Saturday, May 5, 2007

EGD

Upper Endoscopy
Esophagogastroduodenoscopy (EGD)
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What is it?
It is a procedure that enables the examiner (usually a Gastroenterologist) to examine your esophagus (swallowing tube), stomach, and duodenum (first portion of small bowel) using a thin flexible tube that can be looked through or seen on a TV monitor.
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How do I prepare for it?
To accomplish a safe and complete examination, the stomach should be empty. You will most likely be asked to have nothing to eat or drink for 6 hours, or more, before the procedure. Prior to the scheduling you should inform your physician of any medications you are taking, any allergies, and all your health problems. This information will remind your doctor whether you need any antibiotics prior to the test, what potential medications should not be used during the exam because of your allergies, and will give the scheduling individual an opportunity to instruct you whether any of your medications should be held or adjusted prior to the endoscopy. Knowledge whether you have any major health problems, such as heart or lung diseases, will alert the examiner of possible need for special attention during the procedure.
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Why have you been scheduled for the procedure?
EGD is usually performed to evaluate possible problems with the esophagus, stomach or duodenum and evaluate symptoms such as upper abdominal pain, nausea or vomiting, difficulty in swallowing, anemia, etc. It is more accurate than x-ray for detecting inflammation or small lesions such as ulcers or tumors within the reach of the instrument. Its other major advantage over x-ray is the ability to perform biopsies (obtain small pieces of tissue) or cytology (obtain some cells with a fine brush) for microscopic examination to determine its nature and whether the lesion is benign or malignant (cancerous). Biopsies are taken for many reasons and may not mean that cancer is suspected. It can also be used to treat many conditions within its reach. The endoscope's channels permit passage of accessory instruments enabling the examiner to treat many of the conditions such as stretching areas of narrowing (strictures) , removal of benign growths such as polyps or of accidentally swallowed objects, treating upper gastrointestinal bleeding as seen in ulcers or lining tears which, in the last two, has markedly reduced the need for transfusions or surgery.
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What can I expect during the endoscopy?
It is most likely that before the procedure the doctor will discuss with you why the test is being ordered, whether there are alternative means to accomplish the same, and what possible complications may result from the endoscopy. Practices vary amongst physicians but you may have your throat sprayed with a numbing solution and will probably be given a sedating and pain alleviating medication through the vein. While lying on your left side the flexible endoscope, the thickness of a finger, is passed through the mouth into the esophagus, stomach, and duodenum. This procedure will NOT interfere with your breathing. Most patients experience only minimal discomfort during the test and many sleep throughout the entire procedure.
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What happens after the procedure?
After the test you will be observed and monitored by a qualified individual in the endoscopy or a recovery area until a significant portion of the medication has worn off. Occasionally a patient is left with a mild sore throat, which promptly responds to saline gargles, or a feeling of distention from the insufflated air that was used during the procedure. Both problems are mild and fleeting. When fully recovered you will be instructed when to resume your usual diet (probably within a few hours) and your driver will be allowed to take you home. (Because of the use of sedation, most facilities mandate that you be taken by a driver and not to drive or handle machinery for the remainder of the day.)
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When do I get the results of the endoscopy?
Under most circumstances the examining physician will inform you of the test results or the probable findings prior to your discharge from the recovery area. The results of biopsies or cytology usually take 72-96 hours and the doctor may only give you a presumptive diagnosis pending the definitive one, after the microscopic examination.
..
What can I expect during the endoscopy?
It is most likely that before the procedure the doctor will discuss with you why the test is being ordered, whether there are alternative means to accomplish the same, and what possible complications may result from the endoscopy. Practices vary amongst physicians but you may have your throat sprayed with a numbing solution and will probably be given a sedating and pain alleviating medication through the vein. While lying on your left side the flexible endoscope, the thickness of a finger, is passed through the mouth into the esophagus, stomach, and duodenum. This procedure will NOT interfere with your breathing. Most patients experience only minimal discomfort during the test and many sleep throughout the entire procedure.
..
What happens after the procedure?
After the test you will be observed and monitored by a qualified individual in the endoscopy or a recovery area until a significant portion of the medication has worn off. Occasionally a patient is left with a mild sore throat, which promptly responds to saline gargles, or a feeling of distention from the insufflated air that was used during the procedure. Both problems are mild and fleeting. When fully recovered you will be instructed when to resume your usual diet (probably within a few hours) and your driver will be allowed to take you home. (Because of the use of sedation, most facilities mandate that you be taken by a driver and not to drive or handle machinery for the remainder of the day.)
..
When do I get the results of the endoscopy?
Under most circumstances the examining physician will inform you of the test results or the probable findings prior to your discharge from the recovery area. The results of biopsies or cytology usually take 72-96 hours and the doctor may only give you a presumptive diagnosis pending the definitive one, after the microscopic examination.
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