Upper GI Endoscopy in Malvern, PA
Upper GI endoscopy, sometimes referred to as gastroscopy or EGD (esophagogastroduodenoscopy), is an examination of the esophagus, stomach and duodenum with a lighted, thin, flexible tube. These instruments transmit light with a flexible bundle of glass fibers. Most of the newer instruments now utilize a tiny TV camera at the end of the instrument to transmit a visual image of the inside lining of the upper part of gastrointestinal tract to a video monitor. An open channel in the endoscope allows other instruments, such as biopsy forceps, to pass through the endoscope.
Reasons to have upper GI endoscopy
- Indigestion and Abdominal Pain: Ulcers, tumors and gastritis (inflammation in the lining of the stomach) can be readily identified by visual inspection of the lining.
- Evaluation of Heartburn: Acid reflux esophagitis and its complications (such as stricture and Barrett’s esophagus) can be diagnosed, and the effectiveness of therapy can be evaluated.
- Anemia and Gastrointestinal Bleeding: Endoscopic examinations can identify the presence of abnormal blood vessels, ulcers, and tumors as the source of blood loss. In addition, there are therapeutic modalities, such as application of cautery and banding of abnormal blood vessels, that can be applied through the endoscope.
- Difficulty in Swallowing: Partial blockages in the esophagus, which can cause difficulty in swallowing, can be identified with gastroscopy. In addition, dilators can be used through the endoscope to stretch narrowed areas to make swallowing easier. Medications can be injected into the esophagus to improve the swallowing in patients who have achalasia.
- Tumors of the Esophagus and Stomach: Tumors can be diagnosed and occasionally treated with laser therapy applications and placement of a stent to expand a narrowed esophagus. In addition, endoscopic surveillance and application of phototherapy can be utilized to prevent esophageal cancer in patients who have Barrett’s esophagus related to gastroesophageal reflux disease.
- Placement of a Feeding Tube: Endoscopic techniques can be used to place a feeding tube (PEG) through the abdominal wall into the stomach for patients who have difficulty with swallowing.
- Diarrhea and Malabsorption: Endoscopic examinations can be utilized to obtain biopsy of the small intestine to assist in diagnosis of diarrhea and malabsorption syndromes.
Preparation for the examination
An eight-hour fast is required so that the stomach will be completely empty during the examination. Individuals with diabetes or on blood thinners (aspirin and Coumadin) should discuss their medications with the physician prior to the examination. Individuals with abnormalities of the heart valves should discuss the use of antibiotics with their physician prior to a dilation of an esophageal stricture.
Description of the procedure
The procedure is usually performed either in the doctor’s office or in an outpatient setting of a hospital. The back of the throat may be anesthetized by a spray. Intravenous sedation is often used to relax the patient during the procedure. The patient will generally be lying on his or her left side. The endoscope is then gently inserted through the mouth into the upper esophagus. It does not interfere with breathing. The examination may take five to ten minutes, after which the patient is taken into a recovery area until the sedation starts to wear off. There is no pain with the procedure. Air is placed into the stomach and therefore patients often feel somewhat bloated and may belch during the procedure. Patients who are given sedation should not drive a car for at least 12 hours and will need to arrange for a ride home.
Upper GI x-ray can be used to look for structural abnormalities in the esophagus, stomach or intestine. This does not allow direct visualization of the lining and lacks the accuracy of upper GI endoscopy. It does not allow therapeutic intervention such as biopsy or cautery to stop bleeding. It may be useful in patients who have difficulty in swallowing prior to endoscopic therapy.
Side effects and risks
Side effects and risks There is occasionally a temporary mild throat irritation after the examination. There may be bleeding after a biopsy or removal of a polyp. There may be a perforation or tear in the esophagus or wall of the stomach. These serious complications are exceedingly rare.