Upper Endoscopy (EGD)

Upper Endoscopy (EGD)

Share this:

Upper endoscopy or esophagogastroduodenoscopy (EGD) is a test to examine the lining of the esophagus (the tube that connects your throat to your stomach), stomach, and first part of the small intestine. It is done with a small camera (flexible endoscope) that is inserted down the throat.

An anesthesiologist or nurse anesthetist will administer high level intravenous sedation before the procedure. You should feel no pain and not remember the procedure. A mouth guard will be inserted to protect your teeth and the endoscope. Dentures must be removed. A needle (IV) will be inserted into a vein in your arm to give you medications during the procedure. After the sedatives have taken effect:

  • The endoscope is inserted through the esophagus (food pipe) to the stomach and duodenum. Air is put into the endoscope to make it easier for the doctor to see.
  • The lining of the esophagus, stomach, and upper duodenum is examined. Biopsies can be taken through the endoscope. Biopsies are tissue samples that are looked at under the microscope.
  • Different treatments may be done, such as stretching or widening a narrowed area of the esophagus.

EGD may be done if you have symptoms that are new, cannot be explained, or are not responding to treatment, such as:

  • Black or tarry stools or vomiting blood
  • Bringing food back up (regurgitation)
  • Feeling full sooner than normal or after eating less than usual
  • Feeling that food is stuck behind the breastbone
  • Heartburn
  • Low blood count (anemia) that cannot be explained
  • Pain or discomfort in the upper abdomen
  • Swallowing problems or pain with swallowing
  • Weight loss that cannot be explained
  • Nausea or vomiting that does not go away

Your doctor may also order this test if you:

  • Have cirrhosis of the liver, to look for swollen veins (called varices) in the walls of the lower part of the esophagus, which may begin to bleed
  • Have Crohn's disease
  • Need more follow-up or treatment for a condition that has been diagnosed

The test may also be used to take a piece of tissue for biopsy.

An abnormal EGD may be the result of:

  • Celiac disease
  • Esophageal rings
  • Esophageal varices (swollen veins in the lining of the esophagus caused by liver cirrhosis)
  • Esophagitis (when the lining of the esophagus becomes inflamed or swollen)
  • Gastritis
  • Gastroesophageal reflux disease
  • Hiatal hernia (a condition in which part of the stomach sticks up into the chest through an opening in the diaphragm)
  • Lower esophageal ring
  • Mallory-Weiss syndrome (tear in the esophagus)
  • Narrowing of the esophagus
  • Tumors or cancer in the esophagus, stomach, or duodenum (first part of small intestine)
  • Ulcers - gastric (stomach) or duodenal (small intestine)

REFERENCES

  1. Grainek IM, Barkun AN, Bardou M. Management of acute bleeding from a peptic ulcer. N Engl J Med. 2008;359(9):928-937.
  2. Maish M. Esophagus. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 41.
  3. Mercer DW, Robinson EK. Stomach. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 47.
  4. Pasricha PJ. Gastrointestinal endoscopy. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 136.