1.
Upper GIT symptoms and the
role of endoscopy
Chrispin Nuwemukama
nurse

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.

6.
Examples of upper GIT diseases
• Acute
• Gastritis
• Duodenitis
• Esophagitis
• PUD
• GERD
• Chronic
• MALIGNANT/pre-malignant
• Ca stomach
• Ca esophagus
• Burret esophagus
• NON-malignant
• Varices
• Chronic gastroduodenitis
• Strictures
• Achalasia
• Hernias
• Polyps and other growths
• Mallory-weis tear

7.
Examples of UGIT symptoms
• Epigastric pain, peri-umbilical pain
• Heartburn
• Sometimes chest pain
• Vomiting, Nausea, Anorexia
• Dyspepsia/indigestion
• Dysphagia (difficulty in swallowing)
• Regurgitation/Reflux/waterbrash
sensation.
• Retching
• Gaseous abdomen/bloating
• belching
• Malaise
• Weight loss
• Anemia
• Melena stools
• hematemesis

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

12.
An endoscope

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

21.
END