Nathan Schneider, MD, FACS, provides endoscopies (and colonoscopies) at the Keokuk County Health Center Specialty Clinic. Dr. Schneider received his medical education from the University of Iowa, completed his residency at Iowa Health Des Moines, and is certified by the American Board of Surgery and General Surgery. He is also the Medical Director for the Mercy Iowa City Vein Center.
To schedule a colonoscopy with Dr. Schneider, please call your Primary Care Provider for a referral. Colonoscopies are offered the 3rd Friday of each month.
What is an Upper GI Endoscopy/Gastroscopy?
Upper GI endoscopy, sometimes called EGD (esophagogastroduodenoscopy) is a visual examination of the upper gastrointestinal tract using a lighted, flexible fiberoptic or video endoscope. It allows the physician to look inside the esophagus, the stomach, and the uppermost portion of the small intestine (duodenum). A flexible instrument called a gastroscope is used and is about as big around as the little finger. The flexible endoscope can be directed and moved around the many bends in the gastrointestinal tract. Electronic signals are transmitted up the scope to the computer, which then displays the image on a large video screen and allows the doctor to take pictures if needed for medical documentation and consultation. Biopsies (small pieces of tissue) may be taken and sent to the pathologist for further studies. Please note that biopsies are taken for many reasons and do not necessarily imply cancer. You will not feel any sensation or discomfort when the biopsies are performed.
The upper gastrointestinal tract begins with the mouth and continues with the esophagus (food pipe) which carries food to the stomach. The J-shaped stomach secretes a potent acid and churns food into small particles. The food then enters the duodenum (small bowel) where bile from the liver and digestive juices from the pancreas mix with it to help the digestive process.
Reasons to Have an Upper GI Endoscopy/Gastroscopy:
Due to factors related to diet, environment and heredity, the upper GI tract is the site of numerous disorders. These can develop into a variety of diseases and/or symptoms. Upper GI endoscopy helps in diagnosing and often in treating these conditions:
- Ulcers which can develop in the esophagus, stomach, or duodenum
- Tumors of the stomach or esophagus
- Difficulty in swallowing
- Upper abdominal pain or indigestion
- Intestinal bleeding – hidden or massive bleeding can occur for various reasons
- Esophagitis (and heartburn) – chronic inflammation of the esophagus due to a back up of stomach acid and digestive juices
- Gastritis – inflammation of the lining of the stomach
Possible complications or risks of Upper GI endoscopy:
A temporary, mild sore throat sometimes occurs after the exam. Serious risks with upper GI endoscopy, however, are very uncommon. One such risk is excessive bleeding, mainly with the removal of a polyp. In extremely rare instances a tear in the esophagus wall can occur. These complications may require hospitalization and, rarely, surgery.
The Upper GI endoscopy will take about 30 minutes, but expect the visit to last from 2-4 hours to allow for preparation and recovery time.
To ensure a successful examination, the stomach must be completely empty. It is important that you have nothing to eat or drink after midnight the evening before your exam. Please ask your doctor about necessary prescription medications. You may brush your teeth and rinse your mouth the morning of the procedure, but do not swallow any water.
Because you will be sedated you will not be able to drive after the procedure, therefore, you must arrange for a responsible adult (over age 18) to accompany you after your upper GI endoscopy. Your procedure will not begin until a responsible adult driver is present. This person should remain in the hospital during your entire visit so that they are available as soon as you are ready to be discharged. You should also make arrangements for a responsible adult to stay with you the first night at home.
Complications are rare. However, there are potential complications associated with all medical procedures. These will be explained to you on the day of your colonoscopy before you sign the consent for the procedure.
Upper GI endoscopy is performed on an outpatient basis. The throat is often anesthetized by a spray or liquid. Intravenous sedation is usually given to relax the patient, deaden the gag reflex and even cause short-term amnesia. For some individuals who can relax on their own and whose gagging can be controlled, the exam is done without intravenous medications. The endoscope is gently inserted into the upper esophagus. The patient can breathe easily throughout the exam. The exam takes 15 to 30 minutes, after which the patient is taken to the recovery area. There is no real pain with the procedure and patients seldom remember much about it.
After the Procedure
After the procedure you will be transported back to your room. You will be observed closely for approximately one hour. The nursing staff will periodically check your vital signs.
You will feel bloated for awhile. Belching will help relieve this discomfort. You may experience a mild sore throat following the exam.
Usually upon arrival to your room you will be allowed to drink liquids and advance to your regular diet as tolerated. However, if an anesthetic spray has been used, you will not be allowed to eat or drink for one hour afterwards.
When you are fully awake and taking liquids well, your IV will be removed. Your doctor will discuss the findings of your exam with you.
Because of the after effects of the medication you are advised that for the remainder of the day you should not:
- Return to work
- Drive a car or motor vehicle
- Operate any machinery (including kitchen equipment)
- Drink alcohol
You should call your physician if you develop:
- Temperature of 101 degrees or greater
- Difficulty breathing
- Severe abdominal pain
- Nausea or vomiting
These are general instructions. Your physician may give you more specific instructions related to your individual case which will take priority over these general guidelines. Your physician will review pathology findings with you when he/she receives them. Please feel free to ask your physician or nurse any questions you may have about your procedure.