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.
Esophagogastroduodenoscopy; Upper endoscopy; Gastroscopy
How the test is performed:
You will be given a sedative and an analgesic (painkiller). 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, the endoscope will be advanced through the esophagus (food pipe) to the stomach and duodenum . Air will be introduced through the endoscope to enhance viewing. The lining of the esophagus, stomach, and upper duodenum is examined, and biopsies can be obtained through the endoscope. Biopsies are tissue samples that are reviewed under the microscope.
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.
How to prepare for the test:
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.
Infants and children:
The preparation you can provide for this test depends on your child's age, previous experiences, and level of trust. For general information regarding how you can prepare your child, see the following topics:
How the test will feel:
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.
Why the test is performed:
This test is helpful in determining:
- The cause of abdominal pain
- The cause of unexplained anemia
- The cause of swallowing difficulties
- The cause of upper GI (gastrointestinal) bleeding
- The condition of the stomach and duodenum after an operation
- The presence of tumors or other abnormalities of the upper GI tract
- The presence of ulcerations or inflammation
- The type and extent of inflammatory bowel disease (Crohn's disease)
- Narrowing or tumors of the esophagus
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.
What abnormal results mean:
An EGD may show:
What the risks are:
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:
- Apnea (not breathing)
- Excessive sweating
- Hypotension (low blood pressure)
- Laryngospasm (spasm of the larynx)
- Respiratory depression (difficulty breathing )
The overall risk is less than 1 out of 1,000 people.
If any of these conditions arise after the test, contact the health care provider:
References: Pasricha PJ. Gastrointestinal endoscopy. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 136.