Upper GI endoscopy (EGD)

Overview

  • What is an upper endoscopy or EGD?

    If you have symptoms that do not go away, such as heartburn, vomiting or belly pain, your doctor may recommend an upper endoscopy. Doctors use this test to see inside the upper digestive tract and find the cause of your symptoms. An upper endoscopy is also known as an esophagogastroduodenoscopy (EGD). It is a test that enables doctors to examine the upper digestive tract, which includes the:

    • Esophagus (“food tube” that connects the mouth to the stomach)
    • Stomach
    • Duodenum (upper part of the small intestine)

    Doctors perform an EGD using an endoscope, which is a long, flexible tube with a camera and light at its tip. The doctor carefully guides the endoscope through the mouth and down the throat to view the upper digestive tract.

    Doctors see images of the digestive tract and can take color photos of specific areas. They may take a biopsy (tissue sample) of abnormal tissue, such as growths, irritations or ulcers, which are sores in the intestine’s lining.

    The doctor then sends the tissue sample to a pathologist, a doctor who analyzes tissues under a microscope to help diagnose diseases. The pathologist can identify disorders in the upper digestive tract.

  • Why might I need an EGD?

    Doctors use an EGD to diagnose upper digestive tract conditions. They may also use it to perform certain procedures to treat your symptoms.

    Your doctor may recommend an EGD if you have symptoms such as:

    • Bleeding in the upper digestive tract
    • Heartburn
    • Nausea or vomiting
    • Pain in the belly (abdomen)
    • Trouble swallowing
    • Unexplained weight loss
     

    Some diseases that doctors can diagnose with an EGD include:

    • Bacterial infections such as Helicobacter pylori (H. pylori)
    • Celiac disease
    • Crohn’s disease
    • Gastroesophageal reflux disease (GERD, or acid reflux)
    • Irritation of the esophagus (esophagitis), stomach (gastritis) or small intestine (duodenitis)
    • Narrowing or blockage of the esophagus
    • Tumors, either benign (noncancerous) or malignant (cancerous)
    • Ulcers in the stomach (gastric) or small intestine (duodenal)
     

    Doctors may use an EGD for disease treatment, such as:

    • Checking for signs of complications
    • Controlling bleeding
    • Monitoring how well treatment is working
    • Opening narrowed areas
    • Removing growths, tumors or foreign objects
  • Is an upper endoscopy painful? Will I be sedated?

    An EGD is not painful, but it can cause discomfort. People usually get a sedative (medication to help them relax) before the procedure. You receive the sedative through an IV (intravenous) line into a vein.

    The sedative works quickly to make you drowsy and unable to feel pain. There are different types of sedatives. With some, you are drowsy but may remain awake. Other types put you to sleep. Before the EGD, your doctor will discuss with you the right sedative for your situation and ensure that you are not allergic to it.

  • How do I prepare for an EGD?

    A member of your care team will discuss preparation instructions with you.

    For your safety, it is important to follow the pre-procedure instructions you receive. Review them in advance to provide enough time for your doctor to answer any questions.

    Typical instructions include:

    • Not eating or drinking anything for 6 to 8 hours before the procedure
    • Stopping certain medications for a period of time before the procedure
    • Having a trusted friend or family member accompany you to and from the procedure
  • What can I expect the day of the procedure?

    When you arrive for the EGD, a member of your care team will:

    1. Ask you to change into a hospital gown and remove objects such as jewelry, watches or dentures
    2. Measure your blood pressure, heart rate, height and weight
    3. Place an IV into your arm or hand
    4. Ask you about your medical history, any medications and any previous surgeries, even if you have already answered these questions
  • What should I expect during the procedure?

    After the preparation, the care team takes you to the room for the EGD:

    1. You may have a numbing medicine sprayed into your throat to help pass the scope. You will also have a mouth guard to protect your teeth and the scope.
    2. You receive the sedative and lie on your left side on the table.
    3. The doctor guides the endoscope down your throat, through the esophagus and stomach and into the duodenum.
    4. The doctor may take biopsies of any abnormal areas or may perform treatments, depending on your needs.
  • What should I expect after the procedure?

    When the EGD is finished:

    1. A member of the care team takes you to a recovery area and monitors you until the sedative wears off.
    2. You receive instructions on what to eat, what activities you can do and what medications to take.

    Depending on your situation, you may stay in the hospital overnight. If you are going home after the procedure, you will need someone to drive you.

  • What are the possible risks of an EGD?

    An EGD is safe but carries some rare risks, as with any medical procedure. Your doctor will discuss them with you. Risks may include:

    • Tear in the lining of the esophagus, stomach or duodenum
    • Bleeding
    • Infection
     

    Some people may have a reaction to the sedative, such as:

    • Difficulty breathing
    • Low blood pressure
    • Slow heartbeat
  • Are there other tests that I can have instead of an EGD?

    Alternatives to an upper endoscopy are diagnostic imaging tests, which may include:

    • CT scan: This imaging test takes cross-sectional X-ray images of the abdomen. You will likely need to drink a material called contrast, which appears white in the scan and helps show structures more clearly. Sometimes, the doctor may also use IV contrast to examine the vessels that supply blood to the organs.
    • Upper GI (gastrointestinal) series: This procedure uses X-rays and fluoroscopy (moving X-ray images, like a video). You first drink barium, a contrast material. Then the technician takes a series of X-rays and fluoroscopy tests.

    These imaging tests are not invasive, and you will not need sedation. These tests do not provide as much detail as an EGD may, so they may not be right for you. Your doctor will discuss with you the best testing options for your needs.

Author(s) and Publication Date(s)

Sophie M. Balzora, MD, FACG, New York University School of Medicine – Published September 2018