Patient Education In Critical Care

UPPER ENDOSCOPY

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WHAT IT IS?

UPPER ENDOSCOPY (EGD, Gastroscopy) is a test that allows the doctor to look at the lining of your swollowing tube (esophagus) the stomach an the first part of the small gut (intestine). This is done by using a flexable tube about the size of your little finger which is placed through your mouth and into the stomach. With this tube, several instruments can be passed through the tube which would allow your doctor to treat many problems which may or may not be present. Among these, are treatment of polyps, treatment of bleeding. The safe and effective control of bleeding may reduce the need for transfusions.

WHY DO I Need This?

This test is done to find out what is causing your symptoms. If you have upper abdominal pain, nausea, vomiting, difficulity swallowing or heartburn, the best way to find out what is causing it is to actually take a look. This is especially true if you have been vomiting blood. Additionally this test may be used to detect early cancer. By taking a look, your doctor can distinguish between cancer and other diseases by taking a small sample of tissue from you and sending it to the laboratory for additional testing.

WHAT PREPARATION IS REQUIRED?

Most of the time before the test your stomach should be completely empth. This means that you can't have anything to eat or drink after midnight the evening before the procedure. This means that some of your medication may be adjusted or withheld. You will be given some sedatives by a vein which will make you very sleepy. Before starting your throad will be sprayed with some numbing medicine. You will be placed on your side as the procedure starts.

DURING THE UPPER ENDOSCOPY.

. The endoscope does not interfere with your breathing. Most patients fall asleep during the procedure. A few find it only slightly uncomfortable. The nurse will record your vital signs every five minutes. Additionally, you will have several heart monitor strips taken.

AFTER UPPER ENDOSCOPY

You will be monitored in the endoscopy area for 1-2 hours until the effects of the sedatives have worn off. Your throat may be a little sore for a day or two. You may feel bloated immediately after the procedure because of the air that is introduced into your stomach during the examination. You will be able to resume your diet and take your routine medication after you leave the endoscopy area, unless otherwise instructed. Your surgeon will usually inform you of your test results on the day of the procedure, unless biopsy samples were taken. These results take several days to return. The effects of sedation may make you forget what you were told and you should call your surgeon's office for follow-up or instructions, if you were not given any.

WHAT COMPLICATIONS CAN OCCUR?

Gastroscopy and biopsy are generally safe when performed by surgeons who have had special training and are experienced in these endoscopic procedures. Complications are rare. However, they can occur and include bleeding from the site of a biopsy or polypectomy and a tear (perforation) through the lining of the intestinal wall. Blood transfusions are rarely required. A reaction to the sedatives can occur. Irritation to the vein that medications were given is uncommon, but may cause a tender lump lasting a few weeks. Warm, moist towels will help relieve this discomfort.

It is important for you to recognize the early signs of possible complications and to contact your surgeon if you notice symptoms of difficulty swallowing, worsening throat pain, chest pains, severe abdominal pain, fevers, chills or rectal bleeding of more than one-half cup.