Patient Education :
UPPER GASTROINTESTINAL ENDOSCOPY
WHAT IS AN ENDOSCOPY ?
An endoscopy (upper gastrointestinal endoscopy) is a test which allows a doctor to look at the lining of the oesophagus (gullet), stomach and duodenum. It is carried out under local anaesthesia spray / sedation and patients do not usually remember having it done afterwards. An endoscope is a long flexible tube (the thickness of a little finger) with a bright light at the end. In some cases biopsies (small pieces of tissue) may be taken with tiny forceps and sent to the laboratory. Taking biopsies is painless and is very safe.
MEDICATION :
Please continue to take any essential drugs such as steroids or heart tablets as usual on the day of the procedure. If you are on treatment for diabetes or take anticoagulants (Warfarin) you will be given the necessary instructions at the time of booking the test.
PREPARATION :
To allow a clear view the stomach must be completely empty, so it is important that you do not eat or drink anything for at least 6 hours before the test.
CONSENT :
On arrival at the department the doctor will explain the test and ask you to sign a consent form agreeing for the test to be carried out. Do not be afraid to ask any questions or state any worries that you may have about the test. At this time please inform the nurse or doctor if you have any allergies or have had bad reactions to any previous tests. Inform the nurse of any medication that you may be taking.
SEDATION :
The nurse will ask you to remove any dentures. No clothing needs to be removed, but loose fitting clothes are best to wear during the test.
You will be asked to lie on your left hand side on a comfortable couch. A small probe will be applied to your finger so as to monitor your pulse. The nurse will stay with you throughout. The doctor may give an injection into your arm to make you feel sleepy and relaxed.
Some patients prefer to have their endoscopy done without the sedative injection. If you require this please let the nurse know when you arrive at the endoscopy unit. Instead of giving an injection you will be given a throat spray which will numb the back of the throat. The advantage of not having a sedation is that you don't need an escort to take you home afterwards and you can drive and go about your normal activities immediately after the test. The disadvantages are that you cannot eat or drink until the throat spray has worn off (usually 1 hour) and of course you will be aware of the whole procedure which may be a little uncomfortable.
PROCEDURE :
A plastic mouthpiece will be placed gently between your gums, or teeth, in order to keep your mouth open. The doctor passes the endoscope (tube) through this mouthpiece and into your stomach. Should you have a lot of saliva in your mouth the nurse will clear it using a small suction tube. When the examination is finished the tube is removed quickly and easily. The procedure will last approximately 15 minutes.
AFTER THE TEST :
You will stay in our recovery room where a nurse will look after you for about one hour when you have finally recovered refreshments will be offered. Any discomfort will soon settle and no medication is needed.
ESCORT :
You require someone to come with you for the procedure. This escort must remain in the department whilst you are haying your endoscopy and then must take home afterwards and stay with you for 24 hours. They do not actually go into the endoscopy room with you when you have your procedure. Sedation lasts longer than you think. It is important that if you have been given an injection you should NOT: DRIVE A CAR, OPERATE MACHINERY, DRINK ALCOHOL, or SIGN ANY LEGAL DOCUMENTS for the next 24 hours. You may also suffer from forgetfulness. You should rest quietly for the remainder of the day.
RESULTS :
The endoscopy report will be ready in an hours time. If biopsies have been taken these will take a few days to process.
Video Esophagogastroduodenoscopy is a diagnostic endoscopic procedure that visualizes the upper part of the gastrointestinal tractup to the duodenum. It is considered a minimally invasive procedure since it does not require an incision into one of the major body cavities and does not require any significant recovery after the procedure (unless sedation or anesthesia has been used.
Diagnostic
Unexplained anemia (usually along with a colonoscopy)
Upper gastrointestinal bleeding as evidenced by hematemesis or malena
Persistent dyspepsia in patients over the age of 45 years
Heartburn and chronic acid reflux - this can lead to a precancerous lesion called Barrett's esophagus
Persistent vomiting
Dysphagia - difficulty in swallowing
Odynophagia - painful swallowing
Persistent nausea
Surveillance
Surveillance of Barrett's esophagus
Surveillance of gastric ulcer or duodenal ulcer
Occasionally after gastric surgery
Confirmation of diagnosis/biopsy
Abnormal barium swallow or barium meal
Confirmation of celiac disease (via biopsy)
Therapeutic
Treatment (banding/sclerotherapy) of esophageal varices
Injection therapy (e.g. epinephrine in bleeding lesions)
Cutting off of larger pieces of tissue with a snare device (e.g. polyps, endoscopic mucosal resection)
Application of cautery to tissues
Removal of foreign bodies (e.g. food) that have been ingested
Tamponade of bleeding esophageal varices with a balloon
Application of photodynamic therapy for treatment of esophageal malignancies
Endoscopic drainage of pancreatic pseudocyst
Tightening the lower esophageal sphincter
Dilating or stenting of stenosis or achalasia
Percutaneous endoscopic gastrostomy (feeding tube placement)