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. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. 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: A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• 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: This medicine is given to make you comfortable. You may not feel discomfort, pressure, or pain. An adult will need to drive you home and should stay with you for 24 hours. Ask your caregiver if you can drive or use machinery within 24 hours. Also ask if and when you can drink alcohol or use over-the-counter medicine. You may not want to make important decisions until 24 hours have passed.
  
  
• Monitoring:
  
  
  • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
    
    
  • Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
    
    
  • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

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.

• Eat healthy foods: Choose 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. Include dairy products such as low-fat milk, yogurt, and cheese. Choose protein sources, such as lean beef and chicken, fish, beans, eggs, and nuts. Ask how many servings of fats, oils, and sweets you should have each day, and if you need to be on a special diet.
  
  
• Drinking liquids: Men 19 years old and older should drink about three Liters of liquid each day (about 13 eight-ounce cups). Women 19 years old and older should drink about two Liters of liquid each day (about 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: This medicine is given to help treat or prevent an infection caused by bacteria.
    
    
  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
    
    
    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
      
      
    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

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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.

Learn more about Upper Gastrointestinal Endoscopy (Inpatient Care)