Esophagogastroduodenoscopy (EGD)

Commonly referred to as an Upper Gastrointestinal Endoscopy or EGD, it is a procedure that allows your doctor to look at your esophagus, stomach and the first part of the small intestine (duodenum) and is used to diagnose and treat conditions in the upper gastrointestinal tract.

The procedure is done using a long, thin, flexible viewing tool called an endoscope that has a small light and video camera at one end. The endoscope is inserted in your mouth and then slowly and gently pushed down your throat, through your esophagus and stomach, and into the beginning of your small intestine.

The endoscope sends images to a monitor in real-time, allowing your doctor to look for inflammation, bleeding, ulcers or infection.

Small tools may also be inserted into the endoscope. These tools can be used to:

• Take tissue samples for a biopsy.
• Remove things such as food that may be stuck in the upper GI tract.
• Inject air or fluid.
• Stop bleeding.
• Do procedures such as endoscopic surgery, laser therapy, or open (dilate) a narrowed area.

What are the Reasons for Doing an EGD?

An upper gastrointestinal endoscopy may be done to diagnose and treat problems in your upper gastrointestinal tract.

Many times it is used to identify the cause of unexplained symptoms such as:

• Trouble swallowing
• Unexplained weight loss
• Upper belly pain or chest pain that is not heart-related
• Continuous vomiting for an unknown reason
• Bleeding in the upper gastrointestinal tract

It can be used to identify problems such as:

• Inflammation of the esophagus (esophagitis) or the stomach (gastritis)
• Gastroesophageal reflux disease (GERD)
• A narrowing (stricture) or blockage of the esophagus
• Enlarged and swollen veins in the esophagus or stomach (Esophageal varices)
• Barrett’s esophagus, a condition that increases the risk for esophageal cancer
• Damage caused by swallowing caustic substances such as household detergents
• Infections of the upper gastrointestinal tract
• Crohn’s disease
• Celiac disease
• Hiatal hernia
• Ulcers
• Cancer

The procedure is also used to treat a variety of issues:

• Control bleeding
• Remove tumors or growths (polyps)
• Open (dilate) narrowed areas
• Remove things that may be stuck
• Perform laser therapy
• Insert a tube used for tube feeding into the stomach
• Band abnormal veins in your esophagus (esophageal varices)

An endoscope can also be used to take tissue samples (biopsies) or gastrointestinal fluid samples. An EGD may also be used to check your stomach and duodenum after undergoing a surgery.

Your healthcare provider may have other reasons to recommend an upper GI endoscopy.

What are the Risks of an EGD?

Complications are rare during an upper gastrointestinal endoscopy, though like any procedure there are certain risks, such as:

• Bleeding
• Infection
• There is a slight risk of perforation in your esophagus, stomach or upper small intestine. If this happens, you may need surgery to fix it.

There may be other risks that are unique to you, be sure to talk to your doctor about any concerns before the procedure.

How do you prepare for an EGD?

Before having an upper gastrointestinal endoscopy, be sure to inform your doctor if you:

• Are sensitive to or allergic to any medicines, latex, tape or anesthesia medicines
• Are pregnant or believe you might be pregnant
• Have a history of bleeding disorders; take any blood-thinning medicines such as aspirin or other medicines that affect blood clotting. You may need to suspend their use before the procedure.
• Have diabetes or take insulin
• Have had any surgery or radiation treatments in your esophagus, stomach or upper part of your small intestine
• Have any heart problems

You will be asked not to eat or drink anything for 8 hours before the test. Having an empty stomach allows your doctor a clear view of your stomach during the test.

You may be asked to sign a consent form stating that you understand the risks and agree to have it done.

You will be awake during the procedure, but you will be given a sedative to help you relax so you should arrange to have someone take you home after the test.

How is an EGD performed?

An upper gastrointestinal endoscopy may be performed in a doctor’s office, a clinic or a hospital; an overnight stay is usually not required.

The procedure is done as follows:

• You will be asked to remove any clothing, jewelry, dentures or anything else that might interfere with the procedure. You will be given a gown to wear.
• You will receivemedicine into a vein to help you relax. You should feel no pain and not remember the procedure.
• Your heart rate, blood pressure, respiratory rate, and oxygen level will be checked during the procedure.
• A local anesthetic may be sprayed into your mouth to prevent you from coughing or gagging when the scope is inserted. A mouth guard is used to protect your teeth and the scope.
• You then lie on your left side.
• You will not be able to swallow the saliva that may collect in your mouth during the procedure. This happens because the tube is in your throat. The saliva will be suctioned from your mouth from time to time.
• The scope is inserted through the esophagus (food pipe) to the stomach andduodenum. Air is put through the scope to make it easier for the doctor to see.
• The lining of the esophagus, stomach, and upper duodenum is examined.Biopsies can be taken through the scope. Biopsies are tissue samples that are looked at under the microscope.
• Different treatments may be done, such as stretching or widening a narrowed area of the esophagus.

After the test is finished, you will not be able to have food and liquid until your gag reflex returns (so you do not choke).

The test lasts about 5 to 20 minutes.

What happens after an EGD?

After the test, you will be observed for 1 to 2 hours until the medicines wear off. If your throat was numbed before the test, you should not eat or drink until your throat is no longer numb and your gag reflex has returned to normal. This is to prevent you from choking. You might experience a sore throat or pain when swallowing for a few days after the test, this is completely normal.

When you are fully recovered, you can go home. You will not be able to drive or operate machinery for 12 hours after the test. You may go back to your usual diet and activities, unless otherwise instructed by your doctor. Do not drink alcohol for 12 to 24 hours after the test.

Be sure to call your immediately if you have any of the following:

• Symptoms of infection, such as fever or chills
• Redness, swelling, or bleeding or other drainage from the IV site
• Shortness of breath of dizziness
• Belly pain, nausea, or vomiting
• Black, tarry, or bloody stools
• Trouble swallowing
• Throat or chest pain that gets worse

Your doctor may be able to talk to you about some of the findings right after your endoscopy. However, the medicines you get to help relax you may impair your memory, so your doctor may wait until they fully wear off.