When is this exam indicated?
The examination is recommended by the doctor in case of symptoms such as epigastric pain, nausea, vomiting, digestive or swallowing difficulties, either new or persisting over a long period of time. It also allows to determine the cause of bleeding in the upper digestive tract or some anemias. During the examination, the physician may deem it appropriate to take small fragments of material (biopsies), which are sent to pathological anatomy laboratory for microscopic analysis. The collection of these fragments is totally painless and is done for many reasons - for example, to search for Helicobacter pylori, a bacterium that is often associated with gastric/duodenal ulcer and gastritis - and not necessarily only in cases of a suspected cancer.
How is it performed?
The examination does not cause pain, but modest discomfort upon insertion of the instrument; for this reason an intravenous sedative and/or local anesthesia may be applied in the throat. In case of drug allergies - to be reported to the doctor - or by the patient's will, the examination can be performed without any sedation or local anesthesia. The endoscope is introduced while the patient clasps a mouthpiece between his teeth. During the examination, which is usually of short duration, it is necessary to maintain a relaxed attitude, breathing deeply and slowly: this helps to control the possible feeling of vomiting and to bear the examination better, allowing the doctor to complete the procedure quicker. After the examination, a short observation period follows. In the following 24 hours, it is recommended to refrain from work activities that require special attention or that may involve risks or accidents in case of dizziness, lack of attention or motor coordination. Due to the sedative effect of the drugs, although mild, it is recommended to avoid driving for the next 24 hours (arriving to the hospital, for the examination, with an attendant or by public transport). It is possible to take food and drink after a few hours, avoiding food that is too hot.
How to prepare for the examination?
Esophagogastroduodenoscopy requires fasting for at least 6 to 8 hours. Therefore, if the examination is carried out in the morning, fasting from midnight the night before is recommended; if it is scheduled in the afternoon, a light breakfast in the morning (tea, honey and/or jam) is recommended. The consumption of solutions (antacids, sucralfate) should be avoided, as they may make it difficult to visualize the mucosa of the organs. The medications used should also be taken on the day of the examination (with a glass of water). If you take aspirin, anti-platelet drugs, anticoagulants and non-steroidal anti-inflammatory drugs (NSAIDs), we recommend you to request the specific form with instructions for the therapy before and after the procedure. Any removable dental prostheses should be removed prior to the procedure.
Esophagogastroduodenoscopy is a safe and almost complication-free procedure. Conscious sedation can be burdened, as any medical act, by very rare complications such as: bronchospasm, allergic reactions, alteration of blood pressure, heart rate and rhythm, respiratory depression. Occasionally, after the examination there may be pain at the injection site or thrombophlebitis, which resolves spontaneously or with the help of anti-inflammatory ointments. In case of biopsy, there may be a risk of bleeding less than 1%, which in most cases stops spontaneously or with endoscopic techniques. The most important incident related to the performance of the procedure is perforation (the incidence of which is less than 1 case per 10000 examinations) and is often related to severe esophageal disease.