Esophagogastroduodenoscopy; Upper endoscopy; Gastroscopy
Esophagogastroduodenoscopy (EGD) is an examination of the lining of the esophagus, stomach, and upper duodenum with a small camera (flexible endoscope) which is inserted down the throat.
You will be given a sedative and an analgesic (painkiller). You should feel no pain and not remember the procedure. A local anesthetic may be sprayed into your mouth to suppress the need to cough or gag when the endoscope is inserted. A mouth guard will be inserted to protect your teeth and the endoscope. Dentures must be removed.
In most cases, an intravenous line will be inserted into your arm to administer medications during the procedure.
You will be instructed to lie on your left side.
After the sedatives have taken effect:
After the test is completed, food and liquids will be restricted until your gag reflex returns (so you don't choke).
The test lasts about 5 to 20 minutes.
Fasting is required overnight (6 to 12 hours before the test). An informed consent form must be signed. You may be told to stop aspirin and other blood-thinning medications for several days before the test.
The local anesthetic makes swallowing difficult. This wears off shortly after the procedure. The endoscope may stimulate some gagging in the back of the throat. There may be a sensation of gas, and the movement of the scope may be felt in the abdomen. Biopsies cannot be felt. Because of the intravenous sedation, you may not feel any discomfort and may have no memory of the test.
When you wake up, you may feel a little bloated from the air that is introduced through the endoscope, but this will wear off in a short period of time.
Your doctor may order this test if you have any of the following conditions or symptoms:
The test may also be used to obtain a tissue specimen for biopsy.
The esophagus, stomach, and duodenum should be smooth and of normal color. There should be no bleeding, growths, ulcers, or inflammation.
An abnormal EGD may be the result of:
There is a small chance of perforation (hole) of the stomach, duodenum, or esophagus. There is also a small risk of bleeding at the biopsy site. A patient could have an adverse reaction to the anesthetic, medication, or tranquilizer. This reaction could cause:
The overall risk is less than 1 out of 1,000 people.
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Mercer DW, Robinson EK. Stomach. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 47.
Pasricha PJ. Gastrointestinal endoscopy. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 136.
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