Esophagogastroduodenoscopy (EHD), often called upper endoscopy, is an invasive procedure that can aid in the evaluation and treatment of various conditions that affect the upper gastrointestinal (GI) tract, which consists of the esophagus , stomach, and gastrointestinal tract. higher. small intestine Using your mouth and throat for access, a fiber optic endoscope equipped with a camera is used to view your upper gastrointestinal tract, perform biopsies , or treat gastrointestinal conditions.
What is EGD?
EGD can be an intervention, a diagnostic tool, or both. This procedure may be part of your medical care if your healthcare provider needs to access the lumen of your upper GI tract, which is within this continuous GI tract. Both children and adults can have this procedure.
EGD uses an endoscope that extends from the mouth to the gastrointestinal tract. The endoscope is thin and flexible, with an attached camera and microsurgical instruments. The camera is used to view the inner lining of the light, and your healthcare provider can also take photos or videos of the region to help diagnose and plan future treatment. Surgical instruments can be used to correct defects and diseases.
Your EGD may include one or more of the following components:
- Esophagoscopy: reaches the interior of the esophagus.
- Gastroscopy: extends into the stomach.
- Duodenoscopy: access to the inside of the duodenum , the first part of the small intestine.
EGD does not view the upper gastrointestinal tract system from the outside and does not provide reliable information about the lungs, liver, spleen, or other nearby organs.
Your healthcare provider may recommend that you postpone upper lung endoscopy if you have an active lung condition such as asthma, severe exacerbations of COPD, or severe heart disease that makes anesthesia difficult, or an infection of the nose, throat, or nose. the pulmonary system. especially if the procedure is done for a diagnostic purpose. Cancer in the neck or oral cavity can prevent the tube from passing into the esophagus, but cancer does not prevent EGD from passing.
As a general rule, complications are mild and appear during the procedure or within a few days. EGD can cause serious complications, but they are rare.
An abrasion or tear in the lining of the esophagus, stomach, or small intestine can cause bleeding. It can heal on its own if the abrasion is minor. If it is larger, it can lead to blood loss and may need to be corrected during the EGD procedure or later.
The intervention can also cause a puncture in the upper gastrointestinal tract, which can lead to severe bleeding or a life-threatening gastric leak that will require urgent repair.
The cardiac or respiratory effects of anesthesia are also possible, especially in people with severe heart or lung disease .
Complications are more likely if you already had a serious upper GI disorder before the procedure, such as a bleeding ulcer or large swelling. Furthermore, therapeutic EGD causes more tissue destruction than diagnostic EGD and is more likely to cause complications.
The purpose of the EGD
EGD may be done for diagnostic or therapeutic purposes, depending on your condition.
Your healthcare provider may recommend an EGD if you have any of the following symptoms:
- Swallowing problems (dysphagia)
- Pain when swallowing (odonophagia)
- Excessive or persistent vomiting
- Hematemesis (vomiting blood) or hemoptysis (coughing up blood)
- Excessive or unusual belching
- Bitter taste in the mouth
- Abdominal pain
- Chest pain
- Unexplained anemia (reduced function of red blood cells)
Visualizing light can help determine its cause, which may otherwise be unclear based solely on perception.
You may also need EGD if you've already had an abdominal X-ray, ultrasound, or computed tomography (CT) scan that suggests an upper GI tract abnormality. Imaging tests can usually visualize the anatomical structure of the upper gastrointestinal tract and nearby organs, but they do not give an idea of the appearance of the innermost lining. This makes upper endoscopy a useful adjunct when used in conjunction with imaging tests.
EGD is also considered when the history and physical examination suggest the possibility of a lesion in the lumen that cannot be well visualized with a less invasive test (such as an imaging test).
Additionally, EGD may be indicated if you have ingested a foreign body or corrosive substance.
As a diagnostic tool, EGD is also useful when it is the easiest and safest way to obtain a biopsy. During the procedure, your doctor may take one or more tissue samples so that they can be examined under a microscope.
Conditions that can be diagnosed or treated with EGD include:
When done for medicinal purposes, your healthcare provider may do any of the following, depending on your condition:
EGD has also been used in the treatment of severe obesity as one of the alternatives to other types of weight loss surgery . This procedure includes techniques such as reducing the size of the stomach with an endoscopic suture approach rather than an abdominal incision.
How to prepare
Before EGD, your healthcare provider may pre-schedule imaging tests to help plan your procedure.
EGD is usually done in an endoscopy room, which is a special treatment room. It may be in a hospital, surgery center, or clinic.
You should be prepared to spend a few hours at your EGD appointment and rest for the rest of the day after your procedure.
What to wear
You will need to change into a gown so that what you wear to your appointment does not interfere with your procedure. However, since you may feel bloated after EGD, you may want to consider wearing clothing that does not restrict your abdomen area.
Food and drink
You will be asked to stop eating and drinking about eight hours before the EGD. You may be allowed to drink clear liquids up to five hours before your visit, and your healthcare team will give you more detailed instructions, if any. Special considerations to keep in mind based on your specific condition.
If you are taking blood thinners, your doctor may direct you to stop taking them a few days before your test. And they may also give you instructions on how to adjust the dose of steroids or other anti-inflammatory drugs you are taking.
Cost and health insurance
Your health plan may require a prior authorization to approve payment and the provider will handle this step.
You may have to pay a copayment and you can find out your share of the cost from your health insurance company and the facility where the procedure will be performed.
If you pay EGD out of pocket, you can expect it to cost between $ 1,000 and $ 3,000.
You should bring the EGD order form that your healthcare provider gave you, your health insurance card, your identification form, and how you paid your share.
Since you will need sedation to treat EGD, you should make sure you have someone to drive you home after the procedure.
Lifestyle changes before surgery
Your healthcare provider may recommend diet changes several weeks before your EGD. For example, you may be asked to avoid gluten if you fear you may have celiac disease .
What to Expect on EGD Day
When you sign up for an EGD, you will be asked to fill out a few forms, including a consent form, a payment authorization, and a patient privacy form.
EGD is usually performed by a gastroenterologist , a doctor who specializes in treating diseases of the gastrointestinal system. A nurse or technician will help you with the procedure.
Before the procedure
Sometimes there is a preoperative area where you can put on a gown before the procedure. But often patients do it in the treatment room. If you have any, the dentures or partial plates should be removed so that the pain reliever can reach all areas of the mouth and avoid damage with the endoscope.
Your heart rate, blood pressure, breathing rate, and oxygen levels will be monitored throughout the procedure. A pulse oximeter is placed on the finger to measure oxygen saturation and pulse, and a cuff is placed on the arm to measure blood pressure.
You will need IV sedation, as well as a local pain reliever injected into the throat to avoid discomfort and vomiting .
The nurse will place an IV in your arm or arm; You should feel the first offense, but then there will be no pain. You will then be given an IV medicine to make you feel sleepy and relaxed. Although the medication itself will not make you sleep, it is not uncommon to fall asleep during this procedure.
Then your throat will be treated with pain reliever medicine for 30 to 45 minutes.
You will be given a protective device that you can insert into your mouth to protect your teeth from exposure to the endoscope. Then you will find yourself on the left side.
During the procedure
When you are relaxed enough, you will be asked to swallow once or twice during the initial insertion period of the endoscope. The tube will not interfere with your breathing and will only be slightly uncomfortable after the first insertion.
You should not feel discomfort during EGD and you should not feel pain or notice incisions due to techniques such as biopsy or tumor resection.
You may experience a feeling of fullness in your abdomen when your doctor injects a moderate amount of air to expand your stomach and improve visualization. Photographs or videos of the inside of the digestive tract may be taken to track abnormalities and plan treatment.
A biopsy may be done for research purposes. If this happens, you will be stitched up to stop the bleeding and speed healing.
If you are prescribed EGD for a gastrointestinal disorder, the electrosurgical instruments attached to the endoscope will be used as planned.
You may have diagnostic and therapeutic aspects of your EGD. Your physician may choose some of the therapeutic approaches during your procedure based on observations made during EGD.
After the procedure
Once the endoscope is removed, your healthcare team will inform you that the procedure is complete. You may not remember the procedure due to the sedative effect.
You will need to recover and wait until you are awake and awake before you are discharged. Until then, you can keep track of vital signs, such as blood pressure and heart rate.
Be sure to let your healthcare team know if you experience any discomfort or pain.
Your healthcare provider will discuss the results of an upper limb endoscopy with you immediately after your procedure, or you can schedule another appointment and make a plan, especially if you have had a biopsy. This can take days or weeks. Before leaving, make sure you have a clear schedule.
Expect to feel lethargic for several hours after EGD. After the procedure, which should take about 24 hours, you may experience a mild sore throat.
Follow your doctor's instructions for resuming eating and drinking after your procedure. When you do, it is best to eat or drink slowly. Cold liquids and soft foods are best; avoid anything very sharp or sharp.
Promote your diet slowly and don't force yourself to eat more than you can eat too soon. You should learn to eat well in a week.
Endoscopy recovery shouldn't take more than a few days. If your sore throat lasts longer, if the pain worsens or you have trouble swallowing, or if you have swelling in the back of your throat, call your doctor.
Seek emergency medical help if you experience unusual or severe abdominal pain or bleeding after the procedure. Dark-colored stools, coughing, saliva, or bloody vomit are signs to watch for. Lightheadedness or dizziness can indicate serious blood loss and is a medical emergency.
Long term care
You will not need long-term care for the EGD procedure alone. But you may need medicine to fix problems found during EGD.
Treatment may include chemotherapy and radiation therapy for cancer, hernia surgery, or anti-inflammatory drugs for Crohn's disease.
Possible future operations
In general, you do not need to regularly repeat EGD procedures. But if your symptoms suddenly get worse or you develop new symptoms, your healthcare provider may ask you to do another EGD to investigate a cause that has not yet been established.
Depending on your condition, you may need to make some dietary changes. For example, your health care professional or dietitian may recommend avoiding acidic foods that can make ulcers worse. Or, you may need to limit your meals to small portions if you have a chronic problem of narrowing your upper GI tract.
And if you've had EGD for obesity, you'll need to restrict calories to maintain long-term benefits.
Keep in mind that each gastrointestinal condition is regulated by a specific diet. There is no one-size-fits-all strategy.
Get the word of drug information
EGD can be an important part of the diagnosis and treatment of diseases of the upper gastrointestinal tract. The procedure is usually well tolerated and recovery usually takes no more than a few days.
If you have a short-term or chronic upper gastrointestinal disorder that requires EGD, feel free to ask your healthcare provider and healthcare team to explain EGD results to you so that you can understand what is happening to your health.
Frequently asked questions
It will take 30 to 60 minutes for your doctor to examine your esophagus, stomach, and duodenum during an FGD endoscopy.
Within 24 hours of your procedure, you will have a mild sore throat, bloating, gas, or mild cramps. Some people also feel sick from the anesthesia. If these symptoms last more than a day, see your doctor.
Your doctor will give you specific instructions based on your procedure. In most cases, you can resume eating light meals shortly after the endoscopy. If you have a sore throat or the residual effects of local anesthesia, you may need to wait until the pain or numbness is gone before eating.