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gastroenterology and hepatology illness

Endoscopy

Endoscopy involves passing a tube(endoscope) through a natural human orifice. If it involves passing the scope through the mouth, it is called upper endoscopy or esophago-gastro-duodenoscopy or EGD. The tube or scope is flexible and has a fiber-optic light source and a camera that can be used to see the lining of the upper gastro-intestinal tract. The procedure is usually performed with sedation which can be light or conscious sedation or deeper sedation called monitored anesthesia care or MAC sedation. The latter usually is administered intravenously by a qualified anesthesiologist or certified registered nurse anesthetist or CRNA. Conscious sedation involves use of sedative medication like midazolam along with a pain medication like Demerol or Fentanyl. MAC sedation usually involves administering propofol.

Upper Endoscopy is usually indicated as a diagnostic test to investigate patients presenting with complaints like heartburn or acid reflux, upper abdominal pain, trouble swallowing food, nausea, vomiting, anemia, gastrointestinal bleeding or malabsorptive disorders like celiac disease. In patients with cirrhosis of liver, it is used to screen for varices which are engorged veins in inner lining of esophagus that can cause severe internal bleeding. These veins can be ligated using rubber bands to prevent bleeding. In patients that cannot swallow solid foods due to anatomic narrowing of the food pipe or esophagus, dilatation can be performed to allow more room for the food to go down and alleviate this symptom.

Endoscopy usually takes 15-20 minutes with an additional half hour to recover from the sedation. Patients who are sedated for the procedure need to avoid driving for the day of the procedure but can return to normal activity the following day.  Patients can eat a normal diet as soon as they awaken from the sedation and are ready to go home. The patient must avoid eating all solids and liquids usually after midnight before day of the procedure.

The complication rate of endoscopy is extremely low and includes aspiration which usually happens if the stomach has food at time of the procedure. Other complications are bleeding or perforation. Overall incidence of such complications is less than 0.01%. For endoscopy or colonoscopy in Redding, contact us.

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