The assessment of esophagogastroduodenoscopy tolerance a prospective study of 300 cases

Esophagogastroduodenoscopy (EGD) is useful in the diagnosis and evaluation of dyspepsia. We investigated factors that might be associated with self-reported patient tolerance of EGD and therefore might serve as objective, reliable and useful surrogates for self-reported patient tolerance. We also investigated factors that might influence EGD tolerance.

We prospectively evaluated 300 cases prior, during and after an EGD procedure. None received sedation.

Seventy-nine percent of patients reported "good" tolerance of their EGD procedure. Other variables including (1) ease of intubation, (2) number and severity of retching episodes and (3) patient's cooperation during the endoscopic procedure, associated positively and robustly with patient self-reports of EGD tolerance. Evaluating the parameters that might predict EGD tolerance, only (4) age and (5) patient's gagging during Lidocaine throat spraying correlated closely with patient perception of EGD intolerance. Self-reported EGD tolerance did not correlate with gender, education level, body habitus (obesity), prior EGD experience, fear or anxiety about the procedure, procedure type or procedure duration.

Several parameters might be used instead of or in addition to patient perception of EGD tolerance. Age and patient gagging during Lidocaine throat spraying, but not patient fear and anxiety about the procedure can be used to predict EGD intolerance and used for selection of patients for sedation.