advisable to gargle saltwater if encountered to ease the pain. Also, bloating might be eminent due to the air that has entered into the system. 

Other effects encountered after the upper endoscopy has been performed on a patient are listed below:

1. Fever or chills
2. Pain in the belly.
3. Vomiting.
4. Nausea.
5. Swallowing problem.
6. Redness, swelling, or bleeding, or another drainage from the IV site
7. Pain around the throat.
8. Hard breaths.
9. Abdominal pain.

WHO PERFORMS THE UPPER ENDOSCOPY?

A gastroenterologist is a specialist responsible for performing the upper gastrointestinal test. 

The test is conducted in a hospital or clinic in some cases, the doctor’s office. Though other doctors can perform the test the gastroenterologist specializes in it. 

There are endoscopic units where the upper endoscopy is performed and for this procedure to be safe and efficient, certain measures have been outlined to ensure a successful process.

1. The doctor and nurse staff that is to perform the upper endoscopy must be well trained and must have the experience of performing such a process. 
2. The area in which the upper endoscopy is to be performed must be very clean.
3. Proper working and maintained equipment is a necessity.
4. Personnel available must have specialized training in performing cardiopulmonary resuscitation
5. There should be a quality improvement program available.

DURATION

The upper endoscopy test will only be needed to be performed once. Also, the duration for the output of the result depends solely on the problem diagnosed with different diagnoses all having different periods of accessibility of result.

COST

The cost of upper endoscopy is not fixed and varies depending on the country and hospital. In the U.S, the stipulated cost range is between $1000 and $3000.

FAQs

• Who will do my upper endoscopy? 

A gastroenterologist is a specialized doctor that conducts all tests regarding the upper gastrointestinal tract. Therefore, the test is conducted by the specialist but in some cases, a doctor that has grounded knowledge on how to perform the procedure is still eligible to conduct it.

• How long will the procedure take?

The procedure takes a short period, mainly about 20 to 30 minutes.

• Is the process painful?

The process is not painful as anesthesia and sedatives are given to numb all pains and relax the nerves before the process begins.

• How accurately does an upper endoscopy find cancer?

There is a small camera attached to the end of the tube that clearly shows everything inside the upper gastrointestinal tract that helps indicate if there is cancer or not. It is very accurate as it has proven to be more efficient than the X-ray method.

• How long does it take to recover from an upper endoscopy?

On a normal condition, it takes the patient 2 hours to recover from the anesthesia and sedatives placed under without complications. If there are complications, the doctor prescribes certain medication or even a surgery for affected people diagnosed with a disease.

• Do you have to undress for an endoscopy?

Yes, it is required of the patient to undress and change into a hospital gown before the process is conducted.

• What is the difference between upper GI and endoscopy?

The upper GI is known as the upper gastrointestinal tract which consists of the upper digestive system i.e duodenum, stomach, and esophagus while the endoscopy is the test performed on the upper GI to source out problems encountered in the tract.