EGD, commonly known as an upper endoscopy, is a procedure similar to colonoscopy that is performed in the upper gastrointestinal (GI) tract. The medical term for an EGD procedure is esophagogastroduodenoscopy. The test allows a doctor to look at the lining of your esophagus, stomach and upper duodenum by interesting an endoscope down your throat.
The device used during an EGD procedure is called a flexible endoscope. It is tubular in shape and is very similar to the colonoscope that gastroenterologists use to examine a patient’s colon during a colonoscopy procedure, just thinner in diameter. At the end of the flexible endoscope, there’s a small camera and a small light bulb that will capture images of the patient’s body and project them on a television or computer screen.
Once the tubular endoscope is in your throat, air can be pumped through the esophagus and open up the area inside for better viewing. Side effects of the air in your body include temporary feelings of bloating or soreness in the abdominal area after the procedure. EGD procedures are relatively quick, lasting less than 20 minutes while the doctor closely examines your esophagus, stomach and upper duodenum (the upper-most part of the small intestine) for polyps, cancer or other suspicious signs. Surgical tools can be inserted through the endoscope in order to collect tissue samples or to remove suspicious tissue. The process is just like polyp removal during a colonoscopy. The doctor can even stretch the lining of your esophagus if it is abnormally narrow and is causing difficulty swallowing or breathing.
There are small risks associated with this procedure, similar to colonoscopy – including but not limited to: pain, discomfort, bloating, risk of infection, risk of aspirating stomach contents into the lungs, risk of missed pathology, risk of early termination of the procedure, risk of bleeding, risk of perforation of the esophagus/stomach/duodenum which can require surgery to repair and very rarely death. Additionally, sedation carries its own risks, including lowering of the heart rate, blood pressure and respiratory rate, which can affect your lungs, heart or brain – although close monitoring is always employed to help prevent these complications.
You will not be allowed to eat anything for about 12 hours before your EGD procedure. You may also need to stop taking certain medications, such as aspirin, that have blood-thinning tendencies which may increase the chances of gastrointestinal bleeding during or after the test.
Sedation is always required for any upper endoscopy. A mouth guard is also routinely used for additional protection for your tongue and teeth; it’ll also keep you from damaging the endoscope while it’s situated in your mouth. You will be given two medications prior to the procedure: one intravenous (IV) sedative designed to numb your body and also one painkiller. The painkiller is sometimes a local anesthetic that is sprayed directly into your mouth, which may make breathing or swallowing saliva feel more difficult than usual. The main function of the anesthetic is primarily to prevent you from coughing or gagging when the doctor inserts the flexible endoscope into your throat. Another effect of the medication is that the majority of patients cannot remember any details of the procedure at all once it’s over. You will not be allowed to eat or drink anything until the sedation medication wears off and your gag reflex starts functioning properly again—this is too prevent you from choking on your food or drink unknowingly.
You may need to have this test performed if you find yourself suffering any of the following symptoms: blood in your stool, heartburn, difficulty swallowing, persistent vomiting, Crohn’s disease (which can occur anywhere along the GI tract, not only your colon), unexplained weight loss, among other conditions. Since the procedure is a thorough examination, it is also a routine screening test for patients at risk for esophageal and stomach cancer. Contact a gastroenterologist listed in our directory if you have any questions about EGD or think you may need to be screened for cancer, internal bleeding or any other symptom.
Reviewed 12/16/2011 by David M. Nolan, M.D.
Diplomate of the American Board of Internal Medicine, 2011
Currently a Fellow of Gastroenterology, at UCI 2011-2014