Pictured is a lighted camera called an endoscope used for the EGD (upper endoscopy) diagnostic procedure.

EGD (esophagogastroduodenoscopy) is a procedure for examining the upper gastrointestinal (GI) tract. A flexible tube with a lighted camera (endoscope) is introduced through the mouth or nose passing through the esophagus and stomach up to the top part of the small intestine (duodenum). An EGD is also known as an upper endoscopy.

EGD is not a surgery. It is generally an outpatient procedure lasting about 30 to 60 minutes.

An EGD is performed to examine the lining of the esophagus, stomach and duodenum. It may be performed for diagnosis or treatment of digestive disorders. The doctor may recommend an EGD for patient with symptoms such as

Persistent pain in the upper abdomen

• Chronic heartburn
• Chest pain (after heart problems are ruled out)
• Difficulty or pain swallowing
• Feeling full with small quantity of food
• Nausea and vomiting
• Vomiting blood
• Anemia and weight loss
• Blood in stool
• Feeling of food stuck in the throat

EGD is also performed as a regular screening procedure for people

• at risk for upper GI diseases
• with existing GI disorders
• with liver cirrhosis

The doctor may perform an EGD for treatments such as

• Removal of foreign bodies
• Control of bleeding
• Widening or stenting of narrowed esophagus
• Removal of polyps and ablation of pre-cancerous growths
• Placement of drainage or feeding tubes

EGD may be avoided in patients who

• are medically unstable
• are unwilling
• have perforated or inflamed bowel
• have bleeding disorders
• have diverticulitis or adhesions from previous surgery

EGD is used to diagnose diseases of the digestive system such as

• Celiac disease

Inflammatory conditions such as

• Esophagitis
• Gastritis
• Duodenitis
• Hiatal hernia
• Ulcers
• Gastroesophageal reflux disease (GERD)
• Narrowing of esophagus due to abnormal tissue growth (esophageal rings)
• Swollen veins in the esophagus (esophageal varices)
• Esophageal tears
• Tumors or cancer in the GI tract

An EGD is usually performed by a gastroenterologist as an outpatient procedure.

Preparation

• The patient undergoes blood and imaging tests.
• The patient must not eat or drink 8 hours before the procedure.
• The patient must check with the doctor before taking any regular medications and inform them of any allergies.

Procedure

• The patient lies on their left side.
• The doctor administers pain medication and light sedation, and numbs the patient’s mouth and throat with a topical anesthetic.
• The doctor may place a mouthguard between the teeth to prevent the patient from biting the scope or their own tongue.
• The doctor may use gentle air pressure to inflate the GI tract.
• The doctor inserts the endoscope through the mouth and passes it through the esophagus and stomach to the duodenum.
• The doctor examines the digestive tract on a monitor and may take a biopsy sample for testing or perform treatment as needed using tools that are part of the endoscope.
• The endoscope is slowly withdrawn.
• The actual procedure may take about 20 minutes.

Post-procedure

• The patient is monitored in the recovery room and will be able to leave in about an hour.
• The patient must not eat or drink until they are able to swallow without gagging.

EGD may cause a few side effects such as

• sore throat
• gas and bloating
• cramping

These side effects usually resolve on their own within 24 hours.

EGD is a fairly routine and safe procedure for most people. Complications arise rarely, occurring in fewer than 2% of patients. Complications and risks may include:

• Perforation of the digestive tract
• Bleeding
• Infection
• Breathing problems
• Drop in blood pressure and heart rate
• Excessive sweating
• Spasm of the throat
• Allergic reaction to the medication