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Upper GI Endoscopy Upper GI endoscopy, sometimes called EGD (esophagogastroduodenoscopy), is a visual
examination of the upper intestinal tract using a lighted, flexible fiberoptic or video endoscope. The upper gastrointestinal
tract begins with the mouth and continues with the esophagus (food tube) which carries food to the stomach. The
J-shaped stomach secretes a potent acid and churns food into small particles. The food then enters the duodenum,
or small bowel, where bile from the liver and digestive juices from the pancreas mix with it to help the digestive
process.
The flexible endoscope is a remarkable piece of equipment that can be directed
and moved around the many bends in the gastrointestinal tract. Endoscopes now come in two types. The original pure
fiberoptic instrument has a flexible bundle of glass fibers that collect the lighted image at one end and transfer
the image to the eye piece. The newer video endoscopes have a tiny, optically sensitive computer chip at the end.
Electronic signals are then transmitted up the scope to the computer which then displays the image on a large video
screen. An open channel in these scopes allows other instruments to be passed through in order to take tissue samples,
remove polyps and perform other exams
It is important not to eat or drink anything for at least eight hours before the
exam. The physician instructs the patient about the use of regular medications, including blood thinners, before
the exam. Upper GI endoscopy is usually performed on an outpatient basis. The throat is
often anesthetized by a spray or liquid. Intravenous sedation is usually given to relax the patient, deaden the
gag reflex and cause short-term amnesia. For some individuals who can relax on their own and whose gagging can
be controlled, the exam is done without intravenous medications. The endoscope is then gently inserted into the
upper esophagus. The patient can breath easily throughout the exam. Other instruments can be passed through the
endoscope to perform additional procedures if necessary. For example, a biopsy can be done in which a small tissue
specimen is obtained for microscopic analysis. A polyp or tumor can be removed using a thin wire snare and electrocautery
(electrical heat). The exam takes from 15 to 30 minutes, after which the patient is taken to the recovery area.
There is no pain with the procedure and patients seldom remember much about it. After the exam, the physician will explain the results to the patient and family.
If the effects of the sedatives are prolonged, the physician may suggest an interview at a later date when the
results can be fully understood. If a biopsy has been performed or a polyp removed, the results are not available
for three to seven days. |
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