It has been decided after careful medical assessment that esophagogastroduodenoscopy (EGD) is necessary for further evaluation and treatment of your condition. This information has been prepared to help you understand the procedure.
What is an EGD?
An EGD endoscope is a long, flexible tube about the size of your little finger. During the procedure, you are sedated and the EGD scope is passed through the mouth and back of the throat into the upper digestive tract, allowing the physician to examine the lining of the esophagus, stomach and duodenum (the first portion of the small intestine).
EGD can confirm abnormalities suspected by X-ray and detect others that are too small to be seen on X-ray. If the doctor sees a suspicious area, he or she can pass an instrument through the endoscope and take a small piece of tissue (a biopsy) for examination in the laboratory. Biopsies are taken for many reasons and do not necessarily imply cancer.
Other instruments can also be passed through the EGD endoscope without causing discomfort, including a wire loop (snare) to remove polyps (abnormal, usually benign growths of tissue) or probes to destroy abnormal tissue using either radiofrequency current (BARRx), laser or other forms of heat delivered to the tissue.
What preparation is required?
For the best possible examination, the stomach must be completely empty, so you should have a light supper on the evening before the examination and nothing by mouth for at least six hours before the procedure. Your doctor will be more specific about the time to begin fasting, depending on the time of day that your EGD is scheduled.
You will be sedated during the procedure, so you will need someone to take you home since you will not be allowed to drive after the procedure. Even though you may not feel tired, your judgment and reflexes may not be normal.
What should you expect during the EGD procedure?
Your doctor and anesthesia personnel will give you a medication through a vein to make you relaxed and sleepy. Propofol is recommended and is used for anesthesia in our centers. With this medicine, EGD is essentially painless and you will recall little and usually nothing.
While you are in a comfortable position, the EGD endoscope is inserted through the mouth into the esophagus; then, each part of the esophagus, stomach and duodenum is examined.
The procedure is extremely well tolerated with little or no discomfort. The EGD scope will not interfere with your breathing. The medication usually prevents gagging.
What happens after the EGD?
You will be able to leave the recovery area as soon as most of the effects of the medication have worn off. Your throat may be a little sore for a couple of hours, and you may feel some “gassiness” and fullness in the abdomen for a few minutes right after the procedure because of the air that was introduced to examine your stomach.
You will be able to resume your diet as soon as the EGD is over unless your doctor instructs you otherwise.
Are there complications of EGD?
EGD is safe and associated with low risk when performed by physicians who have been specially trained and are experienced in this endoscopic procedure.
One major complication is perforation, in which a small tear through the wall may allow leakage of digestive fluid. This complication may be managed simply by suctioning the fluid through a tube until the opening seals, or it may require surgery.
Bleeding may occur from the site of biopsy or polyp removal. It is usually minimal but rarely may require transfusions or surgery.
Localized irritation of the vein may occur at the site of medication injection. A tender lump develops that may remain for several weeks to several months but goes away eventually.
Although uncommon, aspiration (breathing in) of stomach contents that come up through the esophagus can occur. This could lead to pneumonia and the need for hospitalization.
Death is extremely rare but remains a remote possibility. Other risks include drug reactions.
What are the reasons for doing the EGD?
Many problems of the upper digestive tract cannot be diagnosed by X-ray. EGD is considered to be a more accurate way to evaluate many, if not most, diseases of the esophagus, stomach and duodenum.
EGD is the only way to accurately diagnose and biopsy Barrett’s esophagus. EGD also provides the most accurate way to diagnose causes of why “food hangs up” during swallowing. EGD is helpful for the diagnosis of inflammation of the esophagus, stomach and duodenum (esophagitis, gastritis, duodenitis) and for identification of the site of upper gastrointestinal bleeding.
EGD is more accurate than X-ray in detecting gastric (stomach) and duodenal ulcers, especially when there is bleeding or scarring from a previous ulcer. EGD may detect early cancers too small to be seen by X-ray and can confirm the diagnosis by biopsies and brushings.
EGD may also be needed for treatment, such as removal of swallowed objects, removal of polyps and stretching (dilation) of narrowed areas of the esophagus. EGD allows for safe and effective endoscopic control of bleeding from the upper digestive tract in most cases.
Are there alternatives to EGD?
In some situations, upper gastrointestinal X-rays and CT or PET scans can be used as alternative or complimentary tests to EGD. Please discuss these options with your physician if you have any questions about undergoing the procedure. However, EGD is the only procedure that allows either biopsy of an abnormality, removal of a polyp or destruction (ablation) of an abnormality (e.g. Barrett’s esophagus).
Additional important patient information
EGD is an extremely worthwhile and safe procedure that is very well tolerated and is invaluable in the diagnosis and proper management of disorders of the upper digestive tract. Because of the use of intravenous anesthetic agents during the procedure, arrangements must be made for the patient to be picked up at the end of the exam.
Your doctor’s decision to perform this procedure was based upon his/her assessment of your particular problem. If you have any questions about the procedure or your need for an EGD, do not hesitate to discuss them with your gastroenterologist. Both of you share a common goal – your good health – and it can only be achieved through mutual trust, respect and understanding.
This information is provided as an educational service of Gastrointestinal Associates, P.C. The content is limited and is not a substitute for professional medical care.