What Is an Upper Endoscopy (EGD)?
For an upper endoscopy, doctors use a thin, flexible, lighted tube called an endoscope (en-doh-scope) – or "scope" for short – to get a good look at a child's digestive system. You might also hear doctors refer to this procedure as a "scope" or an "EGD". EGD stands for esophagogastroduodenoscopy (eh-sah-fuh-goh-gas-troh-doo-ah-duh-nah-skuh-pee). Children may have an upper endoscopy if they are in need of a transplant.
Body parts involved
Upper endoscopy lets the physician look inside the:
- Esophagus
- Stomach
- Duodenum (first part of the small intestine)
Why Does My Child Need an Upper Endoscopy Procedure?
Your child's doctor may order an upper endoscopy to find out the reason for certain symptoms your child is having. These symptoms include:
- Swallowing difficulties
- Nausea and vomiting
- Reflux
- Bleeding
- Indigestion
- Abdominal or chest pain
The endoscope transmits an image of the inside of your child's esophagus, stomach, and duodenum, so the doctor can carefully examine the lining of these organs. Through the endoscope, doctors can see abnormalities (like inflammation or bleeding) that don't show up well on X-rays. The doctor can also insert instruments into the scope. By doing this, he or she can remove tiny samples of tissue (biopsy) for further tests, or treat bleeding problems.
What's It Like to Get an Upper Endoscopy?
Prior to the upper endoscopy
Your child's stomach and duodenum must be empty for the procedure to be thorough and safe. For this reason, you will be advised to have your child fast (not eat or drink) for at least six hours before the upper endoscopy.
During the upper endoscopy
Right before the upper endoscopy procedure, the doctor will spray your child's throat with a numbing agent that may help prevent gagging. Your child will also receive pain medicine and a sedative. This will make him or her feel drowsy and relaxed. During the exam, your child will not be deeply asleep as with a general anesthetic, but in a "twilight sleep". Most people do not feel discomfort during the upper endoscopy.
The endoscope is placed in your child's mouth, and he or she swallows it. Doctors help guide the tube gently down his or her esophagus. The scope never enters the windpipe (trachea), so it will not interfere with your child's breathing. Many patients say that they are afraid they will not be able to swallow the scope because of gagging. Thanks to the medications given beforehand, this usually does not happen.
A small mouthpiece is placed between your child's teeth, which will allow him or her to relax his or her jaws.
The scope also blows a small amount of air into the stomach; this expands the folds of tissue and makes it easier to see all parts of the stomach. While this air may cause the sensation of abdominal fullness, it should not be painful. The entire upper endoscopy procedure takes about twenty to thirty minutes.
After the upper endoscopy
After the upper endoscopy, your child will need one or two hours to rest at the hospital. This way, the sedative has a chance to wear off somewhat. Your child may feel slightly bloated from the air that was placed in his or her stomach during the examination. This feeling will gradually go away.
Since the effects of the sedatives may take up to 24 hours to wear off completely, you should plan to take your child directly home – not to a restaurant. Your child may have a light meal if he or she wants it. It is a good idea to take it easy for a few more hours at home. While the sedative is still wearing off, your child may feel groggy and uncoordinated.
After the sedation has completely worn off, your child may resume his or her normal diet. It is generally recommended that people who have had endoscopies should not to go to work, drive, or operate any dangerous machinery for the rest of the day. Your child's doctor may give other special instructions.
UGD Complications
Possible EGD complications include bleeding and puncture of the stomach lining. However, such complications are rare. Most people will probably experience nothing more than a mild sore throat after the procedure.
What's next?
The doctor may discuss what he or she saw during the exam while your child is still resting. If a biopsy was obtained, the doctor will contact you with the results when they become available. He or she will be able to suggest treatments based on the results of the upper endoscopy and/or biopsy.