This procedure uses a lighted, flexible endoscope to examine the the esophagus, stomach, and duodenum. This procedure can detect abnormalities in the stomach and intestinal lining including, abnormal growths such as polyps, ulcers, precancerous conditions such as Barret’s esophagus, inflammation, and structural abnormalities. This test can be used to obtain biopsies of inflamed or suspicious areas for further histological examination in the laboratory by a pathologist. The endoscope has channels that allows the passage of instruments which allows the physician to treat at the time of endoscopy a variety of conditions related to the upper GI tract. Some of the treatments include removal of polyps and other noncancerous (benign) tissue growths, dilation of narrowed areas in the esophagus or stomach, treating active ulcers or vascular structures that are bleeding and removing foreign objects that have been swallowed.
Prior to the procedure patients may be asked to gargle a local anesthetic or will have an anesthetic sprayed onto the back of the throat to numb the gag reflex, however depending on the anesthetic agent used to provide sedation this may not be necessary. The gastroenterologist will then guide the endoscope through the mouth into the upper gastrointestinal tract while the patient is lying on his or her left side. There is a camera at the end of the instrument that allows the physician to examine each portion of the upper gastrointestinal tract by looking at the images on the monitor. Photographs are usually taken as well. Air is pumped in through the instrument during the procedure to expand the lumen and allow better viewing. After the procedure, the patient will be observed in the endoscopy suite or in a separate recovery area for an hour, or until the sedative or pain medication has worn off. Someone should be available to take the patient home and stay with them for a while. Eating and drinking should be avoided until the local anesthetic has worn off in the throat and the gag reflex has returned, which may take two to four hours. Hoarseness and a mild sore throat are normal after the procedure; the patient can drink cool fluids or gargle to relieve the soreness. The patient may experience some bloating, belching, and flatulence after an EGD because air is introduced into the digestive tract during the procedure. To prevent any injury to the esophagus from taking medications by mouth, patients should drink at least 4 or more ounces of liquid with any pill, and remain sitting upright for 30 minutes after taking pills that are likely to cause injury. The physician should be notified if the patient develops a fever, difficult or painful swallowing, breathing difficulties, pain in the throat, chest, or abdomen.