Endoscopy (EGD)


Common Procedure Examines Esophagus, Stomach, Duodenum

Endoscopy, also known as esophagogastroduodenoscopy or EGD, is a common procedure doctors use to examine the lining of the esophagus (swallowing tube), stomach, and duodenum (beginning of the small intestine). Endoscopy is most often done in the doctor’s office or hospital outpatient unit by a highly trained physician known as a gastroenterologist.

An endoscopy is ordered when a patient has symptoms such as difficulty or painful swallowing or persistent nausea, vomiting, or upper abdominal pain. Endoscopy is much more accurate than an x-ray in the detection of ulcers, inflammation, or tumors of the upper gastrointestinal tract.

During endoscopy, once the patient is medicated, a tiny, flexible tube is inserted into the mouth and then slowly advanced down the throat and into the stomach. The tube has a tiny camera with a light to allow the doctor to see clearly the lining of the esophagus, stomach, and duodenum. The endoscopy tube can also be used as an instrument to treat bleeding or remove tissue for later examination.

An endoscopy helps reveal what is causing the patient’s symptoms. During the procedure, the doctor can detect ulcers, inflammation, polyps, and tumors that may be present in the upper gastrointestinal tract.

Results Known Quickly

Endoscopy is a commonly used procedure that helps a doctor look at the lining of the esophagus, stomach, and duodenum using a lighted, flexible tube with a tiny camera attached. This procedure can also be used to take a tiny sample of the gastrointestinal tissue for later examination in a laboratory. Tissue samples, or biopsies, can be used to diagnose the presence of the bacteria that cause ulcers or to check for cancerous cells. Endoscopy can also be used to treat conditions such as bleeding or to remove a polyp.

Preparing for Endoscopy
Endoscopy is most often done in the doctor’s office or outpatient unit of a hospital by a highly trained physician known as a gastroenterologist. Prior to undergoing endoscopy, a patient should inform the doctor about current medications or known allergies to medications. The patient will receive instructions on preparing for the endoscopy, which will include a period of no food or drink (usually six to 12 hours) before the endoscopy. If necessary, prior to the procedure the patient will receive antibiotics similar to those taken in advance of surgery or dental procedures.

What Happens
Just before the endoscopy begins, the doctor will order pain medication with or without sedation to ensure the patient is comfortable during the procedure. Typically, a local anesthetic spray is used in the throat so the endoscope can be inserted without pain. Monitors for blood pressure, heart rate, and oxygen level are attached. The patient lies on one side, and a mouthpiece will be placed to keep the mouth open. The doctor passes the endoscopy tube through the mouth and into the esophagus, then slowly advances the tube through the stomach and finally to the duodenum. The tube blows gentle puffs of air ahead of it to unfold any part of the lining that is folded so the doctor can see the tissues clearly. The endoscope does not affect breathing. Most patients are not bothered by the procedure and may even fall asleep for a short period. The entire procedure usually lasts no more than 15 to 30 minutes.

After the procedure, the endoscopy tube is removed from the gastrointestinal tract. The patient is watched for a short time until fully awake and ready to leave; however, he or she must be driven home by a companion. In most cases, the patient is allowed to eat as soon as the sedation has worn off. The doctor typically informs the patient of the results of the endoscopy at that time, and if tissue samples are taken, these results are usually available in a few days. The doctor may prescribe medication to heal any irritation or ulcerations or to prevent future damage.

The most common side effects after endoscopy are a mild bloating sensation and a sore throat. A small amount of bleeding can occur if a tissue sample was taken or a polyp removed. Endoscopy is a very safe procedure. Rarely, a complication can occur, such as perforation or a tear in the gastrointestinal tract lining. Problems after endoscopy such as fever, difficulty swallowing, or pain in the throat, stomach, or upper abdomen should be reported to the patient’s doctor.
US Pharmacist
Copyright 2003 Jobson Publishing, LLC