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ABOUT YOUR UPPER ENDOSCOPY
Dear Patient:
Your physician has referred you for an exam of your upper digestive tract, which is called an upper endoscopy or an
EGD. Sometimes it is called a gastrostomy.
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How to fill out about your upper endoscopy

How to fill out about your upper endoscopy
01
To fill out about your upper endoscopy, follow these steps:
02
Gather all the necessary information about your medical history, including any previous endoscopies or other relevant procedures.
03
Make sure you have all the details about the upcoming upper endoscopy, such as the date, time, and location of the procedure.
04
Begin by providing your personal details, including your name, date of birth, and contact information.
05
Next, fill out the sections related to your medical history, mentioning any past or current medical conditions, allergies, and medications you are taking.
06
Provide details about your symptoms or reason for undergoing the upper endoscopy. Be as specific as possible to help the healthcare provider understand your situation better.
07
If you have any concerns or questions about the procedure, note them down in the appropriate section.
08
Finally, carefully review the filled-out form to ensure all the information is accurate and complete.
09
Submit the form as instructed by the healthcare provider.
Who needs about your upper endoscopy?
01
Upper endoscopy is generally recommended for individuals who:
02
- Experience persistent symptoms such as abdominal pain, difficulty swallowing, or gastrointestinal bleeding.
03
- Have a history of certain conditions that require monitoring or evaluation, such as gastroesophageal reflux disease (GERD), Barrett's esophagus, or peptic ulcers.
04
- Need a biopsy or tissue sample from the upper digestive tract for further examination.
05
- Require the removal of polyps or foreign objects from the esophagus, stomach, or small intestine.
06
- Suspect the presence of digestive system abnormalities or diseases.
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What is about your upper endoscopy?
An upper endoscopy is a procedure used to examine the upper digestive system, including the esophagus, stomach, and the beginning of the small intestine (duodenum).
Who is required to file about your upper endoscopy?
Patients who undergo an upper endoscopy are required to provide information about the procedure.
How to fill out about your upper endoscopy?
Patients can fill out information about their upper endoscopy by providing details such as the date of the procedure, the findings, and any follow-up recommendations.
What is the purpose of about your upper endoscopy?
The purpose of reporting about your upper endoscopy is to document the procedure and its findings for medical records and future reference.
What information must be reported on about your upper endoscopy?
Information such as the date of the procedure, the endoscopist's name, the findings, any biopsies taken, and any follow-up recommendations must be reported.
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