2. Presentation outline
• Learning objectives
• The Upper GIT Anatomy
• Examples of upper GIT diseases
• Examples of UGIT symptoms
• Risk Factors For upper GIT D’se
• Definition of upper gi endoscopy
• Uses
• Indications
• Patient preparation
• Additional tests
• complications
3. Learning objectives
• To understand what the upper GIT is.
• To identify upper GI symptoms and signs among patients.
• To know when endoscopy should be done
• To know the uses/roles of endoscopy in patient management
• To learn how to prepare a patient for endoscopy
4. Reasons for discussing upper
GIT/symptoms diseases
• They are common, especially in outpatient departments.
• And cause Significant morbidity among adults
• To increase on the awareness among medical staff about the
treatment options available especially the role of Endoscopy
• As a reminder, trigger for everyone to actively participate in
investigating upper GI symptoms
5. What’s the Upper GIT? -- Anatomy
• For endoscopic purposes, upper
GI includes the
• esophagus,
• stomach and
• duodenum.
• It ends at the duodenojejunal
junction (ligament of trietz)
• And lower GI includes the
• anus, rectum, colon and cecum.
8. Symptoms that signify chronic disease
• Progressive vomiting
• Progressive weight loss
• Evening fevers, night sweats,
(B-symptoms)
• Unexplained anemia
9. Risk factors for upper git d’se
• Age >40yrs, >60yrs
• H. pylori infections
• Longterm use of high dose NSAIDs
• Highly spiced foods
• Heavy alcohol consumption
• Long spells of hunger, irregular
meals
• Physical inactivity
• Physiological Stress
• Family h/o malignancy e.g ca
stomach
• Genetic predisposition
10. UPPER GI ENDOSCOPY
aka – Esophagogastroduodenoscpy (EGD)
• DEFINITION.
• Is a procedure used to examine the
lining of the upper digestive tract,
using an endoscope (a flexible tube
with a camera & light at its end)
• Is an intermediate surgical
procedure, done under light
11. Endoscopy
• It’s an outpatient procedure if the
patient is stable (without
compelling comorbidities)
• Is used to investigate the cause of
symptoms, treat symptoms, help in
diagnosis
13. Indications of endoscopy of upper GI
• Dysphagia
• Odynophagia
• Hematemesis or melena
• Persistent heartburn/reflux
• Dyspepsia unresponsive to treatment
• Intractable vomiting
• Foreign body ingestion
14. Uses of endoscopy
1. To investigate the cause of symptoms.
1. biopsy
2. To diagnose
3. To treat/intervene
1. FB removal
2. Stenting
3. Banding
4. Stricturotomy
15. Preparation for endoscopy I
• In general, the patient should
be stable, stabilize all unstable
patients e.g.
• Correct hypovolemia,
electrolytes, anemia
• Control bleeding in case there
is
• Stabilize vitals-BP, PR, RR, SPO2,
RBS
• Screen for communicable
diseases-Hep B, Hep C,
covid=?
• Counsel the patient about the
procedure, provide information,
then
• Consent
• Inform theater
• IV access
• Prepare to monitor recovery
16. PREPARATION II
• the patient to continue with normal
diet till the day before the
procedure.
• If the procedure is scheduled in the
morning (before 12pm), patient
should stop eating/drinking at
midnight.
• If the procedure is in the afternoon
(after 12pm, patient is allowed to eat
solid foods till 8 hours before the
procedure (5am).
• Clear fluids are allowed up to 2 hours
before the procedure.
• Clear fluids include water, coffee, tea,
soda.
• The following are not clear fluids:
alcohol, milk, juice with pulp, and
liquid you cannot see through.
• Patient should come with
attendant/driver because the
procedure involves sedation.
17. Additional tests done to add value to endoscopy
• Depend on the findings during endoscopy and patient’s
presentation.
• Histology on biopsies taken
• H.pylori Antigen test (on stool)
• Urea breath test
• Tumor markers
18. Complications/Risks of endoscopy
• Can be minimized by properly preparing the patient and having the
procedure done by skilled personnel
• The risk of complication increases with any additional
procedure/intervention done during endoscopy e.g. biopsy, stenting,
releazing strictures, FB removal, etc,
• Perforation.
• Bleeding.
• Infections (to and from the patient).
• Cardiac arrest
• Effects of drugs
19. Have learning objectives been achieved?
• What are the structures in the upper GI?
• Can you identify upper GI symptoms and signs among patients?
• Some examples of chronic upper GI diseases
• What are the uses/roles of endoscopy in patient management?
• How do you prepare a patient for endoscopy?
• Any complications?
• Any additional tests you can do?
20. Video summary of endoscopy
Upper Gastrointestinal Endoscopy Procedure - YouTube
• Watch this YouTube video to give you a brief overview of
endoscopy procedure
• thanks
