Preparation for Procedure
Welcome and thank you for choosing Conemaugh Memorial Medical Center for your EGD. Our physicians and nurses are dedicated to providing highly skilled and compassionate care for you and your family. We understand that you may be apprehensive about your procedure. We hope the following information will be helpful to you as you prepare for your procedure, the day of your procedure and during your recovery.
The Gastroenterology Lab is on the 4th floor of Memorial’s Main Building. Take the elevator in the M Building to the 4th floor.
We want to make your experience with us as comfortable as possible. If you have any questions or concerns that are not answered here, please do not hesitate to call your physician or the GI Lab at (814) 534-9122 between 8:00 a.m. and 4:00 p.m.
Click here to view a list of all GI Lab locations within the Conemaugh Health System
Before Your Procedure
Your gastroenterologist, primary care physician or other designated physician will do a history and physical examination prior to your procedure.
Your physician may order laboratory tests, x-rays or EKG’s. These tests should be done 3 to 7 days prior to your procedure date. You may have repeat labs drawn the day of your procedure depending on your previous results or the medications you are currently taking.
The physician will specify when to stop taking certain medications prior to the procedure. Do not take any medications the day of the procedure unless instructed to take it by the physician or nurse.
If you are pregnant or think you might be, or if you are breast-feeding, tell the doctor and technologist before your test.
If you have questions about your insurance coverage or pre-certification, call your insurance company. If you are not covered by insurance, please make arrangements for payment by calling 814-534-9000 and ask for the Business Office. No financial arrangements are made on the day of the procedure.
If you develop an abnormal temperature or a communicable disease prior to your procedure please call your physician. It may be necessary to reschedule your procedure for a time when you are feeling better.
The Day Before Your Procedure
The afternoon prior to your procedure, we will call you, and we will let you now what time to arrive at the hospital to prepare for your procedure.
Your physician will specify what prep you should use prior to your procedure. This generally includes dietary modifications. If you can't remember when you are scheduled or the preparation involved, please call your physician or the GI Lab at (814) 534-9122 between 8:00 a.m. and 4:00 p.m.
You may eat and drink until midnight on the day before your procedure. Please avoid anything with a red or purple coloring.
Day of Your Procedure
After midnight no solid food, gum, tobacco, alcoholic beverages or lozenges are permitted.
Do not smoke for 12 hours prior to your procedure. Eating, drinking or smoking can cause a delay or cancellation of your procedure.
You may be instructed to take certain medications by your physician the morning of the procedure. You may take them with a sip of water. These may include Cardiac, blood pressure, seizure or respiratory inhalation medications. Do not take any medications the day of the procedure unless instructed to take it by the physician or nurse. Never take blood thinners, insulin or diabetic medications unless instructed to by the physician.
Wear loose fitting, clean, comfortable clothing and flat shoes.
Wear your glasses instead of contact lenses
Do not wear make up, nail polish, hairspray or jewelry
Do not bring money, jewelry or valuables with you
Children under 18 years of age or incapacitated adults must be accompanied by a parent or legal guardian.
Please bring all insurance forms / cards with you.
You may be accompanied by one adult family member or friend. Children should not accompany adults having any procedures. Because you are not permitted to drive after your procedure, an adult must accompany you to take you home. A responsible adult should stay with you the night following your procedure. Children scheduled for a procedure should be accompanied by two adults, one to assist the child and one to drive home.
When you arrive at the hospital on the day of your procedure report directly to the 4th floor M building and sign in at desk. You will be called to your room. You will be given a hospital gown to wear. You will be asked to remove dentures, hairpieces or hair pins, artificial limbs and contact lenses. You will be asked to remove nail polish and makeup if you didn’t already do it at home. Any jewelry that you wear to the hospital such as a wedding band must be given to your family member or friend. Please remember to remove all body piercing.
You will be interviewed by a registered nurse who will do a nursing assessment, document your historical information and verify all medications (both prescribed by a physician and over the counter) that you are taking and the last time you took each of your medications. Please bring a list of your medications with you, including over the counter, herbs, vitamins and supplements. Include the name, dose and how often you take each item. You will have an Intravenous (IV) line inserted and be given IV fluids.
If you are pregnant or think you might be, or if you are breast-feeding, tell the doctor and technologist before your test.
Healthcare professionals will be available in this area to make you comfortable and to answer your questions. The staff may ask you the same questions several times. They will ask your name, what procedure you are having done, your medications and your allergies. By repeating our questions, we are verifying and re-verifying very important information to ensure that your time with us is as safe as possible. This is a double check system to ensure your safety which is our number one priority.
You will be seen by your physician who will ask you to sign a consent form. This legally permits your physician to perform your procedure.
During the Procedure
You will be taken to procedure room on the same cart and positioned on your left side.
You will be attached to a cardiac monitor and your blood pressure and vital signs will be continually monitored. You may have an oxygen mask or oxygen prongs in your nose. The people around you in the room will be preparing for your procedure. The registered nurse will always be in the room with you, and staff will stay by your side and will explain everything that is happening.
You will be given a moderate, twilight sedation and/or pain medication through your IV line to make you comfortable, less anxious and help diminish gagging. During the procedure you may be partially awake, but comfortable, or asleep and not be able to remember the procedure at all. You will be continually monitored and made as comfortable as possible.
The test will be performed by the physician. The endoscope is a narrow tube with a tiny light and camera at the end. It is approximately 3 feet long and the width of your little finger. A mouth guard will be inserted to protect your teeth and the endoscope. Dentures must be removed.
The doctor will pass the endoscope through your mouth into the back of your throat and ask you to swallow. Most people spontaneously swallow and the scope is easily passed into the esophagus. It will not affect your breathing. The endoscope is advanced through the esophagus (food pipe) to the stomach and duodenum.
Air is introduced through the endoscope to expand your Gastrointestinal (GI) tract and enhance viewing. It can make you burp. The physician may also use water and suction in order to better visualize the lining of the upper GI tract. The endoscope may stimulate some gagging in the back of the throat. There may be a sensation of gas, and the movement of the scope may be felt in the abdomen.
The endoscope carries magnified images of your upper GI tract to a video screen
The test lasts about 5 to 20 minutes
There are several procedures that may be performed during the EGD. Tiny tools can be passed through the scope to perform a variety of functions. Suction or water can be used to remove fluid or to better visualize the lining.
The doctor can remove abnormal tissue samples with biopsy forceps. If any bleeding occurs it is treated with an electrical probe to cauterize the area or special medication passed through the scope. This is generally a painless procedure. The tissue is then sent to a pathology lab to be tested for signs of cancer or disease.
If your esophagus is narrowed with a stricture an esophageal dilation can be performed. Special instruments are carefully guided through the scope in the mouth and down into the esophagus. They either stretch or widen the narrowed area and are then removed. You might experience mild pressure in the back of your throat or in your chest during the procedure. Your doctor may also use x-rays during the esophageal dilation procedure.
The type used depends on the width and cause of the stricture. Types include:
Balloon dilator – A tiny deflated balloon is inserted into the stricture using an endoscope. The balloon is slowly inflated. It’s deflated when the stricture is widened enough.
Guided wire dilator – A thin wire is eased down the esophagus. A small tube that’s wider on one end is guided down the wire into the stricture to stretch it.
Bougies – These are weighted, cone-shaped tubes. Starting with smaller cones, your doctor uses increasingly larger cones until the stricture is stretched the right amount.
You may need to have the procedure repeated one or more times. This depends on the cause and extent of the narrowing. Repeat procedures can allow the dilation to take place more gradually. This reduces the risks of the procedure.
A special x-ray machine called fluoroscopy may also be used. This imaging technique creates a continuous x-ray image on a monitor throughout the procedure. This enables the Radiologist to see the area in motion. The exposure to x-rays may be a little higher than a normal x-ray. The Radiologists and technologists are trained to deliver dosages that are not harmful and that are within strictly established guidelines.
Feeding Tube Placement or Removal
A feeding tube insertion is the placement of a feeding tube through the skin and the stomach wall, directly into the stomach. A gastrostomy feeding tube insertion is done in part using a procedure called endoscopy. This ensures correct placement.
After the endoscopy tube is inserted, the skin over the left side of belly (abdomen) area is cleaned and numbed. The doctor makes a small surgical cut in this area and inserts a small, flexible, hollow tube with a balloon or special tip into the stomach. The stomach and abdomen will heal in 5 to 7 days. Moderate pain can be treated with medications. Feedings will start slowly with clear liquids, and increase slowly.
After Your Procedure
After your procedure you will be taken to the recovery area. The physician will explain the results of the test to your family. During this time you will awaken from sedation. The nurse will continue to monitor your vital signs; blood pressure, pulse, temperature, and your breathing.
When you wake up, you may feel a little bloated from the air that is introduced through the endoscope, but this will wear off in a short period of time. You may have a sore throat for the rest of the day. The local anesthetic makes swallowing difficult. Food and liquids will be restricted until your gag reflex returns so you don't choke. You can start drinking again after the numbness in your throat goes away shortly after the procedure. You can resume eating the same day. Try to avoid anything with a red or purple color for a few days.
After you are recovered from the sedation, your vital signs (blood pressure, pulse, respiration and temperature) are stable and you are comfortable, your IV will be removed. You will be seen by your physician, and given discharge instructions. In order to be discharged from the GI Lab you must have a driver because of the sedation you received.
Your time in the GI Lab will vary depending on the procedure you had done, how well you are doing and how comfortable you are. It will be approx 2.5 hours.
You should notify your physician immediately if you develop any of these rare side effects:
• Fever of 100.4°F or greater
• Chest pain / Abdominal pain
• Trouble swallowing
• Black stools
Thank-you for allowing us to care for you during your GI Lab procedure.