Endoscopy is a medical procedure performed to view the anatomy of the diseased human body part, which is either upper part of the body or lower part. A small diameter flexible tube is inserted through the mouth and which goes up to small intestine it is called upper GI Endoscopy.
Similarly a small diameter flexible endoscope is inserted through the rectum and covers entire colon is called lower GI endoscopy.
Previous decades a CCD camera is inserted on the tip of the flexible endoscope and viewed the anatomy, but today thanks to the technology 4K endoscopy is used across the hospital’s to get a high quality images to evaluate the disease.
What is an endoscopy like?
Endoscopy means, basically, looking inside. So, there are many types of endoscopy. In most medical settings endoscopy refers to an esophagogastroduodenoscopy, mercifully abbreviated as EGD. So I will describe an EGD.
While it is possible to do an EGD without sedation, only a very, very small percentage are done without sedation. For a routine EGD with sedation (not an emergency EGD), here is how it goes:
The patient will have a consultation with the doctor who will explain the reasons for the EGD, give an overview of the process, review the necessary preparation for the procedure, and the risks and benefits of the procedure. If the patient decides to have the EGD, he or she will be asked to sign a standardized consent form.
To prepare for the EGD the patient should have no solid food or full liquids at least eight hours prior to the procedure. Full liquids are liquids you cannot see through, like milk, orange juice or any liquid you could not read a newspaper through. Usually the patient may have 8 ounces of a clear liquid (water, 7-Up, clear apple juice) not less than two hours before the procedure. The patient should usually take regular medications at their normally scheduled time with sips of water. Some medications may require special instructions (insulin, warfarin, seizure medications, blood pressure medications). The reasons for the food and fluid restrictions is that it is possible for the patient to have gag and cough reflexes blunted by the sedation, so if they regurgitate any stomach contents they might aspirate them into the lungs. Stomach acid, digestive enzymes and residual food in the lungs can cause serious and even fatal condition called aspiration pneumonitis. The patient will need to have an adult driver with a drivers license with them to take them home.
On arrival the patient will be prepared for the procedure, which includes starting an intravenous line (IV), vital signs, and assessment of cardio-pulmonary system. The consent form will be verified and any questions answered.
The patient is taken into the procedure room, with the team (usually the doctor who performs the EGD, the RN who provides the sedation and the technician who assists the doctor with the procedure). The patient will be hooked up to monitors – usually blood pressure, EKG, pulse oximeter. There will be a brief “time out” to verify that it is the right patient, the right procedure, that a consent form is signed and any special needs are addressed (like equipment or medications) or any problems that are anticipated. Once that is complete, the doctor orders the sedation to start.
The doctor may or may not spray a topical anesthetic down the throat. He or she will then place a bite block in the mouth; this helps keep the mouth open, protects the teeth from trauma and prevents the patient from biting the endoscope. The RN is likely to apply low-flow oxygen via nasal cannulae to ensure adequate oxygenation. The RN will be specially trained to administer the sedative. The medication will be given in small incremental doses, titrated to produce sedation and comfort, but not enough to abolish protective reflexes or cause vital signs to deteriorate. The RN will ensure that reversal agents are immediately available should the sedative or narcotic need to be reversed. The medications used are usually midazolam (trade name Versed) and a narcotic analgesic (fentanyl, trade name Sublimaze, or meperidine, trade name Demerol). The narcotic relieves pain and produces some sedation, while the midazolam produces sedation and causes amnesia for the procedure.
The doctor will then introduce the gastroscope, and inspect the esophagus, stomach and the first few inches of the duodenum. The doctor can take biopsies, inject medication and take pictures. The actual time of the EGD is fairly short, usually from a few minute, although more complex procedures can last up to a half hour.
After the procedure is complete, the patient is taken to the recovery area and allowed to wake up, being monitored continuously. When the patient is sufficiently awake, a family member or friend will be brought in and the doctor will go over findings and give general instructions for home care. The nursing staff will usually give more detailed instructions, often providing a written copy of the instructions and answering questions. Usually the patient is given something light to eat and drink prior to discharge. When they are ready, usually 30–60 minutes after the procedure, the driver will be sent for the car and the patient taken out by wheelchair.
I have had both an EGD and a colonoscopy, and a barely remember anything about the procedure. It was comfortable and the midazolam worked.
What is the endoscopy experience?
Upper endoscopy in Baltimore is a type of medical practice which is used by the surgeons for examining the several parts of the body from oesophagus to stomach and sections of the small intestine. The person should be on empty stomach before an upper endoscopy. This is the safest methods for examining the stomach. For around 6 to 7 hours, nothing should be consumed by mouth. Such things are asked by the medical experts from the patient before the process.
These are some of the signs which make a patient go for upper endoscopy:
1. Bleeding
2. Nausea
3. Vomiting
4. Swallowing problems
5. Pain in the upper abdominal segment constantly.