Upper GI endoscopy, sometimes called EGD (esophagogastroduodenoscopy), is a visual examination of the upper intestinal tract using a lighted, flexible fiberoptic or video endoscope, which is usually performed on an outpatient basis. The throat is often anesthetized by a spray or liquid. Intravenous sedation is usually given to relax the patient, deaden the gag reflex and cause short-term amnesia. The endoscope is then gently inserted into the upper esophagus. The patient can breathe easily throughout the exam. Other instruments can be passed through the endoscope to perform additional procedures if necessary. For example, a biopsy can be done in which a small tissue specimen is obtained for microscopic analysis. A polyp or tumor can be removed using a thin wire snare and electrocautery (electrical heat). The exam takes from 5 to 15 minutes, after which the patient is taken to the recovery area. There is no pain with the procedure and patients seldom remember much about it.
An upper GI endoscopy is performed primarily to identify and/or correct a problem in the upper gastrointestinal tract. This means the test enables a diagnosis to be made upon which specific treatment can be given. If a bleeding site is identified, treatment can stop the bleeding, esophageal narrowing can be dilated, or if a polyp is found, it can be removed without a major operation. Other treatments can be given through the endoscope when necessary.
A temporary, mild throat irritation sometimes occurs after the exam. Serious risks with upper GI endoscopy, however, are very uncommon. One such risk is excessive bleeding, especially with removal of a large polyp. In extremely rare instances, a perforation, or tear, in the esophagus or stomach wall can occur. These complications may require hospitalization and, rarely, surgery. Quite uncommonly, a diagnostic error or oversight may occur. Due to the mild sedation, the patient should not drive or operate machinery following the exam. For this reason, someone else should be available to drive the patient home.
Alternative tests to upper GI endoscopy include a barium x-ray and ultrasound (sonogram) to study the organs in the upper abdomen. Study of the stools, blood and stomach juice can provide indirect information about a gastrointestinal condition. These exams, however, do not allow for a direct viewing of the esophagus, stomach and duodenum, removing of polyps or taking of biopsies.
Upper Endoscopy Preparation Instructions
Your stomach must be completely empty to allow for an adequate examination. Please do not eat anything after midnight on the evening prior to the procedure. However, if you have an afternoon appointment, you may have a clear liquid breakfast on the day of the examination up until 4 hours prior to your appointment. Clear liquids consist of: water, tea, coffee (no milk), soda broth, strained fruit juices, Popsicles, and jello. Do not ingest red liquids.
On the day of the endoscopy you should take your regular medication with clear water, unless otherwise instructed by your doctor. If you are diabetic take ½ your usual dose of insulin on the morning of the procedure. If you take a “diabetes pill” you may skip it on the morning of the procedure unless instructed otherwise.