| Do not eat or drink
after midnight before this test. During the procedure, you will
be sedated and may remain groggy for up to two
hours afterwards. For this reason, we ask that
you plan to have someone accompany you to the
office to drive your home.
Some Answers to Questions About EGD:
It has been decided after careful medical
assessment that esophagogastroduodenoscopy (EGD,
"panendoscopy") is necessary for
further evaluation and treatment of your
condition. This information has been
prepared to help you understand the procedure.
What
is an EGD (Panendoscopy)?
What
preparation is required?
What
should I expect during the procedures?
What
happens after the EGD?
Are
there any complications of EGD?
Why is
EGD necessary?
A panendoscope is a long, flexible tube that
is thinner than most food you swallow. It is
passed through the mouth and back of the throat
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).
Abnormalities suspected by X-ray can be
confirmed and others may be detected which are
too small to be seen on X-ray. If the
doctor sees a suspicious are, he can pass an
instrument through the endoscope and take a small
piece of tissue (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 without causing discomfort,
including a small brush to wipe cells from a
suspicious are for examination in the laboratory
(a form of "pap test" or cytology) and
a wire loop (snare) to remove polyps (abnormal,
usually benign growths of tissue).
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For the best possible examination, the stomach
must be completely empty, so you should have
nothing to eat or drink (including water from 11
p.m. on the evening before the examination or for
at least six hours before its performance.
Your doctor will be more specific about the time
to begin fasting, depending on the time of day
that your EGD is scheduled.
Be sure to let your doctor know if you are
allergic to any drugs.
A companion must accompany you to the
examination because you will be given an
injection to help you relax.
It will make you drowsy so you will need some-one
to take you home. You will not be allowed to
drive after the procedure. Even though you may
not feel tired, judgment and reflexes may not be
normal.
Please bring your X-rays with you, they may be
very important for comparison and localization of
abnormalities.
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Your doctor will give you a medication through
a vein to make you relaxed and sleepy, and the
back of your throat may be sprayed with local
anesthetic. While you are in a comfortable
position, the panendoscope is inserted through
the mouth and each part of the esophagus, stomach
and duodenum is examined.
The procedure is extremely well tolerated with
little or no discomfort. Many patients even fall
asleep during EGD.
The tube will not interfere with your
breathing. Gagging is usually prevented by the
medication.
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You will be able to leave the endoscopic area
as soon as most of the affects of the medication
have worn off. Your throat may be a little sore
for a couple of hours and 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 EGD is over unless your doctor instructs
you other-wise.
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EGD is safe and associated with low risk when
performed by physicians who have been specially
trained and are experienced in the endoscopic
procedure.
One major complication is perforation in which
a small tear through the wall may allow leakage
of digestive fluid. This complication may be
managed simply by aspirating the fluid until the
opening seals or may require surgery.
Bleeding may occur from the site of biopsy or
polyp removal. It is usually minimal but 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 but goes away eventually.
Death is extremely rare but remains a remote
possibility. Other risks include drug reactions,
etc.
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Many problems of the upper digestive tract can-not
be diagnosed by X-ray, EGD may be helpful for the
diagnosis of inflammation of the esophagus,
stomach and duodenum (esophagitis, gastritis,
duodentis) and to identify the site of upper
gastrointestinal bleeding.
EGD is more accurate than X-ray in detecting
gastric (stomach) and duodenal ulcers, especially
when there is bleeding or scarring from a
previous ulcer.
EGD may detect early cancers too small to be
seen by X-ray and can confirm the diagnosis by
biopsies and brushings.
EGD may also be needed for treatment, such as
removal of swallowed objects and polyps and
stretching of narrowed areas of esophagus. Active
investigation is currently in progress on methods
to control upper gastrointestinal bleeding
through the panendoscope. Safe and effective
endoscopic control of bleeding could drastically
reduce the need for transfusions and surgery in
these patients.
EGD 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 digestive tract. Your
doctor's decision to perform these procedures was
based upon his assessment of your particular
problem. If you have any questions about your
need for an EGD, do not hesitate to discuss them
with your doctor who will also be happy to
discuss the cost of the procedure, method of
billing and insurance coverage with you. Both of
you share a common goal -your good health -and it
can only be achieved through mutual trust.
respect, and understanding.
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