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Upper Endoscopy -- The Procedure

Clip Number: 6 of 25
Presentation: EGD (Upper Endoscopy)
The following reviewers and/or references were utilized in the creation of this video:
Reviewed By: Arthur Schoenstadt, MD
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When ready, medication may be given through your IV to make you sleepy and relaxed. Also, to make this examination more comfortable, your healthcare provider may spray a numbing medication into the back of your throat or you may gargle with it. This may taste slightly bitter and will make your mouth and throat numb for approximately 30 minutes. Then you will be positioned on your left side.
A small plastic mouthpiece, or guard, will be put into your mouth to protect your teeth when the tube is slowly placed into your esophagus, or food-pipe, and to keep you from accidentally biting the tube.
In order to help relax the muscles in the back of your throat and help open the passageway, you will need to take slow, deep breaths. You will then be instructed to put your chin to your chest and open your mouth. As the doctor begins to push the tube in, you will be asked to swallow. Swallowing makes the tube go down more easily.
During this procedure your doctor will use an endoscope. The endoscope is a long, soft, bendable tube. This instrument acts as a camera and allows your doctor to view the inside of your digestive system on a video screen. It can also take pictures and videotape the procedure.
Once the endoscope is inside, your doctor will examine your esophagus, stomach, and the first part of the small intestine. To better see this area, these structures may be filled with a small quantity of air through the endoscope. While this air may cause you to feel full it should not be painful.
Depending on what is found during the endoscopy, your doctor may perform several procedures through the endoscope. A photograph, biopsy, or cytology may be taken. A biopsy involves taking a small sample of tissue. And cytology is a brushing of cells.
Other procedures that may be performed include stretching narrowed areas of the esophagus, stomach, or duodenum, removing polyps and swallowed objects, or treating bleeding vessels and ulcers.
If your doctor finds a narrowed area, it may be possible to dilate, or widen, this narrowed section, or stricture, with a dilator. Your doctor has two options for doing this. The first is balloon dilation. During this procedure your doctor inserts a special balloon-tipped catheter through the endoscope and guides it to the narrowed area. Once the balloon catheter is correctly placed it is often inflated and deflated several times to increase the size of the narrowed area. The balloon catheter is then removed.
The second option is to use plastic tube dilators. In this method a guide-wire is passed through the endoscope into the narrowed area. Then progressively larger dilators are passed over the guide-wire to dilate the narrowed area. Both of these methods have the same effect.
When the examination is finished, the doctor will slowly pull the endoscope out through your mouth. The upper endoscopy procedure usually takes about 20 to 30 minutes.
 

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