By Kevin RR Williams
A View From Both Ends
Upper endoscopy is a medical gastroenterology procedure that inserts a flexible tube down your esophagus with a camera on the end. The gastroenterologist looks for polyps, gastrointestinal bleeding, or signs of erosion within the esophagus, stomach, or duodenum. Patients with Barrett’s esophagus should be enrolled in a surveillance program to look for signs of abnormal tissue (dysplasia) or cancer.
Warranted Over Time
The American College of Physicians (ACP) recommends doctors not regularly perform upper endoscopy screening in women of any age. ACP also discourages endoscopy in men under the age of 50 with heartburn because the prevalence of cancer is extremely low in this age range. Multiple risk factors for Barrett’s esophagus include obesity, tobacco use, or nocturnal acid reflux. In men over 50 years of age, this warrants upper endoscopy screening.
Based on patient history, age and symptoms, doctors may first prescribe antacid or proton pump inhibitor medications. After a few weeks without resolution, diagnostic endoscopy can help determine the cause of persistent abdominal pain, vomiting, or bleeding.
Generally Painless Procedure
During the gastroenterology procedure, the endoscopist or gastroenterologist can do a biopsy on suspicious areas or remove polyps. An endoscope can be retrofitted with an ultrasound probe to create unique images of the wall of your esophagus or stomach. An endoscopic ultrasound may also help your doctor develop images of hard-to-reach organs, such as your pancreas.
Pain could be a result of heartburn or gastroesophageal reflux disease (GERD). Gastrointestinal ulcers can develop from taking too many NSAIDs over a long period of time. Treatment can include dietary modification such as elimination of caffeine and spicy foods. Alternative prescriptions can neutralize stomach acids.
Your doctor will give you specific instructions to prepare for your endoscopy. Despite mild sedation or local anesthetic, there is no thrill in taking time away from other activities to have someone snake a tube down your throat. Depending on your insurance plan, it might even cost money you do not want to spend. Appreciate that the inconvenience will help doctors to prescribe the best course of treatment and possibly make you feel better.
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