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An endoscopy is a procedure in which a long, flexible tube is passed through the mouth and back of the throat and into the upper digestive track. This allows your doctor to see and examine the lining of the esophagus, stomach and duodenum (the first portion of the small intestine).
Having an endoscopy allows abnormalities suspected by X-ray to be confirmed and can also show abnormalities that cannot be detected by X-ray. If a suspicious area is spotted, your doctor can pass an instrument through the endoscope and remove a tiny piece of tissue. This is known as a biopsy. Remember that biopsies are taken for many reasons and do not necessarily imply cancer.
Your doctor may also pass other instruments through the endoscope, including a small brush for wiping cells to examine them in the laboratory (cytology) and a wire loop or snare to remove polyps (abnormal, usually benign growths of tissue).
Many problems of the upper digestive tract cannot be diagnosed through an X-ray. This makes endoscopy an important way to diagnose inflammation of the esophagus, stomach and duodenum and to identify the site of gastrointestinal bleeding. Endoscopy can also be used to detect gastric (stomach) and duodenal ulcers, especially when there is bleeding or scarring from a previous ulcer. Endoscopy is also used to detect early forms of cancer that are too small to be seen by an X-ray. Endoscopy can also be used for treatment, including stretching narrowed areas of esophagus or removal of polyps or swallowed objects.
Endoscopy is an extremely worthwhile and safe procedure, which is well tolerated by patients. It is invaluable in the diagnosis and proper management of disorders of the upper digestive tract. The decision to perform an endoscopy is based on the assessment of your particular problem. If you have any questions about your endoscopy, do not hesitate to speak with your physician, who will be happy to discuss the procedure with you.
For the best possible examination, the stomach must be completely empty, so you should have nothing to eat or drink, including water, from 11:00pm the evening before the examination or for at least six hours before its performance. Your physician will be more specific about the time to begin fasting, depending on the time of day your endoscopy is scheduled.
A companion must accompany you to the examination because you will be given medication to help you relax. It will make you drowsy, so you will need someone to take you home. You will not be allowed to drive after the procedure until the next day. Even though you may not feel tired, your judgment and reflexes may not be normal.
Patients that do not have an adult to accompany them home WILL NOT be able to undergo the procedure (unless they choose to have it performed without sedation). If you decide to take a taxi, you will still need to be accompanied to your destination with another adult other than the taxi driver. Another adult must accompany you into your home.
Please bring your X-rays with you, as they may be important, and a list of medications that you are currently taking. Aspirin, Ibuprofen, and other nonsteroidal medications are usually held for five days prior to your examination. You may discuss this further with your nurse when you call two weeks prior to your procedure. Continue to take any blood pressure, heart or respiratory medicine, including prednisone on the day of the procedure with a small amount of water. Bring any inhalers with you as well.
Your doctor will give you medication through a vein to make you relaxed and sleepy, and your throat may be sprayed with a local anesthetic. While you are in a comfortable position, the endoscope 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 fall asleep during the procedure. The tube will not interfere with your breathing. Gagging is usually prevented by the medication.
You will be kept in the endoscopic area until most of the effects of the medication have worn off. Your throat may be a little sore for a couple of hours and you may feel bloated for a few minutes after the procedure because of the air that was introduced to examine your stomach.
You will be able to resume your diet after the procedure unless you are instructed otherwise.
Endoscopy is safe and is associated with very low risk when performed by physicians who are experienced in this endoscopic procedure. Complications can occur but are rare.