What Is an Esophageal Culture?
An esophageal culture is a simple laboratory test that checks tissue samples from the esophagus for germs that might be causing an infection. Your esophagus is the long tube between your throat and stomach. It transports food, liquids, and saliva from your mouth to your digestive system.
For an esophageal culture, tissue from the esophagus is obtained through a procedure called esophagogastroduodenoscopy—more commonly referred to as an upper endoscopy, or EGD. Your doctor may order this test if he or she suspects you have an infection in your esophagus, or if you are not responding to treatment for an esophageal problem.
Endoscopiesare generally performed on an outpatient basis using a mild sedative. During the procedure, an instrument called an endoscope will be inserted down your throat and into your esophagus to get tissue samples. Most patients are able to return home within a few hours of the test and report little or no pain or discomfort.
The tissue samples are sent to a lab for analysis and your doctor will call you with the results within a few days.
Purposes of an Esophageal Culture
Your doctor may suggest an esophageal culture if he or she thinks that you may have an infection of the esophagus, or if you have an existing infection thatis not responding to treatment like it should.
In some cases, your doctor will also take a biopsy during your EGD. A biopsy checks for abnormal cell growth, such as cancer. Tissues for the biopsy can be taken using the same procedure as your throat culture.
The samples are sent to a lab and placed in a culture dish for a few days to see if any bacteria, fungi, or viruses grow. If nothing grows in the laboratory dish, you are considered to have a normal result. If there is evidence of infection, your doctor may need to order additional tests to determine the cause and to help come up a treatment plan.
If a biopsy was also taken, a pathologist will study the cells or tissues under a microscope to determine if they are cancerous or pre-cancerous—cells that have the potential to develop into cancer. A biopsy is the only way to accurately identify cancer.
How are Esophageal Cultures Obtained?
To obtain a sample of your tissue, your doctor will perform a procedure called an esophagogastroduodenoscopy, sometimes known as an upper endoscopy or EGD. For this test, a small camera, or flexible endoscope, is inserted down the throat. The camera projects images onto a screen in the operating room, allowing your doctor to have a clear view of your esophagus.
This test does not require too much preparation on your part. You should stop taking any blood-thinning medications for several days before the test is done. Your doctor will also ask you to fast for six to 12 hours before your scheduled test time. The EGD is generally an outpatient procedure, meaning you can go home immediately following it.
In most cases, an IV will be inserted into a vein in your arm.A nurse will inject a sedative and a painkiller through the IV. He or she may also spray a local anesthetic into your mouth and throat to numb the area and prevent you from gagging during the procedure. A mouth guard will be inserted to protect your teeth and the endoscope. If you wear dentures, you will need to remove them beforehand.
You will lie on your left side and the doctor will insert the endoscope through your mouth or nose, down your throat and into your esophagus. Some airwill also inserted to make it easier for the doctor to see.
The doctor will visually examine your esophagus and may also examine your stomach and upper duodenum, which is the first part of the small intestine. These should all appear smooth and of normal color. If there is visible bleeding, ulcers, inflammation, or growths, your doctor will take biopsies of those areas. In some cases, your doctor will try to remove any suspicious tissues with the endoscope during the procedure.
The test generally lasts about five to 20 minutes.
Following the procedure, you will need to stay away from foods and beverages until your gag reflex returns. You will most likely feel no pain and will have no memory of the operation. You will be able to return home the same day.
Your throat may feel a little sore for a few days. You may also feel some minor bloating or the sensation of gas,since the air was inserted during the procedure. However, most people feel little or no pain or discomfort after an endoscopy.
If your doctor removed any suspicious tissue or precancerous cells during your procedure, he or she may ask that you schedule a follow-up endoscopy. This will ensure that all the cells were removed and that you do not need any additional treatment.
Your doctor should call you to discuss your results in a few days. If an infection was uncovered, you may need additional tests or your doctor may prescribe you with medications to treat your condition.
If you had a biopsy and cancerous cells were discovered, your doctor will try to identify the specific type of cancer, its origins, and other factors. This information will help determine your treatment options.
Risks of an Esophageal Culture and Biopsy Procedure
There is a slight chance of a perforation or bleeding during this test. As with any medical procedure, you may also have a reaction to the medications. These could result in difficulty breathing, excessive sweating, spasm of the larynx, low blood pressure, or a slow heartbeat. However, according the National Institutes of Health, the risk of having a reaction is less than one out of every 1,000 people (NIH, 2012).
You should contact your doctor immediately if you develop black stools, bloody vomit, difficulty in swallowing, fever, or pain following this test.