EGD

What is EGD?

Esophagogastroduodenoscopy, or EGD, is an endoscopic examination of the esophagus, stomach and duodenum (the uppermost part of the small intestine) for hiatal hernias, ulcers, bleeding sources, tumors  or other problems. The procedure can also offer a number of therapeutic interventions such as control of bleeding, manometry, or dilation. The procedure’s medical name is actually a combination of the names of three different procedures that are usually performed collectively:

• Esophagoscopy—looking inside the esophagus for hiatal hernias, polyps, strictures, etc.
• Gastroscopy—looking inside the stomach for ulcers, polyps, inflammation, etc.
• Duodenoscopy—looking inside the duodenum for inflammation, diverticulosis, etc.

 

Together, the three procedures are referred to as EGD, or Upper Endoscopy. The EGD procedure is usually done by a GI doctor (gastroenterologist). Your GI doctor might order an EGD if you are displaying persistent dysphagia (difficulty swallowing), if you bleeding either when you cough or pass stool, if you have GERD (acid reflux disease) or if you’ve had unexplained abdominal or chest pains. If you’re vomiting severely, the procedure may also be able to find an underlying cause.

What Happens During an EGD Procedure?

After the patient is adequately sedated, a flexible device called an endoscope is inserted into a patient’s throat and guided downward through the gastrointestinal tract, all the way to the duodenum. There is a little fiber-optic light and a camera attached to the endoscope’s tip, which gives the GI doctor a view of the inner lining of the GI tract while the endoscope passes through. The procedure is very similar to a traditional colonoscopy, except that it is performed to the upper GI tract and not the lower intestines.

The entire process takes no more than 20 minutes. It is slightly uncomfortable when the endoscope is initially inserted, with the sedation, you will hardly feel it. Before the doctor examines you, he or she might pump air into your throat using the tubular endoscope to inflate the muscles and open the tract for a better view. Getting air pumped through your body can sometimes cause cramps or slight pain in the chest

Is EGD Dangerous?

Oftentimes, EGD tests are ordered after an x-ray or other, less invasive test shows signs of an abnormality that may need further examination. During the EGD, a surgeon can actually remove small growths or cancers detected—so that the patient will not have to under another medical procedure. This type of minor surgery very rarely results in gastrointestinal bleeding or perforation (tearing) that may need additional surgery to repair. In general, the procedure is not associated with very much increased risk.

Another complaint is that the sedation medication given to patients before an EGD procedure makes it hard for them to breathe or swallow easily. However, this rarely results in long-term trouble, as the sedated patient is always closely attended to by nurses, doctors and other practitioners while the procedure is happening. Since the effects of the sedation medications can last several hours, it’s also important to have a family member or friend pick you up after the procedure because driving would be unsafe.

How Do I Prepare for an EGD?

Your upper GI tract—the esophagus, stomach and duodenum—must be empty if you want the EGD to produce accurate results. Food remaining in the tract can get in the way of the doctor’s examination and can look like something suspicious. To empty your upper GI tract, simply stop eating food and drinking beverages for 8 to 12 hours before the EGD. Also note that you will not be able to eat or drink anything for a couple of hours after the EDG, as well, because if you eat while sedated you might choke without feeling or noticing it.

In general, the preparation required before and after screenings of the upper GI tract is much preferred to bowel prep required for a colonoscopy or other lower GI exam, for which you’ll need to consume laxatives and use the bathroom frequently to empty the colon completely. If you have questions about bowel prep, EGD or colonoscopy—you can always contact a medical doctor listed in our directory and schedule an appointment, or fill out one of the questions forms around the site for more information.

 

Reviewed 12/29/2011 by David M. Nolan, M.D.
Diplomate of the American Board of Internal Medicine, 2011
Currently a Fellow of Gastroenterology, at UCI 2011-2014