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.

GETTING READY:

The week before your procedure:

• Ask a family member or friend to drive you home after your procedure. Do not drive yourself home.
  
  
• Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery. Some medicines may need to be stopped days before your procedure:
  
  
  • If you are taking blood thinning medicines, you may need to stop them before your procedure.
    
    
  • Ask your caregiver if you need to stop any of your medicines before your EGD.
  
  
• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
  
  
• Dye may be used during your procedure to help caregivers mark the spot where they found some abnormalities in your upper GIT. Tell your caregiver if you are allergic to any dye.
  
  
• Tell your caregiver if you already had an EGD, barium swallow, or other similar procedures before and when they were done.
  
  
• Tell your caregiver if you have other known diseases. These diseases may include diabetes (high blood sugar level), bleeding disorders, or heart, liver, or kidney problems. Your caregiver may also need to know whether you had past surgeries of your esophagus, stomach, or duodenum. If you are a woman, tell your caregiver if you know or think you might be pregnant.
  
  
• You may need to have blood tests, manometry, or x-rays to check how well your body is working. Ask your caregiver for more information about these tests. Write down the date, time, and location of each test.

The night before your procedure:

• Ask caregivers about directions for eating and drinking.
  
  
  • You may eat meals or drink liquids that you normally have until midnight. Try to avoid eating foods with residue or fiber that are not easy to digest. These include fruits, vegetables, cereal, nuts, peas, beans, fried foods, and bread.
    
    
  • Increase the amount of water you are drinking. This will help wash down foods with residue or fiber from the upper GIT.
  
  

The day of your procedure:

• Write down the correct date, time, and location of your procedure.
  
  
• What to bring: You may want to bring items such as a toothbrush and bathrobe.
  
  
• Ask your caregiver before taking any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.
  
  
• Ask caregivers about directions for eating and drinking.The pictures may not be seen clearly if your stomach or small intestines are not totally empty. You may brush your teeth. If you need to take medicines, you may have them the morning of your procedure with few small sips of water.
  
  
• If you wear contact lenses, do not wear them on the day of your procedure or surgery. Glasses may be worn.
  
  
• Do not wear tight-fitting clothes on the day of your procedure or surgery.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine. Antibiotic medicines may be given 30 minutes before your procedure. This may be needed if you have an artificial heart valve, a pacemaker, or have a history of heart, lung, or liver problems.
  
  
• You or a close family member will be asked to sign a legal piece of paper (consent form). It gives your caregiver permission to do the procedure. It also explains the problems that may happen, and your choices. Be sure all your questions have been answered before you sign this form.

TREATMENT:

What will happen:

• You will be taken on a stretcher to the endoscopy room and then moved onto a special bed or table. Your caregiver may give you medicine to help you relax, make you drowsy, or stop coughing or gagging. This medicine may be taken by mouth, gargled, sprayed on your throat, or injected in your IV. You will be asked to lie on your left side. Your caregiver may place a mouth guard to protect your teeth as the scope is placed.
  
  
• Your caregiver will gently pass 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 will be wiped, suctioned, or allowed to drain from the side of your mouth. Your caregiver will slowly advance the scope while watching on a small video screen and taking pictures. Air or water may be injected through the scope so he can see clearly. Suction will 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. This is done so the tissues are easier to remove. 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 will be slowly removed and your mouth will be 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 bowel. When your caregiver sees that you are OK, you will be allowed to change clothes and go home. If your caregiver wants you to stay in the hospital, you will be taken back to your hospital room. Ask your caregiver for information on how to take care of yourself after your procedure.

Waiting room: This is a room where your family and friends can wait until you are ready for visitors. If your family leaves the hospital, ask them to leave a phone number where they can be reached.

CONTACT A CAREGIVER IF:

• You cannot make it to your appointment on time.
  
  
• You have a fever (increased body temperature).
  
  
• You have questions or concerns about your procedure.

SEEK CARE IMMEDIATELY IF:

• You are not able to eat or drink, or are urinating less or not at all.
  
  
• You have blood in your bowel movement (BM).
  
  
• Your abdomen becomes tender and hard.
  
  
• Your signs and symptoms are getting worse.
  
  
• Your vomit (throw up) has blood or bile in it.

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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