What Is an EGD?

What to expect when undergoing this test

An esophagogastroduodenoscopy (EGD), often referred to as an upper endoscopy, is an invasive diagnostic test that visualizes the esophagus, stomach, and upper portion of the small intestine. It uses a fiberoptic endoscope, which is a flexible tube equipped with a camera. The endoscope is passed down the throat to the regions of the upper intestinal tract to provide a real-time video. An EGD can be used to obtain a biopsy or to treat gastrointestinal conditions as well.

what to expect during an EGD
 Illustration by Emily Roberts, Verywell

Purpose of Test

An EGD is used to visualize the upper portion of the gastrointestinal tract for diagnostic purposes. Using the test, your doctor will examine several regions of your upper GI tract and take pictures, particularly of concerning areas or lesions.

During an EGD, your doctor may collect a sample of tissue for a biopsy or treat small lesions of the gastrointestinal tract by performing procedures such as tumor removal, banding (tying off) of enlarged or bleeding blood vessels, and widening of strictures (narrowing)

The EGD is actually a combination of three tests:

  • An esophagoscopy views the inside of the esophagus.
  • A gastroscopy views the inside of the stomach.
  • A duodenoscopy views the inside of the duodenum, the first part of the small intestine.

You may need to have an EGD if you have symptoms involving your esophagus, stomach, or small intestine.

Symptoms that may prompt an EGD can include:

  • Swallowing difficulties
  • Vomiting
  • Vomiting blood or coughing up blood
  • Heartburn
  • Excessive burping
  • A bitter taste in your mouth
  • Indigestion
  • Abdominal pain
  • Chest pain
  • Weight loss
  • Unexplained anemia (low red blood cell count)

You may also need to have an EGD if you had an X-ray, ultrasound, or computed tomography (CT scan) that showed an abnormality of your esophagus, stomach, small intestine. Typically, imaging tests can examine the anatomic structure of the upper GI system and nearby organs, but they do not provide a view of the appearance of the inner lining itself, which makes an EDG a useful adjunct when used along with imaging tests.

Limitations

An EGD does not visualize the upper GI system from the outside and does not provide reliable information about the lungs, liver, spleen, or other nearby organs.

Risks and Contraindications

Because this is an invasive test, there can be complications, although they are uncommon. You may have abrasion of the inner lining of your esophagus, stomach, or small intestine, which can cause bleeding. You may also experience a puncture in any of these regions, which could cause serious bleeding or life-threatening gastric fluid leaks that would require urgent repair. Cardiac or respiratory effects of the anesthesia that is required are also possible.

Before the Test

If you are going to have an EGD, your doctor may order some imaging tests ahead of time to help plan the procedure. If you are taking blood thinners, your doctor may give you instructions to stop taking them for a few days before the test.

Timing

You should be prepared to spend several hours at your test appointment. You will need to sign in, fill out some forms, and undergo test preparations. The procedure itself will take about 10 to 30 minutes, and you may need about 10 to 20 minutes to recover from sedation after the procedure is completed. You may be tired for the rest of the day after your test.

Location

An EGD is typically done in an endoscopy suite, which is a special procedure room. It may be in the hospital, a surgical center, or located in an outpatient clinic.

What to Wear

You will be asked to change into a gown, so you can wear whatever is comfortable.

Food and Drink

You will be asked to stop eating and drinking for approximately eight hours prior to your test. You may be permitted to drink clear liquids up to five hours prior to your test, and your medical team will give you more detailed instructions if there are special considerations that you need to be aware of based on your specific condition.

Cost and Health Insurance

Your health insurance plan may require a pre-authorization for this test, and the facility where you will have the procedure will take care of that step. You may have to pay a co-pay, and you can find out your portion of the cost from your health insurance company and the facility where you will have your procedure done.

If you are paying for your EGD out of pocket, you can expect the cost to range between $1000 and $3000.

What to Bring

You should bring your test order form, your health insurance card, a form of personal identification, and a means to pay for the co-pay or for the test itself, if necessary. Because you will need to have sedation for this test, you should make sure that you have someone who will drive you home after the test is complete.

During the Test

An EGD is usually performed by a gastroenterologist, a physician specialized in treating diseases of the gastrointestinal system. A nurse or a technician will assist with the procedure.

Pre-Test

When you check in for the test, you will be asked to fill out some forms, including a consent form, authorization for payment, and a patient privacy form.

You will be led to the procedure room. You will need to have intravenous (IV) sedation as well as local numbing medicine administered to your throat to prevent discomfort and gagging.

A nurse will place an IV line in your hand or arm; you should feel an initial pinch, but no pain thereafter. The IV medication will then be pushed, which will make you sleepy and relaxed. While the drug itself won't put you to sleep, it's not uncommon to fall asleep during the test.

If you have them, dentures or partial plates will be removed so the numbing medicine can reach all areas of the mouth. Your throat will then be sprayed with the medicine, which will have a numbing effect for about 30 to 45 minutes.

You will be given a protective device to put into in your mouth to protect your teeth from the endoscope and then be positioned so that you lie on your left side.

Throughout the Test

When you are properly relaxed, you will be asked to swallow once or twice during the initial period of insertion of the endoscope. The tube will not interfere with your ability to breathe and is only mildly uncomfortable following the initial insertion.

The exam will take about 10 to 30 minutes. You may experience a feeling of fullness in your abdomen as the doctor injects a moderate amount of air to expand your stomach, allowing for better visualization. Pictures may be taken of the inside of your digestive tract to monitor abnormalities and for treatment planning.

A biopsy may be taken for examination. You will not feel any discomfort from this. If you are having your EGD for treatment of a gastrointestinal condition, electrosurgical instruments attached to the endoscope will be used.

Post-Test

If you received sedation, you will need to recover and wait until you are awake and alert before being discharged to home. You may not recall the procedure because of the effect of the sedation.

Your doctor will tell you when you will be able to eat or drink following the procedure. You may receive your results the same day or have to wait several days or weeks to discuss them with your doctor.

After the Test

You should expect to feel groggy for several hours after the test. You may have a slightly sore throat after the procedure, which should for approximately 24 hours. It is best to take it easy and avoid eating or drinking extremely hot or spicy foods and drinks on the day of the test.

Managing Side Effects

It is possible for a sore throat to last for a few days after your EGD. This should improve gradually. You can drink soothing fluids to ease the discomfort. If your discomfort lasts for longer than a few days, if you experience worsening pain or trouble swallowing, or if you observe swelling in the back of your throat, call your doctor.

Likewise, if you develop unusual or severe abdominal pain or bleeding following the procedure, you need to let your doctor know. Dark-colored stools or blood with coughing, spitting, or vomiting are signs to watch for.

Interpreting Results

Your doctor will either discuss the results with you immediately after your test or may schedule another appointment to discuss the result and a plan, especially if your test involved a biopsy. Often, when the doctor performing the test is not the doctor who you regularly see, you need to come back to have this discussion.

Your doctor will determine the outcome of your upper endoscopy based on what he or she saw during the test. An EGD can help diagnose several problems based on the appearance of the inner lining of the gastrointestinal tract and any anatomical variations seen on the exam.

Conditions that may be diagnosed with the aid of EGD include:

Follow-Up

Depending on your test results, you may need to have treatment for a medical problem. For example, an infection may require treatment with antibiotics, while esophageal varices may require an interventional procedure to prevent the blood vessels from bleeding. A tumor may require removal, as well as chemotherapy or radiation therapy.

In general, you should not need to have EGD procedures routinely repeated, but if your symptoms unexpectedly worsen, or if you develop new symptoms, your doctors may want you to have another EGD to investigate the cause.

A Word From Verywell

An EGD is generally well tolerated and is not painful. However, it is an invasive test and requires sedation.

Most gastrointestinal conditions can be treated, either medically or surgically. Some chronic gastrointestinal problems require long-term treatment. If you have an EGD for treatment of a gastrointestinal condition, your recovery should be relatively quick.

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