The upper gastrointestinal (GI) tract is the site of many disorders, usually related to diet, environment and heredity. These disorders can develop into a variety of diseases or symptoms, which can be diagnosed with a procedure called an upper gastrointestinal endoscopy or EGD (esophagogastroduodenoscopy).
By visually examining the upper intestinal tract using a lighted, flexible endoscope, gastroenterologists can diagnose:
- ulcers — which can develop in the esophagus, stomach, or duodenum
- tumors of the stomach or esophagus
- difficulty in swallowing
- upper abdominal pain or indigestion
- intestinal bleeding
- esophagitis and heartburn — a chronic inflammation of the esophagus due to reflux of stomach acid and digestive juices
- gastritis — an inflammation of the lining of the stomach
During an EGD, other instruments can be passed through the endoscope to perform additional procedures if needed. These procedures could include a biopsy, in which a small tissue specimen is obtained for microscopic analysis, or removal of a polyp or tumor using a thin wire snare and electrocautery (electrical heat).
The upper gastrointestinal tract begins with the mouth and continues with the esophagus (food tube) which carries food to the stomach. The acid in the stomach churns food into small particles. The food particles then enter the duodenum, or small bowel, where bile from the liver and digestive juices from the pancreas mix with it to help the digestive process. Both bile and enzymes are needed to digest food, so it is important to diagnose any problems as quickly as possible.
An endoscope is flexible tube with a tiny, optically sensitive computer chip at the end. As the physician moves it through the upper gastrointestinal tract, electronic signals are transmitted from the scope to a computer that displays the image on a video screen. An open channel in the scope allows other instruments to be passed through it to take tissue samples, remove polyps and perform other exams.
First, your physician will anesthetize your throat with a spray or liquid. The endoscope is then gently inserted into the upper esophagus. The exam takes from 15 to 30 minutes, then you are taken to the recovery area. There is no pain with the procedure and patients seldom remember much about it.
It is important not to eat or drink anything for at least eight hours before the exam. Your physician will give you instructions about the use of regular medications, including blood thinners, before the exam. Because of the mild sedation, you are not allowed to drive, operate heavy machinery or make any important decisions for up to six hours following the exam. It’s important to have someone with you to drive you home.
After the exam, the physician will explain the results to you. If the effects of the sedatives are prolonged, the physician may suggest a follow-up appointment to review your results. If a biopsy has been performed or a polyp removed, it usually takes several days to get the results.
A temporary, mild sore throat sometimes occurs after the exam. Serious risks with upper gastrointestinal endoscopy, however, are very uncommon. One such risk is excessive bleeding, especially if a large polyp is removed. In extremely rare instances, a perforation, or tear, in the esophagus or stomach wall can occur. These complications may require hospitalization and, rarely, surgery.