MUHC-MONTREAL GENERAL HOSPITAL
7TH FLOOR – MAIN BUILDING / ROOM D7-102
TEL: (514) 934-1934 LOC: 43906
This test involves your doctor passing an endoscope, a long flexible tube, through the mouth and back of the throat into the upper digestive tract. It allows the physician to examine the lining of the esophagus, stomach and duodenum (the first portion of the small intestine).
Abnormalities suspected by x-ray can be confirmed and others may be detected which are too small to be seen clearly on x-ray. If the doctor sees a suspicious area, he can pass an instrument through the scope and take a small piece of tissue (a biopsy) for examination in the laboratory. Biopsies are taken for many reasons, such as ulcers, inflammation, and not necessarily cancer. Other tubes can be passed through the scope without causing additional discomfort, including a small brush to wipe cells from a suspicious area for culture, or for “pap test”, to remove polyps or to dilate narrowed areas. Gastroscopy can be used to control bleeding.
Many problems of the upper digestive tract cannot be diagnosed accurately by x-ray. Included are inflammation of the esophagus, stomach, and duodenum, and many causes of gastrointestinal bleeding. This technique is more accurate in detecting ulcers and cancers than x-rays. It allows for biopsies, pap tests, cultures and stretching of narrowing areas.
For the best possible examination, the stomach must be completely empty. The following dietary instructions must be followed:
1. If your examination is in the morning: FAST FROM MIDNIGHT (NO LIQUIDS OR SOLIDS).
2. If your examination is in the afternoon: CLEAR FLUIDS ARE PERMITTED FOR BREAKFAST BEFORE 9:00 A.M.
Mild sedatives are usually given by injection at the beginning of the examination. Your doctor may give you medication through a vein to make you sleepy and comfortable; your throat may be sprayed with a local anaesthetic. The scope will then be inserted through the mouth into the esophagus. The procedure is extremely well tolerated with little or no discomfort. You may fall asleep during the procedure. Gagging is usually prevented by the medication. After the procedure you will be kept in the endoscopy area until most of the effects of the medication have worn off. Your throat may be sore for a few hours, and may feel bloated for a few minutes. You will be able to resume your regular diet after the procedure.
A friend or relative MUST accompany you, because you will be drowsy from the medication given to you and you will not be able to drive yourself home. It is illegal to drive following sedation as judgement and reflexes may be affected long after the medication has worn off.
COMPLICATIONS: Complications occur but are rare. This procedure is safe and associated with very low risk when performed by physicians specially trained and experienced with this procedure. One possible complication is perforation in which a tear through the wall of the esophagus or stomach may allow leakage of the digestive fluids. This complication may be managed simply by aspirating the fluids until the opening seals, or may require surgery. Bleeding may occur from the site of the biopsy or polyp removal. It is usually minimal but rarely may require transfusions or surgery. Localized irritation of the vein may occur at the site of medication injection. A tender lump develops which may remain for several weeks to months but goes away eventually. Other risks include drug reactions, aspiration, and complications from unrelated diseases such as heart attack or stroke. Death is extremely rare, but remains a remote possibility.
BE SURE TO LET YOUR DOCTOR KNOW IF YOU ARE ALLERGIC TO ANY MEDICATIONS OR IF YOU ARE TAKING ANTICOAGULANTS (BLOOD THINNERS)