Upper Gastrointestinal Endoscopy
When the decision has been made by your physician that an EGD (esophagogastroduodenoscopy) is necessary for further evaluation and treatment, this page will help you to understand the procedure.
What is an EGD (Esophagogastroduodenoscopy)?
An endoscope is a long flexible tube thinner than your little finger. It is passed through the mouth and back of the throat into the upper digestive tract and allows the physician to examine the lining of the esophagus, stomach, and duodenum (the first portion of the small intestine).
Abnormalities suspected by x-ray can be confirmed and others may be detected which are too small to be seen on x-ray.
If the doctor sees a suspicious area or needs to evaluate an area of inflammation in greater detail, he can pass an instrument through the endoscope and take a sample of tissue (a biopsy) for laboratory examination. A small brush can be introduced as well to collect cells from an abnormal area for laboratory examination (cytology). Biopsies are taken for many reasons and do not necessarily mean that cancer is suspected.
What preparation is required?
For the best possible examination, the stomach must be completely empty. You should have nothing to eat or drink, including water, from midnight on the evening before the examination or for at least six hours prior to its performance. Your doctor will be more specific about the time to begin fasting, depending upon the time of the day your EGD is scheduled.
Be sure to let your doctor know if you are allergic to any medications.
A companion must accompany you to the examination because you will be given medication to help you relax. The medication will make you feel drowsy, and even though you may not feel tired, your judgment and reflexes will not be normal. Therefore, you will need someone to drive you home, since you will not be able to drive immediately after the procedure.
Please bring any recent stomach x-rays with you because they may be important.
What should be expected during the procedure?
Your doctor will give you medication by IV injection to make you relaxed and sleepy during the exam. The back of your throat may be sprayed with a topical anesthetic. While you are lying in a comfortable position, the endoscope is inserted through the mouth, and each part of the esophagus, stomach, and duodenum is examined.
The procedure is extremely well tolerated with little or no discomfort. Many patients even fall asleep during the EGD. The tube will not interfere with your breathing. Gagging is usually minimized by the medication.
What happens after the EGD?
You will be kept in the endoscopy area until most of the effects of the medication have worn off. A bloated feeling may last for a few minutes right after the procedure because of the air introduced during the exam and your throat may feel sore for a short period of time.
Unless further testing is required, you will be able to resume your regular diet after the endoscopy has been completed.
Are there any complications from an EGD?
EGD is safe and is associated with very few risks when performed by physicians who have been specially trained and are experienced in this endoscopic procedure.
One rare complication is a perforation in which a small tear through the wall in an area being examined may allow for the leakage of digestive fluids. Such a complication can be managed simply by aspirating the fluid until the opening seals or it may require surgery.
Infrequently, a localized irritation of the vein may occur at the site of medication injection. A tender lump may develop and remain for several weeks, but it will go away eventually.
Other possible risks include drug reactions and complications from unrelated diseases, such as heart attack or stroke.
Why is EGD necessary?
Many problems of the upper digestive tract cannot be diagnosed by X-ray. EGD can be helpful for the diagnosis of inflammation of the esophagus, stomach, and duodenum (esophagitis, gastritis,
duodenitis) and for identifying the site of upper gastrointestinal bleeding.