Patient Education: Transnasal EGD Frequently Asked Questions
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This guide is for patients who are going to have a transnasal upper endoscopy, also called transnasal esophagogastroduodenoscopy, or transnasal EGD. This guide will answer some of the most commonly asked questions. Please do not hesitate to ask your doctor or nurse for more information.
What is a transnasal EGD?
An EGD is a procedure involving the use of an endoscope, a lighted, flexible tube. Transnasal means "through nose" so a transnasal EGD is an EGD performed through the nose which is different from the conventional EGD which is performed through the mouth. For the transnasal EGD, the doctor will pass the very thin tube through the nose and back of the throat into the esophagus, stomach and duodenum (the first part of the small intestine). The endoscope used is "ultrathin" so it can pass the nostril. Because it does not touch the pharynx as approaching the inlet of the esophagus without triggering gagging reflexes, it is well tolerated by patients even without sedation. The patient can even talk during the procedure. Because it does not require sedation, patients may leave the facility after short observation and can even drive home by themselves. With rare cases, the endoscope may not be able to pass the nostril. In this case, a "through mouth approach" may be attempted if you agree. Because the endoscope used is very thin, you still will be much more comfortable compared to the conventional endoscope. You will NOT be sedated even with a "through mouth approach". This procedure is solely for screening to check for cancers and other abnormalities. This procedure does not involve a biopsy (taking a small piece of tissue for examination in the laboratory).
You will NOT be sedated with the Transnasal EGD, which is different from the conventional EGD. You will be able to drive after your transnasal EGD.
This procedure will not be covered by insurance. You are responsible for payment of charges.
The procedure will take about 10 minutes, but expect the visit to last 40 minutes to allow for preparation and recovery.
How to Prepare -- READ ONE WEEK BEFORE THE Transnasal Upper Endoscopy (Transnasal EGD)
If you are on any anticoagulant medications (blood thinners), including aspirin or non-steroidal anti-inflammatory drugs, please notify the physician that ordered your test. Your medication may have to be adjusted the week before your test.
A few of these products include:
- Non-steroidal anti-inflammatory drugs, such as Motrin, Advil (Ibuprofen) or Naprosyn (Naproxen)
- Anti-platelet drugs
- ReoPro (abciximab)
- Aggrenox (aspirin plus dipryridamole)
- Plavix (clopidogrel)
- Persantine (dipyridamole)
- Integrillin (eptifibatide)
- Ticlid (ticlopidine)
- Aggrastat (terofiban)
Be sure to tell the doctor that ordered your test if you are on Coumadin or other blood thinners. You will need special instructions.
If you take oral diabetes medications (pills) or insulin (injections) you may take your usual doses until the night before the procedure. Please refer to the instruction for "the day of the test" below regarding how to take those medications for diabetes in the morning of the procedure.
If you have an implanted cardiac defibrillator (ICD), please call 734-647-6523 as soon as possible with the ICD name and manufacturer.
You may eat your normal diet the day before the procedure. Do not eat any solid food or non-clear liquids, such as milk or orange juice, for six (6) hours prior to your scheduled appointment time. You may drink clear liquids such as water or black coffee up to two (2) hours before your test. Take your medications with a few sips of water no later than four (4) hours before your appointment. If you are taking pain medication, you may do so up to four (4) hours before the procedure.
HOW TO PREPARE -- THE DAY OF THE Transnasal Upper Endoscopy (Transnasal EGD) -- Important Information
1. Your procedure is scheduled for:
If you are unable to keep your appointment, please call 734-647-6523 as soon as possible.
2. Your procedure will be performed at Domino's Farms Family Medicine -- Japanese Family Health Program, 24 Frank Lloyd Wright Drive, Lobby H, Ann Arbor, MI 48106. A map guiding you the site has been mailed to you or is available online at: http://www2.med.umich.edu/pcdv2/maps/dsp_maps.cfm?maplocation=DominosFarms. If you are uncertain at which site your procedure is scheduled, please call 734-647-6523
3. Please bring the following with you on the day of your procedure:
- A list of all medications you are taking
- A list of any allergies you have
- Health insurance cards
- Your blue University of Michigan hospital card
4. Do not eat any solid food or non-clear liquids, such as milk or orange juice, for six hours before your scheduled appointment time.
5. If you take oral diabetes medications (pills): Do not take the medication the morning of your test. Bring your diabetes medication with you. If you take insulin (one or two injections per day): Take one-half of your usual morning dose of NPH, Lente, Novolin 70/30 or Lantus insulin and NO Regular or Humalog insulin the morning of your test. If you take Ultralente insulin or are on three or more injections per day, please contact the health care provider who manages your diabetes.
Please refer to the handout, "Instructions for Patients with Diabetes Having Outpatient Procedures".
6. Please leave jewelry at home.
In the reception or preparation area you will answer questions about your health history, current medicines and allergies. You will sign a consent form. The procedure is performed in a room specially designed for endoscopic procedures. Your nostril and throat will be numbed with jelly and a spray prior to the procedure. After your nostril and throat are numbed appropriately, the endoscope will be inserted through your nostril. You will be able to breathe normally, burp and even talk if needed during the test. There usually is no pain associated with this test, even if a biopsy is done.
Complications are extremely rare. However, there are potential complications
associated with all medical procedures. Those complications inlude;
- A local anesthetic may not numb the area quite enough and you may feel some minor discomfort.
- There is some risk of tearing the throat, stomach, or intestine. If this happens, surgery may be necessary.
- There is a risk of infection or bleeding.
You should ask you health care provider how these risks apply to you.
A doctor specially trained in gastrointestinal procedures will perform the test. The doctor who ordered your procedure will make decisions regarding your plan of care.
After your procedure you will be required to stay in the clinic at least 10 minutes for observation. When you are ready to go home the nurse will discuss discharge instructions and answer your questions. You MAY drive yourself home.
- You may return to work or school on the day of your test.
- Do not drink or eat for at least one hour following your procedure to prevent choking or difficulty with swallowing.
You may be given specific instructions about resuming your activity, medications and diet.
When should I call my health care provider?
Call your health care provider right away if:
- You have severe pain.
- Mild nausea may occur after the procedure, but if nausea contniues longer than 4 hours after the procedure or you vomit.
- You develop fever greater than 100.4 F.
Call during office hours if:
- You have questions about the procedure.
- You want to make another appointment.
Domino's Farms Family Medicine -- Japanese Family Health Program Office Hours, Call (734) 647-6523:
- Monday - Friday: 8:00 am to 4:00 pm
- Saturday: 8:20 am to 11:40 am (Urgent Care Only)
After Office Hours, Call: (734) 647-5640
Usually, the result will be mailed to you within one week.