Upper GI Endoscopy (EGD)

If you have stomach pain, problems swallowing or unexplained weight loss, your health care provider may recommend an upper endoscopy or esophagogastroduodenoscopy (EGD) to diagnose and/or treat your symptoms. 

Read on to understand EGD, why one may be ordered and what to expect before, during and after the procedure.

What is EGD?

Esophagogastroduodenoscopy (EGD), sometimes called an upper endoscopy, is an exam that looks at the lining of the upper part of the gastrointestinal (GI) tract. It is just one of many types of endoscopy procedures that look inside the body.

EGDs are used by specialists known as gastroenterologists and can be done in their office, an outpatient surgery center or a hospital. The gastroenterologist passes a thin, flexible tube fitted with a tiny camera, called an endoscope, through your mouth and back of the throat into the esophagus (swallowing tube), stomach and upper part of the small intestine (duodenum). This tube also has a channel inside that allows the passage of small instruments. 

These small instruments can be passed through the tube to take a small piece of tissue or a cell sample (a biopsy) to aid in or confirm a diagnosis. Tools can also be used to repair or treat conditions.

Why might I need an EGD?

An upper GI endoscopy is used to see the organs in your upper GI and check for problems such as ulcers, swelling (inflammation) or tumors. Your provider may recommend an endoscopy to:

• Investigate symptoms: It can help determine the cause of problems like frequent heartburn, trouble swallowing, upper belly (abdominal) pain, unexplained weight loss, non-cardiac chest pain, prolonged nausea and vomiting.
• Diagnose a condition: EGD helps diagnose conditions such as gastroesophageal reflux disease (GERD), peptic ulcers, gastritis, Barrett’s esophagus and even cancers of the upper GI tract.
• Treat a condition: EGD can be used to treat a problem. By attaching tiny tools to the endoscope, your provider can remove growths (polyps) or a foreign object, stop bleeding, open narrowed passages or repair holes.

Possible complications of an EGD

EGDs are very safe procedures. But like other endoscopies, they carry potential risks. These risks, though rare, include:

• Bleeding after a biopsy or treating a problem.
• Reaction to the medication (sedative) that helps you relax and feel sleepy.
• A small tear or hole (perforation) in your throat, stomach or upper part of your intestines.
• Infection if the equipment is not properly cleaned and sterilized.

It’s important to talk to your provider if you have any worries or questions about getting an EGD. They’ll help you understand everything and ensure your safety during the procedure.

How to prepare for an EGD

Your provider will give you specific instructions on how to prepare for an EGD, but generally, you’ll need to:

• Sign a consent form: You may be asked to sign a form giving your provider permission to perform the procedure. Read the form carefully and ask your provider questions if anything is unclear.
• Fast: You should avoid eating and drinking, including water, for at least six to eight hours before the procedure to ensure your stomach is empty.
• Adjust medications: Your provider may ask you to temporarily stop certain medications, especially blood thinners, to reduce the risk of bleeding during the procedure. Do not take any antacids, aspirin or ibuprofen. If you have ongoing conditions such as diabetes or heart disease, your provider will give you specific instructions about your medications. Usually, it is suggested, that GLP-1 medications (used to treat type 2 diabetes and obesity), not be taken for up to a week prior to the procedures.
• Make arrangements: Since you will take medicine to relax you (a sedative), you will need to have someone drive you home after the exam. Sedatives can affect your judgment and reflexes for the rest of the day, so do not operate machinery or make any important decisions.

Let your provider know if you have allergies or reactions to medications, latex or tape and if you are pregnant or think you may be pregnant.

What to expect during an EGD

An EGD can be done as an outpatient procedure or as part of your stay in a hospital. How the test is performed may vary depending on your condition and your provider’s practices. 

In general, it follows this process:

• You may be asked to change into a gown and remove any jewelry or accessories. This ensures your comfort during the procedure.
• An intravenous (IV) line will be started in your arm or hand. You will be given medicine (a sedative) through the IV to help you relax and feel sleepy. With the sedative, you will also have a local anesthetic sprayed into your mouth and throat to numb the area.
• During the procedure, trained medical professionals will closely monitor your vital signs, such as heart rate, blood pressure and oxygen levels.
• A medical specialist will place a small mouth guard to protect your teeth and the endoscope.
• Once fully sedated, you will lie on your left side and the lubricated endoscope will be gently put into your mouth and moved down into your stomach. You may be asked to swallow once or twice to help push the endoscope down. You may feel pressure, but you should not feel pain.
• When the endoscope is in place, air is pumped into the tube to expand your organs so your provider can see them better. The camera sends pictures to a screen so your provider can see inside your digestive system. Tools may also be used to take a sample or make a small repair.
• When the exam is done, the scope will be taken out.

The procedure may take 10 minutes for an exam and around 30 minutes if there are any extra steps. 

Recovery from an EGD

After the procedure, you’ll be taken to a recovery area where you’ll rest until the effects of the medicine wear off. You may feel a little groggy or sleepy for a short time. Have someone bring you home after the procedure. Do not drive yourself home or return to work for the rest of the day.

You may have a mild sore throat, bloating, gas or mild stomach cramping. These should get better within a day or two. 

Your medical staff will provide you with post-procedure instructions, including any restrictions on eating or drinking, when you can resume taking medications and when to follow up with your provider for the results of the procedure and biopsy, if performed. Your provider may discuss the results of your EGD immediately after the procedure or during another appointment, especially if you had a biopsy. 

Call your provider immediately if you have any of the following:

• Fever and chills
• Belly pain that doesn’t go away
• Coughing, spitting or vomiting blood
• Dark or black stools (poops)
• Feel dizzy or faint
• Have not had a bowel movement for 3 days after your procedure

Call 911 or have someone take you to the nearest emergency department if you experience any of the following:

• Sudden chest pain
• Difficulty breathing and swallowing or gasping for air 
• Sudden loss of consciousness

What happens if the results are abnormal?

If your provider finds anything unusual, like inflammation or signs of a condition, they will talk to you about what it means and what to do next. They might suggest additional testing, treatments and follow-up care. 

If you have any questions about your results, ask your provider to help you understand.

Expert care 

Peace of mind starts with a clear diagnosis. Banner Health's advanced endoscopy procedures can help identify and treat digestive issues effectively. Learn more about our services.