An OGD procedure, or test, is short for OesophagoGastroDuodenoscopy which is quite a mouth full to pronounce!
This is a special endoscopy which views the:
- O – oesophagus (also known as the gullet or food pipe)
- G – gastro (is the medical word for stomach) and
- D – duodenum (this is the first part of the small bowel)
The other name for this procedure is an Upper GI endoscopy – as it examines the upper gastrointestinal (GI) tract. The procedure is carried out in the endoscopy department and patients are advised to stop eating for 6 hours before the test to make sure the stomach is empty.
An OGD procedure can be carried out awake with local anaesthetic throat spray. Although the spray doesn’t taste particularly nice (some patient’s say it tastes like banana!) it is usually the safest and quickest way to have the procedure.
Sedation can be given for patients who are very nervous or who have had bad experiences of the procedure in the past, or when a longer procedure is anticipated such as a therapeutic procedure (i.e. doing something more advanced rather than just looking).
The endoscope is about the size of the little finger and better technology means the cameras are getting smaller and smaller. Most endoscopes for an OGD are designed to be passed via the mouth. Small tiny biopsies of tissue can be taken if any abnormalities are seen.
Why might I need an Upper GI endoscopy or OGD procedure?
An OGD procedure is performed to evaluate symptoms of persistent upper abdominal pain, nausea, vomiting, difficulty swallowing or heartburn. It is an excellent method for finding the cause of bleeding from the upper gastrointestinal tract.
It can be used to evaluate the oesophagus or stomach after major surgery. It is more accurate than barium X-rays for detecting inflammation, ulcers or cancers of the oesophagus, stomach and duodenum.
An upper endoscopy can detect early cancer and can distinguish between cancerous and noncancerous conditions by performing biopsies of suspicious areas. Biopsies are taken by using a specialized instrument to sample tissue. These samples are then sent to the laboratory to be analysed. A biopsy is taken for many reasons and does not mean that cancer is suspected.
How long does an OGD procedure take?
The procedure takes between 5 – 10 minutes
Is a gastroscopy painful?
The procedure should not be painful, it can be slightly uncomfortable especially initially when the camera first goes down the throat. In the stomach, air is used to blow up the stomach to look in detail and patients can feel a bit bloated. If sedation is given some patients may fall asleep during the procedure, but most are just relaxed and conscious.
What can you expect during the procedure?
If you chose throat spray you will have your throat sprayed with a local anaesthetic before the test begins
If you chose sedation, a needle will be placed in a vein to give a medication to help you relax during the examination.
You will be laid on your side in a comfortable position and a small ‘clothes peg’ type device will be attached to your finger to monitor your oxygen levels and pulse during the procedure. A mouth guard will be placed to protect your teeth and the specialist camera from damage.
The endoscope is gently passed through your mouth and into your oesophagus, stomach and duodenum. Try to relax as much as possible during this initial phase of the procedure, as once the camera is done the procedure can be carried out fairly quickly.
Air is introduced into your stomach during the procedure to allow a better view of the stomach lining. The endoscope does not interfere with your breathing. The endoscopist and endoscopy staff will talk to you during the procedure and explain what is happening.
What preparation is required for an OGD test?
The stomach should be completely empty. You should have nothing to eat or drink for approximately 6 hours before the examination. Your surgeon will be more specific about the time to begin fasting depending on the time of day that your test is scheduled.
Medication may need to be adjusted or avoided. It is best to inform us of ALL your current medications as well as allergies to medications a few days prior to the examination. Most medications can be continued as usual. Medication such as aspirin, nonsteroidal anti-inflammatories (such as ibuprofen), blood thinners (such as warfarin, rivaroxaban, apixiban etc) and diabetic medication (such as insulin) should be discussed with us prior to the examination.
If you chose to be sedated during the procedure it is vitally important that you make arrangements for someone to drive you home afterward. Sedatives will affect your judgment and reflexes for the rest of the day. You should not therefore, not drive or operate machinery until the next day.
What complications can occur with an OGD?
Thankful major complications with this procedure are very rare and the procedure is very safe. Mr Griffiths is fully JAG accredited in Upper GI Endoscopy and performs the procedure 300-400 times per year.
If biopsies are taken, it is possible that bleeding occurs, however this is actually pretty rare. Another rare but serious risk is causing an injury with the camera or perforation; thankfully this is very rare, especially with camera tests which are just diagnostic (i.e just looking) rather than for therapy (for example dilatation or stretching or removing polyps etc).
It is important for you to recognize the early signs of possible complications and to seek medical advice if you notice symptoms of difficulty swallowing, worsening throat pain, chest pains, severe abdominal pain, fevers, or vomiting blood. Please contact the hospital or endoscopy department for advice if this occurs.
How much does a self pay OGD procedure cost?
A full quote can be obtained from the BMI Hospitals for an OGD procedure, but a standard diagnostic endoscopy with biopsies if required costs in the region of £1,300.
What happens if I’m profoundly nervous about the procedure and request a General Anaesthetic?
Mr Griffiths offers endoscopy with the aid of a consultant anaesthetist for private and self-pay patients. In this scenario the anaesthetist will give ‘heavy sedation’ with propofol anaesthesia and the patient will be fully asleep for the procedure and not remember anything about it.
In this case the anaesthetist has special training to manage this form of deep sedation and the procedure may be carried out in the operating theatre. Patients with private insurance will need to get authorisation for the extra anaesthetic fee prior to the procedure. Self-pay patients should ask for a quote for this service.