Upper Gastrointestinal Endoscopy

WHAT YOU SHOULD KNOW:

• Upper gastrointestinal (gas-tro-in-TES-ti-nal) endoscopy (en-DOS-ko-pe) is also called esophagogastroduodenoscopy (EGD). This is a procedure to examine the lining (walls) of the upper gastrointestinal tract (GIT). The upper GIT includes the esophagus (food pipe), stomach, and duodenum (first part of the small intestine). EGD is used to help diagnose diseases and other problems that affect the upper GIT. These may include inflammation (swelling), infections, tumors, ulcers (sores), bleeding, or polyps (growths).
  
  
• With EGD, caregivers use an endoscope to help see the lining of the upper GIT. An endoscope is a thin and flexible (bendable) metal tube with a light and tiny video camera on the end. This gives caregivers a clear view of the esophagus, stomach, and duodenum while watching the images on a monitor. A small amount of tissue may be taken from the upper GIT and sent to the lab for tests. Your caregiver may also remove polyps or foreign objects, place a stent (tube), or treat bleeding during the endoscopy. With EGD, diseases of the upper GIT may be diagnosed and treatment given to relieve your symptoms.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

• EGD is a common and safe procedure. You may have infection, or more pain or bleeding as the scope goes inside your upper GIT. You may also have a slow heartbeat, decreased blood pressure, increased sweating, or fainting (passing out). Your esophagus, stomach, or duodenum may get punctured or perforated (torn). This may be due to increased pressure while the scope and air are passing through them. Following your caregiver's advice during and after the procedure may decrease your chances of having any problems.
  
  
• Without this procedure, diseases may not be diagnosed and proper treatment may not be given. The signs and symptoms you have may continue and worsen. You may have problems swallowing, eating, or digesting food that may lead to other serious medical problems. Ask your caregiver if you are worried or have questions about your procedure, medicine, or care.

WHILE YOU ARE HERE:

Before your procedure:

• Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.
  
  
• IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.
  
  
• Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.
  
  
• Anesthesia: Anesthesia is medicine to make you comfortable during surgery. Caregivers work with you to decide which anesthesia is best and whether you will be awake or completely asleep. Do not make important decisions for 24 hours after having anesthesia. Also, do not drive or use heavy equipment. An adult may need to drive you home and stay with you after you have had anesthesia.
  
  
• Monitoring:
  
  
  • Heart monitor: This is also called an ECG. Sticky pads are placed on different parts of your body. Each pad has a wire that is hooked to a TV-type screen. This shows caregivers a tracing of the electrical activity of your heart.
    
    
  • Pulse oximeter: A pulse oximeter is a machine that tells how much oxygen is in your blood. A cord with a clip or sticky strip is placed on your ear, finger, or toe. The other end of the cord is hooked to a machine. Caregivers use this machine to see if you need more oxygen.
    
    
  • Vital signs: This includes taking your temperature, blood pressure, pulse (counting your heartbeat), and respirations (counting your breaths). To take your blood pressure, a cuff is put on your arm and tightened. The cuff is attached to a machine which gives your blood pressure reading. Caregivers may listen to your heart and lungs by using a stethoscope. Your vital signs are taken so caregivers can see how you are doing.

During your procedure:

• Once you are transferred onto the special table or bed, you are asked to lie on your left side. Your caregiver may place a mouth guard to protect your teeth as the endoscope is placed.
  
  
• Your caregiver gently passes the endoscope through your mouth and down into your esophagus, stomach, and duodenum. You may be asked to swallow to help the scope move along. The passage of the endoscope may cause a feeling of pressure and a little discomfort. Tell your caregiver when you feel too uncomfortable by making a signal or tapping him. Your saliva is wiped, suctioned, or allowed to drain from the side of your mouth. Your caregiver slowly advances the scope while watching on a small video screen and taking pictures. Air or water may be injected through the scope so he could see clearly. Suction may be used to remove air, water, blood, or other secretions.
  
  
• Your caregiver may inject a fluid under tissues that look suspicious or use dye to mark them. He may take tissue samples and send them to the lab for tests. He may remove foreign objects, tumors, or polyps that may be blocking your esophagus, stomach, or duodenum. Your caregiver may also insert special tools using the scope to treat bleeding or place a stent (tube). When the procedure is finished, the endoscope is slowly removed and your mouth is wiped with gauze.

After your procedure: You may lie in bed and rest for a while since the procedure may be tiring. You may also pass some air that may be left in your stomach and intestines. When your caregiver sees that you are OK, you may be allowed to change clothes and go home. If your caregiver wants you to stay in the hospital, you may be taken back to your hospital room. Ask your caregiver for information on how to take care of yourself after your procedure.

• Diet: Eat a variety of healthy foods from all the food groups every day. Include whole grain bread, cereal, rice and pasta. Eat a variety of fruits and vegetables, including dark green and orange vegetables and legumes (dry beans). Include dairy products such as low-fat milk, yogurt and cheese. Choose protein sources such as lean meat and poultry (chicken), fish, beans, eggs and nuts. Ask your caregiver how many servings of fats, oils, and sweets you may have each day, and if you need to be on a special diet.
  
  
• Drinking liquids: Men 19 years old and older should drink about 3.0 Liters of liquid each day (close to 13 eight-ounce cups). Women 19 years old and older should drink about 2.2 Liters of liquid each day (close to 9 eight-ounce cups). Follow your caregiver's advice if you must change the amount of liquid you drink. For most people, healthy liquids to drink are water, juices, and milk. If you are used to drinking liquids that contain caffeine, such as coffee, these can also be counted in your daily liquid amount. Try to drink enough liquid each day, and not just when you feel thirsty.
  
  
• Medicines: You may need any of the following:
  
  
  • Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
    
    
  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain. Medicine may be given regularly, or may only be given if you ask caregivers for it. Tell caregivers if your pain does not decrease enough for you to feel better. Do not wait to ask for your pain medicine until the pain is very bad. The medicine may not work as well at controlling your pain if you wait too long to take it. Ask your caregiver for help getting out of bed if you feel tired or dizzy.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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