What is an upper GI endoscopy?
An Upper Endoscopy is a procedure performed by a Gastroenterologist to examine the upper part of your digestive system, which includes the esophagus (the muscular pipe connecting your mouth and throat to the stomach), stomach, and duodenum (the first part of your small intestine). During the procedure, a thin, flexible camera called an endoscope is inserted through your mouth and into your stomach and small bowel to transmit high quality images of the inside lining of your gastrointestinal tract to a video monitor.
Can you do anything apart from looking at the inner lining?
Yes! A variety of diagnostic (for diagnosis of diseases) and therapeutic (treatment) interventions can done via the endoscope. If necessary, biopsies can be taken during this procedure. Other associated procedures can be performed including dilation of strictures (stretching narrowed or scarred areas), cauterization of bleeding sources, mucosal resections (removal of the inner lining of the digestive tract called the mucosa when there are abnormal areas in the mucosa) and ablation (destruction using heat) of abnormal mucosa or Barretts segments.
What do I have to do to prepare for the procedure?
Your stomach should be empty to allow an effective and safe examination.
You should not eat or drink, including water, for about 8 hours prior to your endoscopy (we will usually ask that you fast from midnight onwards on the day of your procedure).
Most medications can be continued prior to the exam but some medications such as aspirin or blood thinners may need to be stopped and we will give you instructions based on your individual circumstance.
If you are diabetic, you will need to monitor your blood glucose carefully on the day prior to your procedure. We will give you instructions based on your individual circumstance.
If you are diabetic, you will need to monitor your blood glucose carefully on the day prior to your procedure. We will give you specific instructions, if you are on insulin or take oral hypoglycemic agents like Glyburide or any of the newer drugs. We will try and schedule your procedure(s) early in the morning on the planned date.
What happens on the day of my procedure?
We will ask you to come an hour prior to your scheduled time to register and be admitted to our endoscopy unit (we do procedures at the hospital or at the ambulatory surgical center). The nursing staff will help you change into a comfortable gown and place you on a stretcher. An IV line will be placed to help us give you fluids and medications for the procedure. You will be asked to complete a health questionnaire, confirm your consent for the procedure and may meet a member of the anesthesia staff. Once the documentation and safety checks have been completed, you will be taken to the procedure room and asked to lie on your left side. You will be asked to have mouth guard to protect your teeth and keep your mouth open for the procedure. You will then be given anesthesia or moderate sedation and go off to sleep. Once the procedure is completed, you will wake up and usually experience no pain or discomfort. Rarely, people may complain of a sore throat.
You will be taken to the recovery area and be monitored for about 30 mins prior to being discharged home.
You will need to have a driver pick you up from the unit and drive you home. Ideally, there should be someone with you at home to supervise your recovery as you may experience some drowsiness or groggy feeling as the sedative/anesthetic agent works its way out of your body.
1. We strongly urge you to not drive on the day of your procedure as your reflexes may be slower that you anticipate.
2. For safety reasons, you cannot use a taxi or public transportation to go home.
3. We strongly urge you to defer planning or making any legal decisions for up to 24 hours after the procedure, to ensure that your mind is clear and unaffected from the residual effects of anesthesia or moderate sedation.
4. We recommend not making any travel plans for up to a week after your procedure. This varies greatly – please discuss any planned or upcoming travel with Dr. Siddique at the time of scheduling.
Is endoscopy safe? What are the risks?
Endoscopy is an extremely safe procedure with a low risk of complications (less than 1 in 100). But like any other medical procedure, there are some complications that can potentially occur. These include:
- Infections: Infection can occur in the part of the body where the endoscope is used. Infections are rare, occurring at a rate of 1 in 1000 procedures. All endoscopes undergo thorough cleaning using high level disinfection techniques recommended by the manufacturer and according to strict protocols. However, there is a small risk that some resistant bacteria may remain on the scope resulting in transmission of infection. This is usually treated with antibiotics.
- Perforation (piercing or tearing) of an organ: Perforation can occur in the part of the body on which endoscope is used. If a perforation occurs in any part of the body, you may need to be hospitalized, require antibiotics or if the perforation is large, may even require surgery to repair it.
- Excessive bleeding: The risk of bleeding after endoscopy is higher if the patient is on blood thinners and/or has tissue removed or burnt. If significant bleeding occurs, you may require a blood transfusion, admission into hospital and/or a repeat procedure.
If you develop any sign or symptoms suggestive of some complication after endoscopy, consult your doctor and/or visit the emergency department of your local hospital without delay.