EGD Procedure (Upper Endoscopy)
During an EGD procedure (upper endoscopy), a digestive tract specialist (gastroenterologist) uses a scope to view the inside of your esophagus, stomach and duodenum (the upper part of your small intestine). Providers use the procedure to diagnose and treat acid reflux, stomach ulcers, celiac disease and other digestive tract problems.
An EGD, or upper endoscopy, is a procedure to examine the upper part of your digestive tract. EGD stands for “esophagogastroduodenoscopy.” Phew! Let’s break that down.
Working backward through the word, “-scopy” means an examination with a visual instrument. A “scope” is that instrument (as in “telescope” or “microscope”). During an EGD procedure, a gastrointestinal (GI) doctor (gastroenterologist) uses an instrument called an endoscope to examine the inside of your body. The endoscope is a small, lighted camera on the end of a long, flexible tube.
After a healthcare provider gives you medication to make you comfortable, your gastroenterologist passes the endoscope down your mouth, then your throat, through your esophagus (swallowing tube), into your stomach and then into your duodenum (the upper part of your small intestine). The camera sends images to a computer screen showing your esophagus, stomach and duodenum. Similarly, your gastroenterologist can visually examine these areas of your body.
That’s where the rest of the word comes from. “Duodeno-” means duodenum, “gastro-” means stomach and “esophago-” means esophagus.
You may need an upper endoscopy if you have unexplained symptoms like:
- Abdominal pain.
- Nausea and vomiting.
- Swallowing problems.
- Weight loss.
- Heartburn.
- Non-cardiac chest pain.
- Vomiting blood.
- Anemia.
- Functional indigestion.
An upper endoscopy allows for a direct view into your upper digestive system. It can be more accurate than X-rays in diagnosing problems. These problems include:
- Acid reflux (gastroesophageal reflux disease or GERD).
- Inflammation, like esophagitis, gastritis and duodenitis.
- Gastrointestinal disorders, like celiac disease and Crohn’s disease.
- Stomach (peptic) ulcers.
- Swallowing disorders.
- Intestinal metaplasia.
- Barrett’s esophagus.
- Hiatal hernia.
- Cirrhosis of the liver.
- Portal hypertension.
- Cancerous and noncancerous tumors.
Healthcare providers can also do treatments with an endoscope. They might want to take a tissue sample to examine in the lab (biopsy). They can do these things with the endoscope.
By attaching tiny tools to the endoscope, EGD technicians can often fix small problems on the spot. For example:
- Repair holes.
- Drain abscesses.
- Open narrowed passages.
- Insert medical devices for therapy.
- Manage upper digestive tract bleeding.
- Remove polyps (growths), tumors or swallowed objects.
EGD is a simple outpatient procedure that shouldn’t take more than an hour of your day. But you’ll have to prepare in a few ways ahead of the appointment:
- Screening. Since the test involves sedation and sometimes general anesthesia, your healthcare provider will want to screen you in advance for any health conditions that might make these unsafe for you.
- Fasting. You’ll need to avoid eating anything within eight hours of the procedure. That’s to avoid complications from food that may still be in your stomach during the procedure. You can drink clear liquids up to two hours before the test.
- Medications. You may need to stop taking blood thinners and adjust your diabetes medications the day before the test. Your healthcare provider will instruct you.
- Driver. Because most people require sedation for the procedure, a provider will ask you to have a responsible adult accompany you and take you home afterward. You can’t drive or operate heavy machinery after you receive the medications.
When you arrive for your EGD, a provider will lead you to the endoscopy suite. A nurse will check your vital signs to make sure you’re in good condition for the procedure. Then, your nurse will install an intravenous (IV) catheter into a vein in your arm to deliver your medicine.
If you have general anesthesia, the medication will put you completely to sleep. You won’t feel anything. But most people will have conscious sedation instead. A provider who specializes in anesthesia (anesthesiologist) will give you a sedative to make you feel sleepy and relaxed, but you may not be completely asleep. With the sedative, a provider will also spray a local anesthetic spray into your mouth and throat. This has a numbing effect.
Your nurse will place a mouthguard in your mouth to protect your teeth, tongue and the scope. They’ll position you on your left side on the procedure table.
To perform the procedure, your provider:
- Guides the endoscope through your mouth and down into your esophagus, stomach and duodenum.
- Pumps air through the endoscope into your stomach and duodenum to make it easier to see your organs.
- Views images from the endoscope on a video monitor while looking for problems or performing treatments.
- Removes small pieces of tissue to biopsy (examine in a lab), if necessary.
- Performs treatments, if needed.
An upper endoscopy is typically an outpatient procedure, meaning you go home the same day. The procedure may be uncomfortable, but it shouldn’t be painful.
The procedure takes about 30 to 60 minutes.
Your provider will suction the air out of your stomach after withdrawing the endoscope. But there may be some gas left in there. This will pass over the next day or so. Side effects may include bloating and passing gas (burping and farting).
You may also have a sore throat for a day or two as the numbing agent wears off. Cold foods and drinks can help soothe your throat. Your healthcare provider may recommend some more specific food-related guidelines for the days following the test.
You may not remember the test afterward. You’ll need to stay at the medical office until you’re alert enough to be discharged. In some cases, your healthcare provider may be able to discuss the test results with you right away. In other cases, you may need to make a separate appointment.
An EGD is a minimally invasive procedure that allows a healthcare provider to examine the inside of your upper digestive tract. They’re able to diagnose, biopsy or treat conditions without the risks of traditional surgery. The procedure is painless, and you can go home the same day.
An upper endoscopy is a relatively low-risk procedure. Potential complications include:
- Allergic reactions to the sedative, like low blood pressure and low blood oxygen.
- Digestive tract bleeding or infection.
- Tear (perforation) in your digestive tract lining.
If you don’t have results immediately after the test, it might be because your healthcare provider needs to wait for biopsy results. This can take up to two weeks. As soon as your healthcare provider has results to share, they’ll be able to discuss what they found, what it means and what comes next.
When should I call my healthcare provider?
You should call your healthcare provider if you experience:
- Chronic cough or coughing up or vomiting blood.
- Difficulty swallowing.
- Fever and chills.
- Rectal bleeding (black, tarry stool).
- Severe throat pain, chest pain or abdominal pain.
References
- Ahlawat R, Hoilat GJ, Ross AB. Esophagogastroduodenoscopy (https://www.ncbi.nlm.nih.gov/books/NBK532268/). 2023 Aug 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. Accessed 11/27/2024.
- American College of Gastroenterology. Upper GI endoscopy (EGD) (https://gi.org/topics/upper-gi-endoscopy-egd/). Published 9/2018. Accessed 11/27/2024.
- National Library of Medicine (U.S.). EGD – esophagogastroduodenoscopy (https://medlineplus.gov/ency/article/003888.htm). Last reviewed 8/7/2023. Accessed 11/27/2024.
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