EGD (Upper Endoscopy)

Medically Reviewed by Nayana Ambardekar, MD on August 29, 2022
4 min read

An 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. It’s also called an upper endoscopy, or an esophagogastroduodenoscopy.

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:

  • Anemia

  • Black or tarry stools

  • Ongoing heartburn

  • Vomiting and nausea

  • Blood in vomit 

  • Swallowing problems

  • Belly pain 

  • Unexplained weight loss

  • A feeling of unusual fullness  

  • A feeling that food is lodged behind your breast bone

Endoscopy can also help identify inflammation, ulcers, and tumors.

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 structure to prop it open.

  • Objects stuck in the esophagus or stomach can be removed.

  • Bleeding due to ulcers, cancer, or varices can be treated.

Before an upper endoscopy, tell your doctor if you are pregnant, have a lung or heart condition, take blood thinners or have a bleeding disorder, or are allergic to any medications.

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.

Fasting before the test is usually recommended to reduce the risk of aspiration during the endoscopy. 

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 8 hours following the procedure.

 

Before your doctor performs an upper endoscopy, they’ll explain the procedure in detail, including possible complications and side effects. The doctor will also answer any questions you may have.

You’ll 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. Also, tell your doctor if you have:

Don’t eat or drink anything for 8 hours before the procedure.

  • 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 15-20 minutes.

 

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

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.

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.