Upper endoscopy/EGD

Your upper digestive tract consists of your esophagus, stomach and duodenum, which is where your small intestine starts. Sometimes, it’s necessary for doctors to examine the lining of your upper digestive tract. An upper endoscopy may be the best way to see it.

Your doctor may refer to an upper endoscopy as an esophagogastroduodenoscopy, or EGD. They are the same procedure. Another term that may be used for it is gastroscopy.

During an upper endoscopy, a thin, flexible tube equipped with a light and small video camera is inserted into your mouth and threaded down your throat into your esophagus and stomach until it reaches your small intestine.

Why you may need an upper endoscopy

• Investigate why you’re experiencing symptoms such as trouble swallowing, heartburn, fullness that comes on quickly, bloody vomit or cough, or unexplained weight loss
• Examine an abnormal area seen on another imaging test such as an X-ray or computed tomography (CT) scan 
• Take biopsy samples of the esophagus, stomach or small intestine, and determine whether cancer is present
• Treat a blockage in your digestive tract or other issues caused by a tumor
• Monitor how well your cancer treatment is working

Six ways to prepare for an upper endoscopy

• Before your procedure, be sure to remove your watch or other jewelry. If you wear dentures, you must remove them too.
• Tell your care team about any medicines you take, including vitamins, herbs and supplements, and whether you are allergic to any medicines.
• If you take a blood thinner, you may be asked to stop a few days before the procedure. This includes baby aspirin.
• Don’t eat or drink for six to eight hours before your upper endoscopy.
• This test is done under a sedative to help keep you comfortable. Arrange for someone to drive you home afterward.
• Be sure to ask questions if there’s anything you don’t understand.

What happens during an upper endoscopy

The procedure is typically performed as an outpatient procedure.

First, your throat is sprayed with numbing medicine. Or, you may be asked to gargle with a liquid that numbs the throat.

Next, you’ll be asked to lie on your left side on the examination table and given a sedative. Some sedatives keep you drowsy but awake. If necessary, your doctor may perform your upper endoscopy under general anesthesia. Speak with your doctor about which option is best for you.

A mouthpiece is placed to keep your mouth open during the procedure.

The scope is guided down your throat as far as the start of your small intestine. Doctors are able to see images of your digestive tract and to examine specific areas of concern. They can take color photographs for further review.

Sometimes, it’s necessary to pump air into your stomach so the images are easier to see.

The procedure takes about 15 minutes to a half hour.

You will be observed for a while to make sure you’re OK and until the sedative wears off. You should be able to go home after a few hours. In rare cases, some people may stay in the hospital overnight.

Benefits and risks of upper endoscopy

An upper endoscopy provides better detail than a CT scan or an upper gastrointestinal (GI) series, which uses X-rays.

However, there are some risks to consider. These include:

• If you had a biopsy as part of your procedure, you may experience bleeding at the site.
• Your mouth and throat may be numb for a couple of hours. You may be hoarse or cough for a couple of days afterward.
• Some people react to the sedative with breathing difficulties, low blood pressure and a slow heartbeat. Or, you may have a reaction to the anesthesia.
• A perforation could occur in the lining of your digestive tract during the procedure and require surgery.
• It’s possible to develop an infection.

If you have any symptoms that are unexplained, including bleeding that doesn’t stop, call your doctor’s office and ask what you should do.

When you can expect results

Results typically take a few days. If you had a biopsy during the procedure, the results may take a little longer. The samples that were taken need to be studied in a pathology laboratory.

Your doctors should follow up with you once the results are available. The results can help guide your treatment.