Upper endoscopy, also known as EGD, is a procedure in which a thin scope with a light and camera at its tip is used to look inside the upper digestive tract -- the esophagus, stomach, and first part of the small intestine, called the duodenum.
Usually performed as an outpatient procedure, upper endoscopy sometimes must be performed in the hospital or emergency room to both identify and treat conditions such as upper digestive system bleeding.
The procedure is commonly used to help identify the causes of:
Upper endoscopy is more accurate than X-rays for detecting abnormal growths such as cancer and for examining the inside of the upper digestive system. In addition, abnormalities can be treated through the endoscope. For example:
- Polyps (growths of tissue in the stomach) can be identified and removed, and tissue samples (biopsies) can be taken for analysis.
- Narrowed areas or strictures of the esophagus, stomach, or duodenum from cancer or other diseases can be dilated or stretched using balloons or other devices. In some cases, a stent (a wire or plastic mesh tube) can be put in the stricture to prop it open.
- Objects stuck in the esophagus or stomach can be removed.
- Bleeding due to ulcers, cancer or varices can be treated.
How Do I Prepare for an Upper Endoscopy?
Also, tell your doctor if you have:
- Ever been told you need to take antibiotics before a dental or surgical procedure
- Ever had endocarditis (an infection of the heart valves)
- An artificial heart valve
- Rheumatic heart disease
Do not eat or drink anything for eight hours before the procedure.
Medications for high blood pressure, heart conditions, or thyroid conditions may be taken with a small sip of water before the procedure. If you have diabetes and use insulin, you must adjust the dosage of insulin the day of the test. Your diabetes care provider will help you with this adjustment. Bring your diabetes medication with you to your appointment so you can take it after the procedure.
Make arrangements to have someone drive you home following the endoscopy. The sedation given during the procedure causes drowsiness and dizziness and impairs your judgment, making it unsafe for you to drive or operate machinery for up to eight hours following the procedure.
What Happens During an Upper Endoscopy?
Before your doctor performs an upper endoscopy, he or she will explain the procedure in detail, including possible complications and side effects. The doctor will also answer any questions you may have.
- You will be asked to wear a hospital gown and to remove your eyeglasses and dentures.
- A local anesthetic (pain-relieving medication) may be applied at the back of your throat.
- You will be given a pain reliever and a sedative intravenously (in your vein) to help you relax and make you feel drowsy.
- A mouthpiece will be placed in your mouth.
- You will lie on your left side during the procedure.
- The doctor will insert the endoscope into your mouth, through your esophagus (the "food pipe" leading from your mouth into your stomach) and into your stomach.
Most procedures take 15 to 20 minutes.
What Happens After the Upper Endoscopy?
After an upper endoscopy:
- You will stay in a recovery room for about 30 minutes for observation.
- You may feel a temporary soreness in your throat. Lozenges may help.
- The doctor who performed the endoscopy will send the test results to your primary or referring doctor.
- The specialist or your primary health care provider will discuss the results with you after the procedure. If the results indicate that prompt medical attention is needed, the necessary arrangements will be made and your referring health care provider will be notified.
Warning About Upper Endoscopy
If you have severe abdominal pain, a continuous cough or fever, chills, chest pain, nausea, or vomiting within 72 hours after an upper endoscopy, call your doctor's office right away or go to the emergency room.
Is Endoscopy Safe?
Serious risks with an endoscopy are rare. However, excessive bleeding is always a possibility and rarely a tear in the esophagus or stomach wall can occur.