Upper GI Endoscopy

Procedure

Overview of Upper Endoscopy

An upper GI endoscopy is a procedure that lets doctors directly look at the upper part of your digestive system, including your esophagus, stomach, and duodenum (the first part of the small intestine). The term 'endoscopy' refers to a special technique for looking inside a part of the body. 'Upper GI' is the portion of the gastro-intestinal tract, the digestive system, that includes the esophagus (Food Pipe), the stomach, and the duodenum ( the beginning of the small intestine).

Upper GI endoscopy is a procedure performed by a gastroenterologist, a well-trained specialist who uses the endoscope to diagnose and, in some cases, treat problems of the upper digestive system.

The endoscope is a long, thin, flexible tube with a tiny video camera and light on the end.

The doctor may start by spraying your throat with a local anaesthetic. Then you will be given sedation to help you relax.The doctor performing this procedure is called an endoscopist, and they use a flexible tube with a camera (an endoscope) to check for issues like inflammation, ulcers, bleeding, or tumors.

You will then lie on your left side, a mouth piece will be put in your mouth and the doctor will pass the tube into your mouth and down your food pipe (oesophagus), stomach and duodenum (small bowel leading from the stomach).

Small pieces of tissue (skin inside your oesophagus, stomach, duodenum) may need to be removed for pathology tests.

The endoscope does not cause problems with breathing unless you have lung or heart problems.

Why is an Upper Endoscopy Done?

Doctors use an upper endoscopy for several reasons, including:

• Unexplained stomach or upper abdominal pain
• Heartburn or GERD (gastro-esophageal reflux disease) symptoms that don't improve with treatment
• Ongoing nausea or vomiting
• Upper GI bleeding, like vomiting blood or having black stools, which may suggest bleeding in the upper digestive system
• Iron deficiency anemia (low iron) without obvious bleeding
• Difficulty swallowing or feeling like food is stuck in the esophagus
• Follow-up on abnormal findings from X-rays, CT scans, or MRIs
• Removal of swallowed objects (foreign bodies)
• Checking on previous abnormalities, like ulcers, polyps, or tumors, to see if they have healed or changed

Preparing for an Upper Endoscopy

Regardless of why upper GI endoscopy has been recommended for you, there are important steps you can take to prepare for and participate in the procedure.

Before the procedure, you'll get instructions on how to prepare. These steps are important for your safety and to ensure the best results:

• Don't eat or drink for about 8 hours before the test. This helps prevent food or drink from going into your lungs during the procedure.
• To properly prepare for your procedure, you may need to make certain changes to your daily medication routine.
• If you take insulin or diabetic tablets, consult with your physician about making any necessary changes in you daily regimen.
• You must tell your doctor what drugs you are taking, particularly: Aspirin products, Arthritis drugs, Blood thinners eg. Warfarin (anticoagulants). It may be necessary to stop taking them seven days before your procedure. They may increase your risk of bleeding after removal of a polyp or a biopsy during your upper GI endoscopy by interfering with the normal clotting of your blood. IF YOU ARE TAKING COUMADIN OR HEPARIN, YOU MUST CHECK WITH YOUR PRESCRIBING PHYSICIAN BEFORE CHANGING OR INTERRUPTING YOUR DAILY ROUTINE.
• Certain medications should be continued prior to your upper GI endoscopy. If you take cardiac (heart) or anti-hypertensive (high blood pressure) pills, take them as you normally do with small sips of water.
• In addition to changes to your medication, you'll also need to:
• Bring a list of all your medications (prescription medications, over-the-counter medications and eye drops) with you on the day of your procedure. You may bring the medication bottles themselves.
• Be prepared to list and describe your ALLERGIES and REACTIONS to any medications.
• Tell the doctor if you have: a pacemaker, a joint replacement, heart, lung or other medical conditions that may need special attention.
• Tell your doctor if you have to take antibiotics before dental treatment. If so, you may also need antibiotics before an upper endoscopy
• Because you will receive a relaxing medication during your procedure, you must arrange to have a responsible adult pick you up and/or accompany you home if you taking public transportation.
• You may not operate an automobile or other mechanical equipment until the day following your procedure. Arrange a ride home.
• You will be given sedatives, and you shouldn't drive or make big decisions right after the procedure.

Preparation for the Procedure

• You must not eat or drink anything for at least six hours before the procedure. Ideally you must not eat or drink anything after midnight the night before your procedure. Food in the stomach will block the view through the endoscope and it could cause vomiting. The exception is medication taken with small sips of water.
• If you are scheduled for a morning procedure: You should have nothing by mouth (including gum and mints) after midnight. The exception is medication taken with small sips of water.
• If you are scheduled for an afternoon procedure: You may continue drinking small quantities of clear liquids up to 6 hours prior to your scheduled arrival time.
• CLEAR LIQUIDS: water, apple juice, ginger ale, sprite, beef or chicken broth WITHOUT noodles, coffee or tea WITHOUT cream or milk, most sodas, sherbet, pop-sicles, and Jell-O that is not red or orange. DO NOT DRINK ANYTHING RED OR ORANGE.
• On the day of your upper GI endoscopy, please come directly to the requested location at your scheduled arrival time. Plan to spend several hours at the unit to allow time for your preparation, your procedure, and your recovery.
• Before the procedure, a nurse will greet you and assist you with changing into a hospital gown. An IV will be placed in your arm. You will receive relaxing medications through the IV during the procedure. You will be lying on your side during the upper endoscopy and the endoscope will be passed through your mouth and throat to view the upper digestive tract. The procedure takes approximately 15-30 minutes to complete.

What Happens During the Endoscopy?

• When you arrive, the medical team will go over your medical history and explain the procedure. You'll also be asked to sign a consent form. The procedure usually lasts about 10 to 15 minutes.
• You'll be lying on your left side, and a soft mouth guard will be placed between your teeth to protect them and the endoscope. The endoscope is a thin, flexible tube with a light and camera that allows the doctor to see inside your digestive system.
• If necessary, the doctor may take biopsies (small tissue samples) or treat problems like narrowed areas in the esophagus or remove growths. The doctor might also use air or gas to help open up the digestive tract for a clearer view. You might feel a little bloated from the air, but it's not harmful.
• You may also have your throat sprayed or be asked to gargle with a local anesthetic to help keep you comfortable as the endoscope is passed through. A supportive mouthpiece will be placed to help you keep your mouth open during the endoscopy. Once you are fully prepared, your gastroenterologist will gently maneuver the endoscope into position.
• During the procedure, everything will be done to help you be as comfortable as possible. Your blood pressure, pulse and blood oxygen level will be carefully monitored. Your gastroenterologist may give you a sedative to help make you relaxed and drowsy, but you will remain awake enough to cooperate.
• As the endoscope is slowly and carefully inserted, air is introduced through it to help your gastroenterologist see well. During the procedure, you should feel little to no pain and it will not interfere with your breathing.
• Your gastroenterologist will use the endoscope to look closely for any problems that may require evaluation, diagnosis or treatment.
• In some cases, it may be necessary to take a sample of tissue, called a biopsy, for later examination under the microscope. This, too, is a painless procedure. In other cases, the endoscope can be used to treat a problem such as active bleeding from an ulcer.

After the Endoscopy

• When your endoscopy is completed you will be cared for in a recovery area until most of the effects of the medication have worn off. You'll be monitored for up to an hour as the sedatives wear off.
• It's common to feel a little tired, and you may have some bloating or a sore throat.
• Rest for the day and avoid driving.
• Occasionally, minor problems may persist, such as mild sore throat, bloating or cramping; these should disappear in 24 hours or less. The air put into your stomach during the test causes this.
• You can usually eat and drink normally afterwards unless you are told otherwise.
• By the time you are ready to go home, you'll feel more alert. Nevertheless, you should plan on resting for the remainder of the day.
• If you are breastfeeding, you may need to discard milk for the rest of the day if you were sedated.
• Do not drink any alcohol for 24 hours post procedure

Potential Risks of Endoscopy

While an upper endoscopy is generally safe, there are a few rare risks:

• Aspiration: If food or liquid gets into the lungs, it can cause pneumonia, but this is minimized by following preparation instructions.
• Reaction to sedatives: Some people may have side effects, so it's important to share any allergies or medical conditions with the medical team beforehand.
• Bleeding: Rarely, bleeding can occur from a biopsy or polyp removal, but it usually stops on its own.
• Perforation: A tear in the lining of the digestive tract is very rare, but it can happen and may require further treatment.

When to Contact Your Doctor

Call your doctor if you experience any of the following after the procedure:

• Severe abdominal pain
• Vomiting
• Difficulty swallowing
• Fever
• Black or red blood in vomit or stool
• Swelling or pain in the neck or chest

What Happens After the Endoscopy?

Most people recover quickly from the procedure. If biopsies were taken or polyps removed, you'll be informed of the results once they're available. You can expect to feel tired for the rest of the day, so take it easy and follow up with your doctor if needed.

Disclaimer: Some portions of this content may be derived from publicly available sources on the internet.