Endoscopy (EGD) Procedure

Endoscopyis a procedureinwhich a camera is inserted into anorificeor surgicalincisionto explore for abnormalities or cancers, or perform minimally invasivesurgery.

Upper endoscopy is a procedure that enables the examiner (usually agastroenterologist) to examine theesophagus(吞下管),stomach, andduodenum(first portion ofsmall bowel) using a thin, flexibletubecalled the upperendoscopewith a camera on the tip through which the lining of the esophagus, stomach, and duodenum can be viewed using a TV monitor.

To accomplish a safe and complete examination, the stomach should be empty. Thepatientwill most likely be asked to have nothing to eat or drink for six hours or more prior to the procedure.

革命制度党or to scheduling the procedure, the patient should informhisor herphysicianof any medications being taken, anyallergies, and all knownhealthproblems. This information will help thedoctordetermine whether the patient may need antibiotics prior to the procedure, and what potential medications should not be used during the exam because of the patient'sallergies. The information will provide the individual scheduling the procedure an opportunity to instruct the patient whether any of the medications should be held or adjusted prior to the endoscopy.

Knowledge that the patient has anymajorhealth problems, such asheartor lung diseases, will alert the doctor of possible need for specialattentionduring the procedure.

Upper endoscopy usually is performed to evaluate possible problems with the esophagus, stomach or duodenum, and evaluate symptoms such as upperabdominal pain,nauseaorvomiting, difficulty in swallowing, or intestinal bleedinganemia. Upper endoscopy is more accurate thangastrointestinalX-raysfor detectinginflammationor smaller abnormalities such as ulcers or tumors within the reach of the instrument. Its other major advantage over X-rays is the ability to perform biopsies (obtain small pieces oftissue) orcytology(obtain some cells with a fine brush) formicroscopicexamination to determine thenatureof the abnormality and whether any abnormality isbenignormalignant(cancerous).

Biopsies are taken for many reasons, and it may not mean that your doctor suspectscancer.Upper endoscopy also can be used to treat many conditions within its reach. The endoscope's channels permit passage ofaccessoryinstruments enabling the examiner to treat many of the conditions such as stretching areas of narrowing (strictures, Schatzki ring), removal of benign growths such as polyps, retrieving accidentally swallowed objects, or treating upper gastrointestinal bleeding, as seen in ulcers tears of the lining. These capabilities have markedly reduced the need for transfusions or surgery

Before the procedure, the doctor will discuss with you why the procedure is being done, whether there are alternative procedures or tests, and what possible complications may result from the endoscopy.

Practices vary amongst doctors, but the patient may have thethroatsprayed with a numbing solution and will probably be given sedating andpainalleviating medications through avein. You will be relaxed after receiving thismedication, usually midazolam (Versed) for sedation and fentanyl forpainrelief, and you may even go tosleep. This form of sedation is calledconscious sedation, and usually is administered by anursewho monitors you during the entire procedure.

You also may be sedated usingpropofol(Diprivan) called "deepsedation”,这通常是由一个护士anesthetistoranesthesiologistwho monitors yourvitalsigns (blood pressureandpulse) as well as the amount ofoxygenin yourbloodduring the procedure.

After you are sedated while lying on your left side the flexible video endoscope, the thickness of a small finger, is passed through themouthinto the esophagus, stomach, and duodenum. This procedure will NOT interfere with yourbreathing. Most people experience only minimal discomfort during the test, and manysleepthroughout the entire procedure using conscious sedation. Deep sedation ensures that you feel no discomfort during the entire procedure.

When the procedure has been completed, you will be observed and monitored by a qualified individual in the endoscopy room or a recovery area until much of the effects of the medications have worn off.

Occasionally, endoscopy may cause a mildsore throat, which promptly responds tosalinegargles, or a feeling ofdistentionfrom the air that was used during the procedure. Both problems are mild and transient.

When fully recovered, the you will be instructed when to resume your usualdiet(probably within a few hours), and the your driver will be allowed to take you home. (Because of the use of sedation, most facilities mandate that a driver take patients home and not drive, handle machinery, or make important decisions for the remainder of the day.)

Endoscopy is a safe procedure and when performed by a physician with specialized training in these procedures, the complications are extremely rare. They may include localized irritation of the vein where the medication was administered, reaction to the medication or sedatives used, complications from pre-existing heart, lung, orliver disease, bleeding may occur at the site of abiopsyor removal of apolyp(which if it occurs is almost alwaysminorand rarely requires transfusions or surgery). Major complications such as perforation (punching a hole through the esophagus, stomach, or duodenum) are rare but usually require surgical repair.

Under most circumstances, the examining physician will inform the patient of the test results or the probable findings prior todischargefrom the recovery area. The results of biopsies or cytology usually take 72-96 hours and the doctor may only give the patient a presumptivediagnosispending the definitive one, after the microscopic examination of the biopsies.

If you have any questions or concerns about the exam, costs, whether your insurance will cover it, or methods of billing, talk to your doctor or another healthcare professional. Most endoscopists are highly trained specialists and will be happy to discuss their qualifications and answer any questions.