An Upper Endoscopy has been determined to be necessary for further evaluation and treatment of your condition. This section has been prepared to help you understand the procedure. Some answers to questions about Upper Endoscopy (also known as an EGD or EsophagoGastroDuodenoscopy)

What Is An Upper Endoscopy?
What Preparation Is Required?
Be sure to let your doctor know if you are allergic to any drugs.
Do I need someone to escort me home?
Can I return to work after my procedure?
What Should I Expect During The Procedure?
What Happens After The Upper Endoscopy?
Are There Any Complications Of Upper Endoscopy?
Are there alternate procedures to an Upper Endoscopy?
Why Is Upper Endoscopy Necessary?
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What Is An Upper Endoscopy?
An endoscope is a long flexible tube that is thinner than most food you swallow. It is passed through the mouth into the upper digestive tract and allows the physician to examine the lining of the esophagus, stomach and duodenum (the first portion of the small intestine). This is done after you have either been sedated and or the back of your mouth has been sprayed with a topical anesthetic.

During the procedure the physician can pass an instrument through the endoscope and take a small piece of tissue (known as taking a biopsy) for examination in the laboratory. Biopsies are taken for many reasons and do not necessarily imply cancer. Other instruments can also be passed through the endoscope including brushes to sample tissue from the lining of the stomach (a form of "pap test" or cytology examination) and wire loops (or snares) to remove polyps (usually benign growths of tissue) from the lining of the stomach.

What Preparation Is Required?
For the best possible examination and to insure the greatest amount of safety for you, the stomach must be completely empty for the Upper Endoscopy. You should have nothing to eat or drink (including water) after 11 pm the evening before the examination. If you are scheduled to have your procedure in the late morning or early afternoon you must be fasting for at least 6 hours before the Upper Endoscopy.

Be sure to let your doctor know if you are allergic to any drugs.
As always, please notify us if you are allergic to any medications. You should also have a list of ALL medications, both prescription and non-prescription, available for us to review.

Do I need someone to escort me home?
YES – it is the law that you be escorted home after the procedure. This may include a driving service that delivers you to you home door in addition to any friends or family members that can escort you home. Although you will probably feel very well following the Upper Endoscopy you are not allowed to drive yourself home – you are not allowed to take a taxi or the subway to your house. There are no exceptions to this rule.

Can I return to work after my procedure?
NO! Do so at your own risk.

What Should I Expect During The Procedure?
When you arrive at the office you will escorted to the back and asked to put on an examination gown. An Anesthesiologist will be introduced to you and ask you some questions and do an examination. An intravenous (IV) will be inserted and fluids will be given. When you are brought into the procedure room and placed on your left side like you were going to go to sleep. You will be hooked up to several “machines”. These include one to monitor your blood pressure and one to monitor how well oxygen is being transported into your blood from your lungs. You will also have oxygen supplied to you for additional safety through either a face mask or nasal cannulas.

Immediately prior to the Upper Endoscopy medications will be given through the IV that will make sleepy; you will have absolutely no recall of the procedure when you wake up. You are never placed on a respirator or other life support equipment during the procedure. This is not necessary since you will receive what is termed “conscious sedation” rather thatn general anesthesia – this is much safer for you and provides for your greatest comfort with the least amount of risk. Some patients may have the back of their throat sprayed with local anesthetic.

The procedure is extremely well tolerated with little or no discomfort. When the Upper Endoscopy is over you will remain on the procedure table for several minutes until you are wide awake – this takes only several minutes from when we are finished. You will then be escorted to the recovery room. Your blood pressure and oxygen saturation will continue to be monitored. You will be given some beverage and food prior to the released from the recovery room. After you have fully recovered, you will be brought to the Doctor’s office to discuss the findings, make future plans, and answer any questions you may have. Your escort will also be invited to speak with the Doctor if you so wish.

What Happens After The Upper Endoscopy?

You will go home! You may have a sore throat, but this is a rare occurrence. You may feel some “gassiness" and fullness in the abdomen for a few minutes right after the procedure because of the air that was introduced to examine your stomach.

You will be able to resume your diet as soon as the exam is over unless your doctor instructs you otherwise.

Are There Any Complications Of Upper Endoscopy?

EGD is very safe and associated with extremely low risks. There are greater risks traveling to and returning home from the office than the procedure itself.

The most major complication, although extraordinarily rare, is perforation. If this happens a small tear through the wall of the esophagus or the stomach is created. This complication may be managed by aspirating the fluid until the opening seals, or may require surgery.

If a biopsy is performed during the Upper Endoscopy bleeding may occur from the site of biopsy. If a polyp is removed this can also cause bleeding. In either case it is usually minimal but very rarely may require transfusions or surgery.

Localized irritation of the vein may occur at the site of medication injection. A tender lump develops which may remain for several weeks to several months.

Death is extremely rare but remains a remote possibility.

Other risks include reactions to the medications administered during the procedure.

Are there alternate procedures to an Upper Endoscopy?
An Upper Gastrointestinal Series (UGI Series) is where you are instructed to drink a large volume of Barium and multiple X-Rays are taken of your esophagus, stomach and duodenum are taken. Its shortcomings include an inability to perform biopsies, an inability to see within the intestine itself, missing small lesions such as ulcers and inflammation, and if anything abnormal is diagnoses you will have to undergo an Upper Endoscopy anyway. There is also radiation exposure during the test.

An UGI Series is purely diagnostic, and can not be used to biopsy or remove polyps, to stretch narrowings, or sample the lining of the upper intestine.

Why Is Upper Endoscopy Necessary?
Many problems of the upper digestive tract can be diagnosed by Upper Endoscopy; it is helpful in the diagnosis of inflammation, ulceration, polyp formation, infection, tumors and bleeding sites of the esophagus, stomach and duodenum.

Upper Endoscopy is more accurate than X-ray in detecting stomach and duodenal ulcers, especially when there is bleeding or scarring from a previous ulcer.

Upper Endoscopy may detect early cancers too small to be seen by x-ray and can confirm the diagnosis by biopsies and/or brushings.

Upper Endoscopy may also be needed for treatment, such as removal of swallowed objects and polyps and stretching of narrowed areas of the esophagus. Upper Endoscopy is used to control upper gastrointestinal bleeding. Effective endoscopic control of bleeding drastically reduces the need for transfusions and surgery in these patients.

Upper Endoscopy is an extremely worthwhile and safe procedure which is very well tolerated and is invaluable in the diagnosis and proper management of disorders of the upper gastrointestinal tract. Our decision to perform this procedure was based upon an assessment of your particular problem. If you have any questions about your need for an Upper Endoscopy, do not hesitate to discuss them with us. Both of us share a common goal - your good health - and it can only be achieved through mutual trust, respect, and understanding.