What is Esophagogastroduodenoscopy (EGD)?
Esophagogastroduodenoscopy, also sometimes referred to as upper GI endoscopy, is a diagnostic test used by gastroenterologists to examine the upper section of the gastrointestinal system. As the long and complicated name implies, the procedure is capable of examining everything from the throat and esophagus to the duodenum, the first section of the small intestine. It is performed with an endoscope, a long, flexible tube with a camera, light, and sometimes special surgical tools.
Endoscopy in general is very useful because it allows doctors to check out the digestive system directly and in a minimally invasive way; this means that no incisions are required in the process. Like other endoscopic procedures, EGD is an outpatient test that can be done relatively quickly, depending on the purpose. Usually EGD is ordered when a physical exam and an evaluation of the symptoms are inconclusive. The EGD can provide additional information that clarifies the patient’s condition.
What is EGD Used to Diagnose?
EGD can be used to evaluate a variety of possible gastrointestinal conditions that affect the lining of the digestive tract. It provides a clear picture of the health of the inner lining, though it isn’t typically used to diagnose problems of function since actions like peristalsis and secretion are not easy to observe with an endoscope. Yet even though some conditions can’t be observed directly, the visual information from EGD can indirectly point to the answer. In some cases, the EGD procedure can also be used to rule out other conditions the doctor may be considering. Below are some examples of how EGD might be used:
- gastroesophageal reflux disease (GERD)
- bleeding in the upper gastrointestinal tract
- unexplained anemia
- persistent dyspepsia (typically in patients over 45)
- difficult or painful swallowing
- inflammatory bowel disease (IBD)
- gastric ulcer
- duodenal ulcer
- confirmation of celiac disease
- tumors and cancer
- Barrett’s esophagus
- gastric ulcer
- duodenal ulcer
- routine follow-up after bariatric surgery
- esophageal varices
- removal of polyps
- removal of foreign bodies
- cauterization of tissues
- tightening the lower esophageal sphincter
- black, tarry stools
- vomiting blood
- unexplained weight loss
- upper abdominal pain
How Does the Procedure Work?
An EGD is an outpatient procedure that can be performed in a hospital or medical center. Though it isn’t a risky procedure, doctors nevertheless monitor oxygen levels, heart rate, and blood pressure. Patients are asked to lie on their side and are given medication to help them relax. Depending on the setting and medical history of the patient in question, anything from mild sedation to general anesthesia may be employed. Additionally, a local anesthetic is also used in the throat to ease the passage of the endoscope and minimize any discomfort.
Most patients will be on their left side during the procedure, and a special mouth guard protects the teeth as the endoscope is fed down the esophagus and down as far as the duodenum. The specifics of how the doctor will proceed is dependent on the location and type of condition being investigated. In many cases, the goal will be to confirm a diagnosis or gather more information, and sometimes the doctor can make a diagnosis and turn directly to treatment. For instance, if discolored or misshapen tissue is detected, the doctor can immediately use the endoscope to extract tissue samples for a biopsy.
What to Expect From the Procedure
Because of the need to clearly visualize any given part of the upper gastrointestinal system, there are several considerations for preparation that patients need to keep in mind. Though the instructions may vary from person to person, a common requirement is to not eat anything for 6-12 hours before the procedure. There may also be restrictions on certain medications prior to the procedure; this is usually related to interactions with anesthesia, and that’s also why it’s important to discuss any allergies and notify the doctor of any current medications.
The procedure itself won’t take very long, but you should still plan to take the day off of work. Most people don’t experience any significant discomfort afterwards, but the anesthesia can take some time to fully wear off. This is also why you need to arrange for a ride home afterwards since you won’t be able to drive. As a minimally invasive procedure, EGD is quick and safe, but it can still be draining and will require resting for the remainder of the day. The good news is that most people will be able to resume a normal diet as soon as the procedure is complete.
Are There Risks or Potential Complications?
An upper endoscopy is a very safe way to investigate the lining of the digestive tract, but it does come with some minor risks. Though unlikely, one possible complication is a perforation in the lining of the esophagus or stomach as a result of the endoscope passing through. In cases where a biopsy is performed via endoscope, some minor bleeding may occur as well. As noted earlier, there may also be irritation in the throat, but that usually goes away after a day or two.
A whole other category of risks is related to the medicines used for anesthesia and the dangers they pose for people with certain medical conditions. A bad reaction to this medicine may cause difficulty breathing, excessive sweating, or spasms in the larynx. In more serious cases, an allergic reaction to anesthesia can cause heart problems and low blood pressure. Moreover, factors like obesity and respiratory disease can also increase the risk of a reaction and subsequent complications.
Contact Cary Gastroenterology
Esophagogastroduodenoscopy is a useful tool for diagnosing a wide range of gastrointestinal conditions, but it isn’t required in all circumstances. Gastroenterologists use medical history, symptoms, and numerous other data points to accurately diagnose and treat diseases. If you have been experiencing symptoms you can’t explain, contact us at Cary Gastro today to request an appointment. Our dedicated staff is passionate about providing excellent digestive healthcare.