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Who doesn’t love a good nap? That’s exactly what it feels like to have an upper endoscopy: a deep nap where you wake up with a sore throat. An esophagogastroduodenoscopy is a technical name for an upper endoscopy or EGD. Honestly, this test is one of the more cumbersome ones you’ll have to do, but it’s also pretty easy. It’s done for a variety of reasons, including pre-bariatric-surgery planning. A thin hose with a camera on the end examines your upper gastrointestinal tract for issues. You’ll be given a mild sedative, and most patients sleep through the procedure. You’ll spend the rest of the day recovering and resting. Getting an upper endoscopy before bariatric surgery may be necessary to check for issues and for pre-operative planning.
Why Do I Need an Upper Endoscopy?
Some surgeons require an upper endoscopy as part of the requirements for bariatric surgery. Some of the reasons an upper endoscopy is performed is to look for the cause of heartburn, bleeding, nausea, vomiting or problems swallowing. It can also allow the doctor to identify any issues in your anatomy before your bariatric surgery. They can also identify anemia, GERD, ulcers, cancer and inflammation.
The process for bariatric surgery is long. Getting an upper endoscopy before bariatric surgery allows the surgeon to diagnose and treat any issues prior to your major surgery. For example, when I had my upper endoscopy, the doctor found several ulcers in my stomach. Had he not done the upper endoscopy before my bariatric surgery, it’s quite possible that he wouldn’t have ever known about them until he was trying to do my bariatric surgery. Finding those ulcers would have put an end to my bariatric surgery.
Can you imagine going through all of the work required of bariatric surgery, not to mention the liver-reducing diet, only to find out you can’t have bariatric surgery because of some dumb ulcers? I would have been so ticked off.
Your doctor also wants to check for any other abnormalities in your upper GI tract that would prevent bariatric surgery. He or she can do any pre-op planning that needs to be done while getting an inside look at your…well, insides.
What Exactly Is an Upper Endoscopy?
According to the University of California San Francisco, an upper endoscopy is an out-patient procedure. A doctor uses an endoscope, which is a long flexible tube with a camera on the end to see your upper GI tract. You’ll get light sedation and lie on a table. The tube is passed through your mouth, down your esophagus and into your stomach and duodenum. The doctor can obtain biopsies for further testing if necessary.
Getting an upper endoscopy before bariatric surgery is recommended according to a report on sages.org. According to the report, the upper endoscopy is useful to diagnose previously unknown issues. Of those patients studied in the report, 21.5% of the patients need some sort of medical intervention based on the finding of the EGD before bariatric surgery. If your doctor recommends an upper endoscopy, it’s best to get one just to make sure there are no issues that would prevent your bariatric surgery from taking place.
Prepping for an Upper Endoscopy
Getting an upper endoscopy before bariatric surgery does not require much prep work. Your doctor will provide you with the details, but generally, you may have to stop a few medications before the procedure. You will most likely not be able to eat or drink for six to eight hours before the appointment time.
Other than those two things, there’s really not much more you need to do. Wear comfortable clothing that you can easily change into and out of at the hospital. Don’t wear contacts if you have them to the procedure. You’ll also need to have someone drive you home, so arrange your transportation to and from the hospital or outpatient testing facility.
The Day of Your Upper Endoscopy
Your day will start as normal, except you won’t eat or drink anything. You can brush your teeth, just don’t swallow anything. Your doctor needs to be able to clearly see your upper GI tract. If you have consumed anything, it could inhibit his or her view. You won’t take any medications that morning either unless directed by your doctor.
When you arrive at the hospital or outpatient facility, you’ll be registered by one of the front office staff. They’ll need your photo ID and insurance cards, so make sure you have them with you. You’ll probably have to sign a few forms, and they’ll place an ID bracelet on your wrist.
Once checked in, you’ll be taken back to an outpatient procedure unit. You’ll change into a hospital gown. A nurse will take your vitals, go over your medication list and insert an IV into your arm. You’ll probably have to repeat your name and birthday a few times. They’ll likely get you hooked up to some fluids for hydration since you might be pretty thirsty by this time.
An anesthesiologist might be by to speak with you. They will want to know if you ever had sedation before and how you handled it, if you have false teeth or dentures and any other issues that might arise during the procedure. They may check your mouth before going into the procedure.
The Procedure
Getting an upper endoscopy before bariatric surgery only takes 15 to 30 minutes once you’re in there. They’ll give you a bite guard for your mouth and a mild sedative or a throat-numbing agent. You’ll lie on your side on the exam table. Once you are comfortable and sedated, the doctor will pass the endoscope through your mouth, down your esophagus, and into your stomach and duodenum. The camera on the end of the endoscope will provide video for your doctor to view your insides.
Your doctor is also able to take biopsies for further lab testing. Once the doctor is satisfied that he or she has all of the information needed, the endoscope will be removed, as well as the bite guard. You’ll be wheeled to recovery, where you’ll spend one to two hours.
After the Procedure
The doctor will come out and speak with whoever brought you to the hospital since you won’t remember what they said. They’ll tell them the results of the procedure, and what the next steps are. Later, after you’ve woken up a bit and are more coherent, the doctor will also come to share the news with you.
As you come out of the sedative, you’ll likely be groggy and tired. The nursing staff will bring you some food, like crackers, and drink, like juice or soda. They’ll want to make sure you can eat and drink before leaving the hospital. Once you are more fully awake, you’ll get dressed and be given discharge instructions to go home.
You may wake up with a sore throat, and that will go away in a day or two. You can take cough drops to help soothe it during the time. For the rest of the day, you’ll rest and let the sedatives finish wearing off. You pretty much take a glorified nap at the hospital and spend the rest of the day recovering and sleeping. Use the day to your advantage and catch up on some precious sleep! Or read a book. Or watch your favorite TV show.
Make sure you’re following all discharge instructions and watch for any of the warning signs that may indicate something is wrong.
My Upper Endoscopies
My surgeon required an upper endoscopy for me due to my history of acid reflux. He wanted to evaluate me for the causes of my reflux symptoms and pre-operative planning. As I wrote earlier, I am so thankful he required it. Had he not required it, I would not have been able to have my bariatric surgery at the time.
I had seven stomach ulcers. I was given Carafate, which is like a strong Pepto-Bismal to dissolve the ulcers. He also took samples of the ulcers to check for the H. Pylori bacteria. I never had symptoms from the ulcers. The Carafate had to be taken four times a day and around a strict schedule with food. It was cumbersome, but I was determined to treat these ulcers so I could get my bariatric surgery.
Because he did find so many ulcers, I had to have a repeat upper endoscopy to make sure they were gone. Praise God that they were! I was then cleared from that standpoint to have my bariatric surgery.
I didn’t really have too many side effects from the actual procedure, other than some discomfort in my throat for a few days. I do remember I felt like I couldn’t quench my thirst for a while. It was like it was hard to get my saliva working again. Otherwise, I just took the day off from work and responsibilities, laid in bed and napped. It really is an easy test, it just takes a whole day away from you.
Getting an Upper Endoscopy Before Bariatric Surgery
Now that you know what to expect, you should feel more comfortable with this simple procedure. Getting an upper endoscopy before bariatric surgery may be necessary to check for issues and pre-operative planning. It’s pretty much like taking a nap and waking up with a sore throat. You don’t want to go through the hard work of completing the bariatric process only to find an issue on the day of your surgery and have it be canceled. So if your doctor requires an upper endoscopy, take a day off and relax. Catch up on some sleep and your favorite TV shows or get some reading done. Your mind and body will thank you. You can also celebrate because you checked another bariatric surgery requirement off your list.
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In Summary
Blood tests and other tests don’t always show the full picture. You may have other GI issues that would prevent a bariatric surgery from being performed. Therefore, a doctor may want to do an upper endoscopy before bariatric surgery to check for issues like anemia, GERD, ulcers, cancer and inflammation. It also allows them to do pre-operative planning, so they can make sure they have all the information they need before your major surgery.
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