An esophagogastroduodenoscopy, often referred to as endoscopy, upper endoscopy, or EGD, is a procedure that allows a gastroenterologist to directly examine the upper part of the gastrointestinal (GI) tract. This includes the esophagus, stomach, and duodenum (the first section of the small intestine).

Why is an EGD necessary?

The most common reasons for an upper endoscopy are:

• Unexplained discomfort in the upper abdomen
• Gastroesophageal reflux disease (GERD), often called heartburn
• Persistent nausea and vomiting
• Upper GI bleeding, such as vomiting blood or dark blood found in the stool
• Difficulty swallowing or food getting stuck in the esophagus when swallowing
• Abnormal or unclear findings on an upper GI x-ray, CT scan or MRI
• Removal of a foreign body, such as a swallowed object
• Surveillance of Barrett’s esophagus
• Check healing or progress of previously found polyps, growths, tumors or ulcers

How do I prepare for an EGD?

You will be given specific instructions regarding how to prepare for the procedure during your office visit. These instructions are designed to maximize your safety during and after the procedure and to minimize possible complications. It is important to read the instructions ahead of time and follow them carefully. Do not hesitate to call the doctor’s office if you have any questions.

You may not eat anything after midnight on the day before your exam. You may not drink anything for four hours before your exam. It is important for your stomach to be empty to allow the doctor to see the entire area and to decrease the possibility of food or fluid aspirating into the lungs while you are under sedation.

You will need to make arrangements to have a responsible adult drive you to and from your procedure. You will be sedated for the procedure and will not be allowed to drive for the rest of the day.

How is an EGD performed?

You should arrive at the facility approximately one hour prior to your scheduled procedure time. You may need to complete and sign some paperwork. The facility will provide you with a gown to wear for the procedure.

An intravenous line (IV) will be started in one of your arms. A blood pressure cuff will be placed on your other arm, you’ll be connected to an EKG machine, and an oxygen saturation device will be placed on your finger. This is so your vital signs can be closely monitored while you are sedated. If you wear dentures, you will be asked to remove them prior to the procedure. A plastic mouth guard is placed between your teeth to prevent any damage to your mouth and to the endoscope.

The doctor will enter the room before you are sedated. You may be asked to lie on your left side to begin the procedure. A certified registered nurse anesthetist (CRNA) will then begin administering the anesthesia and you will fall asleep. You will remain asleep for the entire procedure.

The doctor will insert a long, flexible, lighted tube that contains a small camera, called an endoscope, into your mouth and slowly guide it throughout your upper GI tract. The doctor will be able to see images of your esophagus, stomach, and small intestine on a monitor as the endoscope is advanced. Small amounts of air will be used to inflate the upper GI tract so the doctor will be able to clearly see every part of the tissue. The doctor will be carefully examining the tissue for any signs of abnormalities.

If a polyp is found, the doctor can remove or destroy it using one of a variety of small instruments that pass through the endoscope. If inflamed tissue or anything abnormal is seen, the doctor will take a biopsy or brushing of the suspicious area. Samples of the polyps or abnormal tissue will be sent to the lab for testing. If there is a stricture in your esophagus causing difficulty swallowing, a special instrument may be used to dilate the area. If a source of bleeding is found, the doctor can use another instrument to cauterize and stop the bleeding.

The actual procedure typically takes between ten and twenty minutes to complete. After the exam is complete, the CRNA will stop administering the sedative and you will wake up. The adult who drove you to your exam may be asked to join you in the recovery area so you both can listen to the doctor’s findings. The doctor will explain what was found during the examination and will prescribe any necessary treatment.

Expected side effects from the procedure

You may experience minimal bloating and belching after the procedure as a result of the air used to inflate the upper GI tract. You may also have a sore throat and blood-tinged phlegm. The medication used for sedation may irritate your veins, which can usually be relieved by applying a warm compress to the affected area.

After receiving sedation, you should spend the next twenty-four hours resting. Avoid any strenuous activity. You should not drink alcoholic beverages, sign any legal documents, make any serious decisions, drive or use machinery or appliances for the remainder of the day.

Your first meal after the procedure should be light. The doctor will advise you of any further dietary restrictions. You should resume your medications unless advised otherwise by your doctor.

Possible Complications

Notify your doctor or nurse if you experience severe abdominal or shoulder pain, a fever, vomiting, or a distended abdomen. Notify your doctor or nurse immediately if you start to pass large amounts of blood or if blood passes continuously, or if you notice a crunching feeling under the skin of the neck.

Though uncommon, possible complications of an endoscopy include bleeding and puncture or perforation of the esophagus, stomach or small intestine. Your doctor will explain all the risks of endoscopy before you consent to having the procedure done.

In an emergency, always proceed to the nearest emergency room or call 911.

Disclaimer: The contents of this site are for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this site.