What is EGD?

Esophagogastroduodenoscopy (EGD) is a diagnostic procedure that allows the physician to diagnose and treat problems in the upper gastrointestinal (UGI) tract. The physician uses a long, flexible, lighted tube called an endoscope. The endoscope is guided through the patient's mouth and throat, then through the esophagus, stomach, and duodenum (first part of the small intestine). The physician can examine the inside of these organs and detect abnormalities.

In addition to performing visual examination of the UGI tract with the endoscope, the physician can insert instruments through the endoscope to obtain tissue samples for a biopsy, remove foreign objects, instill air or fluid, stop bleeding, or perform therapeutic procedures, such as endoscopic surgery, laser therapy, or dilatation (opening up). A video camera in the endoscope provides images onto a TV-like monitor.

Reasons for the Exam
An EGD may be performed to diagnose structural or functional abnormalities of the esophagus, stomach, and/or duodenum. These abnormalities may include, but are not limited to, the following:

• Dysphagia (difficulty swallowing)
• Weight loss or anorexia (loss of appetite)
• Upper abdominal pain or chest pain of a noncardiac origin
• Gastroesophageal reflux disease (GERD)
• Intractable vomiting (continuous vomiting from an unknown cause)
• Strictures (narrowing) or obstructions
• Gastrointestinal bleeding and esophageal varices (enlarged veins in the esophagus)
• Inflammation and ulcers
• Tumors (benign or malignant)
• Hiatal hernia - upward movement of the stomach, either into or alongside the esophagus
• Damage caused by ingestion of caustic substances (chemicals such as lye, household detergents)

An EGD may be performed therapeutically to control bleeding, remove tumors or polyps (growths), dilate narrowed areas in the upper GI tract (e.g., esophagus), remove foreign objects, perform laser therapy, and place a percutaneous gastrostomy tube (a tube used for tube feeding into the stomach).

Tissue samples (biopsies) or gastrointestinal fluid samples may be obtained via an endoscope. In addition, an EGD may be used to evaluate the stomach and duodenum after a surgery.

There may be other reasons for your physician to recommend an EGD.

The EGD Procedure

An EGD may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary, depending on your condition and your physician’s practices.

Generally, an EGD follows this process:

1. You will be asked to remove any clothing, jewelry, or other objects that may interfere with the procedure. If you wear dentures, you will be asked to remove them until the procedure has been completed.
2. If you are asked to remove clothing, you will be given a gown to wear.
3. An intravenous (IV) line will be inserted in the arm or hand. A sedative will be injected into the IV.
4. Your heart rate, blood pressure, respiratory rate, and oxygen level will be monitored during the procedure.
5. You will lie on your left side on the x-ray table with your head bent forward.
6. Numbing medication will be sprayed into the back of your throat to prevent gagging as the endoscope is passed down your throat into your stomach. The spray may have a bitter taste to it. Holding your breath while the physician sprays your throat may decrease the taste.
7. You will not be able to swallow the saliva that may collect your mouth during the procedure due to the endoscope in your throat. The saliva will be suctioned from your mouth from time to time.
8. A mouth guard will be placed in your mouth to keep you from biting down on the endoscope and to protect your teeth.
9. Once your throat is numbed and you are sufficiently relaxed from the sedative, the physician will ask you to swallow the endoscope. By using the endoscope’s camera system, the physician will guide the endoscope down the esophagus, through the stomach, and into the duodenum.
10. You may experience a sensation of pressure or bloating as the endoscope is being advanced.
11. If needed for your specific situation, samples of fluid and/or tissue may be taken at any time during the procedure. Other procedures, such as the removal of an obstruction, may be performed while the endoscope is in place.
12. After the examination and procedures have been completed, the endoscope will be withdrawn.

After the Procedure

After the procedure, you will be taken to the recovery room for observation. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or discharged to your home. If this procedure was performed as an outpatient, you should plan to have another person drive you home.

You will not be allowed to eat or drink anything until your gag reflex has returned. You may notice some soreness of your throat and pain with swallowing for a few days. This soreness is normal.

You may resume your usual diet and activities after the procedure, unless your physician decides otherwise.

Notify your physician to report any of the following:

•  Fever and/or chills
• Redness, swelling, or bleeding or other drainage from the IV site
• Abdominal pain, nausea, and/or vomiting
• Black, tarry, or bloody stools
• Swallowing difficulties
• Throat or chest pain that worsens

Your physician may give you additional or alternate instructions after the procedure, depending on your particular situation.

Source:  www.placentialinda.staywellsolutionsonline.com/library/encyclopedia and American Society of Gastrointestinal Endoscopy http://www.asge.org/PatientInfoIndex.aspx?id=378